Introduction about Ashwagandha

Ashwagandha (Withania Somnifera) has become one of the most popular herbs in use in the Western world. And it is no wonder, with all the benefits that Ashwagandha has to offer! Ashwagandha has been used for thousands of years as a rasāyana (rejuvenative) and an adaptogenic herb, meaning that it is used to help the body resist physiological and psychological stress.


Ashwagandha, a small evergreen shrub, is widely cultivated in India and the Middle East for its medicinal properties. It has also been found in parts of Africa.


An erect, grayish plant with long roots, ashwagandha has small greenish flowers and fruits that are orange-red when ripe. Traditionally, ashwagandha has been used in many ways--as a sedative, a diuretic, a rejuvenating tonic, an anti-inflammatory agent, and as an "adaptogen" (endurance enhancer).


Ashwagandha is commonly used in its powdered form, which is made from the whole plant and the root alone. Consult your health-care provider about appropriate dosages for the different forms of the herb.


Ashwagandha is a plant. The root and berry are used to make medicine.


Ashwagandha has a lot of uses. But so far, there isn’t enough information to judge whether it is effective for any of them.


Ashwagandha is used for arthritis, anxiety, trouble sleeping (insomnia), tumors, tuberculosis, asthma, a skin condition marked by white patchiness (leukoderma), bronchitis, backache, fibromyalgia, menstrual problems, hiccups, and chronic liver disease.


Ashwagandha is also used as an “adaptogen” to help the body cope with daily stress, and as a general tonic.


Some people also use ashwagandha for improving thinking ability, decreasing pain and swelling (inflammation), and preventing the effects of aging. It is also used for fertility problems in men and women.


Ashwagandha is applied to the skin for treating wounds, backache, and one-sided paralysis (hemiplegia).


The name Ashwagandha is from the Sanskrit language and is a combination of the word ashva, meaning horse, and gandha, meaning smell. The root has a strong aroma that is described as “horse-like.”


In Indian, and Unani medicine, ashwagandha is described as “Indian ginseng.” Ashwagandha is also used in traditional African medicine for a variety of ailments.


Don’t confuse ashwagandha with Physalis alkekengi. Both are known as winter cherry.


How does it work?

Ashwagandha contains chemicals that might help calm the brain, reduce swelling (inflammation), lower blood pressure, and alter the immune system.



Health Benefits

Antioxidant properties

Researchers from Banaras Hindu University in Varanasi, India, have discovered that some of its chemicals are powerful antioxidants. They tested these compounds for their effects on rat brain and found an increase in the levels of three natural antioxidants — superoxide dismutase, catalase and glutathione peroxidase. They say, “The antioxidant effect of active principles may explain, at least in part, the reported anti-stress, cognition-facilitating, anti-inflammatory and anti-aging effects produced by them in experimental animals, and in clinical situations.


Anti-anxiety herb

In rodent studies the herb has been shown to reduce anxiety and have a positive effect on mood.


“Do you know whether this herb can act as a stimulant (e.g., in the manner of some forms of ginseng)? I recently tried using ashwagandha to help treat my anxiety and depression, and found that my symptoms may have been exacerbated by its use. I experienced a “wired, edgy” feeling that intensified my feelings of anxiety and depression.”


This could be dose dependent. We have learned that high dosages of ashwagandha can cause a feeling of being restless, but you may try a third of a capsule and this way you may notice more of the relaxing effect rather than the stimulation effect. Another option is to use plain herb as opposed to a concentrated extract.


Some more health benefits facts

It is difficult to draw firm conclusions about the significance of ashwagandha for humans, because most studies so far have been limited to test tubes or animals. Extensive research has been done over the decades, however, mostly in India, to identify the herb's chemical nature and potential benefits. These studies have shown that ashwagandha does have anti-inflammatory, anti-stress, and immune-boosting properties.


Various chemical constituents of the herb have shown a number of therapeutic effects. Because ashwagandha has traditionally been used to treat various diseases associated with nerve tissue damage related to the destructive molecules known as free radicals, some researchers speculate that the herb may have antioxidant properties.


Free-radical damage plays a role in normal aging, and in such neurological conditions as epilepsy, Parkinson's disease, and Alzheimer's disease. One reason for ashwagandha's reputation as a general energy-promoting, disease-preventing tonic may be its effect on the immune system.


Multiple studies have shown significant increases in white blood cell counts and other measures of strengthened immunity in rodents given ashwagandha or certain chemicals extracted from the herb.


Ashwagandha also has a mild sedative effect on the central nervous system, and has been shown in animal studies to be a muscle relaxant. No studies have been done to determine appropriate human uses for these effects, however, so caution is advised. As a central nervous system depressant, or tranquilizer, the herb should be used in moderation.


Specifically, taken with the advice of an experienced herbalist, ashwagandha may help to:



Antibacterial research studies

Antibacterial efficacy of Withania somnifera (ashwagandha) an indigenous medicinal plant against experimental murine salmonellosis.

Phytomedicine. 2005 Mar.

We evaluated the antibacterial activity of ashwagandha root and leaves, against pathogenic bacteria. Both aqueous as well as alcoholic extracts of the ashwagandha plant (root as well as leaves) were found to possess strong antibacterial activity against a range of bacteria including Salmonella typhimurium. Moreover, in contrast to the synthetic antibiotic (viz. chloramphenicol), ashwagandha extracts did not induce lysis on incubation with human erythrocytes, advocating their safety to the living cells. Finally, the antibacterial efficacy of the ashwagandha extracts isolated from plant (both root and leaves) was determined against experimental salmonellosis in Balb/C mice. Oral administration of the aqueous extracts successfully obliterated salmonella infection as revealed by increased survival rate as well as less bacterial load in various vital organs of the treated animals.


Blood sugar

One small study found ashwagandha root was able to reduce blood sugar and cholesterol levels, and had a diuretic effect.


Brain health

Ashwagandha is used in India to treat mental deficits in geriatric patients, including amnesia. Researchers from the University of Leipzig in Germany wanted to find out which neurotransmitters were influenced by the herb. After injecting some of the chemicals in ashwagandha into rats, they later examined slices of their brain and found an increase in acetylcholine receptor activity. The researchers say, “The drug-induced increase in acetylcholine receptor capacity might partly explain the cognition-enhancing and memory-improving effects observed in animals and humans.


A study done in 1991 at the Department of Pharmacology, University of Texas Health Science Center indicated that extracts of ashwagandha had GABA-like activity. This may account for this herb’s anti-anxiety effects.


A 2002 laboratory study indicates ashwagandha extract stimulates the growth of axons and dendrites. A 2001 study in rodents showed the extract had memory boosting ability. A 2000 study with rodents showed it to have anti-anxiety and anti-depression effects.


More benefits

Ashwagandha is used to tone, support, and revitalize bodily functions. It has been revered over time for its ironic dual capacity to energize and calm at the same time. Stress can cause fatigue, often manifesting as “hyper” signs like agitation and difficulty sleeping. By providing a nourishing, energizing effect, you can support a healthy nervous system. When the stress doesn’t impact the nervous system as strongly, the “hyper” signs will naturally resolve over time, allowing for a calming effect. This quality of Ashwagandha makes it a prime supplement to use in the toning and rejuvenation process.


In addition to its dual energizing/calming effect, Ashwagandha offers a number of benefits:



Cancer

Withaferin A is a potent inhibitor of angiogenesis (new blood vessel growth). Angiogenesis 2004.


Growth inhibition of human tumor cell lines by withanolides from ashwagandha leaves.

Life Sci. 2003 Nov 21.

The leaves of ashwagandha are used in the treatment of tumors and inflammation in several Asian countries. We have isolated twelve withanolides from the leaves of this species. Compounds were tested for their anti-proliferative activity lung, colon, central nervous system and breast human tumor cell lines. Withaferin A and its derivatives exhibited inhibitory concentrations. Viscosalactone B showed the 50% inhibition. Therefore, incorporation of ashwagandha in the diet may prevent or decrease the growth of tumors in human.


Diabetes and high blood sugar

Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root.

Indian J Exp Biol. 2000.

Hypoglycemic, diuretic and cholesterol lowering effects of roots of ashwagandha were assessed on human subjects. Six mild non insulin dependent subjects and six mild high cholesterol subjects were treated with the powder of roots of ashwagandha for 30 days. Decrease in blood glucose was comparable to that of an oral hypoglycemic drug. Significant increase in urine sodium, urine volume, significant decrease in serum cholesterol, triglycerides, LDL (low density lipoproteins) and VLDL (very low density lipoproteins) cholesterol were observed indicating that this plant is a potential source of hypoglycemic, diuretic and hypocholesterolemic agents.


Heart attack

Cardioprotection from ischemia and reperfusion injury by ashwagandha.

Mol Cell Biochem. 2004.

The efficacy of ashwagandha to limit myocardial injury after ischemia and reperfusion was explored and compared to that of Vitamin E, a reference standard known to reduce mortality and infarct size due to myocardial infarction. Ashwagandha on chronic administration markedly augmented antioxidants (glutathione, glutathione peroxidase, superoxide dismutase, catalase) while Vitamin E did not stimulate the synthesis of endogenous antioxidants compared to sham. Results indicate that it significantly reduced myocardial injury and emphasize its beneficial action as a cardioprotective agent.


Lymphoma

Anticarcinogenic activity of Withania somnifera Dunal against Dalton's Ascitic Lymphoma.

J Ethnopharmacol. 2004.

The effect of ethanolic extract of ashwagandha root against Dalton's Ascitic Lymphoma has been evaluated in Swiss albino mice. A significant increase in the life span and a decrease in the cancer cell number and tumour weight were noted in the tumour-induced mice after treatment. These observations are suggestive of the protective effect of ashwagandha extract in Dalton's Ascitic Lymphoma.


Nerve cell growth

Axon- or dendrite-predominant outgrowth induced by constituents from Ashwagandha.

Kuboyama T.. Neuroreport. 2002.

We previously reported that the methanol extract of Ashwagandha (roots of Dunal) induced dendrite extension in a human neuroblastoma cell line. In this study, we found that compounds isolated from the methanol extract enhanced neurite outgrowth in human neuroblastoma SH-SY5Y cells.


Modern Research

Ashwagandha has become of interest to a number of researchers, particularly as it grows in popularity.



Nitric oxide production

Induction of nitric oxide synthase expression by ashwagandha in macrophages.

Iuvone T, Esposito G, Life Sci. 2003.

Ashwagandha may induce the synthesis of inducible nitric oxide synthase expression likely by acting at transcriptional level. The increased nitric oxide production by macrophages could account, at least in part, for its immune stimulating properties.



Ashwagandha side effects, safety, risk, danger

Ashwagandha herb does not seem to have any significant side effects but long term studies are not yet available to determine ashwagandha side effects from chronic use. Nevertheless, it is best to take breaks from use. For instance, one can take a week off each month or take it 3 or 4 times a week as opposed to daily. There is one case report from Holland of a person taking high doses for prolonged periods who ended up with excessive thyroid hormone production.


Ashwagandha is POSSIBLY SAFE when taken by mouth short-term. The long-term safety of ashwagandha is not known. Large doses of ashwagandha might cause stomach upset, diarrhea, and vomiting.


It’s not known whether it’s safe to apply ashwagandha directly to the skin.


Special Precautions & Warnings

Pregnancy and breast-feeding: Do not use ashwagandha if you are pregnant. It is rated LIKELY UNSAFE during pregnancy. There is some evidence that ashwagandha might cause miscarriages. Not enough is known about the use of ashwagandha during breast-feeding. Stay on the safe side and avoid use.


Stomach ulcers: Ashwagandha can irritate the gastrointestinal (GI) tract. Don’t use ashwagandha if you have a stomach ulcer.


Auto-immune diseases” such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Ashwagandha might cause the immune system to become more active, and this could increase the symptoms of auto-immune diseases. If you have one of these conditions, it’s best to avoid using ashwagandha.


Surgery: Ashwagandha may slow down the central nervous system. Healthcare providers worry that anesthesia and other medications during and after surgery might increase this effect. Stop taking ashwagandha at least 2 weeks before a scheduled surgery.


Effect on thyroid gland

“My name is Rudger Hogeveen, from Netherlands, am a medical student in Holland. Recently I read an article in a Dutch medical journal regarding ashwagandha and thyroid gland. In this journal was a case report about an patient who had thyrotoxicosis after chronic ashwagandha supplement use.” Ned Tijdschr Geneeskd. 2005: [ Thyrotoxicosis following the use of ashwagandha ] van der Hooft CS, Hoekstra A, Winter A, de Smet PA, Stricker BH. Inspectie voor de Gezondheidszorg, sectie Geneesmiddelenbewaking, Postbus Den Haag.


A 32-year-old healthy woman developed thyrotoxicosis while taking capsules that contained ashwagandha herbal extract for symptoms of chronic fatigue. She was not taking any other remedies or medications. During the first few weeks, she took the capsules only occasionally without any symptoms, but after increasing the dose, she experienced clinical symptoms indicative of thyrotoxicosis. This was confirmed by laboratory assessment. The symptoms resolved spontaneously after discontinuation of the ashwagandha capsules and laboratory values normalised. Data from animal studies, however, have suggested that ashwagandha can increase serum concentrations of thyroid hormones. This case study suggests that excess thyroid hormone effects is a potentially serious side effect of ashwagandha. Note: Rudger Hogeveen approved his name being mentioned.


“I have been suffering from a thyroid condition for several years and am taking Synthroid with some benefit, but still am symptomatic despite lab levels which are in the target range. An herbal specialist who recommended ashwahgandha. I did feel significantly better on this supplement, my hair loss stopped, etc, however, I am experiencing some problems with symptoms of increased thyroid production. Because I am finally feeling better/normal for the first time in years, I would like to find a way to perhaps taper my Synthroid and stay on the ashwagandha (since it may enhance thyroid hormone production). my current endocrinologist knows nothing about herb...”


The influence of ashwagandha on thyroid function is still being evaluated and there is very little research on the topic, including what the appropriate dosage would be for the long term and how such supplements interact wish Synthroid or other thyroid medications.


“I started taking ashwagandha capsules for the past 2 months. Last year I got my T3, T4, TSH tested and they were all normal. And now when tested again T3, T4, Ft4 are all normal but TSH is abnormal 13.9. I don't have any symptoms of hypothyroidism and still my blood reports TSH have come out positive. When consulted doctors, they asked me to get on medication Thyronorm 50mg for now. I read that ashwagandha can cause hyperthyroidism. My family has no background of any thyroid dysfunction. All of a sudden I have TSH elevated to high level and this is bothering me a lot. Now my doubt is can ashwagandha also cause hypothyroidism ? Should I stop taking the capsules. Also should I start medication for hypothyroidism or wait for now.”


I can't give specific treatment advice but your doctor may wish to read this page.


“I have Hashimoto's thyroiditis and when I began the herbal product I was Hyperthyroid. After a couple days I felt better, much calmer, more relaxed, etc. I did have to make a slight increase in my Methimazole (anti-thyroid medication) to compensate for what I thought was the mild thyrotoxic effects of ashwagandha. After about 6 weeks of continued daily use, my thyroid blew up. I could not sleep, and had all of the symptoms of severe hyperthyroidism. I had forgotten about the herb's potential to cause thyrotoxicosis, but "re-discovered" it, and stopped. I had to take very high doses of the Methimazole while experiencing the thyrotoxicosis. Once I stopped the ashwaganda, my thyroid appeared to normalize to its previous state after about 5 days. Then after another few days, it went very hyper once again. It did finally settle down to the normal range after a couple of weeks as confirmed by blood tests. It is now a couple months later, and I am borderline hyperthyroid. I am just letting you know, so you can warn others about ashwaganda and the danger it can present. I want to also state that your website is very informative and actually was the site that made me recall that ashwaganda can cause thyrotoxicosis. I feel that the information provided is great because it promotes a cautious approach when using supplements, as there have not been adequate studies on them. You are doing a great service for the public.”


“I find it very interesting and trustworthy to read about various supplements on your site. I have had some mild anxiety and mood disturbances for a while so i decided to try ashwagandha 300 mg of the whole herb, not an extract. I have read on your page that it can interfere with thyroid function. When i have been to the doctor before i asked to have my thyroid checked. I had a normal TSH and a T4 that was in the high normal range. I really want to take this herb. Obviously i am not hyperthyroid since tests are normal and symptoms are non existent. So my question is it so powerful that 300 mg of the whole herb per day can make the thyroid go hyperthyroid?”


It is unlikely that small amounts of the herb will have a strong influence on thyroid hormone levels, but it is difficult to predict in any one individual what would occur.


Contraindications

Large doses of Ashwagandha can cause abdominal discomfort and diarrhea. Ashwagandha has otherwise been tolerated well in the few reported studies that exist.


Though the herb is traditionally used in India during pregnancy, it is recommended that Ashwagandha be avoided in pregnancy in the West; this is because of its spasmolytic activity on the uterus... When used with other respiratory depressants, ashwagandha can be problematic.


ASHWAGANDHA Interactions

Moderate Interaction – Be cautious with this combination


Minor Interaction – Be watchful with this combination



ASHWAGANDHA Uses & Effectiveness

Insufficient Evidence for:


More evidence is needed to rate the effectiveness of ashwagandha for these uses.



ASHWAGANDHA Dosing

The appropriate dose of ashwagandha depends on several factors such as the user’s age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for ashwagandha. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.



Other Names

Ajagandha, Amangura, Amukkirag, Asan, Asana, Asgand, Asgandh, Asgandha, Ashagandha, Ashvagandha, Ashwaganda, Ashwanga, Asoda, Asundha, Asvagandha, Aswagandha, Avarada, Ayurvedic Ginseng, Cerise d'Hiver, Clustered Wintercherry, Ghoda Asoda, Ginseng Ayurvédique, Ginseng Indien, Hayahvaya, Indian Ginseng, Kanaje Hindi, Kuthmithi, Orovale, Peyette, Physalis somnifera, Samm Al Ferakh, Samm Al Rerakh, Sogade-Beru, Strychnos, Turangi-Ghanda, Vajigandha, Winter Cherry, Withania, Withania somnifera.



Buying Ashwagandha

Ashwagandha is most commonly purchased as a bulk powder or as a tablet. The advantage of buying it in bulk is that it is significantly cheaper on a per use basis and it allows one to take the herbs in the most traditional way. Tablets are considered by many to be a quicker, more convenient method of taking the herbs along with providing the option of not having to taste the herbs.


When choosing a supplier of Ashwagandha there are a variety of questions to consider relating to quality of the herbs, the values of the company, and the impact on the environment.


Is the supplier able to trace the herbs back to the field they were grown in?

Traceability of the herbs from field to shelf allows the supplier to know where and how the herbs were grown and when they were harvested.


Are the plants sustainably harvested?

The Ashwagandha plant is a tall, straight plant with green or purple flowers and reddish fruit (winter cherry); they are relatively abundant in many parts of India. All herbal companies have a choice in gathering Ashwagandha, like most other herbs: they can be harvested on private farms where sustainability can be managed, or they may be wild-harvested legally from their natural habitats.



Reviews

These reviews are from WebMD's homepage.


Reviewer: connie, 55-64 Female on Treatment for less than 1 month (Consumer)

Comment:

made me nauseous



Reviewer: Handytim, 45-54 Male (Consumer)

Comment:

I wrote in on this product earlier and spoke o e anti-anxiety and less depression...



Reviewer: 19-24 Male on Treatment for 2 to less than 5 years (Consumer)

Comment:

Excellent all-around nootropic, tonic and adaptogen. I particularly benefited from the anxiolytic and (slightly) anti-depressant effects. Provides a subtle but potent boost to both physical and mental endurance. It is the subject of much ongoing research for a vast variety of conditions.



Reviewer: 25-34 Male on Treatment for less than 1 month (Consumer)

Comment:

I decided to quit smoking. I was purging tobacco products... About 5 weeks into my quit I was still very anxious, depressed, and my thoughts were all over the place, as well as my mood. While researching ways to help restore the balance of my body, I stumbled upon Ashwagandha. After doing a little digging I decided it was worth purchasing a bottle of encapsulated root powder. I didn't expect much other than maybe some effect after taking it for a month. The very first day I was calm and grounded. I forgot I took the capsule until I noticed while driving how alert and calm I was. It struck me that I haven't had peace of mind like that for quite awhile. A week later after taking two capsules daily (60 came in the bottle, assuming it was unit packaged for dose) I feel even more grounded and regulated. I feel calm, but not tired. I sleep naturally and feel very rested when I wake (I previously had many bouts of insomnia). I also feel more in tune with my surroundings, less tense, and ready to engage in life activities. I accept challenge and change, where before the smallest bump caused anxiety.



Reviewer: MikeandIke, 45-54 Male on Treatment for 6 months to less than 1 year (Consumer)

Comment:

This supplement should be considered for it's touted benefits. I felt much better, less anxious, and have experienced no side effects whatsoever.



Reviewer: 25-34 Male on Treatment for 6 months to less than 1 year (Consumer)

Comment:

good



Reviewer: 25-34 Male on Treatment for 1 to 6 months (Consumer)

Comment:

I occasionally take raw Ashwaghanda for sleep. It puts me to sleep quite effectively, but I always have bad dreams or really weird dreams after taking it. I will no longer use.



Reviewer: Angie, 45-54 Female on Treatment for 1 to 6 months (Consumer)

Comment:

Adptenal was prescribed by my doctor because of my adrenal exhaustion. It has helped me to be able to function. Previously I was home bound and almost bedridden because of fatigue and pain. Now I can work in the garden, (first time in at least 6 years) ride bike and do household projects that have been put aside for years. I am very pleased with the energy level I have now. However, I also have been having some side effects, problems that I have never encountered until now. The problems have just started since I have been taking the Adapten-all. At the same time of starting it I also changed Thyroid med. to generic synthroid. I have experienced nueropathy like burning in my feet, plus pain and stiffness in my fingers and toes upon waking in the morning. My fingers and toes have never been stiff and hard to move anytime in my life. They have been in pain at times but this is a different type of pain. I have cut down to half the dosage of Adapten-all and the neuropathy has gone away but the fingers and toes are still bothering me somewhat. With all things considered, I am still very happy to be functioning again. I do hope we can figure out why the stiffness and arthritic type pain is in the picture. …



Reviewer: 97501, 55-64 Male on Treatment for less than 1 month (Consumer)

Comment:

Taken as a stress reliever, and it works.



Reviewer: parrotpal, 55-64 Male on Treatment for 1 to 6 months (Consumer)

Comment:

I have been using a standardized extract of ashwaghanda (...) for sleep. Although it enhances sleep, I have found that I feel fatigued and spacey the following day. I have eliminated other variables and it is clear that this is being caused... The dose used was either 225 mg or 450 mg (8% withanolides). I have not had this side effect from crude ashwaghanda powder; however, it was not as useful for inducing sleep. My reaction may be atypical but users of concentrated, standardized ashwghanda preparations should be aware that some people may experience drowsiness and spaciness that takes a day to resolve.



Reviewer: steve, 35-44 Male on Treatment for 2 to less than 5 years (Consumer)

Comment:

I'm a stroke survivor and sometimes have s tremor in my affected leg which disturbs my sleep.A570 mg tablet before going to bed helps me sleep.I take the same dosage to help with stress.Importantly,It doesn't have an interaction with warfarin the same way that Chinese ginseng does



Reviewer: roadrunner, 35-44 Male on Treatment for 1 to 6 months (Consumer)

Comment:

I bought this product to help me with "holiday stress," to help me sleep better. I didn't understand how taking a product during the day would help me sleep better at night. Well it worked great. I also feel more relaxed and less sressed on a daily basis! I chose ashwaghanda also because it didn't have any side-effects.



Reviewer: Savita, 45-54 Female on Treatment for less than 1 month (Caregiver)

Comment:

My mom was having hallucinations at night, little people, wild animals, the room was changing - all things that were real to her. I give her 8 drops of Ashwagandha extract that I put into a shot glass with a tablespoon of water. … I started her off with a few drops and added drops each night until she began sleeping through the night. My mom is able to distinguish between her dreams and reality. She doesn't wake up screaming about things that she had been dreaming about. During the day she doesn't hallucinate. If she does hallucinate about people and wild animals or the room changing, she takes 4 pellets of a homeopathic remedy, Helleborus Niger 30 C. We also changed her diet. We've cut out gluten - wheat, rice, barley, rye and Oats. We also cut out all plants of the deadly night shade variety - tomatoes, eggplant, peppers and potatoes. She excercises everday on a treadmill for 20 minutes at a slow speed. She plays piano and works on jigsaw puzzles. Ashwagandha is helping my mom to have much better days and nights. I am finally sleeping and have the energy to care for my aging mom during the day. Best of all, my mom is home with me and out of a nursing home!