Ashwagandha – Withania somnifera (L.) Dunal

17 februarja, 2025 17 februarja, 2025

I. Uporabni deli:

Korenina.

II. Aktivne sestavine:

Vitanolidni heterozidi: vitanozidi I-VII, vitaferin A, fisagulin D, coagulin Q. Nekateri vitanolidi so strukturno podobni ginsenozidom iz ginsenga.
Alkaloidi: isopelletierin, anaferin, kuskohigrin, anahigrin, somnin, somniferin, vitanin, tropin, pseudotropin in anaferin.
Saponini.
Vsebuje tudi salvigenin, vitaperuvine 1, eucommiol, vicosalactone B, anamidi D in E ter asomidienon.

III. Mehanizem delovanja:

Korenina vsebuje fitosterole (vitanolide, vitaferin A in sitoindozide), ki imajo opisane adaptogene in protivnetne učinke.
Raziskave na živalih kažejo, da lahko ašvaganda zmanjša imunosupresijo in levkopenijo, ki ju povzroča ciklofosfamid (kemoterapevtik). Zdi se, da tudi povečuje število celic v kostnem mozgu in belih krvničk v živalih, zdravljenih z obsevanjem. Alkaloidi kažejo sproščujoč in antispazmodični učinek na črevesje, maternico, bronhije, sapnik in gladko žilno mišičevje. Vithanolidi in ekstrakt ašvagande imajo citotoksične učinke na rakave celice in druge laboratorijske modele.
Anksiolitični, antidepresivni in antikonvulzivni učinki: Študije na živalih so pokazale, da ašvaganda lahko izboljša serotoninergični prenos preko modulacije postsinaptičnih receptorjev serotonina (5-HT) ter anksiolitične/antikonvulzivne učinke s senzibilizacijo receptorja GABA. Raziskave pri ljudeh kažejo, da ašvaganda povečuje serotoninske ravni in jutranje ravni kortizola, kar nakazuje, da so antidepresivni in anksiolitični učinki povezani s hipotalamusom, hipofizo in nadledvično žlezo (HPA os).
Učinki na reproduktivno zdravje: klinične študije kažejo, da ašvaganda izboljšuje število in gibljivost semenčic pri odraslih moških. Ti učinki so povezani z zvišanjem ravni testosterona, luteinizirajočega hormona (LH), folikle stimulirajočega hormona (FSH) in prolaktina.
Učinki na ščitnico: ašvaganda spodbuja sintezo in/ali izločanje ščitničnih hormonov. Klinične in živalske raziskave so pokazale, da izboljšuje delovanje ščitnice, saj povečuje koncentracijo trijodotironina (T3) in tiroksina (T4) ter zmanjšuje raven ščitničnega stimulirajočega hormona (TSH). Zaradi tega bi lahko bila koristna pri subkliničnem hipotiroidizmu.
Poleg tega so raziskave pokazale, da ima korenina analgetične, antipiretične, antioksidativne, hipotenzivne, nevroprotektivne in nootropne učinke – izboljšuje spomin.

IV. Indikacije

Klinične študije pri ljudeh potrjujejo učinkovitost ašvagande pri zmanjševanju stresa, tesnobe, simptomov generalizirane anksiozne motnje (GAM) in nespečnosti.

Metaanaliza sedmih majhnih kliničnih študij, izvedenih na zdravih odraslih, osebah s kroničnim stresom ali psihiatričnimi stanji, kaže, da jemanje 240–1000 mg ašvagande dnevno v obdobju 8–12 tednov bistveno zmanjša stres v primerjavi s placebom.

Klinične smernice Svetovne zveze biološke psihiatrije (WFSBP) in Kanadske mreže za zdravljenje motenj razpoloženja in tesnobe (CANMAT) pogojno priporočajo jemanje ekstrakta korenine ašvagande v odmerku 300–600 mg (standardizirano na 5 % vitanolidov) kot monoterapijo ali dopolnilno terapijo pri bolnikih z generalizirano anksiozno motnjo.

Raziskave na ljudeh kažejo, da ašvaganda izboljšuje kakovost spanja, zmanjšuje čas uspavanja, podaljšuje skupno trajanje spanja ter zmanjšuje obdobja budnosti po uspavanju. Učinki so bili izrazitejši pri osebah z nespečnostjo, pri odmerkih vsaj 600 mg dnevno in pri trajanju zdravljenja vsaj 8 tednov.

V. Kontraindikacije

Pri alergiji na ašvagando.
Ni primerno uživati med nosečnostjo in dojenjem.
Ni primerno uživati pri jetrni insuficienci.
Ni primerno uživati pri hipertiroidizmu (prekomerno delujoči ščitnici).
Ni primerno za otroke.

VI. Previdnostni ukrepi

Pri avtoimunskih boleznih.
Pri jetrnih boleznih.
V perioperativnem obdobju (pred, med in po operaciji): ašvaganda lahko povzroči dodatno depresijo centralnega živčnega sistema v kombinaciji z anestezijo in drugimi zdravili med operacijo in po njej. Priporočljivo je, da jo bolniki prenehajo jemati vsaj dva tedna pred načrtovanimi kirurškimi posegi.
Pri motnjah delovanja ščitnice: Ašvaganda lahko poslabša hipertiroidizem s povečanjem ravni ščitničnih hormonov.

VI. Neželeni učinki

Peroralna uporaba ašvagande je na splošno dobro prenašana. Najpogostejši neželeni učinki so: driska, prebavne težave, slabost in bruhanje. Pri običajnih terapevtskih odmerkih so ti neželeni učinki redki. V redkih primerih lahko uporaba povzroči dermatitis, hiperaktivnost ščitnice, zmanjšan libido, poškodbe jeter in zaspanost.

VII. Interakcije z zdravili

Ašvaganda lahko okrepi učinek antidiabetičnih, antihipertenzivnih in sedativnih zdravil. Poveča toksičnost hepatotoksičnih zdravil. Zmanjša učinkovitost imunosupresivov. Okrepi zdravljenje hipotiroidizma.

Kako se spopasti s kroničnim vnetjem?

Perimenopavza – čas sprememb in naravna podpora za boljše počutje

Viri

Akhgarjand C, Asoudeh F, Bagheri A, et al. Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials. Phytother Res 2022.

Cooley K, Szczurko O, Perri D, et al. Naturopathic care for anxiety: a randomized controlled trial ISRC TN78958974. PLoS One 2009;4:e6628.

Sarris J, Ravindran A, Yatham LN, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce. World J Biol Psychiatry. 2022;23(6):424-455.

Cheah KL, Norhayati MN, Husniati Yaacob L, Abdul Rahman R. Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. PLoS One 2021;16(9):e0257843.

Bibliografija:

Natmed a tcrhealthcare Brand. Monografía de la whitania somnífera Actualizada hasta ctualizada hasta el 3 de octubre de 2024
Fitoterapia, Vademécum de Prescripción. 5ª ed. Barcelona: Elsevier, 2019. 830 páginas. ISBN: 978-84-9113-299-8.
Vanaclocha B, Cañigueral S. (eds).

Znanstveni članki:
McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association’s Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
Upton R, ed. Ashwagandha Root (Withania somnifera): Analytical, quality control, and therapuetic monograph. Santa Cruz, CA: American Herbal Pharmacopoeia 2000:1-25.
Davis L, Kuttan G. Effect of Withania somnifera on cyclophosphamide-induced urotoxicity. Cancer Lett 2000;148:9-17.
Archana R, Namasivayam A. Antistressor effect of Withania somnifera. J Ethnopharmacol 1999;64:91-3
Davis L, Kuttan G. Suppressive effect of cyclophosphamide-induced toxicity by Withania somnifera extract in mice. J Ethnopharmacol 1998;62:209-14
Bhattacharya SK, Satyan KS, Ghosal S. Antioxidant activity of glycowithanolides from Withania somnifera. Indian J Exp Biol 1997;35:236-9
Nagashayana N, Sankarankutty P, Nampoothiri MRV, et al. Association of l-DOPA with recovery following Ayurveda medication in Parkinson’s Disease. J Neurol Sci 2000;176:124-7
Mishra LC, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): a review. Altern Med Rev 2000;5:334-46
Dasgupta A, Peterson A, Wells A, Actor JK. Effect of Indian Ayurvedic medicine Ashwagandha on measurement of serum digoxin and 11 commonly monitored drugs using immunoassays: study of protein binding and interaction with Digibind. Arch Pathol Lab Med 2007;131:1298-303
Dasgupta A, Tso G, Wells A. Effect of Asian ginseng, Siberian ginseng, and Indian ayurvedic medicine Ashwagandha on serum digoxin measurement by Digoxin III, a new digoxin immunoassay. J Clin Lab Anal 2008;22:295-301
Cooley K, Szczurko O, Perri D, et al. Naturopathic care for anxiety: a randomized controlled trial ISRC TN78958974. PLoS One 2009;4:e6628
Katz M, Levine AA, Kol-Degani H, Kav-Venaki L. A compound herbal preparation (CHP) in the treatment of children with ADHD: a randomized controlled trial. J Atten Disord 2010;14:281-91
Sriranjini SJ, Pal PK, Devidas KV, Ganpathy S. Improvement of balance in progressive degenerative cerebellar ataxias after Ayurvedic therapy: a preliminary report. Neurol India 2009;57:166-71
Andallu B, Radhika B. Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root. Indian J Exp Biol 2000;38:607-9
Ahmad MK, Mahdi AA, Shukla KK, et al. Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males. Fertil Steril 2010;94:989-96
Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5
Ahumada F, Aspee F, Wikman G, Hancke J. Withania somnifera exract. Its effects on arterial blood pressure in anaesthetized dogs. Phytother Res 1991;5:111-14
Agarwal R, Diwanay S, Patki P, Patwardhan B. Studies on immunomodulatory activity of Withania somnifera (Ashwagandha) extracts in experimental immune inflammation. J Ethnopharmacol 1999;67:27-35
Panda S, Kar A. Withania somnifera and Bauhinia purpurea in the regulation of circulating thyroid hormone concentrations in female mice. J Ethnopharmacol 1999;67:233-39
Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol 1998;50:1065-68
Bhattacharya, S. K., Bhattacharya, A., Sairam, K., and Ghosal, S. Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an experimental study. Phytomedicine 2000;7(6):463-469
Davis, L. and Kuttan, G. Effect of Withania somnifera on DMBA induced carcinogenesis. J Ethnopharmacol. 2001;75(2-3):165-168.
Bhattacharya, S. K. and Muruganandam, A. V. Adaptogenic activity of Withania somnifera: an experimental study using a rat model of chronic stress. Pharmacol Biochem.Behav 2003;75(3):547-555.
Gupta, S. K., Dua, A., and Vohra, B. P. Withania somnifera (Ashwagandha) attenuates antioxidant defense in aged spinal cord and inhibits copper induced lipid peroxidation and protein oxidative modifications. Drug Metabol.Drug Interact. 2003;19(3):211-222.
Devi, P. U., Sharada, A. C., Solomon, F. E., and Kamath, M. S. In vivo growth inhibitory effect of Withania somnifera (Ashwagandha) on a transplantable mouse tumor, Sarcoma 180. Indian J Exp Biol. 1992;30(3):169-172.
Kaur, K., Rani, G., Widodo, N., Nagpal, A., Taira, K., Kaul, S. C., and Wadhwa, R. Evaluation of the anti-proliferative and anti-oxidative activities of leaf extract from in vivo and in vitro raised Ashwagandha. Food Chem.Toxicol. 2004;42(12):2015-2020.
Khattak, S., Saeed, Ur Rehman, Shah, H. U., Khan, T., and Ahmad, M. In vitro enzyme inhibition activities of crude ethanolic extracts derived from medicinal plants of Pakistan. Nat.Prod.Res 2005;19(6):567-571.
Choudhary, M. I., Nawaz, S. A., ul-Haq, Z., Lodhi, M. A., Ghayur, M. N., Jalil, S., Riaz, N., Yousuf, S., Malik, A., Gilani, A. H., and ur-Rahman, A. Withanolides, a new class of natural cholinesterase inhibitors with calcium antagonistic properties. Biochem.Biophys.Res Commun. 8-19-2005;334(1):276-287
Kulkarni, S. K. and Dhir, A. Withania somnifera: an Indian ginseng. Prog.Neuropsychopharmacol.Biol.Psychiatry 7-1-2008;32(5):1093-1105
Deocaris, C. C., Widodo, N., Wadhwa, R., and Kaul, S. C. Merger of ayurveda and tissue culture-based functional genomics: inspirations from systems biology. J.Transl.Med. 2008;6:14
Tohda, C. [Overcoming several neurodegenerative diseases by traditional medicines: the development of therapeutic medicines and unraveling pathophysiological mechanisms]. Yakugaku Zasshi 2008;128(8):1159-1167
Singh, R. H., Narsimhamurthy, K., and Singh, G. Neuronutrient impact of Ayurvedic Rasayana therapy in brain aging. Biogerontology. 2008;9(6):369-374
Lu, L., Liu, Y., Zhu, W., Shi, J., Liu, Y., Ling, W., and Kosten, T. R. Traditional medicine in the treatment of drug addiction. Am J Drug Alcohol Abuse 2009;35(1):1-11
Mikolai, J., Erlandsen, A., Murison, A., Brown, K. A., Gregory, W. L., Raman-Caplan, P., and Zwickey, H. L. In vivo effects of Ashwagandha (Withania somnifera) extract on the activation of lymphocytes. J.Altern.Complement Med. 2009;15(4):423-430
Bhat, J., Damle, A., Vaishnav, P. P., Albers, R., Joshi, M., and Banerjee, G. In vivo enhancement of natural killer cell activity through tea fortified with Ayurvedic herbs. Phytother.Res 2010;24(1):129-135
Ven Murthy, M. R., Ranjekar, P. K., Ramassamy, C., and Deshpande, M. Scientific basis for the use of Indian ayurvedic medicinal plants in the treatment of neurodegenerative disorders: ashwagandha. Cent.Nerv.Syst.Agents Med.Chem. 9-1-2010;10(3):238-246
Malviya, N., Jain, S., Gupta, V. B., and Vyas, S. Recent studies on aphrodisiac herbs for the management of male sexual dysfunction–a review. Acta Pol.Pharm. 2011;68(1):3-8
Sehgal, V. N., Verma, P., and Bhattacharya, S. N. Fixed-drug eruption caused by ashwagandha (Withania somnifera): a widely used Ayurvedic drug. Skinmed. 2012;10(1):48-49
Vaishnavi, K., Saxena, N., Shah, N., Singh, R., Manjunath, K., Uthayakumar, M., Kanaujia, S. P., Kaul, S. C., Sekar, K., and Wadhwa, R. Differential activities of the two closely related withanolides, Withaferin A and Withanone: bioinformatics and experimental evidences. PLoS.One. 2012;7(9):e44419
Begum, V. H. and Sadique, J. Long term effect of herbal drug Withania somnifera on adjuvant induced arthritis in rats. Indian J Exp Biol. 1988;26(11):877-882
Malhotra, C. L., Mehta, V. L., Das, P. K., and Dhalla, N. S. Studies on Withania-ashwagandha, Kaul. V. The effect of total alkaloids (ashwagandholine) on the central nervous system. Indian J Physiol Pharmacol. 1965;9(3):127-136
Malhotra, C. L., Mehta, V. L., Prasad, K., and Das, P. K. Studies on Withania ashwagandha, Kaul. IV. The effect of total alkaloids on the smooth muscles. Indian J Physiol Pharmacol. 1965;9(1):9-15
Anbalagan, K. and Sadique, J. Influence of an Indian medicine (Ashwagandha) on acute-phase reactants in inflammation. Indian J Exp Biol. 1981;19(3):245-249
Devi, P. U., Sharada, A. C., and Solomon, F. E. In vivo growth inhibitory and radiosensitizing effects of withaferin A on mouse Ehrlich ascites carcinoma. Cancer Lett. 8-16-1995;95(1-2):189-193.
Praveenkumar, V., Kuttan, R., and Kuttan, G. Chemoprotective action of Rasayanas against cyclosphamide toxicity. Tumori 8-31-1994;80(4):306-308.
Devi, P. U., Sharada, A. C., and Solomon, F. E. Antitumor and radiosensitizing effects of Withania somnifera (Ashwagandha) on a transplantable mouse tumor, Sarcoma-180. Indian J Exp Biol. 1993;31(7):607-611.
Sharada, A. C., Solomon, F. E., Devi, P. U., Udupa, N., and Srinivasan, K. K. Antitumor and radiosensitizing effects of withaferin A on mouse Ehrlich ascites carcinoma in vivo. Acta Oncol. 1996;35(1):95-100.
Dhuley, J. N. Therapeutic efficacy of Ashwagandha against experimental aspergillosis in mice. Immunopharmacol.Immunotoxicol. 1998;20(1):191-198.