The neuroendocrinology of chronic stress: evaluating the clinical efficacy of ashwagandha (withania somnifera) on serum cortisol and psychosocial well-being
Abstract
Background: Chronic stress is a pervasive global health challenge characterized by the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. This neuroendocrine imbalance leads to elevated serum cortisol, which subsequently triggers systemic disruptions in reproductive health, metabolic homeostasis, and psychosocial well-being. Withania somnifera (Ashwagandha), a premier adaptogen, is increasingly recognized for its ability to modulate these multifaceted stress responses.
Objective: This review evaluates the clinical efficacy of Ashwagandha in reducing serum cortisol and enhancing well-being, while synthesizing its systemic impact on the reproductive, metabolic, immune, and sleep systems.
Methods: A comprehensive synthesis of over 48 contemporary sources, including randomized controlled trials (RCTs) and meta-analyses, was conducted to assess hormonal, psychometric, and physiological outcomes.
Results: Evidence consistently demonstrates that standardized Ashwagandha extracts (240–600 mg/daily) reduce serum cortisol levels by 11% to 32%. These changes correlate with significant improvements in anxiety (PSS-10, HAM-A) and sleep parameters, specifically reduced sleep onset latency and enhanced efficiency. Beyond the HPA axis, Ashwagandha restores the hypothalamic-pituitary-gonadal (HPG) axis, significantly improving sperm concentration and testosterone levels in males. Metabolic benefits include modest weight reduction and improved insulin sensitivity, while ergogenic…
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