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Answers About Ashwagandha

Ashwagandha’s all the buzz these days for relieving stress and fatigue. But is there anything to it?

Your Wellness

Medically reviewed by Melanie Fiorella, M.D.

Have you seen ashwagandha’s benefits touted on social media? It’s an herbal remedy used for treating symptoms of stress, anxiety and insomnia — but is it worthy of the attention?

We reached out to Melanie Fiorella, M.D., a primary care physician and director of the Center for Integrative Education at University of California San Diego, to get the facts.

What is ashwagandha?

Ashwagandha, also called winter cherry or ashvagandha, is an herb used in traditional Indian Ayurvedic medicine. It’s best known for reducing stress and improving sleep, but it’s also an anti-inflammatory that can lower blood sugar and increase testosterone, among other things.

Fiorella noted that ashwagandha can be especially helpful for those stuck in the “wired and tired” loop — an increasingly common modern problem. “It calms you down, but also gives you energy,” she explained.

So, how does ashwagandha work? The short answer is that we don’t really know. What we do know is that ashwagandha calms the nervous system. While researchers are trying to uncover the specific mechanisms underlying ashwagandha’s uses, there are studies demonstrating its effectiveness.

What can ashwagandha do?

Ashwagandha is renowned for alleviating stress and anxiety. When a person gets stressed, their body releases cortisol, a hormone that can help manage it, but having too much cortisol in your body can have negative effects on your health over the long term. In clinical studies, ashwagandha has been linked to reducing anxiety and lowering cortisol levels, particularly in the morning.

Ashwagandha is also able to help people sleep better. Researchers have observed ashwagandha helping stressed adults as well as adults struggling with non-restorative sleep (NRS) improve their sleep. And more studies report improved insomnia symptoms following ashwagandha use, though larger studies are needed to fully confirm these findings.

Ashwagandha also helps lower blood sugar and fat, making it a great herb for diabetics. One study even found that ashwagandha has comparable success in reducing blood sugar to oral hypoglycemic drugs.

Emerging research is uncovering ashwagandha’s positive effects on the mind and brain as well. One recent study shows that ashwagandha can significantly improve recall memory and general focus after 90 days, and new studies show that ashwagandha has promising applications to help treat cancer, Alzheimer’s and other neurodegenerative diseases.

Ashwagandha roots and its powder also known as Indian ginsengiStock.com/mirzamlk

Who can’t take ashwagandha?

Generally speaking, ashwagandha is safe to use, although everyone should always consult with their healthcare provider (HCP) before beginning any type of supplement, especially people taking blood pressure or thyroid medicine. It’s also important to note that supplements aren’t monitored by the US Food and Drug Administration, so it’s important to make sure you’re getting any supplements from reliable companies.

People who suffer from heartburn, persistent inflammation, joint pain and diarrhea should avoid ashwagandha. And ashwagandha is in the nightshade family, which includes foods like eggplants and tomatoes, so it’s not an option for people with nightshade allergies.

Additionally, pregnant women should stay away from ashwagandha, unless instructed otherwise by their HCP. Since ashwagandha is a stimulating herb, it could induce contractions.

How should you use ashwagandha?

Ashwagandha isn't a one-stop-shop when it comes to treating anxiety or insomnia. For the best results, Fiorella recommends using ashwagandha alongside a holistic health change, which would include reconsidering one’s lifestyle and diet.

“I would recommend it as a tea or tablet formulation, and I recommend taking them twice a day usually — especially in the morning. Then, we can taper up or down and see the effect after about a month,” Fiorella said. She added that for particularly sensitive patients, she prefers using teas because tea powders allow for lower dosages, reducing the severity of any potential negative reactions. “Especially if [people are] feeling stressed with not enough energy, this would be a great herb to add,” Fiorella explained.

Using too much won’t cause any serious side effects — like an overproduction of testosterone — but you would likely experience heartburn quickly. If you overuse ashwagandha, you may also notice irritability or loose stool.

So, is ashwagandha worth the hype?

Well, if you see ashwagandha as a “miracle drug” or a “cure-all” fix, you may have overestimated its usefulness. But, if you see ashwagandha as a multifaceted, complex herbal supplement with some great benefits, you’re right on track.

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C. diff is the name of a common, easily transmittable infection caused by the bacterium Clostridioides difficile. The infection causes your colon (bowel) wall to become inflamed, resulting in severe, watery diarrhea. Left untreated, it can cause a serious complication called toxic megacolon.

C. diff affects about 250,000 people in the United States every year. Some people get it only once in their lifetime, but if you have a C. diff infection, there is up to a 1 in 4 chance you might relapse (the same infection returns) or get it again within eight weeks. People at the highest risk for a C. diff infection are those who take or have recently taken antibiotics, especially if they have a weak immune system.

The bacteria live in feces (poop), and in soil and water. They spread easily and can live for a long time on hard and soft surfaces, like linens and clothing. If someone who has C. diff on their hands touches a door handle and you touch it after, the bacteria transfer to your hand. They then can enter your gastrointestinal system if you touch your mouth or handle food before washing your hands.

Protect yourself and others from getting a C. diff infection in a healthcare setting

hand washing in a hospital

If you are a patient in a hospital, skilled nursing facility or rehabilitation center, you are at higher risk of getting a C. diff infection — not just because you likely have a weak immune system from the condition that put you in the facility but also because of the number of people you may encounter while you’re there.

Here are some steps you can take to lower the risk of getting C. diff in a healthcare facility:

  1. Make sure all healthcare workers and visitors wash their hands before they touch you and your things. If you don’t see them wash their hands, ask them to do so.
  2. Wash your hands well with soap and water every time you use the bathroom. If you use a bedside commode, ask to be transported to a sink to wash your hands or use a waterless hand sanitizer.
  3. Wash your hands before eating or drinking. If you can’t get to a sink, ask the staff or a friend to supply you with a waterless hand sanitizer to use while you are in bed or sitting in your chair.
  4. Allow cleaning staff access to your environment. Clear everything off the bedside table or nightstand, and remove clothing or linens from the bedside rails so they can be wiped down.

Patients with a diagnosed C. diff infection should not share a room with someone who does not have the infection. If you do share a room and your roommate contracts C. diff, ask to be moved.

Stop the spread of C. diff at home

household cleaning supplies

C. diff doesn’t just affect people in healthcare facilities. It can happen at home, too.

Here are steps you can take to reduce the risk of spreading C. diff at home:

  1. If your home has a second bathroom, reserve one for the person with the C. diff infection to limit exposure to others.
  2. If your home has only one bathroom, make sure the toilet seat, flusher, faucets, light switches and doorknob are cleaned with a bleach-based cleaner after each use.
  3. If the infected person is immobile, keep waterless hand sanitizer within reach.
  4. Clean common home surfaces (door knobs, light switches, fridge handles, etc.).
  5. Wash clothing (especially underwear), towels and linens separately and in the hottest water possible.
  6. Wear disposable gloves while handling clothing and linens, especially if the person is incontinent (loses control of their bowels). Wash your hands after removing the gloves.
  7. Shower with soap to remove C. diff that may be on the skin.

This educational resource was created with support from Seres Therapeutics and Nestle Health Science.