“Three deaths due to ‘sometimes life-threatening’ herbs, RIVM warns”.
“RIVM warns of potentially deadly dietary supplements”
“RIVM warns against dietary supplements with potentially deadly herbs”
“RIVM advises against the use of products with herbs Huperzia serrata, Tabernanthe iboga or Ashwagandha”.
These are just a few of the headlines that appeared in the news on 5 March. One article had a large picture of the herb ashwagandha and the other articles contained capsules and powder of ashwagandha.
The National Institute for Public Health and the Environment (RIVM) has carried out a risk assessment commissioned by the Ministry of Health, Welfare and Sport and more are likely to follow in the near future.
The risk analysis concerns 3 herbs, Huperzia serrata, tabernanthe iboga and ashwagandha. The suggestion is that all of these herbs have deadly effects on humans. This, along with pictures of ashwagandha, suggests that ashwagandha is the most harmful. Huperzia Serrata is a supplement that is used in the treatment of schizophrenia, cognitive dysfunction and dementia (Alzheimer’s). Huperzia has known side effects and interactions with regular medications. Tabernanthe Iboga is originally used in rituals and ceremonies in Africa and has hallucinogenic mind-altering effects. It contains a substance called Ibogaine, which is considered an illegal drug. Tabernanthe has dangerous and sometimes fatal side effects. Such a strange list that is used together…
Because I use ashwagandha a lot as part of my treatments of animals, I mainly want to focus on the use of ashwagandha. Ashwagandha, in addition to CBD oil and elderberry, is also the top 3 most sold supplements.
In the article, it is suggested that ashwagandha has hardly been studied on side effects, and that liver damage has been reported by general practitioners and that there are side effects in patients with thyroid problems. An effect is also found in cortisol levels. What exactly and what this is based on is not elaborated on. Thus, the risk analysis of the RIVM…. Substantiating, scientific…? But certainly fear-mongering.
Because I actually see very nice results from ashwagandha, but also practically no side effects and was a bit surprised about this article, but also because of the anxious reactions of my patients and owners, I dived into the literature a little more.
What does ashwagandha do?
Ashwagandha (Withania Somnifera) has been used in Ayurvedic and Chinese medicine for thousands of years (first use comes from 4-5000 BC). The name comes from the fact that the root smells like horses, Ashwa means horse in India.
Ashwagandha contains 40 active substances. These include alkaloids, steroidal lactones (withanolides, withaferin), saponins and withanoloids. The root, the leaves, and the berries are all used in supplements, and all contain different active ingredients. The root is most commonly used in the supplements. The root mainly contains the active substances withaferin A, withanolide A, withanolide B, 12-Deoxy-withastramonolide and withanosides. Withaferin A is seen as the most important component. Ashwagandha is an adaptogen. Adaptogens are substances that improve a general, non-specific, response to stress. Furthermore, adaptogens ensure that the body can adapt to the recovery from the harmful effects of stress. Adaptogens regulate stress regulation through the hypothalamic-pituitary-adrenal axis. This means that the stress hormones cortisol and adrenaline decrease and serotonin is increased). It also reduces anxiety and depression, has an effective effect against yeasts, microbes (bacteria, parasites) and malaria. Stimulates cell killing (apoptosis) and suppresses tumor proliferation, protects the cartilage, heart, liver, nerves and promotes the immune system (stimulates T helper cells, cytokines, CD 4, CD 8, natural killer cells and leukocytes). Ashwagandha is anti-inflammatory (reduces interleukin 6 concentration) and analgesic (inhibits COX-2 enzyme), promotes learning and memory. Furthermore, ashwagandha has an antioxidant effect, promotes hematopoiesis (increased erythrocytes, hemoglobin, leukocytes and lymphocytes), and is used as an anti-aging and rejuvenator. Ashwagandha normalizes the function of the thyroid gland, increases the levels of TSH, T3 and T4. Ashwagandha strengthens muscle strength and stimulates muscle renewal.
Indications
Ashwagandha has a broad effect, improves the condition of body and mind and contributes to a healthy and long life. In Ayurveda, Ashwagandha is originally used as an aphrodisiac supplement and further for soothing, rejuvenation and life extension.
Other indications include:
- Acute and chronic stress
- Oxidative stress
- Fear
- Unrest
- Osteoarthritis, osteoarthritis, rheumatism. Has an analgesic effect.
- Hypothyroidism. Ashwagandha increases thyroid hormone production
- Cancer:
- Positive examination for mammary gland tumors, lung tumors, liver, kidney tumors, skin tumors (melanoma), prostate tumor and blood tumors.
- Reduces side effects associated with chemotherapy and radiation.
- Cushing’s disease. Lowers cortisol levels.
- Epilepsy
- Bronchitis, asthma
- Liver problems
- Dementia
- Improvement of general condition, recovery after illness
- Increased energy level
- Supporting aging
- Depression
- Insomnia
- Chronic fatigue syndrome
- Strengthened immune system
- Lowered blood pressure
- Neurodegenerative disorders (e.g. Canine Cognitive Dysfunction)
- Diabetes mellitus; Ashwagandha lowers blood glucose levels.
- After using insecticides
- Heart problems
Side effects.
Very high doses can lead to diarrhoea, nausea and vomiting symptoms.
In a study with mice, toxicity was examined. An extremely high dose of 2 grams/kg of body weight for 28 days without side effects was found.
In another study, connections were found with liver damage and ashwagandha. The liver damage was healed within 1-5 months of stopping ashwagandha in all cases.
Contraindications.
Do not use in case of hypersensitivity to ashwagandha.
Do not use during pregnancy or pregnancy.
Do not use in case of Hyperthyroidism.
Do not use in liver diseases
Do not use in case of hormone-sensitive prostate cancer
Interactions.
Ashwagandha affects thyroid function, diabetes, blood pressure, cortisol levels, behavioral medications and epilepsy. This means that it interacts with regular medications, which means that some medications need to be dosed less and adjusted when using ashwagandha.
Conclusion.
Ashwagandha is a complex herb/root with 40 active ingredients. Ashwagandha has a broad effect, improves the condition of body and mind and contributes to a healthy and long life. Ashwagandha has a nice stress and anxiety reducing effect on (humans and) animals and is analgesic. Furthermore, no significant side effects have been found and it is seen as a very safe herb.
There are no known significant side effects as long as you stick to the prescribed dosage. And yes, all supplements have an effect on certain diseases and biochemical reactions and are broken down in the body via the liver or excreted through the intestines. So every supplement, like any drug, has an interaction with certain supplements or medications. Thus, for the above indications, Ashwagandha also interacts with any regular or other supplements for the same indication. This interaction means that you should not use ashwagandha in, for example, a patient with hyperthyroidism.
Literature used
- rivm.nl/publicaties/risk-assessment-of-herbal-preparations-containing-withania-somnifera-ashwagandha
- orthokennis.nl/nutrienten/ashwagandha
- Efficacy and safety of standardized Ashwagandha (Withania somnifera) root extract on reducing stress and anxiety in domestic dogs: A randomized controlled trial. panelJasleen Kaur et al. 2022
- Efficacy, safety and toxicity, Ramesh Gupta et al. 2nd edition, 2021
- Exploring ashwagandha for animal care, Chris Kilham, 2022
- Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind. Jaysing Salve et al. 2019
- Safety, toxicity and pharmacokinetic assessment of oral Withaferin-A in mice. Saurabh Kumar Gupta et al.
- Ashwagandha(Withania somnifera)—Current Research on the Health-Promoting Activities: A Narrative Review, Mikulska et al. 2023.
