RCTPending medical review

The question: Does ashwagandha root extract lower stress in adults who have been under stress for a long time?
Who was studied: 64 adults with a history of chronic stress, enrolled at a single centre. 61 of them completed the 60 days.
What they took: One capsule twice a day for 60 days. In the ashwagandha group each capsule held 300 mg of a concentrated root extract, KSM-66; the other group took placebo capsules. Neither the participants nor the researchers knew who had which.
What happened: Scores on every stress questionnaire fell further with ashwagandha than with placebo. On the Perceived Stress Scale the average score fell 44% from where it started with ashwagandha, against 5.5% with placebo. Blood cortisol, a stress hormone, fell 27.9% with ashwagandha and 7.9% with placebo. These are average falls within each group, not the share of people who improved.[1]
How strong is this: A double-blind, placebo-controlled trial is the right design for this question. But it is one small trial of one product, and it needs repeating by other groups before it can carry much weight.

The limits

Small and single-centre: 64 people enrolled and 61 finished.
Sixty days says nothing about longer use or long-term safety.
The paper gives two P values for the cortisol result: 0.0006 in its summary and 0.002 in the full text. Either way the difference is statistically significant, but the mismatch is not explained.
One branded extract was tested. Other ashwagandha powders, churnas or capsules may not give the same result.
The trial says nothing about how ashwagandha acts alongside other medicines. For thyroid medicines, see Ashwagandha and thyroid medicines, which covers that question separately.
Liver injury has been reported with supplements containing ashwagandha. A 60-day trial in 64 people does not settle that risk.

Who paid for it

The paper lists its source of support as nil and declares no conflicts of interest. The extract tested, KSM-66, is an Ixoreal product. A disclosure like this is the authors' own statement, not a check of independence.

Questions people ask

Does ashwagandha help with anxiety?

This trial measured stress and anxiety in adults under everyday chronic stress, and found lower scores with ashwagandha. It did not test people diagnosed with an anxiety disorder, so it cannot show the extract treats one.[1]

Does ashwagandha help with stress and sleep together?

Sleep was looked at separately. A 2021 review of five trials with 400 adults found a small improvement in sleep with ashwagandha extract compared with placebo.[2]

Will any ashwagandha product work the same way?

Not necessarily. The trial used one concentrated root extract in capsules. A churna, a different extract or a multi-herb product was not tested, and the result cannot simply be carried over to them.[1]

Can ashwagandha harm the liver?

Liver injury has been reported. A 2020 case series from Iceland and the US described five people with liver injury put down to supplements containing ashwagandha. Case reports cannot show how often this happens, and a 60-day trial in 64 people cannot settle it.[3][4]

Evidence

Sources

Awaiting review by The Good Vaidya Medical Board. Prepared from the sources below and checked against each one.

Published 4 November 2026 · Last updated 4 November 2026

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Does ashwagandha reduce stress?

The limits

Who paid for it

Questions people ask

Related

Does ashwagandha improve sleep?

Anxiety and sleep problems: what Ayurveda offers

Ashwagandha and thyroid medicines

Ashwagandha and antidepressants (SSRIs, SNRIs)

Sources