Ashwagandha (Withania somnifera) and Bone Health: A Narrative Review of Emerging Evidence and Mechanistic Insights
Abstract
Abstract
Osteoporosis is a widespread disease of old age, and every fifth elderly person in the world has it, and women after menopause are particularly exposed to it. The condition has a high chance of creating fractures that can lead to severe complications or even death. Available pharmacological interventions (bisphosphonates, RANKL inhibitors, and hormone replacement therapy) are capable of reducing the risk of fractures, but compliance with regular treatment is often a problem among patients, and these medications are associated with such side effects as GI upset, atypical fractures, and other health problems related to hormone activity. In comes Ashwagandha (Withania somnifera), an ancient Ayurvedic plant commonly referred to as a Rasayana. Its extracts contain withanolides, which have anti-inflammatory and antioxidant effects. What actually caught our attention, however, is that preclinical studies revealed that the estrogen-like withanolides in Ashwagandha prevented bone loss in estrogen-depleted rats. In addition to that, laboratory work indicates that the plant regulates endocrine pathways in a way that is beneficial to bone health: it reduces cortisol and increases testosterone. The molecules responsible for these effects are equally interesting from a mechanistic perspective. A major withanolide, Withaferin-A, drives osteoblast proliferation and differentiation via the activation of Runx2 and prevents osteoclast differentiation by inhibiting NF-kappa B and…
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