Dr. Kumar’s Take
This is a well-run crossover trial with an honest result: the hormones moved, the symptoms did not. Ashwagandha extract raised DHEA-S and testosterone more than placebo in aging, overweight men, but fatigue, vigor, and sexual well-being improved in both arms with no significant difference between them. I read that as a biochemical signal in search of a clinical one. Worth watching, not yet worth promising your patients more energy.
Key Takeaways
✔ Ashwagandha intake was associated with an 18% greater increase in DHEA-S (p = .005) than placebo.
✔ Testosterone rose 14.7% more with ashwagandha than with placebo (p = .010).
✔ Fatigue, vigor, and sexual and psychological well-being improved over time in both groups, with no statistically significant between-group differences.
✔ Cortisol and estradiol showed no significant between-group differences.
Actionable Tip
If you are an older man with low energy and symptoms of hormone decline, treat ashwagandha as unproven for symptoms. This trial did not show that it improves fatigue or vigor more than placebo. Talk with your doctor about evaluating the causes of your fatigue before adding a supplement.
Brief Summary
This 16-week randomized, double-blind, placebo-controlled crossover study tested a standardized ashwagandha extract (Shoden beads, delivering 21 mg of withanolide glycosides a day) against placebo for 8 weeks in overweight men aged 40 to 70 with mild fatigue. Fifty-seven participants were enrolled, 50 completed the first 8-week period, and 43 completed all 16 weeks. Outcomes included the Profile of Mood States, Short Form, the Aging Males’ Symptoms questionnaire, and salivary DHEA-S, testosterone, cortisol, and estradiol. Ashwagandha was associated with an 18% greater increase in DHEA-S and a 14.7% greater increase in testosterone compared with placebo. Fatigue, vigor, and sexual and psychological well-being improved over time in both arms without significant between-group differences.
Study Design
- Population: Overweight men aged 40 to 70 years with mild fatigue.
- Intervention: Standardized ashwagandha extract (Shoden beads), 21 mg of withanolide glycosides daily.
- Control: Placebo, with participants crossing over between conditions.
- Duration: 8 weeks per condition, 16 weeks total.
- Outcomes: Salivary DHEA-S, testosterone, cortisol, and estradiol; POMS-SF; Aging Males’ Symptoms questionnaire.
Results
- DHEA-S increased 18% more with ashwagandha than with placebo (p = .005).
- Testosterone increased 14.7% more with ashwagandha than with placebo (p = .010).
- Cortisol and estradiol showed no significant between-group differences.
- Fatigue, vigor, and sexual and psychological well-being improved over time in both groups, with no statistically significant between-group differences.
Biological Rationale
Ashwagandha (Withania somnifera) is a herb used in Ayurvedic medicine to promote youthful vigor, enhance muscle strength and endurance, and improve overall health. The hormonal rationale is straightforward: testosterone and DHEA influence sexual health, lean body mass, mental health, cognition, bone density, cardiovascular function, and metabolic activity, and both decline with age in men. Testosterone falls at a rate of 1% to 2% per year after age 40, and DHEA-S concentrations decrease by an average of 1% to 4% per year between ages 40 and 80. In men, testosterone can be converted by the enzyme aromatase into estradiol, which also tends to decline with age. In this trial the hormonal shift did not translate into a measurable symptom benefit over placebo.
Related Studies and Research
Podcast: Testosterone Replacement Therapy Explained: Anchor breakdown on routes, monitoring, and outcomes.
Ashwagandha and Hormones in Aging Men: Crossover trial showing increases in testosterone and DHEA-S.
Tongkat Ali Raises Testosterone: Meta-Analysis: Evidence that Eurycoma longifolia can elevate total testosterone.
Tongkat Ali Physta in Aging Men RCT: Placebo-controlled multicenter study in older men.
Frequently Asked Questions
How long before results appear?
Over 8 weeks of supplementation, DHEA-S and testosterone rose more with ashwagandha than with placebo. Fatigue, vigor, and well-being improved in both arms, so the trial does not establish a symptom timeline for ashwagandha specifically.
Can younger men benefit?
This trial enrolled overweight men aged 40 to 70 with mild fatigue, so its results do not extend to younger men.
Is ashwagandha safe?
This trial used a standardized extract (Shoden beads) delivering 21 mg of withanolide glycosides a day for 8 weeks. Use standardized extracts and consult your healthcare provider before starting one.
Does it replace testosterone therapy?
No. This study measured salivary hormone changes in men with mild fatigue, not treatment of hypogonadism, and it found no symptom benefit over placebo.
Conclusion
Taking a standardized ashwagandha extract (Shoden beads) for 8 weeks was associated with increased DHEA-S and testosterone in aging, overweight men. There were no significant between-group differences in cortisol, estradiol, fatigue, vigor, or sexual well-being. The authors call for larger studies to substantiate these findings, and I agree: a hormone number that moves without a symptom that follows is a starting point, not a recommendation.
