Ashwagandha and Testosterone: What’s The Connection?

People have been taking herbs to spice up their health for 1000’s of years. Over the past 20 years, there was numerous research to find out how effective a lot of those herbs really are. A key area of study has been focused on herbs that claim to encourage the body to extend its testosterone production. Of all of the natural products which have come under the scientific highlight, one which has gained numerous attention is ashwagandha.

In this text, we go deep into the research to research the connection between testosterone and ashwagandha.

What’s Ashwagandha?

Ashwagandha, or , is an herb that has been utilized in Ayurvedic medicine for 1000’s of years. It is often often known as the Indian winter cherry or Indian ginseng. The herb is a small shrub that has yellow blooms and red berries. It has been used traditionally to treat such conditions as stress, depression, inflammation, and lack of energy. Additionally it is considered to have antioxidant, hormonal, and vitality effects.

Ashwagandha is classed as an adaptogen. These are substances that help the body cope with physical and mental stress. They do that by adapting the body’s response to emphasize, returning it to a balanced state.

The lively compound in ashwagandha is believed to be withanolides. These steroidal lactones have been shown to supply several positive physiological effects on the body.

As an herbal substance, ashwagandha supplements and other supplements containing it are classified as foods somewhat than medicines by the FDA. Consequently, ashwagandha supplements usually are not subject to the identical rigid approval process as medicinal drugs.

The Hindi name for this plant is asgandh, alluding to the smell of horse sweat. Additionally it is said that this herb endows users with a stallion’s power and endurance. This plant, which is often known as a rasayana in Ayurvedic medicine, has been traditionally used to advertise longevity, mental stimulation, increased energy, and sexual prowess, in addition to for its healing properties.

The dried root is incessantly utilized in India to treat quite a lot of ailments, reminiscent of fevers, edema (fluid buildup), asthma, sterility, gastric ulcers, rheumatism, paralysis, and infant malnutrition. It’s used for quite a lot of ailments in various regions of India. The Rajputs use the foundation for lumbago, arthritis, and dyspepsia (digestive problem), while the Punjabis use it for low back pain and as an aphrodisiac. The fresh root has been applied as a poultice for boils, glandular swellings, and decubitus ulcers (bedsores). The leaves are applied locally to cure boils or ulcers, and so they are also taken internally to treat alcoholism and as an anthelmintic (destroying intestinal worms).

The Connection Between Ashwagandha and Testosterone

For hundreds of years there was anecdotal evidence that taking ashwagandha can boost men’s strength, virility, and talent to construct muscle. Although there haven’t been any large-scale clinical trials investigating the connection between ashwagandha and testosterone, there have been quite a lot of smaller studies. These studies support the idea that taking ashwagandha promotes higher levels of testosterone within the body.

The interesting thing in regards to the research that has been done up to now on ashwagandha is that it shows that there are several mechanisms by which it could increase testosterone production within the body. This differs from most other herbal adaptogens, which only have one mechanism.

There are, actually, three key mechanisms by which ashwagandha appears to support increased testosterone:

1. Reducing chronic stress

2. Increasing thyroid hormones

3. Stimulating the discharge of gonadotropic releasing hormone (GnRH)

The primary study to concentrate on ashwagandha and testosterone was published in 2010. The aim of the study was to learn how ashwagandha affected the standard of the sperm and the degrees of reproductive hormones in infertile men. 150 men with infertility diagnoses between the ages of 25 and 40 participated within the study. Two groups were created, one in every of which received ashwagandha supplements and the opposite of which received placebos. The study lasted for 90 days.

On the conclusion of the study, the researchers discovered that semen quality had significantly improved within the group receiving ashwagandha supplementation, including a rise in sperm count, motility, and shape. The group that received ashwagandha also had a big reduction in oxidative stress of their seminal plasma in addition to an uptick in levels of testosterone and luteinizing hormone (LH).¹

A 2015 study focused on ashwagandha’s effect on muscle and strength. For eight weeks, the themes (57 young, healthy men) were randomized to receive either ashwagandha supplementation or a placebo.

Each groups underwent an 8-week resistance training program. The ashwagandha group was given 33 mg of ashwagandha root extract twice day by day, while the control group was given a placebo.

On the conclusion of the study, the researchers found that the ashwagandha supplementation group had significantly more muscle strength than the control group. Reduced levels of muscle injury indicators like creatine kinase and lactate dehydrogenase within the ashwagandha group also showed a big increase in muscle healing. The ashwagandha group also had far higher levels of testosterone at the top of the study. 96.2 ng/dL in comparison with 18.0 ng/dL for the placebo group.²

How does Ashwagandha boost testosterone?

The precise mechanism by which ashwagandha may increase testosterone levels shouldn’t be entirely understood. Nonetheless, the present research indicates that ashwagandha may raise testosterone levels by lowering cortisol levels. Chronic stress can eventually lead to lower testosterone levels since cortisol interferes with testosterone production. Ashwagandha may help to spice up the body’s testosterone synthesis by lowering cortisol levels.³

Cortisol is produced by the adrenal glands in response to emphasize. It has an inverse relationship with testosterone. That implies that when testosterone levels go up, cortisol drops, and vice versa. There are a few reasons for this. Cortisol has been shown to inhibit the production of LH and one other hormone called follicle-stimulating hormone (FSH). Each of those are produced within the pituitary gland. But they stimulate the production of testosterone within the testes.

Cortisol and testosterone each share a standard precursor and substrate called pregnenolone. This substrate can convert into either cortisol or testosterone. The body can only produce a lot pregnanolone. So when you’ve got a high demand for cortisol production brought on by chronic stress, your testosterone production might be negatively affected.

Cortisol has also been shown to extend the body’s production of sex hormone-binding globulin (SHBG). This can be a protein that binds to testosterone, stopping it from getting used by the body.                

Ashwagandha’s ability to extend thyroid hormones is regarded as one other way that it boosts testosterone production. When the brain detects a drop in thyroid hormone production, it releases a hormone called thyrotropin-releasing hormone. This stimulates the pituitary gland to supply thyroid-stimulating hormone, which prompts the thyroid gland to supply thyroid hormones.     

Ashwagandha has been shown to scale back levels of thyroid-stimulating hormone while increasing thyroid hormone production. Because of this it’s in a position to bypass the conventional process by which thyroid hormones increase.⁴ Consequently, a negative feedback loop goes back to the brain, telling it to stop producing thyrotropin-releasing hormone and thyroid-stimulating hormone. The explanation that matters is because each of those hormones each have a negative impact on the HPG axis. Their release causes a rise in prolactin levels in addition to suppression of luteinizing hormone.⁵ Luteinizing hormone is a precursor to testosterone production within the testes. So, by taking ashwagandha, you may negate the testosterone-suppressing effects of natural thyroid production.                     

Ashwagandha can be thought to own antioxidant qualities that might decrease oxidative stress within the body.⁶ Reducing oxidative stress helps to take care of normal testosterone levels since it harms the body’s cells, including those who produce testosterone.

The luteinizing hormone (LH)-raising effects of ashwagandha have also been linked to a rise in testosterone production. The pituitary gland within the brain secretes LH, a hormone that is important for controlling the testicular production of testosterone.

In accordance with studies, ashwagandha can promote the synthesis of LH, which aids in raising male testosterone levels. As an illustration, one study discovered that males who took ashwagandha for 90 days had much higher LH levels than those that took a placebo.⁷

The testes get the signal to make more testosterone when LH levels rise. By increasing LH levels, ashwagandha may support normal testosterone levels and maybe offer benefits, including increased muscular growth, higher bone density, and increased libido.

Gonadotropic-releasing hormone (GnRH) is released by the hypothalamus within the brain to instruct the pituitary gland to release luteinizing hormone. That is triggered by low levels of dihydrotestosterone (DHT), a hormone derived from testosterone, in addition to low levels of estrogen. Nonetheless, there are other mechanisms by which GnRH is released, including by means of certain neurotransmitters which trigger its release.

That is where ashwagandha comes into the image. It has been shown to have the ability to enhance the signaling of three of an important neurotransmitters that stimulate the discharge of GnRH.⁸ In this manner, ashwagandha enhances the discharge of luteinizing hormone, which, in turn, ends in greater production of testosterone by the Leydig cells within the testes.

What’s Ashwagandha used for?

Ashwagandha has been utilized in traditional Ayurvedic medicine for physical and mental health conditions, including stress and anxiety, low energy, weak immunity, and brain fog. Listed below are eight specific areas where ashwagandha is believed to be useful:

• Relieving stress and anxiety: Ashwagandha is believed to have the ability to contribute to a discount in cortisol levels.⁹ Referred to as the stress hormone, cortisol heightens feelings of tension and negatively affects the production of anabolic hormones.

• Enhancing cognitive function: There may be some research indicating that ashwagandha may help individuals with moderate cognitive impairment by enhancing their memory, focus, and cognitive performance.¹⁰

• Immune system support: Ashwagandha is assumed to have immune-modulating effects and will assist in the upkeep of a robust immune system.¹¹

• Sleep support: Ashwagandha may help to advertise rest and sound sleep habits.¹²

• Increased inflammation: Ashwagandha is assumed to have anti-inflammatory qualities. It might help to scale back bodily inflammation, which is related to general unwell health.¹³

• Boosts virility: Ashwagandha is assumed to have aphrodisiac effects and will improve each men’s and ladies’s sexual performance.¹⁴

• Increases testosterone: Ashwagandha’s claimed ability to assist boost the body’s natural production of testosterone has made it a key ingredient in testosterone boosters.¹⁵

Science-Backed Advantages of Ashwagandha on Testosterone:

Let’s now drill down on the research-backed advantages of testosterone in an try to separate fact from fiction on this much-vaunted herbal complement,

1. Luteinizing hormone

Luteinizing hormone (LH) is a hormone that is important for controlling the testicular production of testosterone. It’s secreted by the pituitary gland within the brain. There may be some research to point that ashwagandha may raise LH levels, which, in turn, increases testosterone production.

Ashwagandha’s effects on regulating reproductive hormone levels of healthy males were the topic of a 2015 study. The participants’ hormonal profiles were evaluated firstly and end of the 12-week trial. The ashwagandha group had significantly higher levels of LH in comparison with the placebo group. The ashwagandha group’s testosterone levels significantly increased.¹⁶

A 2010 study examined the impact of ashwagandha on the amount and levels of reproductive hormones in infertile males. The themes took ashwagandha root extract for 90 days. The participants’ hormonal profiles and semen quality were evaluated originally and end of the study. It was shown that LH levels were significantly higher within the ashwagandha group.¹⁷

2. Increased Sperm Quality

Resulting from its antioxidant, anti-inflammatory, and adaptogenic qualities, ashwagandha may enhance the standard of sperm by lowering levels of oxidative stress, inflammation, and stress-related male fertility issues. Ashwagandha’s effects on sperm quality have been the topic of quite a little bit of research, especially in infertile males.

The 2010 study mentioned above also showed that supplementing with ashwagandha significantly improved semen quality. This included an increase in sperm count, motility, and shape.

The consequences of ashwagandha root extract on sperm quality in males with oligospermia, a disorder characterised by a low sperm count, were examined in a study that was published within the  in 2013. The semen parameters of the participants were evaluated firstly and end of the trial, which involved giving them ashwagandha root extract for a complete of 90 days. The researchers found a considerable improvement within the sperm count, semen volume, sperm motility, and sperm morphology of the ashwagandha group to those of the placebo group.¹⁸

A 2018 study examined the results of ashwagandha root powder on the semen parameters in males with idiopathic oligoasthenoteratozoospermia (OAT), a condition marked by low sperm count, poor sperm motility, and abnormal sperm morphology. The participants were divided into two groups. The ashwagandha group was given ashwagandha root powder for 90 days, while the opposite group was given a placebo. The semen parameters of the participants were evaluated firstly and conclusion of the trial. The study team discovered that sperm count, sperm motility, and semen volume were all significantly higher within the ashwagandha-treated group than within the control group.¹⁹

3. Reduces Stress

Ashwagandha has been used for millennia as a strategy to reduce stress and control anxiety. A handful of recent studies have investigated this ability. In a 2012 study, participants got either ashwagandha or a placebo for 60 days. Their stress and anxiety levels were assessed before and after the study period. The ashwagandha group had significantly lower serum cortisol levels, which was related to lowered stress. The researchers concluded that a “high-concentration full-spectrum Ashwagandha root extract safely and effectively improves a person’s resistance towards stress and thereby improves self-assessed quality of life.” ²⁰

A 2009 study that was published within the specifically checked out how useful ashwagandha was in treating individuals with chronic stress. After 60 days, the stress and anxiety levels of those people were significantly lower. Significant differences between groups were also observed in mental health, concentration, fatigue, social functioning, vitality, and overall quality of life, with the ashwagandha group displaying improved ends in each of those areas.²¹

There may be some evidence to point that ashwagandha may help to scale back the symptoms of mental health conditions reminiscent of depression. A 2019 study that was published in tested the results of ashwagandha on individuals with schizophrenia. Sixty-six people got 1000 mg of ashwagandha day by day for a period of twelve weeks. All participants had lower levels of stress, anxiety, and depression than the second group who took a placebo pill.²²

In accordance with the identical 2012 study as above, taking ashwagandha helped adults who were chronically stressed and reduced their symptoms of depression by 77%. The ashwagandha group took 600 mg per day for 60 days, while the control group took a placebo. The control group reported a decrease in depressive symptoms of just 5%.²³

4. Increased Strength

The adaptogenic, antioxidant, and anti inflammatory properties of ashwagandha are believed to have the ability to enhance strength levels by reducing muscle damage, inflammation, and stress.

A 2015 study checked out the effect of ashwagandha root extract on muscle strength in young men who worked out. Through the 8-week trial, the ashwagandha group was given 300 mg of ashwagandha root extract per day, while the control group was given a starch placebo. In the beginning and end of the study, the participants’ strength levels were measured on the bench press and the leg extension. The typical bench press increase was 46 kg within the ashwagandha group compared with 26.4 kg for the placebo group. The leg extension improvements were just as impressive, being 14.5 kg for the ashwagandha group compared with 9.8 kg for the placebo group. The ashwagandha group also experienced reduced muscle damage post-workout. Muscle mass was also significantly greater within the ashwagandha group.²⁴

One other study checked out the results of ashwagandha extract on the muscle strength and endurance of elite athletes. Forty elite athletes were randomly chosen after which divided into two groups. One group was given 1000 mg of ashwagandha root extract daily divided into 2 500 mg dosages, while the opposite group was given a placebo. That is one in every of the only a few studies to have a look at how ashwagandha impacts the performance of very fit people. The outcomes showed that every one of the parameters of muscular and cardiovascular endurance were significantly higher within the ashwagandha group than within the placebo group. These included VO2 max, where the ashwagandha group improved by 13% in comparison with no change within the placebo group.²⁵

5. Promotes Sleep Quality

One of the vital vital facets of getting your body performing at a high level is sleep. Ashwagandha may help to advertise sleep by lowering stress and anxiety levels. The herb has adaptogenic properties that assist the body in coping with stress by controlling the discharge of stress hormones and lowering oxidative stress and inflammation. Stress and anxiety are frequent causes of sleep disruptions.

Ashwagandha root extract’s advantages on healthy individuals’ sleep quality were a part of a 2012 study that was published within the Indian Journal of Psychological Medicine. The study involved 64 people, with half of them taking 600 mg of ashwagandha day by day for 60 days. The themes’ sleep quality was evaluated through the trial. Cortisol levels were also lower within the ashwagandha group.²⁶

A 2015 randomized, double-blind, placebo-controlled study examined the advantages of ashwagandha root extract for insomniac patients. Over the course of the study’s ten weeks, participants got either ashwagandha root extract or a placebo. Comparing the ashwagandha group to the placebo group, the researchers discovered that the ashwagandha group had a lot better sleep quality. A major decrease in anxiety and depressive symptoms was also seen within the ashwagandha group. The sleep efficiency rating for the ashwagandha group increased from 75.63 at baseline to 83.48 at the top of the study. This in comparison with a baseline of 75.14, increasing to 79.68 for the placebo group.²⁷

Side Effects of Ashwagandha

Although ashwagandha is usually considered protected, some people may experience some negative effects. Listed below are a couple of of essentially the most common ashwagandha adversarial effects:

1. Stomach issues: Abdominal discomfort, diarrhea, and constipation are a couple of gastrointestinal problems that some people using ashwagandha can have. The herb can have a laxative effect on the digestive tract, potentially explaining these effects.

2. Headaches: Although they’re very unusual, some individuals who use ashwagandha occasionally report getting headaches.

3. Drowsiness: Ashwagandha may make you are feeling sleepy, especially in case you take it in large doses or when mixed with other sedatives.

4. Reduced blood pressure: Ashwagandha may lower blood pressure, which is sweet for many who have hypertension but may make some people feel lightheaded or dizzy.

5. Allergic response: An allergic response to ashwagandha may cause some people to exhibit symptoms like hives, itching, and respiration difficulties.

6. Thyroid problems: Ashwagandha can increase thyroid activity, which is helpful for individuals with hypothyroidism but may exacerbate the symptoms of hyperthyroidism.

7. Medication interactions: Certain medicines, including sedatives, thyroid hormones, and medicines for hypertension or diabetes, may interact with ashwagandha.

The intensity and frequency of negative effects might change from individual to individual and may also rely upon the dosage and length of usage.

Reddit users report quite a lot of negative effects, a few of them quite serious. Here’s the experience of Reddit user :

For those who experience any negative negative effects, it is best to stop taking ashwagandha.

Types of Ashwagandha present in Supplements

Ashwagandha is available in the next forms:

1. Raw Ashwagandha Root

The purest and most conventional type of ashwagandha is accessible as raw ashwagandha root, which is made by drying and powdering the roots of the ashwagandha plant. It is often utilized in Ayurvedic medicine for its therapeutic benefits, along with being utilized as a dietary complement.

2. Ashwagandha Extract

Ashwagandha extract is a distilled type of the herb that’s made by extracting the lively ingredients from the plant’s roots and leaves. Ashwagandha’s withanolides, that are its lively components, are frequently present in capsule or tablet form and might include higher quantities of those compounds.

3. Ashwagandha Tea

The powdered root is traditionally steeped in hot water to make ashwagandha tea. As a well-liked all-natural treatment for stress and anxiety, ashwagandha tea is incessantly eaten.

4. Ashwagandha oil

Ashwagandha powder is combined with a carrier oil, reminiscent of sesame or coconut oil, to generate ashwagandha oil. Consequently of its alleged anti-inflammatory properties, ashwagandha oil is often utilized in Ayurvedic massage.

5. Patented Ashwagandha Extracts

The withanolide content of standardized, patented extracts of ashwagandha are higher than standard ashwagandha. This include popular extracts reminiscent of KSM-66® and Shoden®. It’s asserted to scale back stress, improve cognitive function, and offer further health advantages. It is often marketed as a high-end ashwagandha variety.

How much ashwagandha should you are taking?

The best dosage of ashwagandha is determined by quite a lot of things, including the variety of ashwagandha, why it’s being taken, the person’s age, health, and every other medications they could be taking. Typically, 1-2 grams of ashwagandha root or powder every day, divided into two or three dosages, is suggested. The suggested dosages for ashwagandha extract capsules or pills can vary, but they commonly range from 300 to 500 mg day by day.

To stop any possible adversarial effects, it is necessary to start out with a lower amount and step by step increase it to the advised dose over a couple of weeks. Some folks that experience stomach discomfort may opt to take ashwagandha at night. It’s best to talk with a healthcare provider in case you are taking ashwagandha for a specific medical issue to ascertain the best dosage for you. As well as, women who expect or nursing should avoid taking ashwagandha or check with their doctor before doing so.

Summary

Ashwagandha shows numerous promise when it comes to its ability to spice up natural testosterone production. Although the available studies are limited of their size and scope, they show some pretty impressive results. It seems that the fundamental ways in which ashwagandha increases testosterone are by enhancing the production of luteinizing hormone, a precursor to testosterone, reducing cortisol levels, and decreasing oxidative stress.

We conclude that ashwagandha has enough research backing to make it a reputable testosterone-boosting ingredient. Search for it as a key ingredient in any testosterone-boosting complement you’re considering purchasing.

References

1. Ahmad, Mohammad Kaleem, et al. “Withania Somnifera Improves Semen Quality by Regulating Reproductive Hormone Levels and Oxidative Stress in Seminal Plasma of Infertile Males.” , vol. 94, no. 3, 2010, pp. 989–96
2. Wankhede, Sachin, et al. “Examining the Effect of Withania Somnifera Supplementation on Muscle Strength and Recovery: A Randomized Controlled Trial.” , vol. 12, no. 1, 2015, p. 43
3. K, Chandrasekhar, et al. “A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults.” , 1 July 2012
4. Abdel-Wahhab, Khaled G., et al. “Role of Ashwagandha Methanolic Extract within the Regulation of Thyroid Profile in Hypothyroidism Modeled Rats.” , vol. 46, no. 4, 15 June 2019, pp. 3637–3649
5. Sharma, Ashok Kumar, et al. “Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial.” , vol. 24, no. 3, 2018, pp. 243–248
6. Bhattacharya, A, et al. “Antioxidant Effect of Withania Somnifera Glycowithanolides in Chronic Footshock Stress-Induced Perturbations of Oxidative Free Radical Scavenging Enzymes and Lipid Peroxidation in Rat Frontal Cortex and Striatum.” , vol. 74, no. 1, Jan. 2001, pp. 1–6
7. Wankhede, Sachin, et al. “Examining the Effect of Withania Somnifera Supplementation on Muscle Strength and Recovery: A Randomized Controlled Trial.” , vol. 12, no. 1, 2015, p. 43
8. Bhattarai, Janardhan P., et al. “The Methanolic Extract of Withania Somnifera ACTS on GABAA Receptors in Gonadotropin Releasing Hormone (GnRH) Neurons in Mice.” , vol. 24, no. 8, 31 Dec. 2009, pp. 1147–1150
9. K, Chandrasekhar, et al. “A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults.” , 1 July 2012
10. Xing, Dante, et al. “Effects of Acute Ashwagandha Ingestion on Cognitive Function.” , vol. 19, no. 19, 20 Sept. 2022, p. 11852
11. Agarwal, Ramesh, et al. “Studies on Immunomodulatory Activity of Withania Somnifera (Ashwagandha) Extracts in Experimental Immune Inflammation.” , vol. 67, no. 1, Oct. 1999, pp. 27–35
12. Langade, Deepak, et al. “Clinical Evaluation of the Pharmacological Impact of Ashwagandha Root Extract on Sleep in Healthy Volunteers and Insomnia Patients: A Double-Blind, Randomized, Parallel-Group, Placebo-Controlled Study.” , vol. 264, Jan. 2021, p. 113276
13. Sikandan, Abudubari, et al. “Ashwagandha Root Extract Exerts Anti‑Inflammatory Effects in HaCaT Cells by Inhibiting the MAPK/NF‑ΚB Pathways and by Regulating Cytokines.” , 2 Apr. 2018
14. Ambiye, Vijay R., et al. “Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania Somnifera) in Oligospermic Males: A Pilot Study.” , vol. 2013, 2013, pp. 1–6
15. Lopresti, Adrian L., et al. “A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (Withania Somnifera) in Aging, Chubby Males.” , vol. 13, no. 2, Mar. 2019, p. 155798831983598
16. Wankhede, Sachin, et al. “Examining the Effect of Withania Somnifera Supplementation on Muscle Strength and Recovery: A Randomized Controlled Trial.” , vol. 12, no. 1, 2015, p. 43
17. Ahmad, Mohammad Kaleem, et al. “Withania Somnifera Improves Semen Quality by Regulating Reproductive Hormone Levels and Oxidative Stress in Seminal Plasma of Infertile Males.” , vol. 94, no. 3, 2010, pp. 989–96
18. Ambiye, Vijay R., et al. “Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania Somnifera) in Oligospermic Males: A Pilot Study.” , vol. 2013, 2013, pp. 1–6,
19. Nasimi Doost Azgomi, R., et al. “Comparative Evaluation of the Effects of Withania Somnifera with Pentoxifylline on the Sperm Parameters in Idiopathic Male Infertility: A Triple-Blind Randomised Clinical Trial.” , vol. 50, no. 7, 16 May 2018, p. e13041
20. K, Chandrasekhar, et al. “A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults.” , 1 July 2012
21. Cooley, Kieran, et al. “Naturopathic Take care of Anxiety: A Randomized Controlled Trial ISRCTN78958974.” , vol. 4, no. 8, 31 Aug. 2009, p. e6628
22. Gannon, Jessica M., et al. “Effects of a Standardized Extract of Withania Somnifera (Ashwagandha) on Depression and Anxiety Symptoms in Individuals with Schizophrenia Participating in a Randomized, Placebo-Controlled Clinical Trial.” , vol. 31, no. 2, 1 May 2019, pp. 123–129
23. K, Chandrasekhar, et al. “A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults.” , 1 July 2012
24. Wankhede, Sachin, et al. “Examining the Effect of Withania Somnifera Supplementation on Muscle Strength and Recovery: A Randomized Controlled Trial.” , vol. 12, no. 1, 2015, p. 43
25. Shenoy, Shweta, et al. “Effects of Eight-Week Supplementation of Ashwagandha on Cardiorespiratory Endurance in Elite Indian Cyclists.” , vol. 3, no. 4, 2012, pp. 209–14
26. K, Chandrasekhar, et al. “A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults.” , 1 July 2012