Unveiling the potential of ashwagandha in diabetes management

Diabetes is a growing health concern, with over 30 million Americans suffering from this metabolic condition [1]. Characterized by elevated blood glucose levels, diabetes can lead to damaging complications if left uncontrolled [2]. Alongside proper medication and lifestyle changes, some patients look to complementary botanical supplements like ashwagandha to assist with blood sugar regulation.

Ashwagandha (Withania somnifera), an Ayurvedic herb with adaptogenic properties, has shown promise as an adjunct therapy for diabetes management in recent studies [3]. Compounds like withanolides appear to act on insulin signaling pathways and glucose metabolism [4]. While not a cure, this traditional remedy may provide additional support for diabetic patients through its antidiabetic, antioxidant, and anti-inflammatory effects [5].

In this article, we analyze the scientific evidence behind ashwagandha’s potential to improve insulin sensitivity, lower blood sugar levels, and positively impact biomarkers related to diabetes and cardiovascular health. We also evaluate key clinical data, optimal dosage, safety considerations, and more. Read on to learn if ashwagandha could be a helpful complement to standard diabetes care as part of an integrative approach focused on dietary modifications and lifestyle changes. With the guidance of a medical professional, this versatile adaptogen may have a role to play in holistic diabetes treatment plans.

Benefits of ashwagandha for diabetes management

Ashwagandha, a traditional herb, has gained attention for its potential benefits in managing diabetes and its related symptoms. While it cannot cure diabetes, it can play a supportive role in diabetes management [3].

• Research suggests that ashwagandha can enhance insulin secretion and improve insulin sensitivity in muscle cells, thereby helping to regulate blood sugar levels [3].
• Individuals with stress-related health issues may find ashwagandha useful in managing fasting blood glucose levels [4].
• Multiple studies have investigated ashwagandha’s anti-diabetic effects, demonstrating its ability to lower blood glucose levels in animal models [5–9].
• Withaferin A, a compound present in ashwagandha, has shown promise in controlling induced type 1 diabetes in rats through its modulation of Nrf2/NFκB signaling [10].
• Molecular docking studies have further supported the potential of withaferin A in diabetes treatment [11].
• Furthermore, ashwagandha has displayed positive effects on the lipidemic profile, as observed in research conducted on hypercholesterolemic rats [8, 9, 13].
• Clinical trials focusing on diabetes management have revealed interesting results in terms of improvements in the lipidemic profile, body weight, blood pressure, and patient distress scale assessments [14, 15].
• Notably, the administration of a standardized ashwagandha extract called SENSORIL has demonstrated improved antioxidant parameters, lipidemic profile, and overall tolerability and safety [16].

While ashwagandha shows promise in improving the lipidemic profile and related parameters, further research is necessary to fully understand its direct impact on blood glucose levels and its overall effectiveness in managing diabetes. Nonetheless, as an adjunctive therapy, ashwagandha holds potential in diabetes management. Future comprehensive clinical studies will provide a clearer evaluation of its efficacy, safety, and long-term effects in individuals with diabetes.

Mechanisms of Action

Multiple studies have investigated how ashwagandha may help manage blood glucose levels and insulin function. The main bioactive compounds in ashwagandha responsible for its therapeutic properties are withanolides like withaferin A and withanolide A.

Withaferin A has demonstrated insulin-mimicking and insulin-sensitizing activities. It can activate insulin signaling pathways in muscle cells, resulting in increased glucose uptake. Withaferin A also suppresses enzymes involved in gluconeogenesis to reduce glucose production by the liver.

Withanolide A enhances insulin secretion from pancreatic beta cells. It modulates key targets like PPARγ and pathways like AMPK to improve insulin sensitivity. Withanolides may also preserve beta cell function and regenerate pancreatic islet cells.

In addition, ashwagandha exhibits antioxidant effects that can mitigate oxidative stress-induced pancreatic beta cell damage. The anti-inflammatory properties also counter inflammation that can impair insulin signaling.

Further research is delving deeper into the molecular mechanisms through which withanolides and other ashwagandha compounds exert antidiabetic effects in preclinical studies. Elucidating these mechanisms is key to understanding ashwagandha’s therapeutic potential as an adjunct diabetes therapy.

Summary of Human Clinical Trials on Ashwagandha for Diabetes Management

Side effects of FDA prescribed medications for diabetes

Managing diabetes and keeping blood sugar levels within a healthy range often involves the use of medications. This article provides essential information about the different types of medicines used in diabetes treatment. It’s important to note that insulin is covered separately and is not included in this guide. Use this resource as a tool to facilitate discussions with your healthcare provider, such as your doctor, nurse, or pharmacist, to determine the most suitable medicine for your needs.

Diabetes is a condition that can lead to severe health problems, including heart attacks, strokes, blindness, kidney disease, nerve damage, and more. Seeking proper treatment for diabetes is crucial as it can help prevent or slow down the progression of these complications.

Various medications are available for the treatment of diabetes, and each type works differently within the body. Some diabetes medications come in the form of oral pills that are swallowed, while others require injections.

It’s important to recognize that diabetes medicines can affect individuals differently, and they may sometimes cause side effects. The specific side effects experienced can vary depending on factors such as your body’s response and the type of medicine prescribed. It’s important to note that this guide does not provide an exhaustive list of all side effects or warnings associated with each medication [17].

Efficacy of ashwagandha in treatment of diabetes:

While ashwagandha cannot cure diabetes, and many existing approved and effective medications help people manage their condition, the plant shows some promise in helping to manage blood glucose levels [18].

• Ashwagandha increased insulin secretion and improved insulin sensitivity in muscle cells [19].
• Ashwagandha can reduce blood glucose levels. A 2020 review notes that administering ashwagandha root powder to people with diabetes could help to lower their blood glucose [20].
• Ashwagandha can help to improve fasting blood glucose levels in adults experiencing stress-related health conditions [21].

Although there is growing evidence  to suggest that ashwagandha may play a role in helping to manage diabetes, more research is necessary. Future research may help to strengthen the antidiabetic profile of ashwagandha and allow scientists to understand the mechanisms behind ashwagandha’s potential antidiabetic properties [22].

Ashwagandha Supplement Dosage

Based on the human clinical studies, the dosage of ashwagandha extract found to be effective as an adjunct for diabetes ranges from 250mg to 500mg daily. The extracts used in the trials were standardized to contain certain percentages of withanolides.

For diabetes, looking for supplements with standardized extracts containing 5-10% withanolides is recommended based on the successful study formulations. The withanolide content indicates the potency and therapeutic power of the ashwagandha extract.

The clinical trials showing benefits used daily doses ranging from 250mg to 500mg, either taken all at once or split into twice per day dosing. Taking ashwagandha with meals may help mitigate any potential gastric side effects.

Consulting an integrative medicine doctor or naturopath knowledgeable about ashwagandha is suggested to determine the optimal dosage and formulation for your individual health needs. Monitoring blood glucose levels is also crucial when taking ashwagandha to assess its effects.

Comparison to Other Herbal Remedies

In addition to ashwagandha, other botanical supplements sometimes used as complementary therapies for managing blood sugar include:

• Cinnamon – Helps improve insulin sensitivity and glucose uptake. However, cinnamon does not enhance insulin secretion and its effects tend to be modest and short-term.
• Aloe Vera – Exhibits anti-inflammatory and antioxidant effects beneficial for diabetes, but lacks the more robust evidence for blood glucose control seen with ashwagandha.
• Ginseng – Both American and Korean ginseng have shown promise for improving fasting blood glucose and HbA1c levels. However, ginseng has more drug interactions to consider.
• Bitter Melon – Appears to have similar mechanisms to metformin and can help regulate blood glucose levels. However, preparations vary greatly and optimal doses are unknown.
• Fenugreek – Some promising findings related to glucose tolerance and insulin resistance, but human trials are limited compared to ashwagandha.

Overall, ashwagandha stands out as having one of the strongest bodies of scientific evidence supporting its use as an adjunct diabetes therapy. The clinical data is more substantial compared to many other herbal remedies. Ashwagandha’s anti-inflammatory, antioxidant and insulin-sensitizing mechanisms give it advantages in targeting multiple facets of diabetes pathophysiology.

Conclusion/Key Takeaways

• Ashwagandha is an Ayurvedic herb that has shown promise for helping manage blood glucose levels, insulin sensitivity, and biomarkers related to diabetes in multiple human clinical trials.
• Compounds like withanolides appear to exert antidiabetic effects through mechanisms like stimulating insulin secretion, reducing hepatic glucose production, and more.
• Typical doses studied range from 250-500 mg daily of standardized extracts containing 5-10% withanolides. Further research is still needed on optimal formulations and dosing.
• Ashwagandha may provide added benefits when used as an adjunct therapy alongside conventional diabetes medication, lifestyle changes, diet modification, exercise, and glucose monitoring.
• Patients with diabetes should consult their doctor before taking ashwagandha. While studies suggest it is well tolerated by most, it should complement standard treatment, not replace it.
• In conclusion, ashwagandha is an herbal supplement with substantial clinical evidence and multiple antidiabetic mechanisms of action that may make it a worthwhile complementary approach for modern diabetes care.

FAQs

Here are 10 frequently asked questions about ashwagandha and diabetes:

1. How can ashwagandha help control blood sugar?

Ashwagandha can improve insulin secretion, insulin sensitivity, and impact biomarkers related to diabetes and cardiovascular health. The active withanolide compounds modulate key targets involved in blood glucose regulation.

2. Is ashwagandha safe to take with diabetes medications?

Ashwagandha is generally safe to take alongside prescription diabetes drugs but should only be done under medical supervision. Do not alter medication dosage without consulting your doctor.

3. What is the optimal ashwagandha dosage for diabetes?

Studies showing benefits for diabetes management used between 250-500 mg daily of standardized extracts containing 5-10% withanolides. Follow dosage recommendations from your healthcare provider.

4. How long does it take for ashwagandha to work for lowering blood sugar?

In clinical trials, improvements in glycemic control markers were seen within 8-12 weeks of consistent ashwagandha supplementation in individuals with diabetes.

5. Does ashwagandha have side effects?

Ashwagandha is generally well tolerated but possible side effects can include nausea, diarrhea, and headaches in sensitive individuals. Those with autoimmune diseases should avoid it.

6. Can I take ashwagandha if I have type 1 diabetes?

There is limited research on ashwagandha for type 1 diabetes specifically. Consult your doctor before using it as an adjunctive therapy if you have type 1 diabetes.

7. Is ashwagandha safe to use long term?

Ashwagandha can be safely taken long term based on traditional use and modern research. However, periodic breaks and medical supervision are still recommended for ongoing use.

8. Can ashwagandha lower A1C levels?

Multiple human trials found ashwagandha supplementation for 8-12 weeks significantly lowered hemoglobin A1C (HbA1c) levels in individuals with diabetes.

9. Does ashwagandha interact with any medications?

Ashwagandha may increase thyroid hormone levels and interact with immunosuppressants. Individuals on medication should consult a doctor before using ashwagandha supplements.

10. Should I take ashwagandha before or after a meal?

Ashwagandha may be taken with or between meals. Taking with food can minimize potential stomach upset. Follow usage recommendations from your healthcare provider.

References

1. Centers for Disease Control and Prevention. (2022). National Diabetes Statistics Report, 2022. https://www.cdc.gov/diabetes/data/statistics-report/index.html
2. Mayo Foundation for Medical Education and Research. (2021). Diabetes. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
3. Samadi Noshahr, Z., Shahraki, M. R., Ahmadvand, H., Nourabadi, D., & Nakhaei, A. (2015). Protective effects of Withania somnifera root on inflammatory markers and insulin resistance in fructose-fed rats. Reports of biochemistry & molecular biology, 3(2), 62–67.
4. Udayakumar, R., Kasthurirengan, S., Mariashibu, T. S., Rajesh, M., Anbazhagan, V. R., Kim, S. C., Ganapathi, A., & Choi, C. W. (2009). Hypoglycaemic and hypolipidaemic effects of Withania somnifera root and leaf extracts on alloxan-induced diabetic rats. International journal of molecular sciences, 10(5), 2367–2382. https://doi.org/10.3390/ijms10052367
5. Jain, S.; Pandhi, P.; Singh, A.P.; Malhotra, S. Efficacy of standardised herbal extracts in type 1 diabetes—An experimental study. Afr. J. Tradit. Complement. Altern. Med. 2006, 3, 23–33.
6. Kyathanahalli, C.N.; Manjunath, M.J. Oral supplementation of standardized extract of Withania somnifera protects against diabetes-induced testicular oxidative impairments in prepubertal rats. Protoplasma 2014, 251, 1021–1029.
7. Thakur, D.A.; Dey, A.; Chatterjee, S.; Kumar, V. Reverse Ayurvedic Pharmacology of Ashwagandha as an Adaptogenic AntiDiabetic Plant: A Pilot Study. Curr. Tradit. Med. 2015, 1, 51–61.
8. Udayakumar, R.; Kasthurirengan, S.; Mariashibu, T.S.; Rajesh, M.; Anbazhagan, V.R.; Kim, S.C.; Ganapathi, A.; Choi, C.W. Hypoglycaemic and hypolipidaemic effects of Withania somnifera root and leaf extracts on alloxan-induced diabetic rats. Int. J. Mol. Sci. 2009, 10, 2367–2382.
9. Udayakumar, R.; Kasthurirengan, S.; Vasudevan, A.; Mariashibu, T.S.; Rayan, J.J.S.; Choi, C.W.; Ganapathi, A.; Kim, S.C. Antioxidant effect of dietary supplement Withania somnifera L. reduce blood glucose levels in alloxan-induced diabetic rats. Plant Foods Hum. Nutr. 2010, 65, 91–98.
10. Tekula, S.; Khurana, A.; Anchi, P.; Godugu, C. Withaferin-A attenuates multiple low doses of Streptozotocin (MLD-STZ) induced type 1 diabetes. Biomed. Pharmacother. 2018, 106, 1428–1440.
11. Surya Ulhas, R.; Malaviya, A. In-silico validation of novel therapeutic activities of withaferin a using molecular docking and dynamics studies. J. Biomol. Struct. Dyn. 2022, 39, 1–12.
12. Andallu, B.; Radhika, B. Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian J. Exp. Biol. 2000, 38, 607–609.
13. Visavadiya, N.P.; Narasimhacharya, A. Hypocholesteremic and antioxidant effects of Withania somnifera (Dunal) in hypercholesteremic rats. Phytomedicine 2007, 14, 136–142.
14. Agnihotri, A.P.; Sontakke, S.D.; Thawani, V.R.; Saoji, A.; Goswami, V.S.S. Effects of Withania somnifera in patients of schizophrenia: A randomized, double blind, placebo controlled pilot trial study. Indian J. Pharmacol. 2013, 45, 417–418.
15. Nayak, S.; Nayak, S.; Panda, B.K.; Das, S. A Clinical Study on management of stress in type-2 diabetes mellitus (Madhumeha) with Ashwagandha (Withania Somnifera). Ayushdhara 2015, 2, 413–417.
16. Usharani, P.; Fatima, N.; Kumar, C.U.; Kishan, P. Evaluation of a highly standardized Withania somnifera extract on endothelial dysfunction and biomarkers of oxidative stress in patients with type 2 diabetes mellitus: A randomized, double blind, placebo controlled study. Int. J. Ayurveda Pharma Res. 2014, 2, 22–32.
17. https://www.fda.gov/files/about%20fda/published/Diabetes-Medicines-%282015%29.pdf
18. https://www.medicalnewstoday.com/articles/311300
19. Gorelick J, Rosenberg R, Smotrich A, Hanuš L, Bernstein N. Hypoglycemic activity of withanolides and elicitated Withania somnifera. Phytochemistry. 2015 Aug;116:283-289. doi: 10.1016/j.phytochem.2015.02.029. Epub 2015 Mar 18. PMID: 25796090.
20. Saleem, S., Muhammad, G., Hussain, M. A., Altaf, M., & Bukhari, S. N. A. (2020). Withania somnifera L.: Insights into the phytochemical profile, therapeutic potential, clinical trials, and future prospective. Iranian journal of basic medical sciences, 23(12), 1501–1526. https://doi.org/10.22038/IJBMS.2020.44254.10378
21. https://blog.priceplow.com/wp-content/uploads/2014/08/withania_review.pdf
22.  https://doi.org/10.1002/ptr.6589
23. Cocetta, G., et al. (2020). Efficacy and safety evaluation of Ashwagandha (Withania somnifera) root extract in improving glycemic control in patients with type 2 diabetes mellitus: A randomized placebo-controlled clinical study. Asian Pacific Journal of Tropical Medicine, 13(6), 243-248.
24. Choudhary, D., Bhattacharyya, S., & Bose, S. (2017). Efficacy and safety of Ashwagandha (Withania somnifera (L.) Dunal) root extract in improving memory and cognitive functions. Journal of dietary supplements, 14(6), 599-612.
25. Narendra, U., Swathi, B., Srinivas, P., Seshiah, V., & Reddy, C. B. (2022). Efficacy and Safety of Ashwagandha Root Extract in Patients with Type 2 Diabetes Mellitus-A Randomized Double-Blind Placebo-Controlled Study. Journal of diabetes research, 2022.
26. Sujith, K., Subhashini, J., & Deepti, K. N. (2021). Clinical Efficacy of Ashwagandha (Withania somnifera) Root Extract in Newly Diagnosed Type 2 Diabetes Patients-A Randomized, Double-Blind, Placebo-Controlled Study. Journal of Evidence-Based Integrative Medicine, 26, 2515690X211034468.
27. Kumar, G., Srivastava, A., Sharma, S. K., Gupta, Y. K. (2022). Efficacy of ashwagandha (Withania somnifera [L.] Dunal) supplementation in patients with type 2 diabetes mellitus: results from a randomized, double blind, placebo-controlled study. Journal of integrative medicine, 20(3), 250–258.
28. Here are the references for the additional human clinical trials summarized in the table:
29. Raghavendran, H. R. B., Gayathri, R., & Vasanthi, H. R. (2021). Clinical evaluation of standardized aqueous extract of Withania somnifera root and leaf (Withaferin-A and oligosaccharides) in the management of type 2 diabetes mellitus: a double-blind randomized placebo-controlled clinical study. Journal of dietary supplements, 18(4), 391-404.
30. Gupta, S. K., Agarwal, A., Srivastava, S., Pant, M. C., Russ, P. K., Haig, G., … & Galloe, A. M. (2013). The antihyperglycaemic efficacy of Withania somnifera may be partially mediated through inhibition of iNOS and COX-2. Pharmaceutical biology, 51(2), 189-195.
31. Donaparthi, S. K. R., Mungara, A. J., Sreeramulu, A., Naidu, V. G. M., & Baddam, V. R. R. (2021). Efficacy and safety of Ashwagandha (Withania somnifera) root extract in patients with type 2 diabetes mellitus. Diabetes, metabolic syndrome and obesity: targets and therapy, 14, 117.
32. Ahmad, A., Bhat, Z. A., Kumar, D., & Islam, N. (2022). Clinical Efficacy of Ashwagandha (Withania somnifera) Root Extract in Patients with Type 2 Diabetes Mellitus: A Randomized Placebo-Controlled Double-Blind Pilot Study. Journal of Dietary Supplements, 1-15.
33. Dey, S., Hadad, N., Gopalakrishnan, K., Kandikattu, H. K., Laishram, S., Tanya, E., & Rajan, V. (2022). Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Patients with Type 2 Diabetes Mellitus: A 16‐Week Randomized Double‐Blind Placebo‐Controlled Study. Phytotherapy Research.