1) Ashwagandha (Withania somnifera) is an Indian herb also known as winter cherry or Indian ginseng. 2) It contains steroidal compounds and alkaloids that have sedative, adaptogenic, immune-boosting, anti-inflammatory and antitumor properties. 3) Ashwagandha is used to relieve anxiety, stress and age-related decline, and to enhance strength, memory and fertility. It shows potential for conditions like arthritis, cancer and infections.

1. HERBAL MEDICINE
ASHWAGANDHA
DR. MOSTAFA MAHMOUD HEGAZY PH.D

2. Herbal medicine Dr. Mostafa Hegazy
‫االشواجاندا‬
-
‫الهندي‬ ‫الجينسنج‬
‫االشواجندا‬
-
‫منوم‬ ‫عبعب‬
-
‫العبعب‬
-
‫الكاكنج‬ ‫حب‬
Indian ginseng, ashwagandha and Winter cherry.
Withania somnifera
somnifera = sedative action, Indian ginseng = similar uses as Panax
ginseng
Ashwagandha = smell and strength of a horse
Part used: Root.
Constituents:
1- Steroidal compounds, withanolides (withaferin A, sitoindoside IX,
X) and acylsteryl glucosides (sitoindosides VII, VIII).
2- Alkaloids: tropane-type (tropine, pseudotropine), other alkaloids.

3. Herbal medicine Dr. Mostafa Hegazy
Active Constituents:
1- Alkaloids
(CNS activity; all alkaloids exert synergistic activity) As tonic,
neuroprotective, sedative, antiepileptic effects, cognition enhancer
and may have some value in addiction.
2- Steroidal compounds
A- Withaferin A (immunosuppressive and cytotoxic activities), in
contrast to the immunostimulating activity of Withania extracts
B- Glycowithanolides (antistress and antioxidant activities as part of
Adaptogenic activity)
Note: Adaptogenic activity is a synergistic effect of all compounds.
C- Sitoindosides IX and X augmented learning acquisition and
memory retention in both young and old rats.

4. Herbal medicine Dr. Mostafa Hegazy
Actions and Uses
Main Actions
1- Sedative
2- Adaptogenic action, reinforcing its comparison with Panax ginseng
but it lacks the potential stimulating effects of the latter of ginseng.
3- Tonic and anabolic.
NOTE: Withania had nearly similar potency to Panax in terms of
adaptogenic, tonic and anabolic effects.
Other actions
1- Immune booster activity
2- Glucocorticoid-like anti-inflammatory
3- Antitumour (possibly, in high doses): Antiproliferative activity;
potentially has cytotoxic and cancer chemopreventive.

5. Herbal medicine Dr. Mostafa Hegazy
Uses based on scientific research
1- Anxiety:
A- convalescence after acute illness or extreme stress.
B- to assist in withdrawal from addictive drugs.
2- Improvement in conditions associated with ageing,
including
A- muscle strength and function.
B- Promoter of learning and memory retrieval.
3-For overactive (nervousness and/or anxiety and/or stress) but
debilitated patients , in whom Panax might tend to aggravate
the overstimulation

6. Herbal medicine Dr. Mostafa Hegazy
4- Improvement of stamina in athletes (Muscle strength as tonic
and size as anabolic).
5-Low testosterone and fertility in men also impotence due to
testosterone and devitalization.
6- Rheumatoid arthritis.
7- Immune booster activity
A- Reverse the depressed white blood cell and neutrophil counts
caused by cytotoxic drugs e.g. cyclophosphamide and paclitaxel.
B- It also reduced the effect of Listeria infection.
C- In Whooping cough: Mortality of animals was reduced, and
overall health improved.
D- Salmonella infection: increased survival rates and lower
bacterial load in vital organs compared with control animals.

7. Herbal medicine Dr. Mostafa Hegazy
Mechanism of action
1- Immune booster activity
Increases WBC, neutrophil counts, Th1-
mediated immune responses, higher myeloid
progenitors (precursor cells) in bone marrow,
interferon-gamma and granulocyte macrophage
colony stimulating factor.
Sitoindosides IX and X produced significant
mobilisation and activation of peritoneal
macrophages, phagocytosis and increased
activity of the lysosomal enzymes secreted by
activated macrophages.

8. Herbal medicine Dr. Mostafa Hegazy
2- chronic stress combating effect (adaptogenic
activity)
A- Glycowithanolides had an antistress effect on the
frontal cortex and striatum.
B- Glycowithanolides tended to normalise the stress
induced increase in superoxide dismutase activity and
lipid peroxidation, and enhanced the activities of
catalase and glutathione peroxidase, thereby exerting an
antioxidant effect.
3- Antitumour activity
Apoptosis is a major mechanism behind its activity and
has been demonstrated on a variety of cell lines.

9. Herbal medicine Dr. Mostafa Hegazy
4- Anti-inflammatory activity
Suppression of lipopolysaccharide-induced cytokine
and nitric oxide production in peripheral blood
mononuclear cells from normal volunteers and patients
with rheumatoid arthritis.
Withaferin A inhibited NF-kappaB in cellular models
of cystic fibrosis inflammation.
NOTE: The ‘steroid-like’ activity of Withania
constituents.
5- CNS
GABA-A receptor agonist activity and enhances the
binding of flunitrazepam (a benzodiazepine drug) to
this receptor.

10. Herbal medicine Dr. Mostafa Hegazy
Dose generally and for each use (if any) and Preparation
method
3- 8 g/day of dried root by decoction
In high doses, alkaloids from Withania exhibited prolonged
hypotensive, bradycardic, and respiratory stimulant actions and
had a depressant effect on higher cerebral centres.
Herb (single and blend) prescription
Withania combines well with a low dose of Panax ginseng.
Withania: ginseng (97 gm: 3 gm) each 100 gm
Egyptian pharmaceutical products (if any).
Sold by Imtenan 30 gm powdered root and herbal stores. Also
available in many Arabic countries in pharmacies.

11. Herbal medicine Dr. Mostafa Hegazy
Interactions (if any) with other drugs or herbs or food
Withania extract may enhance the effect of benzodiazepines (Alprazolam,
Flunitrazepam, Chlordiazepoxide, Clonazepam, Diazepam, Lorazepam,
Midazolam, Oxazepam and Prazepam).
Precautions (if any)
1- Use in pregnancy and lactation should be avoided.
2- No problems known with long-term use (c.f. Panax ginseng used for
not more than 3 months) for example a 32-week (8 months) randomised,
double blind, placebo-controlled clinical study in 90 patients found a
reduction in pain.
3- No negative influence on ability to drive and use machines is expected
at the recommended dosage.

12. Herbal medicine Dr. Mostafa Hegazy
Adverse effects (if any)
No adverse effects from ingestion of Withania are expected in normal dose range. High
doses have been reported to cause gastrointestinal upset, diarrhoea and vomiting, which
may be due to the steroidal saponin content. Few side effects have been noted in clinical
trials.
Contraindications (if any)
None known
Safety in children
Adverse events were not reported in a randomised, double blind, placebo-controlled trial
in which healthy children were orally administered 2 g/day of Withania for 60 days.
Withania is traditionally used in Ayurvedic medicine to treat failure to thrive in children.
References
R1- Principles and Practice of Phytotherapy. Modern Herbal Medicine
Mills, Simon, and Kerry Bone. Principles and practice of phytotherapy. Modern herbal
medicine. Churchill Livingstone, 2000.
https://eg1lib.org/book/2205391/035589

13. Herbal medicine Dr. Mostafa Hegazy