Rankings / Mood, Anxiety & Stress
Ashwagandha (Withania somnifera)
Mood, Anxiety & Stress · Adaptogen
Also known as: KSM-66 ·Sensoril
Tier B-
Bottom line
Read Off Label grades Ashwagandha (Withania somnifera) as B- (6.3/10) based on moderate evidence, moderate benefit magnitude, and a low-med-risk safety profile.
Most-popular adaptogen in the West, with better clinical trial base than most (Chandrasekhar 2012, Lopresti 2019, 2021).
Typical use: 300-600 mg/day standardized extract (KSM-66 or Sensoril most studied) — OTC.
What this is
Most-popular adaptogen in the West, with better clinical trial base than most (Chandrasekhar 2012, Lopresti 2019, 2021). Iceland and Denmark added warnings 2023 after multiple case reports of DILI (drug-induced liver injury). Take time-separated from thyroid hormone (can affect absorption). Cycle if using chronically. Emerging 2025-2026 case reports describe HPA-axis suppression and withdrawal-type symptoms with chronic use — too sparse to establish incidence but reinforcing the case for cycling. A 2026 meta-analysis (20 RCTs, n=1,249) reported significant cognitive gains - memory SMD 0.52, attention/processing speed SMD 0.29 - plus muscle-strength, testosterone, and body-composition improvements (GRADE-assessed; Front Pharmacol 2026).
Mechanism
Ayurvedic 'Indian ginseng'; withanolides (withaferin A, withanolide D); HPA axis modulation — reduces cortisol response to stress; GABAergic; thyroid-stimulating effects
Dose & route
300-600 mg/day standardized extract (KSM-66 or Sensoril most studied)
Citations
- https://pubmed.ncbi.nlm.nih.gov/32162423/
- https://pubmed.ncbi.nlm.nih.gov/33450840/
- https://www.mast.is/en/news/news-of-the-month/risk-assessment-published-for-ashwagandha
- https://clinicaltrials.gov/study/NCT01311180
- https://pubmed.ncbi.nlm.nih.gov/41901106/
- https://pubmed.ncbi.nlm.nih.gov/36017529/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC12242034/
- https://www.sciencedirect.com/science/article/abs/pii/S1550830724001691
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Common questions
- Does Ashwagandha (Withania somnifera) work?
- Read Off Label rates the evidence for Ashwagandha (Withania somnifera) as Moderate and the benefit magnitude as moderate, producing an overall grade of B- (6.3/10). Most-popular adaptogen in the West, with better clinical trial base than most (Chandrasekhar 2012, Lopresti 2019, 2021).
- Is Ashwagandha (Withania somnifera) safe?
- Ashwagandha (Withania somnifera) has a low-med risk profile in published human data. Legal status: OTC. This is not medical advice — see the disclaimer.
- What is the typical dose for Ashwagandha (Withania somnifera)?
- 300-600 mg/day standardized extract (KSM-66 or Sensoril most studied)
- How does Ashwagandha (Withania somnifera) work?
- Ayurvedic 'Indian ginseng'; withanolides (withaferin A, withanolide D); HPA axis modulation — reduces cortisol response to stress; GABAergic; thyroid-stimulating effects
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.