Ashwagandha: the wonder herb
Ashwagandha and cancer
Ashwagandha (Withania somnifera) has to be my favourite herb because it covers so many things that are relevant to cancer patients:
It has anti-cancer properties, so it will help slow tumour growth and could help cancer cells from growing.
It’s an adaptogen, which means that it helps the body to balance its stress levels.
It can help to improve depression, which many cancer patients suffer from.
It’s anti-inflammatory, so it will help to reduce the inflammation caused by cancer treatments.
It’s neuroprotective, which means that it will help to protect the brain from cell degeneration. If you’ve got chemobrain, that means that it’ll help you to recover more quickly.
It boosts immune function, so it can help you to recover your neutrophils, red blood cells and platelets after treatment.
It increases your endurance and stamina, so it will help you recover from fatigue.
It helps improve muscle strength. If you’ve been bedridden or chair bound during your treatment, you’ll almost certainly have lost muscle. Ashwagandha will help you to build it back up with exercise.
It improves thyroid function. Read my article on the links between hypothyroidism and cancer to understand the importance of this.
It helps with balancing blood sugar levels, improving insulin sensitivity. This will help you to avoid Type II diabetes, which is a risk factor for cancer, and also help with weight control. A healthy weight reduces your risks of cancer.
It’s a natural aphrodisiac and improves sexual function in both men and women. It’s not often discussed by doctors but this can suffer during cancer treatments, resulting in a lower quality of life.
Ashwagandha’s anti-cancer actions
The most solid evidence for Ashwagandha’s anti-cancer actions comes from a Phase II clinical trial conducted on 50 breast cancer patients with cancers ranging from Stage I to Stage IV. They were given 2 grams of Ashwagandha 3 times a day DURING their 6 courses of chemotherapy, with another 50 patients receiving chemotherapy alone. The effectiveness of their chemo didn’t change, but at the end of the trial those receiving Ashwagandha had less fatigue and a significantly better quality of life than the control group and there was a trend for longer survival in the Ashwagandha group too (1).
Breast cancer isn’t the only cancer that responds to Ashwagandha, though. Animal and in vitro studies show that it can help prevent lung cancer in vulnerable mice, and mice that had lung cancers had improved white blood cell counts, slower tumour growth, and had protection against the reactive oxidative species (ROS) that paclitaxel treatment created (2).
Glioma (a type of brain cancer) cells, responded to Ashwagandha too, showing that it killed the cancer cells and reduced their ability to metastasise (2). In rats, it reduced the size of the tumours (2) and in vitro it re-sensitised glioma cells to temozolomide, suggesting that it might be helpful alongside this chemo treatment to prevent chemo-resistance (2).
There is evidence that it can also help with prostate cancer. In vivo, it killed prostate cancer cells and it reduced the growth of human prostate cancer cells grafted onto mice (2). It seems to reduce angiogenesis in mice with prostate cancer, cutting of the cancer cells’ ability to metastasise (2).
Colon cancer cells also respond to Ashwagandha. It killed colon cancer cells in vitro and another study showed that it caused changes that reduce the likelihood of colon cancer beginning at all (2). In mice with human colon cancer cells grafted on to them, it reduced the size and weight of the tumours (2). In mice with polyps in their colons, it significantly reduced the size of the polyps and their ability to develop into cancer (2).
There is also some evidence that Ashwagandha can kill melanoma cells and other skin cancer cells (2).
It also significantly inhibited the growth of human osteosarcoma, gastric and oral cancer cells (2).
Both in vitro and in mice studies, it showed that it could kill pancreatic cancer cells alongside oxaliplatin chemo (2).
Ovarian cancer cells also responded to it in combination with doxorubicin, and in a mouse study there was a 70-80% reduction in the size of ovarian cancer tumours compared with the controls (2). In another mouse study using Ashwagandha and cisplatin it inhibited metastasis, although with cisplatin alone it didn’t, suggesting that Ashwagandha could be useful for cisplatin-resistant ovarian cancer (2).
Cervical cancer tumours in mice showed a 70% reduction in tumour size after treatment with Ashwagandha (2).
Kidney cancer cells treated with Ashwagandha also showed multiple anti-tumour effects in vitro (2).
A recent study showed some evidence that Ashwagandha could prevent angiogenesis, the development of new blood vessels around tumours that allows them to grow and metastasise (3).
Ashwagandha for balancing stress
Stress is a natural and normal reaction to a potentially dangerous situation. The exhilaration you might experience when you’re doing something exciting is a form of stress. It initiates the ‘flight and fight’ response that we all recognise: a faster heartbeat, clammy hands, dry mouth and so on. And once the situation has resolved, we go back into the ‘rest and digest’ mode. But that’s acute stress. Chronic stress, on the other hand, such as experienced with a cancer diagnosis, doesn’t resolve and it can be very debilitating. You can end up feeling tired all the time and it can have severe effects on the body, such as insomnia, digestive issues, you may put on weight, have impaired immunity, and it can end up causing serious illness, like heart disease, high blood pressure, cognitive problems, and autoimmune disorders. There is even a suggestion that it could potentially cause cancer (4).
And that’s where Ashwagandha can help. One study showed that it’s as effective as lorazepam (Ativan), an anxiolytic medication, and imipramine (Tofranil), a tricyclic antidepressant often used for anxiety (5).
In a recent systematic review and meta-analysis, 12 randomised placebo-controlled trials with a total of 1,002 participants found that Ashwagandha significantly reduced both anxiety and stress levels at doses of 600 mg per day (6).
Can Ashwagandha lift depression?
One of the by-products of stress is depression, and it’s a condition suffered by many cancer patients. If the diagnosis doesn’t cause it, some of the medications can. I had a pretty bad case of it myself when I was put on steroids long-term, a side effect not mentioned by the doctors.
A review of 3 human studies on Ashwagandha found that it reduced depression in 3 groups: healthy adults, stressed adults and those diagnosed with schizophrenia or schizoaffective disorder. The latter 2 groups had significant reductions in depression, but the healthy adults didn’t show a statistically significant reduction. The reviewers noted that none of the participants was suffering from severe depression or Seasonal Affective Disorder, but Ashwagandha definitely helped those with mild to moderate depression. They suggested that this was because of both its antioxidant effects and its ability to protect serotonin levels. Serotonin is a natural mood stabiliser (7).
Ashwagandha’s anti-inflammatory effects
In both in vitro and animal studies, Ashwagandha reduced many inflammatory markers. In an animal study, it reduced inflammatory bowel disease, which is a precursor to colon cancer. It also reduced the symptoms of lupus. It led to a reduction in the inflammatory markers in cystic fibrosis cells. And in a study on rats that had arthritis after exposure to methotrexate, which is often used in cancer treatments, there was a reduction in tissue inflammation, and their body weight and organ measures were restored, as well as a reduction in their arthritis scores (8).
Ashwagandha protects the brain
Ashwagandha has been used for many years in Ayurvedic medicine, Indian traditional medicine, to treat memory and cognitive problems after injury, illness or as a result of ageing. More recent studies show that it’s effective against Parkinson’s disease, senile dementia and Alzheimer’s, and clinical studies show improvements in patients with bipolar disorder (9).
In a small randomised, double blinded, placebo-controlled trial, patients with mild cognitive impairment or the early signs of dementia were given 300 mg of Ashwagandha twice a day for 8 weeks and then assessed using a variety of recognised testing methods. Their results were significantly better than those in the placebo group for improving immediate and general memory, attention, the speed of information processing and in planning, monitoring and successfully achieving goals (10).
Ashwagandha improves immune function
One of the biggest problems with chemo is the damage that it causes to the bone marrow, which results in low neutrophils, the white blood cells that are our first line of defence against infection, fewer red blood cells (causing anaemia) and low platelets, which enable our blood to clot. Infections and uncontrolled bleeding are two of the big life-threatening problems that cancer patients face during treatment.
In animal trials, Ashwagandha has shown that it can reverse the damage to the bone marrow caused by paclitaxel and cyclophosphamide in a similar way to G-CSF (granulocyte-colony stimulating factor), the medication often used (10). But Ashwagandha doesn’t have the side effects of G-CSF, which include severe bone pain that can linger for years after treatment.
Ashwagandha boosts energy levels
Cancer treatments can severely sap your strength, leaving you feeling tired all the time, and the feeling doesn’t go away with rest. About 70% of cancer patients experience it and it can have a profound effect on your quality of life (11).
A clinical trial on (mostly Stage II or III) breast cancer patients who were currently undergoing treatment (surgery, chemo and/or radiation) tested a dose of 2 g of Ashwagandha taken 3 times daily throughout their chemo treatment. They experienced a statistically significant reduction in their fatigue levels (11).
Ashwagandha builds muscle strength
I don’t know about you but after I’d spent a month in hospital during my treatment, my muscle strength was very low. I went out to a Look Good, Feel Better session and went to the Ladies toilet afterwards and I had a devil of a job raising myself off the toilet afterwards! And there was nothing to hang on to either. I have to admit that I found it hilarious, but I did manage it in the end. It really brought home to me how much muscle I’d lost, though.
Ashwagandha can come to the rescue here too. In a study on, admittedly, young men who had little experience of resistance training, they took 300 mg of Ashwagandha twice daily for 8 weeks whilst they did muscle strength exercises. They built up their muscle strength significantly (12).
I’m not suggesting that you have to go to the gym, though. Depending on where you are on your cancer journey, you may not be able to manage a gym workout anyway, even if you enjoy it. But there are plenty of muscle strength exercises that you can do at home that don’t cost much, if anything, in equipment and that can be done at your own pace. For some ideas, check out this link - https://www.cancervic.org.au/living-with-cancer/exercise/strength-training-exercises.
Improve thyroid function with Ashwagandha
Low thyroid function has been linked with a higher risk of cancer, so if yours is on the low side of normal, you might want to give it a boost. If you aren’t sure whether yours is low, if you have several of the following signs and symptoms, it might give you a clue:
feeling tired
weight gain
feeling cold
aches and weakness in your muscles and joints
losing hair
dry, itchy skin
low mood or depression
mental fogginess
constipation
irregular heavy periods in women.
Unfortunately, the tests that doctors generally do, certainly in Australia, don’t include all the indicators for thyroid function and you can suffer these symptoms if your levels are at the low end of normal anyway (considered to be sub-clinical hypothyroidism).
A small randomised placebo-controlled study used 600 mg of Ashwagandha each day on patients with low thyroid function for 8 weeks. At the end of the trial, the group taking Ashwagandha had significantly higher levels of thyroid-stimulating hormone (TSH) and thyroid hormones (13).
Balance blood sugar levels with Ashwagandha
Insulin resistance and diabetes can increase the risks of cancer, so finding something that can stabilise blood sugar levels without side effects is valuable.
Two studies using mice (14, 15) and one on rats (16) have demonstrated that Ashwagandha is as effective than Metformin at reducing blood sugar levels, although it takes a couple of weeks to be effective. Its effects are thought to be from its ability to reduce the digestive enzymes that break down carbohydrates.
Ashwagandha’s effects on sexual function
This is probably the part that you’re most interested in, because hardly anyone discusses it. And yet it has a profound effect on quality of life. Let’s explore what Ashwagandha can do to improve your sexual function.
Looking at women to begin with, one study looked at women who had low libido but who were otherwise healthy. After 8 weeks of taking 300 mg of Ashwagandha twice daily, there was a statistically significant improvement in the measurements of desire, arousal, lubrication, orgasm, sexual satisfaction and pain (17).
Ashwagandha can also help with menopausal symptoms, such as hot flashes and mood swings. A randomised, double blinded, placebo-controlled trial tested 300 mg twice daily on women with menopausal symptoms and found that it reduced their symptoms significantly. However, it also had a significant impact on their hormone levels, so this treatment may not be suitable for women who have had hormonal cancers (18).
And for the men, Ashwagandha can improve your fertility. Researchers looked at a group of men undergoing infertility screening. After treatment with Ashwagandha, their sperm count and motility increased significantly and their hormone levels were corrected (19). This was reproduced in another, more recent study (20). Again, the fact that it affects hormone levels means that it may not suit men who have had hormonal cancers.
However, men should be aware that one study did show a drop in libido, sexual vigour and performance, and erectile dysfunction in male rats after they were given 3 g doses per kilo body weight daily for a week. The researchers concluded that, although it raised their testosterone levels, the sedative effects of Ashwagandha at those very large doses were probably to blame (21). At normal doses, this may not happen.
Ashwagandha Dosage and Safety
The normal dose for Ashwagandha is 300 mg taken twice daily, but you can increase that if necessary up to 625 mg twice daily.
At doses of up to 1250 mg daily, it is considered to be safe to use for up to 6 months (22).
You may experience some digestive upsets with its use: vomiting, diarrhoea or upset stomach. If this happens, stop using it.
If you have or are recovering from a blood cancer, you shouldn’t use Ashwagandha, as its effects on your bone marrow could increase your cancer’s growth.
Women who are pregnant or breastfeeding shouldn’t use it because of its hormonal effects. It could potentially cause miscarriage and the hormonal effects could pass into a suckling infant.
Take care if you are taking anti-diabetic medication, as it could increase its effects.
Don’t use it if you are taking immunosuppressants, as it’s likely to reduce their effects.
If you are on thyroid medication, consult your doctor before using it.
Stop taking Ashwagandha before any surgery that requires a general anaesthetic because its sedative effects could increase the effects of the anaesthetic.
Conclusion
As you can see, the many uses of Ashwagandha on your cancer journey ensure that it lives up to the description, the Wonder Herb. Congratulations, if you’ve managed to read this far. I hope you’ve found some useful information here and will incorporate this magical herb to experience its many benefits .
If you’ve enjoyed this article, you can find more information about other herbs in my book. If you’d like to buy the book, just click on the button below.
References
1 Biswal BM, Sulaiman AM, Ismail HC, Zakaria H, Jalil Abdul MI, Muhammad KI. AOS14 phase II clinical study of combination chemotherapy with Herb Withania somnifera (ashwagandha) in breast cancer. European Journal of Cancer. 2012;48:S8-S9. doi:10.1016/j.ejca.2012.02.031
2 Mehta V, Chander H, Munshi A. Mechanisms of anti-tumor activity of Withania somnifera (Ashwagandha). Nutrition and Cancer. 2020;73(6):914-926. doi:10.1080/01635581.2020.1778746
3 Samant RR, Samant RS. Abstract 4: Choking cancer: Developing a pathway of Withaferin A for the Prevention of Angiogenesis (abstract) In: Proceedings of the Annual Meeting of the American Association for Cancer Research . Cancer Research. 2020;80(16_Supplement):4. doi:10.1158/1538-7445.am2020-4
4 Iarocci T. The links between stress and cancer. Verywell Health. https://www.verywellhealth.com/can-stress-lead-to-cancer-4125575. Published February 23, 2022. Accessed November 1, 2022.
5 Cooley K, Szczurko O, Perri D, et al. Naturopathic care for anxiety: A randomized controlled trial ISRCTN78958974. PLoS ONE. 2009;4(8):e6628. doi:10.1371/journal.pone.0006628
6 Akhgarjand C, Asoudeh F, Bagheri A, et al. Does ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta‐analysis of Randomized Controlled Trials. Phytotherapy Research. August 2022:1-10. doi:10.1002/ptr.7598
7 Speers AB, Cabey KA, Soumyanath A, Wright KM. Effects of Withania Somnifera (ashwagandha) on stress and the stress- related neuropsychiatric disorders anxiety, depression, and insomnia. Current Neuropharmacology. 2021;19(9):1468-1495. doi:10.2174/1570159x19666210712151556
8 Paul S, Chakraborty S, Anand U, et al. Withania somnifera (L.) Dunal (ashwagandha): A comprehensive review on ethnopharmacology, Pharmacotherapeutics, biomedicinal and toxicological aspects. Biomedicine & Pharmacotherapy. 2021;143:112175. doi:10.1016/j.biopha.2021.112175
9 Choudhary D, Bhattacharyya S, Bose S. Efficacy and safety of ashwagandha (withania somnifera (L.) dunal) root extract in improving memory and cognitive functions. Journal of Dietary Supplements. 2017;14(6):599-612. doi:10.1080/19390211.2017.1284970
10 Saggam A, Tillu G, Dixit S, et al. Withania somnifera (L.) Dunal: A potential therapeutic adjuvant in cancer. Journal of Ethnopharmacology. 2020;255:112759. doi:10.1016/j.jep.2020.112759
11 Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI. Effect of withania somnifera (ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients. Integrative Cancer Therapies. 2012;12(4):312-322. doi:10.1177/1534735412464551
12 Wankhede S, Langade D, Joshi K, Sinha SR, Bhattacharyya S. Examining the effect of withania somnifera supplementation on muscle strength and recovery: A randomized controlled trial. Journal of the International Society of Sports Nutrition. 2015;12(43):1-11. doi:10.1186/s12970-015-0104-9
13 Sharma AK, Basu I, Singh S. Efficacy and safety of ashwagandha root extract in subclinical hypothyroid patients: A double-blind, randomized placebo-controlled trial. The Journal of Alternative and Complementary Medicine. 2018;24(3):243-248. doi:10.1089/acm.2017.0183
14 Mechchate H, Es-safi I, Louba A, et al. In vitro alpha-amylase and alpha-glucosidase inhibitory activity and in vivo antidiabetic activity of Withania frutescens L. Foliar extract. Molecules. 2021;26(2):293. doi:10.3390/molecules26020293
15 El Moussaoui A, Mechchate H, Bourhia M, et al. Glycemic control potential of chemically characterized extract from Withania frutescens L. roots in severe diabetes-induced mice. Applied Sciences. 2021;11(9):3998. doi:10.3390/app11093998
16 Zohra FT, Islam Z., Nila TS, Cruze LRMD, Das R, Afrin N. In vivo study of anti-diabetic activity and safety profile analysis of ethanolic extract of Withania somnifera on alloxan-induced diabetic rats. World Journal of Pharmaceutical Research. 2019;8(13):318-328.
17 Ajgaonkar A, Jain M, Debnath K. Efficacy and safety of ashwagandha (Withania somnifera) root extract for improvement of sexual health in healthy women: A prospective, randomized, placebo-controlled study. Cureus. 2022;14(10):e30787. doi:10.7759/cureus.30787
18 Gopal S, Ajgaonkar A, Kanchi P, et al. Effect of an ashwagandha (Withania somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double‐blind, placebo‐controlled study. Journal of Obstetrics and Gynaecology Research. 2021;47(12):4414-4425. doi:10.1111/jog.15030
19 Ahmad MK, Mahdi AA, Shukla KK, et al. Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. Fertility and Sterility. 2009;94(3):989-996. doi:10.1016/j.fertnstert.2009.04.046
20 Ambiye VR, Langade D, Dongre S, Aptikar P, Kulkarni M, Dongre A. Clinical evaluation of the spermatogenic activity of the root extract of ashwagandha (Withania somnifera) in oligospermic males: A pilot study. Evidence-Based Complementary and Alternative Medicine. 2013;2013(ID571420):1-6. doi:10.1155/2013/571420
21 Ilayperuma, I., Ratnasooriya, W.D., & Weerasooriya, T.R. Effect of Withania somnifera root extract on the sexual behaviour of male rats. Asian journal of andrology. 2002; 4 4, 295-8 .
22 Natural Medicines Database. Natural Medicines - Login. Natural Medicines Database. https://naturalmedicines.therapeuticresearch.com/databases/food,-herbs-supplements/professional.aspx?productid=960#interactionsWithDrugs. Published 2022. Accessed 2022.
