Hormonal Modulation with Withania somnifera: Systematic Review and Meta-Analysis of Randomized-controlled Trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials.
PubMed 41740946 · doi:10.1055/a-2802-8363
What was done
A systematic review and random-effects meta-analysis evaluated the effects of oral ashwagandha (Withania somnifera) supplementation on circulating hormone levels in adults. Searches of MEDLINE, Embase, and ClinicalTrials.gov (PROSPERO CRD42024611576) identified randomized, placebo-controlled trials measuring endocrine outcomes. Study quality was evaluated using the Cochrane risk of bias tool, and pooled effects were calculated as mean differences (MD) or standardized mean differences (SMD).
What was found
Across 23 trials with 1,706 participants, ashwagandha significantly decreased cortisol (SMD = -1.18, p < 0.04) and increased serotonin (MD = 31.75 ng/ml, p < 0.01). T4 levels increased modestly (MD = 0.61 µg/dL, p = 0.02), while TSH and T3 showed no significant change. Ashwagandha increased testosterone in men (MD = 57.43 ng/dl) but not in women (MD = 5.09 ng/dl), reflecting a significant sex difference. Estradiol (E2) was unaffected in either sex. Subgroup analyses suggested a possible dose-response effect related to withanolide content.
Why it matters
This meta-analysis provides aggregated clinical evidence that ashwagandha modulates key endocrine axes, particularly lowering cortisol and selectively increasing testosterone in men.
Limits
The abstract notes substantial heterogeneity and limited available data for some hormonal endpoints. Study duration, baseline participant health, exact extract preparations, and specific risk of bias results were not detailed in the abstract.
Cited by
- partial Ashwagandha at a dose of approximately 600 mg reduces cortisol and increases testosterone levels by upwards of 100 points.