Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects nearly 1 million people in the United States, with prevalence expected to rise to over 1.2 million by 2030 as the population ages [1]. PD is characterized by the loss of dopamine-producing neurons in the brainstem, leading to motor symptoms such as tremors, rigidity, and postural instability [2, 3].
Currently available treatments can only temporarily alleviate symptoms, highlighting the crucial need for neuroprotective therapies that slow or stop disease progression. One promising natural compound is ashwagandha, an herb used in Ayurvedic medicine. Ashwagandha contains withanolides that have antioxidant, anti-inflammatory, and neuroprotective properties [4].
Preclinical studies demonstrate that ashwagandha protects dopamine neurons, improves motor deficits, and reverses key pathological changes associated with PD in animal models [5, 6]. Although clinical trials are still lacking, these preliminary findings indicate ashwagandha has potential as an adjunct therapy to support conventional PD treatment.
This article summarizes the existing scientific literature on the neuroprotective mechanisms of ashwagandha and evaluates its therapeutic potential in Parkinson’s disease management. Larger scale human studies are warranted to further elucidate the clinical efficacy and safety of ashwagandha for alleviating motor symptoms and slowing disease progression in PD patients.
Benefits of Ashwagandha for Parkinson’s disease:
- Parkinson’s disease is characterized by the progressive degeneration of dopaminergic neurons in the nigrostriatal system, leading to an imbalance in neurotransmitters. Various factors, such as genetics, toxins, infections, oxidative stress, and reduced growth factors, contribute to the deterioration of these cells. While the disease is slightly more prevalent in men, it is suggested that estrogen may have a protective role [5].
- Studies have indicated that Ashwagandha can have positive effects on biochemical parameters in Parkinson’s disease. When administered orally, Ashwagandha extract has shown the ability to normalize dopamine levels and reduce markers of oxidative stress in the striatum [6,7].
- Withanolide A, found in Ashwagandha, has demonstrated potential in mitigating proteopathies by decreasing α-synuclein levels by 38% in a Parkinson’s disease model using NL5901 Caenorhabditis elegans. These findings suggest the potential benefits of withanolide A for individuals with Parkinson’s disease [8].
- While Ubisol-Q10 has shown efficacy in targeting oxidative stress, mitochondrial dysfunction, and impaired autophagy, there remains the possibility of ongoing neuroinflammation. Therefore, combining Ubisol-Q10 with another well-tolerated natural product that can specifically target neuroinflammation may be more beneficial. Ashwagandha root extracts have garnered recent research interest as a potential treatment for neurological diseases and disorders. Ashwagandha, a plant belonging to the nightshade family, has been traditionally used in Ayurvedic medicine as a nerve tonic for conditions such as general debility, nervous exhaustion, insomnia, and memory impairment [9].
- Previous studies have indicated that various root extracts of ashwagandha possess the ability to target oxidative stress and neuroinflammation. The protective compounds in ashwagandha, such as steroidal lactones and saponins (withanolides and sitoinosides), are believed to act as antioxidants, aid in axonal regeneration, and target specific inflammatory activators [9].
These findings indicate that Ashwagandha shows promise as a potential therapeutic option for Parkinson’s disease, as it has demonstrated the ability to improve biochemical markers and alleviate motor symptoms. However, additional research is necessary to determine the optimal dosage and gain a comprehensive understanding of the underlying mechanisms responsible for its effects.
FDA prescribed medications- Possible side-effects
In recent years, there have been significant advancements in the treatment of Parkinson’s disease, leading to notable improvements in the lives of individuals with the condition. Scientists have developed new drugs and gained a better understanding of how to optimize the use of existing treatments.
These advancements have had a profound impact on the daily lives of people living with Parkinson’s. For most individuals, relief from Parkinson’s symptoms can be achieved through medication. However, in cases where medication becomes less effective, surgical interventions may be necessary. The choice of medication in the early stages of the disease can greatly influence its progression over time.
Therefore, it is crucial to collaborate with a neurologist or Parkinson’s specialist who can provide guidance on treatment decisions tailored to your specific needs. The following is a comprehensive list of Parkinson’s medications approved for use in the United States. It is important to note that this information is intended for informational purposes only and should not be used as a substitute for medical advice. It is essential to work closely with your physician to determine the most suitable medications for your condition, taking into account the associated risks and benefits of each option.
| Generic Name | Side-effects |
| Carbidopa-levodopa | Nausea, dizziness, orthostatic hypotension, anxiety, dyskinesia, confusion, hallucinations, somnolence. |
| Levodopa Inhalation Powder | |
| Opicapone | |
| Entacapone | Nausea, dizziness, orthostatic hypotension, anxiety, dyskinesia, confusion, hallucinations, somnolence, diarrhea, discoloration of body fluids. |
| Carbidopa-levodopa Entacapone | |
| Tolcapone | Nausea, dizziness, orthostatic hypotension, anxiety, dyskinesia, confusion, hallucinations, somnolence, diarrhea, discoloration of body fluids, elevated liver function enzymes. |
| Pramipexole | Nausea, dizziness, orthostatic hypotension, swelling of ankles, dyskinesia, hallucinations, confusion, somnolence, sleep attacks, impulse control disorders. |
Ropinirole | |
| Apomorphine | Nausea, dizziness, orthostatic hypotension, swelling of ankles, dyskinesia, hallucinations, confusion, somnolence, sleep attacks, impulse control disorders, skin reaction at patch site (if transdermal patch is used). |
| Selegiline | Insomnia. Dizziness, nausea, gastrointestinal upset, dyskinesia, hallucinations, confusion, headache. |
| Rasagline | |
| Safinamide | |
| Amantadine | Hallucinations, leg swelling, dizziness, mottled skin (livedo reticularis), confusion, dry mouth and eyes, constipation, dizziness, orthostatic hypotension, somnolence. |
| Istradefylline | Dizziness, constipation, nausea, dyskinesia, hallucination and sleeplessness |
| Trihexyphenidyl | Dry mouth and eyes, constipation, urinary retention, memory impairment, confusion, depression, hallucinations. |
| Benztropine |
Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s, affecting 1% of the population by the age of 65 and 4–5% of the population by the age of 85 [16,17]. Parkinson’s disease is caused by the loss of dopaminergic neurons in the substantia nigra pars compacta region of mid-brain [18] resulting in the reduction of dopamine level [19]. Various factors such as age, genetic and environmental exposure are associated with the onset and progression of PD [19,20 ]
Ashwagandha: Recommended dosage
The recommended dosage of ashwagandha and how it is used can vary depending on the condition being treated. It’s important to note that there is no standardized dosage based on modern clinical trials [10]. Studies have used different dosages, with some suggesting that a daily intake of 250–600 mg may help reduce stress, while higher dosages have been used in other studies [10].
Ashwagandha is available in various forms, including capsules, powder, and liquid extract. Capsules typically contain doses ranging from 250 to 1,500 mg of ashwagandha. However, taking high doses of ashwagandha can potentially lead to unpleasant side effects. Therefore, it is advisable to consult with a healthcare professional to ensure safety and determine the appropriate dosage when considering herbal supplements like Ashwagandha.
Side-effects of Ashwagandha
While ashwagandha is generally well-tolerated in small-to-medium doses, there is limited evidence from long-term studies regarding its potential side effects. Taking large amounts of ashwagandha may result in digestive upset, diarrhea, nausea, and vomiting, possibly due to irritation of the intestinal mucosa [11].
Pregnant women should avoid using ashwagandha as it may cause fetal distress and premature labor. Additionally, it’s important to note that Ayurvedic herbs, including ashwagandha, are not regulated by the FDA in the same way as pharmaceutical companies and food producers. This lack of regulation raises concerns about potential contaminants such as heavy metals and the accuracy of product labelling.
To ensure the safety and quality of herbal products, it is recommended to research the manufacturer before making a purchase. The National Center for Complementary and Integrative Health advises that some Ayurvedic products have been found to contain levels of lead, mercury, and arsenic that exceed acceptable limits for daily human intake [12]. Being informed about the manufacturer’s reputation and quality control practices can help mitigate potential risks associated with herbal supplements.
Efficacy of Ashwagandha in treatment of Parkinson’s disease
Ashwagandha, a revered herb in the Indian Ayurvedic system of medicine, has been traditionally used as a nervine tonic and for treating various diseases. It contains numerous active components, including withaferin A, known for its potent antioxidant properties. Several scientific studies have been conducted to explore the efficacy of ashwagandha in the treatment of Parkinson’s disease, yielding promising results. The findings of these studies are summarized below for reference [13].
Index | Findings |
| Oxidative stress | Ashwagandha demonstrated a significant improvement in reducing oxidative stress, which is known to contribute to the progression of Parkinson’s disease. |
| Psychological abnormalities | The use of ashwagandha was associated with significant improvements in psychological abnormalities commonly observed in Parkinson’s disease, suggesting a positive impact on mental well-being. |
| Motor Control and Body Movement | Ashwagandha showed significant improvements in motor control and body movement, which are often impaired in individuals with Parkinson’s disease. |
| Apoptosis (Cell death) | Ashwagandha exhibited a significant decrease in apoptosis, a process of cell death that is increased in Parkinson’s disease, indicating potential neuro-protective effects. |
These findings highlight the potential benefits of ashwagandha in alleviating various aspects of Parkinson’s disease. However, it is important to note that further research is still needed to better understand the underlying mechanisms and determine the optimal dosage and treatment regimen. Individuals considering ashwagandha or any other treatment for Parkinson’s disease should consult with healthcare professionals for personalized guidance and comprehensive management of the condition.
FAQs
Here are some frequently asked questions about the potential benefits of ashwagandha in Parkinson’s disease:
Q: What is ashwagandha?
A: Ashwagandha (Withania somnifera) is an herb used in Ayurvedic medicine. It contains withanolides that have neuroprotective, anti-inflammatory, and antioxidant properties.
Q: How might it help with Parkinson’s symptoms?
A: Animal studies show ashwagandha protects dopamine neurons, improves motor skills, and reverses biochemical changes seen in Parkinson’s. It may also reduce inflammation and oxidative damage in the brain.
Q: What’s the recommended dosage?
A: There is no standard dosage. But most studies showing benefits have used 300-500 mg of high-quality extract once or twice daily. Consult an experienced herbalist or neurologist.
Q: How long before noticing any effects?
A: It may take 4-8 weeks of consistent use to notice benefits. Maximum effects may take several months. Patience is needed when using herbs for chronic conditions.
Q: What are the potential side effects?
A: Ashwagandha is generally well tolerated. High doses may cause nausea, diarrhea or drowsiness. Avoid in pregnancy or with medications for thyroid disorders, diabetes or autoimmunity.
Q: Can it be taken with Parkinson’s medications?
A: There are no known negative interactions with Parkinson’s drugs. However, check with your doctor before combining ashwagandha with prescription medications as a precaution.
Q: Is the evidence strong enough to recommend it?
A: More clinical trials are still needed, but early research is promising. Consult a doctor before trying ashwagandha. While not a cure, it may provide neuroprotective and symptomatic benefits.
In summary, ashwagandha is a herb with potential to support conventional treatment for Parkinson’s disease. Large scale studies on humans are still required to confirm benefits.
References
- Parkinson’s Foundation. Understanding Parkinson’s – Statistics. Retrieved from https://www.parkinson.org/understanding-parkinsons/statistics
- Dauer W, Przedborski S. Parkinson’s Disease: Mechanisms and Models. Neuron. 2003, 39(6). 889-909.
- Singh C, Ahmad I, Kumar A. Pesticides and metals induced Parkinson’s disease: involvement of free radicals and oxidative stress. Cell and Molecular Biology. 2007, 53(5). 19-28
- World Health Organization. Fact Sheet: Parkinson’s Disease. Retrieved from https://www.who.int/news-room/fact-sheets/detail/parkinson-disease
- Zaja˛c, M.; Jelin´ska, A.; Muszalska, I.C. Chemia Leków z Elementami Chemii Medycznej dla Studentów Farmacji i Farmaceutów; Uniwersytet Medyczny im. Karola Marcinkowskiego: Poznan, Poland, 2018.
- RajaSankar, S.; Manivasagam, T.; Sankar, V.; Prakash, S.; Muthusamy, R.; Krishnamurti, A.; Surendran, S. Withania somnifera root extract improves catecholamines and physiological abnormalities seen in a Parkinson’s disease model mouse. J. Ethnopharmacol. 2009, 125, 369–373.
- De Rose, F.; Marotta, R.; Poddighe, S.; Talani, G.; Catelani, T.; Setzu, M.D.; Solla, P.; Marrosu, F.; Sanna, E.; Kasture, S. Functional and morphological correlates in the Drosophila LRRK2 loss-of-function model of Parkinson’s disease: Drug effects of Withania somnifera (Dunal) administration. PLoS ONE 2016, 11, e0146140.
- Akhoon B.A., Pandey S., Tiwari S., Pandey R. Withanolide A offers neuroprotection, ameliorates stress resistance and prolongs the life expectancy of Caenorhabditis elegans. Exp. Gerontol. 2016;78:47–56.
- Kuboyama, T.; Tohda, C.; Komatsu, K. Effects of Ashwagandha (Roots of Withania somnifera) on neurodegenerative diseases. Biol. Pharm. Bull. 2014, 37, 892–897.
- Salve, J., Pate, S., Debnath, K., & Langade, D. (2019). Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study. Cureus, 11(12), e6466. https://doi.org/10.7759/cureus.6466
- LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Ashwagandha. [Updated 2019 May 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548536/
- https://www.nccih.nih.gov/health/ayurvedic-medicine-in-depth
- Singh N, Rai SN, Singh D, Singh SP (2015) Withania somnifera shows ability to counter Parkinson’s Disease: An Update. SOJ Neural 2(2), 1-4. DOI: http://dx.doi,org/10.15226/2374-6858/2/2/00120