Ashwagandha is considered one of the most powerful herbs for men's health. It creates profound changes in the endocrine, digestive, neurological, and reproductive systems.
Men seek out ashwagandha to increase vitality, improve endurance, and enhance mental performance. However, along with the benefits, unwanted effects are also evident.
When used incorrectly, Ashwagandha can become a powerful biological ally or a potential risk factor for men's health.
Ashwagandha may benefit men but carries risks, side effects, and drug interactions.
What is Ashwagandha?
Ashwagandha, or Withania somnifera, is an adaptogenic herb with a long history of use in ancient Indian medicine. It directly affects the central nervous, endocrine, and immune systems, thereby influencing overall health.
Botanical Profile
Ashwagandha belongs to the Solanaceae family, and its roots and leaves contain many bioactive compounds, such as withanolides, alkaloids, and saponins. These active ingredients contribute to the body's physiological and adaptive regulation capabilities.
Traditional and Modern Uses
In Ayurveda, ashwagandha is considered a "Rasayana" – an energy-regenerating nutrient. Men often use it to increase muscle strength, improve endurance, and support the immune system.
Mechanism of Action
Ashwagandha can modulate the HPA (hypothalamic–pituitary—adrenal) axis, helping to reduce stress while also influencing testosterone levels and muscle anabolism.
Hormonal Effects in Men
Ashwagandha affects the male endocrine system through a number of complex biological mechanisms. The herb interacts with the hypothalamic–pituitary–adrenal (HPA) axis, sex sterols, and biomarkers such as DHEA-S and testosterone, leading to changes that may improve energy but also pose risks with long-term use.
Testosterone and Androgens
Several short-term trials have demonstrated increased testosterone and DHEA-S concentrations following ashwagandha supplementation and improvements in muscle strength and libido in the study participants. These changes have been linked to both direct effects on sex steroids and indirect effects through stress reduction.
HPA Axis and Cortisol
Ashwagandha regulates the HPA axis, reducing cortisol production in many studies. This mechanism largely explains the effects on hormonal balance and metabolic status.
Long-term Imbalance Risks
According to some clinical reports, high doses or prolonged use may lead to endocrine disruption or adrenal insufficiency; therefore, hormones, LH/FSH, SHBG, and liver-renal function must be monitored during long-term treatment.
Digestive and Gastrointestinal Side Effects
Ashwagandha directly affects the gastrointestinal tract by affecting the gastric mucosa, microflora, and digestive enzymes. These changes may cause intestinal discomfort in some men, especially with high doses or prolonged use.
Common Gastrointestinal Symptoms
Some people experience nausea, abdominal cramping, diarrhea, or increased gastric acid secretion after taking ashwagandha. These symptoms reflect stimulation of intestinal motility and changes in digestive secretions.
Gut Microbiota Interaction
Withanolides can affect the intestinal microflora, altering the balance between Firmicutes and Bacteroidetes strains, thereby affecting the fermentation process and nutrient absorption.
Higher Sensitivity in Men with GI Conditions
Men with irritable bowel syndrome (IBS), chronic gastritis, or stomach ulcers may experience more pronounced symptoms due to a stronger reaction of the digestive mucosa to the bioactive compounds in ashwagandha.
Mental Health and Sleep Concerns
Ashwagandha acts on the central nervous system by modulating neurotransmitters and the HPA axis, influencing mood, anxiety, and sleep quality. These changes are beneficial in moderation but can also cause overreactions when combined with medications or taken in high doses.
Neurotransmitter Modulation
Withanolides modulate the activity of the GABAergic pathway and serotonin receptors, which can help reduce nervous tension but can also cause excessive sedation.
Anxiety and Overstimulation
Some men with a tendency to anxiety disorders may experience psychomotor agitation or restlessness when their bodies react strongly to ashwagandha.
Sleep Architecture
Ashwagandha improves the amount of deep sleep (NREM) and reduces nighttime awakenings. However, when combined with benzodiazepines or barbiturates, the risk of excessive sleepiness and sleep cycle disturbances may increase.
Impact on Fertility
Ashwagandha has a multifaceted effect on male fertility, directly affecting sperm quality, hormonal balance, and spermatogenesis; this effect stems from both antioxidant and endocrine axis-modulating effects.
Sperm Parameters
Several clinical trials have reported increased sperm concentration, motility, and semen volume following ashwagandha therapy in oligospermic and infertile men.
Hormonal Balance
Ashwagandha increases bioavailable testosterone and luteinizing hormone (LH), which in some studies promotes anabolism and increases libido.
Oxidative Stress and Mechanisms
Withanolides and lipid peroxidation-reducing mechanisms protect sperm cells from oxidative damage, stimulating antioxidant enzyme expression and spermatogenesis.
Clinical Uncertainty and Recommendations
Current clinical data are promising; Larger randomized trials and long-term follow-up are needed to establish treatment guidelines. Monitor semen analysis and hormone profiles before and during treatment, select appropriate doses, and discuss with a fertility specialist when risk factors exist.
Thyroid and Autoimmune Conditions
Ashwagandha exerts a pronounced effect on the thyroid endocrine system and can modulate the immune response. These effects involve both thyroid hormone alterations and activation of cellular immune mechanisms, producing profound changes in homeostasis.
Thyroid Function Modulation
Several studies have shown that ashwagandha increases T3 (triiodothyronine) and T4 (thyroxine) concentrations, while improving thyroid peroxidase activity. This effect promotes energy metabolism and improves physiological alertness.
Autoimmune Activation
Withanolides can stimulate T lymphocyte activity and increase cytokine expression, such as IL-2 and IFN-γ, strengthening the immune response. In men with a predisposition to autoimmune disease, this mechanism may alter the course of the disease.
Clinical Implications
The dual effects on the thyroid and immune systems require close medical supervision. Regular monitoring of TSH, T3, T4, and immune markers may help detect adverse changes in treatment progress.
Drug Interactions in Men
Ashwagandha interacts extensively with various drugs through HPA axis modulation, neurotransmitter modulation, and metabolic effects; these interactions alter clinical response and increase the risk of adverse effects if not closely monitored by a physician.
Cardiovascular Drugs
Ashwagandha lowers blood pressure; combination with beta-blockers, ACE inhibitors, ARBs, or diuretics increases the risk of clinical hypotension, dizziness, and organ hypoperfusion.
Sedatives
The sedative activity of ashwagandha amplifies the effects of benzodiazepines and hypnotics, leading to excessive sleepiness, respiratory depression, and central nervous system depression.
Thyroid Medications
Interactions with levothyroxine and effects on T3/T4; dose adjustment and monitoring of TSH, T3, and T4 during supplementation are recommended.
Antidiabetics & Metabolism
Ashwagandha lowers blood sugar; when used with insulin or oral glucose-lowering drugs, the risk of hypoglycemia increases, and regular blood sugar monitoring is required.
Immunosuppressants & Autoimmunity
The immunostimulatory effects of ashwagandha interfere with immunosuppressive drugs; patients taking medications after transplantation or with autoimmune diseases should discuss with a specialist before starting.
Discussing a complete list of medications with a doctor and performing baseline testing before use helps optimize treatment safety.
Overuse and High-Dose Risks
When used in high doses or for a long time, ashwagandha exerts a biological burden on the liver, kidneys, and central nervous system. These effects are related to the accumulation of withanolides, endocrine changes, and alterations in cellular metabolism.
Acute Toxicity
High doses cause gastrointestinal distress with nausea, diarrhea, severe abdominal pain, accompanied by headache, dizziness, and sudden hypotension. Some cases have reported acute psychosis due to excessive effects on the GABAergic system.
Hepatic and Renal Concerns
Clinical reports indicate the possibility of increased liver enzymes (ALT, AST) and renal dysfunction with elevated creatinine. These complications reflect overload in toxic metabolism and elimination.
Endocrine Disruption
Overuse affects cortisol, testosterone, and thyroid hormones, disrupting endocrine balance. Periodic liver and kidney function monitoring and endocrine testing are important when supplementing at high doses.
Safe Use Guidelines for Men
Ashwagandha provides significant physiological benefits when used in the correct dosage, at the right time, and under medical supervision. Individualizing the dose based on your body condition, underlying medical conditions, and medications helps ensure safety and maximize benefits.
Recommended Dosage
A common dose ranges from 300–600 mg of a standardized extract containing 5% withanolides, taken 1–2 times daily after meals to reduce stomach irritation and increase absorption.
Timing and Duration
Taking ashwagandha in the evening helps improve sleep quality and reduce stress. The optimal duration of use is usually 8–12 weeks, with clinical reassessment to adjust the dose.
Medical Supervision
Monitor liver function tests, renal profile, hormone levels, and blood pressure regularly. Consult a specialist when combining with cardiovascular, endocrine, or neurological drugs to limit the risk of adverse interactions.
Conclusion
Ashwagandha has profound effects on men's endocrine, digestive, neuropsychiatric, and immune systems. Its use should be placed within a medically controlled framework to maximize its benefits and limit potential risks.
Men achieve optimal results when applying personalized dosages, regularly monitoring biochemical indicators, and listening to the body's feedback. This approach helps maintain a state of balance and supports long-term health.
→Discover the best time of day to take ashwagandha to optimize biological effectiveness and improve quality of life.
Frequently Asked Questions (FAQs)
- Does Ashwagandha Affect Testosterone in Men? – Ashwagandha can increase testosterone and support muscle anabolism. This mechanism comes from regulating the HPA axis, reducing cortisol, and stimulating the secretion of luteinizing hormone, thereby improving men's energy and vitality.
- What gastrointestinal side effects can men experience when taking ashwagandha? – Some men experience nausea, diarrhea, or abdominal pain due to stimulating intestinal motility. These symptoms are often related to high doses or pre-existing gastrointestinal conditions and require medical supervision.
- Is Ashwagandha safe for sleep? – Ashwagandha helps improve sleep quality by regulating GABA and serotonin. However, when combined with sedatives, the risk of excessive sleepiness and sleep cycle disturbances may increase, requiring careful monitoring.
- Does Ashwagandha alter thyroid function? – Ashwagandha can increase T3 and T4 levels, thereby promoting energy metabolism. This effect is beneficial in thyroid function fatigue, but regular hormone monitoring is needed to maintain a stable endocrine balance.
- What is the safe dosage of ashwagandha for men? – The recommended dose is 300–600 mg of a 5% standardized extract of withanolides, taken after meals. The optimal duration of use is about 8–12 weeks, with periodic monitoring of liver enzymes, kidney function, and hormone testing.
