What is the recommended dosage of Ashwagandha (Withania somnifera) for anxiety and stress relief?

Ashwagandha Dosage for Anxiety and Stress Relief

For anxiety and stress relief in adults, use 500-600 mg of standardized Ashwagandha root extract daily (standardized to 2.5% withanolides), taken once at night, for a minimum of 60-90 days to achieve clinically meaningful benefits.

Recommended Dosing Protocol

Standard Effective Dose

• 500-600 mg daily of root extract standardized to 2.5% withanolides (delivering approximately 12.5-15 mg withanolides per day) taken once at night 1, 2, 3
• This dosing has demonstrated significant reductions in perceived stress scale (PSS) scores, anxiety (GAD-7 and HAM-A scores), and cortisol levels compared to placebo 1, 2, 3

Lower Dose Alternative

• 225-300 mg daily can be considered for milder symptoms or initial titration, though efficacy is somewhat reduced compared to higher doses 2, 4
• The 225 mg dose showed significant cortisol reduction from baseline to day 15 and day 30 4

Treatment Duration

• Minimum 60 days for stress and anxiety relief, with optimal benefits often seen at 90 days 1, 3, 5
• Significant improvements typically begin at 30 days but continue to increase through 60-90 days of treatment 3, 5

Standardization Requirements

Critical: Use only root extract standardized to 2.5% full-spectrum withanolides as per USP protocol 1, 3

• Non-standardized products have unpredictable withanolide content and unreliable efficacy
• The 2.5% standardization ensures consistent delivery of approximately 12.5 mg withanolides per 500 mg dose 1, 3

Enhancement with Piperine

• 5 mg of 95% piperine co-administered with Ashwagandha enhances bioavailability and efficacy 1, 3
• Studies using this combination showed superior outcomes in reducing cortisol and increasing serotonin 1, 3

Expected Clinical Outcomes

Stress and Anxiety Reduction

• Significant reduction in PSS scores (p < 0.001) by 60-90 days 1, 3
• Significant reduction in HAM-A and HDRS scores (p < 0.001) 2, 3
• Morning salivary cortisol levels decrease significantly compared to placebo 1, 2

Additional Benefits

• Improved sleep quality measured by PSQI and GSQS scores 3, 5
• Enhanced cognitive function including memory recall, concentration, and decision-making time 1, 5
• Increased urinary serotonin levels 1, 3
• Improved quality of life scores 1, 3

Safety Profile

• Well-tolerated with no serious adverse events reported in clinical trials 1, 2, 3, 5
• Biochemical and hematological parameters remained normal throughout studies 1, 3
• Some patients may experience mild nausea or sleep disturbances during initial use, similar to other stress-modulating agents 6

Common Pitfalls to Avoid

• Using unstandardized products: Many commercial Ashwagandha products lack proper withanolide standardization, leading to inconsistent results
• Insufficient duration: Stopping treatment before 60 days may not allow adequate time for cortisol modulation and neurochemical changes
• Incorrect dosing: Doses below 225 mg daily show minimal efficacy; doses of 125 mg twice daily (250 mg total) represent the minimum effective threshold 2
• Wrong plant part: Ensure root extract is used, not leaf-only preparations, as studies demonstrating efficacy used root or root-leaf combinations 4, 5

Timing of Administration

• Once daily at night is the preferred dosing schedule 1, 3
• This timing aligns with cortisol rhythm modulation and may enhance sleep quality benefits 3, 5