Ashwagandha and Testosterone:

Ashwagandha and Testosterone:

A Comprehensive Evidence-Based Guide for Men

Medical Review: Courtney LaSumner Bass, NP  |  Last Updated: December 2024  |  Reading Time: 18 minutes

MEDICAL DISCLAIMER: This article is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any supplement regimen. Individual responses to ashwagandha may vary, and this information should not replace professional medical guidance.

Understanding Ashwagandha: Ancient Wisdom Meets Modern Science

In the realm of men's health optimization, few natural compounds have generated as much scientific interest as ashwagandha (Withania somnifera). This ancient Ayurvedic herb, used for over 3,000 years in traditional Indian medicine, has emerged as one of the most researched adaptogenic botanicals for supporting male hormonal health.

For Utah men exploring natural approaches to support testosterone levels, energy, and overall vitality, understanding the scientific evidence behind ashwagandha is essential. At Arsenal Men's Health, we believe in providing evidence-based information that empowers our patients to make informed decisions about their health optimization journey.

This comprehensive guide examines what peer-reviewed research actually reveals about ashwagandha's effects on testosterone, muscle performance, stress response, and male fertility—while also addressing important safety considerations that every man should understand.

What Is Ashwagandha?

Ashwagandha (Withania somnifera), also known as "Indian ginseng" or "winter cherry," is an evergreen shrub belonging to the Solanaceae (nightshade) family that grows in India, the Middle East, and parts of Africa. The name "ashwagandha" derives from Sanskrit, roughly translating to "smell of the horse"—a reference both to its distinctive aroma and its traditional use for imparting stallion-like strength and vitality.

The Active Compounds: Withanolides

The therapeutic properties of ashwagandha are primarily attributed to a group of naturally occurring steroidal lactones called withanolides. These bioactive compounds, found predominantly in the root and leaves of the plant, are structurally similar to human steroid hormones—which may partly explain ashwagandha's effects on the endocrine system.

Modern ashwagandha supplements are typically standardized to contain specific percentages of withanolides (commonly 2.5% to 10%), ensuring consistent potency across products. Key withanolides include withaferin A, withanone, and various withanolide glycosides, each contributing to the herb's multifaceted biological activity.

Adaptogenic Classification

Ashwagandha is classified as an adaptogen—a category of substances that help the body adapt to physical, chemical, and biological stressors while promoting homeostatic balance. This adaptogenic activity forms the foundation for many of ashwagandha's observed effects, particularly its influence on the hypothalamic-pituitary-adrenal (HPA) axis and stress hormone regulation.

Does Ashwagandha Increase Testosterone? The Clinical Evidence

The relationship between ashwagandha and testosterone has been investigated in multiple randomized, placebo-controlled clinical trials. While the research is promising, understanding the nuances of these findings is crucial for setting realistic expectations.

Key Clinical Trial Findings

The Lopresti Study (2019): Aging, Overweight Males

A 16-week randomized, double-blind, placebo-controlled crossover study published in the American Journal of Men's Health examined ashwagandha's effects in overweight men aged 40-70 with mild fatigue. Participants received either placebo or an ashwagandha extract delivering 21 mg of withanolide glycosides daily for 8 weeks.

• Testosterone increased by approximately 15% compared to placebo

• DHEA-S (a testosterone precursor) increased by 18%

• Testosterone levels remained within normal physiological ranges

• No significant adverse events were reported

The Wankhede Study (2015): Resistance Training

Published in the Journal of the International Society of Sports Nutrition, this 8-week study examined 57 young men (18-50 years) with limited resistance training experience. Participants received either 300 mg of ashwagandha root extract twice daily or placebo while following a supervised strength training program.

• Testosterone levels were significantly greater in the ashwagandha group

• Muscle strength improvements were more pronounced (bench press, leg extension)

• Greater reductions in exercise-induced muscle damage

• Improved body composition with greater fat reduction

The Ambiye Study (2013): Male Fertility

This 90-day pilot study in Evidence-Based Complementary and Alternative Medicine examined 46 men with oligospermia (low sperm count). Participants received 675 mg of ashwagandha root extract daily in three divided doses.

• Serum testosterone increased by 17% (P<0.01)

• Luteinizing hormone (LH) increased by 34% (P<0.02)

• Sperm count increased by 167%

• Semen volume increased by 53%

• Sperm motility increased by 57%

The Smith Study (2023): Stress and Hormones

A 12-week randomized, double-blind, placebo-controlled trial published in the Journal of Psychopharmacology examined overweight adults aged 40-75 experiencing high stress and fatigue.

• Significant increase in free testosterone in men (p = 0.048)

• Significant increase in luteinizing hormone (p = 0.002)

• Significant reduction in fatigue symptoms (p = 0.016)

• Improved heart rate variability indicating better stress adaptation

KEY TAKEAWAY: Clinical trials consistently demonstrate that ashwagandha supplementation can increase testosterone levels by approximately 10-17% in men. However, this magnitude of increase—while meaningful—is generally insufficient to treat clinically diagnosed low testosterone (hypogonadism) on its own. Men with total testosterone levels below 300 ng/dL typically require medical intervention beyond supplementation.

How Ashwagandha May Influence Testosterone: Proposed Mechanisms

Understanding the biological pathways through which ashwagandha may affect testosterone helps contextualize its potential benefits and limitations. Researchers have proposed several interconnected mechanisms:

1. HPA Axis Modulation and Cortisol Reduction

The hypothalamic-pituitary-adrenal (HPA) axis governs the body's stress response. Chronic stress leads to sustained cortisol elevation, which has been shown to suppress testosterone production through multiple mechanisms. A 2023 systematic review found that ashwagandha supplementation reduced serum cortisol levels by 11-32% in stressed individuals over 30-112 days.

Since cortisol and testosterone share common biosynthetic precursors (both derive from cholesterol via DHEA), reducing excessive cortisol production may theoretically "free up" resources for testosterone synthesis. Additionally, cortisol directly inhibits the hypothalamic-pituitary-gonadal (HPG) axis, so lowering cortisol may remove this inhibitory pressure.

2. Luteinizing Hormone Enhancement

Several studies have demonstrated that ashwagandha increases luteinizing hormone (LH) levels. LH, released from the anterior pituitary gland, directly stimulates the Leydig cells in the testes to produce testosterone. The 34% increase in LH observed in the Ambiye fertility study suggests ashwagandha may act at the level of the pituitary or hypothalamus to enhance HPG axis signaling.

3. Antioxidant Protection of Testicular Tissue

Oxidative stress is known to impair Leydig cell function and testosterone production. Withanolides possess significant antioxidant properties, potentially protecting testicular tissue from reactive oxygen species (ROS) damage. Studies have shown increased antioxidant levels (including glutathione and superoxide dismutase) following ashwagandha supplementation, which may create a more favorable environment for testosterone synthesis.

4. GABA-Mimetic Effects

Animal studies suggest ashwagandha may act as a GABA (gamma-aminobutyric acid) agonist, producing calming effects on the central nervous system. This GABAergic activity may contribute to reduced anxiety and improved sleep quality—both factors known to influence testosterone production. Poor sleep, in particular, is strongly associated with decreased testosterone levels.

Ashwagandha and Physical Performance: Beyond Testosterone

For men focused on fitness and athletic performance, ashwagandha's benefits may extend beyond hormonal effects. A 2021 Bayesian meta-analysis in the Journal of Functional Morphology and Kinesiology analyzed data from multiple randomized controlled trials and found compelling evidence for performance enhancement.

Muscle Strength and Size

A 2024 study published in F1000Research examined 80 healthy adults (both male and female) aged 18-45 who received 600 mg of standardized ashwagandha extract daily while following an 8-week resistance training program. Results demonstrated:

• Significantly greater improvement in bench press strength (males: p = 0.0084; females: p = 0.0005)

• Significantly greater improvement in leg press strength (males: p = 0.0049; females: p = 0.018)

• Greater improvements in muscle girth (arm, chest, thigh)

• No adverse events reported throughout the study

Cardiorespiratory Endurance

Multiple studies have shown significant improvements in VO₂max (a key measure of aerobic capacity) with ashwagandha supplementation. Athletes supplementing with 300-500 mg of aqueous root extract daily for 8-12 weeks demonstrated enhanced cardiorespiratory fitness, with improvements particularly notable in individuals engaged in regular training.

Recovery and Muscle Damage

Ashwagandha has demonstrated effects on exercise recovery. Studies show reduced creatine kinase levels (a marker of muscle damage) and improved perceived recovery scores following intense training. This accelerated recovery may enable more frequent or intense training sessions over time.

Ashwagandha and Male Fertility

Perhaps the most striking research on ashwagandha in men's health involves its effects on semen parameters. For couples struggling with conception, these findings may be particularly relevant.

Semen Quality Improvements

The landmark Ambiye study (2013) demonstrated remarkable improvements in men with oligospermia after 90 days of ashwagandha supplementation:

• Sperm concentration increased by 167% (from 9.59 million/mL to 25.61 million/mL)

• Semen volume increased by 53%

• Sperm motility increased by 57%

• These improvements were accompanied by increased testosterone and LH levels

Additional studies have confirmed these fertility-enhancing effects. Research by Mahdi et al. (2011) demonstrated that ashwagandha improved semen quality in stress-related male infertility by reducing oxidative stress markers in seminal plasma and rebalancing reproductive hormones.

Proposed Fertility Mechanisms

• Increased testosterone and LH supporting spermatogenesis

• Reduced oxidative stress protecting sperm DNA integrity

• Lower cortisol reducing stress-related reproductive suppression

• Enhanced antioxidant capacity in seminal fluid

Stress Reduction and Cortisol: The Foundation of Ashwagandha's Effects

While testosterone effects are notable, ashwagandha's most robust and consistently replicated findings relate to stress reduction and cortisol modulation. This adaptogenic property may be the mechanistic foundation underlying many of its other observed benefits.

Clinical Evidence for Stress Reduction

A 2019 study published in Medicine examined 60 stressed adults receiving 240 mg of standardized ashwagandha extract (35% withanolide glycosides) for 60 days. Results included:

• Significant reduction in Hamilton Anxiety Rating Scale scores (p = 0.040)

• 23% reduction in morning cortisol levels

• Testosterone increased in males (p = 0.038) though not significantly different from placebo

• No adverse events reported

A systematic review examining cortisol effects (2023) found that ashwagandha supplementation for 30-112 days was associated with cortisol reductions ranging from 11% to 32.63% across different study populations.

Dosage Considerations

Clinical trials have utilized varying doses of ashwagandha, making it challenging to establish a single "optimal" dose. However, patterns from successful studies provide general guidance:

Commonly Studied Dosages

• General wellness and stress: 240-300 mg of standardized extract daily

• Testosterone and performance: 300-600 mg daily, often divided into two doses

• Fertility support: 675 mg daily in three divided doses

• Higher doses (up to 1,000-1,250 mg) have been studied but are not necessarily more effective

Standardization Matters

The withanolide content significantly impacts potency. Look for products standardized to contain:

• Minimum 2.5% withanolides for general extracts

• 5-10% withanolides for high-potency formulations

• Root extract (not leaf) for testosterone-related effects

Duration of Use

Most clinical trials demonstrating benefits have lasted 8-16 weeks. Effects on testosterone and other parameters appear to develop gradually rather than acutely. Long-term safety data beyond 12 months remains limited, and some practitioners recommend cycling usage (e.g., 8-12 weeks on, 2-4 weeks off).

Safety Considerations and Potential Side Effects

While ashwagandha is generally considered safe for short-term use in healthy adults, emerging case reports highlight important safety considerations that warrant careful attention.

Common Side Effects

• Gastrointestinal discomfort (nausea, diarrhea, stomach upset) at high doses

• Drowsiness or sedation (particularly when combined with sleep-promoting agents)

• Rare cases of hyperthyroidism with prolonged use

Liver Toxicity Concerns

Recent case reports have documented instances of liver injury associated with ashwagandha supplementation. According to the NIH LiverTox database, ashwagandha is classified as a "probable" cause of clinically apparent liver injury (Grade B classification). Key points include:

• Cases typically present with cholestatic hepatitis (jaundice, elevated liver enzymes)

• Most cases resolve within 1-4 months of discontinuation

• Rare severe cases requiring liver transplantation have been reported

• Risk may be higher with excessive doses or pre-existing liver conditions

• Contaminants or adulterants in unregulated products may contribute to some cases

IMPORTANT SAFETY NOTE: If you experience yellowing of the skin or eyes, dark urine, unusual fatigue, or abdominal pain while taking ashwagandha, discontinue use immediately and seek medical attention. Individuals with liver disease, those taking hepatotoxic medications, or heavy alcohol users should consult a healthcare provider before using ashwagandha.

Contraindications and Precautions

• Pregnancy and breastfeeding: Not recommended due to insufficient safety data

• Thyroid disorders: Ashwagandha may affect thyroid hormone levels

• Autoimmune conditions: May stimulate immune activity

• Surgery: Discontinue 2 weeks prior due to potential sedative interactions

• Drug interactions: May interact with sedatives, thyroid medications, immunosuppressants, and medications metabolized by liver enzymes (CYP3A4)

Ashwagandha vs. Testosterone Replacement Therapy: Understanding the Difference

For men concerned about testosterone levels, it's essential to understand the distinction between supplementation and medical treatment.

When Ashwagandha May Be Appropriate

• Men with testosterone levels in the low-normal range (350-500 ng/dL) seeking optimization

• Those experiencing stress-related symptoms that may be suppressing testosterone

• Men seeking to support natural testosterone production alongside lifestyle modifications

• Athletes looking for legal performance support and recovery enhancement

When Medical Intervention Is Needed

• Total testosterone consistently below 300 ng/dL with symptoms

• Significant symptoms of hypogonadism (severe fatigue, erectile dysfunction, depression)

• Secondary hypogonadism due to pituitary or hypothalamic dysfunction

• Conditions requiring medically supervised hormone optimization

A 10-17% increase in testosterone from ashwagandha, while beneficial for some, will not adequately treat clinical hypogonadism. For example, if your testosterone is 200 ng/dL, a 15% increase would only raise it to 230 ng/dL—still well below optimal. Properly managed testosterone replacement therapy, when indicated, can restore levels to the therapeutic range of 400-700 ng/dL under medical supervision.

Practical Recommendations for Utah Men

If You're Considering Ashwagandha

• Get baseline lab work: Know your current testosterone, DHEA-S, cortisol, and liver function values before starting

• Choose quality products: Select supplements from reputable manufacturers with third-party testing (USP, NSF, or ConsumerLab verified)

• Start conservatively: Begin with 300 mg daily and assess tolerance before increasing

• Monitor liver function: Consider periodic liver enzyme testing if using for extended periods

• Combine with lifestyle optimization: Ashwagandha works best alongside proper sleep, exercise, nutrition, and stress management

• Consult a healthcare provider: Especially if you have pre-existing conditions or take medications

If You Have Low Testosterone Symptoms

Before relying solely on supplements, schedule a comprehensive evaluation with a men's health provider. Symptoms like fatigue, decreased libido, erectile dysfunction, depression, and loss of muscle mass warrant proper diagnosis and may require evidence-based medical treatment that supplements cannot provide.

Conclusion: Evidence-Based Perspective

Ashwagandha represents one of the better-studied herbal supplements for men's health, with randomized controlled trials supporting modest benefits for testosterone levels (10-17% increases), stress reduction (11-32% cortisol decreases), physical performance, and male fertility. Its adaptogenic properties, particularly HPA axis modulation and cortisol reduction, appear to be the mechanistic foundation for many of these effects.

However, ashwagandha is not a replacement for medical treatment of low testosterone. Men with clinically low levels (below 300 ng/dL) require proper diagnosis and evidence-based interventions under medical supervision. Additionally, emerging safety signals regarding liver toxicity—while rare—necessitate caution, particularly with prolonged use or in individuals with risk factors.

For Utah men seeking to optimize their health naturally, ashwagandha may offer meaningful support when used responsibly as part of a comprehensive approach that includes proper sleep, regular exercise, stress management, and medical guidance when appropriate.

Take the Next Step in Your Health Journey

If you're experiencing symptoms of low testosterone or want to optimize your hormonal health, schedule a comprehensive evaluation with our experienced providers.

Book Your Free Consultation: (385) 666-6292 or visit arsenalmenshealth.com

References

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2. Wankhede S, Langade D, Joshi K, et al. Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial. J Int Soc Sports Nutr. 2015;12:43.

3. Ambiye VR, Langade D, Dongre S, et al. Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania somnifera) in Oligospermic Males: A Pilot Study. Evid Based Complement Alternat Med. 2013;2013:571420.

4. Smith SJ, Lopresti AL, Fairchild TJ. Exploring the efficacy and safety of a novel standardized ashwagandha (Withania somnifera) root extract (Witholytin®) in adults experiencing high stress and fatigue in a randomized, double-blind, placebo-controlled trial. J Psychopharmacol. 2023;37(10):1091-1104.

5. Bonilla DA, Moreno Y, Gho C, et al. Effects of Ashwagandha (Withania somnifera) on Physical Performance: Systematic Review and Bayesian Meta-Analysis. J Funct Morphol Kinesiol. 2021;6(1):20.

6. Verma N, Gupta SK, Patil S, et al. Effects of Ashwagandha (Withania somnifera) standardized root extract on physical endurance and VO2max in healthy adults performing resistance training. F1000Res. 2024;12:335.

7. Lopresti AL, Smith SJ, Malvi H, et al. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186.

8. Mahdi AA, Shukla KK, Ahmad MK, et al. Withania somnifera Improves Semen Quality in Stress-Related Male Fertility. Evid Based Complement Alternat Med. 2011;2011:576962.

9. Deshpande A, Irani N, Balkrishnan R, et al. A randomized, double-blind, placebo-controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sexual function. Health Sci Rep. 2022;5(4):e741.

10. Ziegenfuss TN, Kedia AW, Sandrock JE, et al. Effects of an Aqueous Extract of Withania somnifera on Strength Training Adaptations and Recovery: The STAR Trial. Nutrients. 2018;10(11):1807.

11. Ashwagandha. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012. Updated December 2024.

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About Arsenal Men's Health

Arsenal Men's Health is Utah's premier nurse practitioner-owned men's health telehealth clinic, providing personalized, evidence-based care for hormone optimization, sexual health, mental wellness, medical weight loss, and more. Founded by Courtney LaSumner Bass, NP—a board-certified nurse practitioner and military veteran—Arsenal delivers discreet, convenient, and clinically excellent care to men throughout Utah.

Location: 489 South Jordan Parkway, Suite #254, South Jordan, UT 84095

Phone: (385) 666-6292

Email: info@arsenalmenshealth.com

Hours: Mon-Fri 8:00 AM - 6:00 PM | Sat 8:00 AM - 1:00 PM | Sun Closed

This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. The information provided is not a substitute for consultation with a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Treatment decisions are made by licensed medical providers based on individual evaluation. Arsenal Men's Health serves patients located in Utah only.