Spor Hek ml ğ Derg s , 60(2):64-73; 2025
Turk sh Journal of Sports Med c ne
Turk J Sports Med. DOI: 10.47447/tjsm.0862
Rev ew Art cle / Derleme Makales
The effect of Ashwagandha (W than a somn fera) on sports performance: a systemat c
rev ew and meta-analys s
Ashwagandha (W than a somn fera)'nın Spor Performansı Üzer ne Etk s : S stemat k B r
Derleme ve Meta-Anal z
Ran l Jayawardena1 , Kalan Weeras nghe2 , P um ka Soor yaarachch 3
1Department of Phys ology, Un vers ty of Colombo, Colombo, Sr Lanka
2Health and Wellness Un t, Un vers ty of Colombo, Colombo, Sr Lanka
3Faculty of Med c ne, The Un vers ty of Queensland, Br sbane, Austral a
ABSTRACT
Ashwagandha is well known for its health benefits, including anti-inflammatory, immunomodulatory, and cardioprotective properties, as well as its po‐
tential to enhance physical fitness and improve sports performance. This review aims to systematically assess the existing literature regarding the ef‐
fect of Ashwagandha on sports performance within the athletic community. A thorough literature search was performed using databases including
SciVerse Scopus®, PubMed®, Web of Science®, Medline, Embase, SPORTDiscus, and AYUSH. A meta-analysis was conducted to evaluate the im‐
pact of Ashwagandha on aerobic fitness levels using RevMan 5.3 software. The screening of 781 potentially relevant articles for eligibility resulted in
the inclusion of eight studies assessing the effect of Ashwagandha on sports performance in the present review. All trials originated in India. The
sports categories involved were athletics, hockey, cycling, boxing, and sprinting. The results demonstrate that Ashwagandha supplementation, at a
dosage of 300 mg to 500 mg of aqueous root extract daily, taken twice a day for a duration ranging from 8 to 12 weeks, is effective in enhancing
sports performance comparing with control or placebo groups. This includes improvements in cardiorespiratory fitness, muscle strength, recovery,
and various physical fitness parameters. The primary finding of the meta-analysis indicates that, in comparison to a placebo, Ashwagandha signifi‐
cantly improved VO2max in athletes by 4.09 ml/min/kg (95% CI, 2.55-5.63, p<0.001; I2=92%, p< 0.001). The analyzed studies did not reveal any ad‐
verse impact; however, seeking guidance from medical professionals before commencing Ashwagandha supplementation in competitive sports is
recommended.
Keywords: Indian ginseng, sports supplementation, Withania somnifera, sports performance
ÖZ
Ashwagandha, anti-inflamatuar, immünomodülatör ve kardiyoprotektif özellikleriyle tanınan bir bitkidir ve ayrıca fiziksel formu artırma ve spor perfor‐
mansını iyileştirme potansiyeline sahiptir. Bu derleme, atletik toplulukta Ashwagandha'nın spor performansı üzerindeki etkisini değerlendiren mevcut
literatürü sistematik olarak incelemeyi amaçlamaktadır. SciVerse Scopus®, PubMed®, Web of Science®, Medline, Embase, SPORTDiscus ve AYUSH
gibi veri tabanlarında kapsamlı bir literatür taraması gerçekleştirilmiştir. RevMan 5.3 yazılımı kullanılarak Ashwagandha'nın aerobik fitness seviyeleri üze‐
rindeki etkisini değerlendiren bir meta-analiz yapılmıştır. Uygunluk açısından incelenen 781 makale arasından, Ashwagandha'nın spor performansı üze‐
rindeki etkisini değerlendiren sekiz çalışma bu derlemeye dahil edilmiştir. Tüm çalışmalar Hindistan'dan kaynaklanmaktadır. İncelenen spor dalları ara‐
sında atletizm, hokey, bisiklet, boks ve sprint yer almaktadır. Sonuçlar, günlük 300 mg ile 500 mg arasında değişen sulu kök ekstresi dozajının, 8 ila 12
hafta boyunca günde iki kez alınmasının, kontrol veya plasebo gruplarıyla karşılaştırıldığında spor performansını önemli ölçüde artırdığını göstermekte‐
dir. Bu gelişmeler arasında kardiyorespiratuvar fitness, kas gücü, toparlanma süreci ve çeşitli fiziksel uygunluk parametrelerindeki iyileşmeler yer almak‐
tadır. Meta-analizin temel bulgusu, Ashwagandha'nın plaseboya kıyasla sporcuların VO2max değerini 4.09 ml/dk/kg artırdığını göstermektedir (95% CI,
2.55-5.63, p<0.001; I2=92%, p<0.001). Analiz edilen çalışmalar herhangi bir olumsuz etki bildirmemiştir; ancak, rekabetçi sporcuların Ashwagandha
takviyesine başlamadan önce tıbbi uzmanlardan rehberlik alması önerilmektedir.
Anahtar Sözcükler: Hint ginsengi, spor takviyesi, Withania somnifera, spor performansı
INTRODUCTION
W than a somn fera, generally known as Ashwagandha (Ind an g nseng), s a trad t onal Ind an herb categor zed under the Solanaceae fam ly (1). Wh le deeply embedded n ts
Ind an her tage, t has also extended ts presence to the
lands of the Med terranean, Afr ca, and Austral a (2). Var ous components of Ashwagandha, encompass ng the root,
seeds, stem, and leaves, have been employed for more than
3000 years, prov d ng d verse health-related benef ts (2).
Currently, Ashwagandha has been repackaged for modern
consumers n the form of capsules, powders, gumm es, and
l qu d extracts, mark ng ts adaptab l ty to chang ng t mes
(3). The worldw de market for Ashwagandha extract reac-
Rece ved / Gel ş: 06.07.2024 · Accepted / Kabul: 07.09.2024 · Publ shed / Yayın Tar h : 16.05.2025
Correspondence / Yazışma: Ran l Jayawardena · Department of Phys ology, Un vers ty of Colombo, Colombo, Sr Lanka · ran l@phys ol.cmb.ac.lk
C te th s art cle as: Jayawardena R, Weerasinghe K, Sooriyaarachchi P. Trunk muscle endurance and upper extremity performance in healthy adults. Turk J Sports Med.
2025;60(2):64-73; https://doi.org/10.47447/tjsm.0862
Th s s an open access art cle under the terms of the Creat ve Commons Attr but on-NonCommerc al L cense, wh ch perm ts use, d str but on and reproduct on n any
med um, prov ded the or g nal work s properly c ted and s not used for commerc al purposes (http://creat vecommons.org/l censes/by-nc/4.0/).
R. Jayawardena, K. Weeras nghe, P. Soor yaarach
hed a value of 864.3 m ll on USD n 2021. It s ant c pated to
surge to 2.5 b ll on USD by 2031 w th n the Un ted States
and Europe (4). Ashwagandha demonstrates prom s ng health benef ts, part cularly n stress management, anx ety
reduct on, cogn t ve enhancement, address ng sleep d sorders, erect le dysfunct on and phys cal performance by
mprov ng muscular strength (2). Add t onally, there s support ng ev dence nd cat ng the pos t ve mpact of Ashwagandha on nfert l ty, and serum testosterone levels among
males w th lower sexual des re (5). Furthermore, t exh b ts
neuroprotect ve, ant - n ammatory, mmunomodulatory,
card oprotect ve, ant -bacter al, ant -cancer, and ant -d abet c propert es (6).
assess ts e cacy n sports performance. T war et al. (11)
conducted an 8-week, double-bl nd tr al to evaluate the eff cacy of 300 mg of Ashwagandha root extract capsules
(tw ce da ly) n enhanc ng card oresp ratory endurance
(VO2max) and recovery among athletes. An ntervent onal
study conducted by Shenoy et al. (12) assessed the e ect veness of 500 mg capsules of aqueous Ashwagandha root taken tw ce da ly for e ght weeks n el te cycl sts, revealed a
s gn f cant mprovement n var ous anaerob c parameters.
S m larly n another tr al, a substant al mpact of Ashwagandha was observed among spr nters, part cularly n relat on to the r stand ng broad jump, 50-yard dash, s t-ups,
shuttle run, 12-m n run/walk and pull-ups (13). Bes des, Ashwagandha supplementat on has been approved by var ous health and nutr t on organ zat ons, re ect ng ts safety
and e cacy n appropr ate contexts (14). Furthermore, t s
not class f ed as a dop ng substance by the World Ant -Dop ng Agency (WADA), ensur ng ts acceptab l ty n compet t ve sports (15).
A double-bl nd random zed controlled tr al (RCT) was performed to evaluate the ant - n ammatory e ect of Ashwagandha n 60 pat ents w th knee jo nt pa n and d scomfort.
Follow ng 12 weeks, s gn f cant reduct ons n knee pa n and
swell ng were observed n the Ashwagandha 250 mg
(p<0.001) and Ashwagandha 125 mg (p<0.05) groups, compar ng to the placebo group. D sab l ty and st ness exh b ted a notable decrease n both the Ashwagandha 250 mg
(p<0.001) and Ashwagandha 125 mg (p<0.01) groups (1).
Chauhan and co-workers reported a s gn f cant elevat on of
serum testosterone levels (66.5 ng/dl; p<0.0001) follow ng
Ashwagandha supplementat on n men (5). In add t on, Ashwagandha s mportant n reduc ng stress, enhanc ng focus and memory, psycholog cal well-be ng, and enhanc ng
sleep qual ty, as well as lower ng stress levels (7).
Wh le many herbal and nutr t onal supplements cla m to
mprove sports performance, Ashwagandha stands out due
to ts un que adaptogen c propert es, wh ch may contr bute
to enhanced phys cal performance, recovery, and overall
well-be ng (16). Unl ke some other supplements, Ashwagandha s cons dered un que because t pos t vely a ects
var ous performance parameters such as card oresp ratory
f tness, muscle strength, and recovery (8-13).
There has been grow ng nterest n Ashwagandha, lead ng
to several systemat c rev ews on ts e ects on phys cal funct on and performance n both athletes and non-athletes (1618). However, no systemat c rev ews or meta-analyses have
spec f cally evaluated Ashwagandha supplementat on n
athletes. G ven the w despread nterest and potent al benef ts of Ashwagandha on sports performance, t s cruc al to
conduct a comprehens ve rev ew focus ng on ts mpact on
athlet c performance. Th s study a ms to f ll th s gap by systemat cally assess ng the e cacy of Ashwagandha supplementat on n athletes, address ng ts potent al benef ts and
prov d ng ns ghts nto ts role n enhanc ng sports
performance.
Bes des ts use n health and well-be ng treatments, Ashwagandha supplementat on has been h ghl ghted n l terature
for ts role n enhanc ng phys cal performance n healthy
adults. In an 8-week RCT led by Wankhede et al. (8), nd v duals who ngested 300 mg of Ashwagandha root extract
tw ce da ly conf rmed noteworthy enhancements n benchpress muscle strength (Ashwagandha group: 46.0 kg, placebo: 26.4 kg; p=0.001), accompan ed by a s gn f cant growth
n arm muscle s ze. In a separate tr al, t was documented
that a 500 mg dosage of aqueous Ashwagandha extract
substant ally enhanced both upper and lower-body strength, promoted a favourable body compos t on, and prov ded benef ts for healthy, act ve men throughout a 12-week
supplementat on per od (9). In a comparable study, Sandhu
and collaborators (10) observed a noteworthy pos t ve n uence of Ashwagandha supplementat on on max mum veloc ty, average absolute and relat ve power, max mum oxygen
consumpt on (VO2max) and balance w th n a group of 40
MATERIAL and METHODS
Follow ng the gu del nes establ shed n the Preferred Report ng Items for Systemat c Rev ews and Meta-Analyses
(PRISMA) statement (19), a systemat c rev ew and metaanalys s were carr ed out. The protocol for th s rev ew was
reg stered prospect vely n the nternat onal systemat c rev ews
reg ster
(PROSPERO
reg strat on
no.
CRD42023460949).
healthy part c pants.
Cons der ng the potent al mpact of Ashwagandha on mprov ng phys cal parameters among healthy adults, several
ntervent onal stud es have been carr ed out on athletes to
65
Turk J Sports Med
Ashwagandha and Sports Performance
de stud es that met the spec f ed cr ter a (20).
Search strategy
Populat on (P): Profess onal athletes or nd v duals part c pat ng n compet t ve sports act v t es were cons dered. Stud es nvolv ng non-athlete populat ons, healthy nd v duals, recreat onal sports personals, or pat ents were
excluded.
A comprehens ve electron c l terature search was conducted n f ve phases us ng PubMed®, Web of Sc ence®(v.5.4)
(Thomson Reuters, USA), Sc Verse Scopus® (Elsev er Propert es S.A, USA), Embase® (Excerpta Med ca), Medl ne
(U.S. Nat onal L brary of Med c ne, USA), SPORTD scus,
and AYUSH Research Portal. The search encompassed art cles publ shed pr or to September 1, 2023. Databases were
searched us ng Med cal Subject Head ngs (MeSH) terms
when poss ble or keywords when otherw se appropr ate,
and the terms ‘W than a somn fera’ OR ‘ashwagandha’ OR
‘Ind an G nseng’ AND ‘sports’ OR ‘exerc se’ OR ‘endurance’
OR ‘strength’ OR ‘runn ng’ OR ‘performance’ OR ‘athlet c’
were ncluded.
Intervent on (I): The ntervent on was supplementat on
w th Ashwagandha, rrespect ve of dosage, formulat on, or
durat on. Stud es where Ashwagandha was comb ned w th
other supplements were removed.
Comparator/Control (C): No supplementat on or rece v ng
a placebo. Stud es w th act ve substance were g ven as comparator were excluded.
Outcomes (O): Stud es measur ng any sports performancerelated outcome, anthropometr c, b ochem cal, phys cal
etc. Stud es that d d not measure sports performance outcomes d rectly (e.g., stud es focus ng solely on stress, and anx ety w thout l nk ng to performance) were excluded.
An advanced search was carr ed out n the PubMed database, us ng the spec f ed MeSH terms and keywords w th n
the art cle t tle and abstract. In the Web of Sc ence® database, the advanced search operator TS (T tle, abstract, author keywords, keywords plus) was ut l zed to search for
Study des gn (S): Us ng the PICO strategy, human ntervent onal stud es assess ng the e ect veness of Ashwagandha on sports performance across any study durat on
were ncluded. Excluded from cons derat on were observat onal stud es (such as cohort, case-control, and cross-sect onal stud es), an mal stud es, n-v tro models, case reports,
case ser es, letters to the ed tor, rev ews, and unpubl shed
data.
the spec f ed terms w th n art cle top cs. The Scopus® database was exam ned for the ment oned terms w th n the art cle t tle, abstract, or keywords. The Embase® database
was explored us ng the keywords n the t tle or abstract. For
Medl ne, a search was done us ng the spec f ed keywords n
the abstracts. In the case of the SPORTD scus database, the
search was l m ted to keywords assoc ated w th ashwagandha w th n abstracts, exclud ng the term ‘sport performance’ due to the sport-centr c nature of the database. On
the AYUSH research portal (https://ayushportal.n c. n/),
the query was narrowed down to ‘cl n cal research (ev dence grade-A, B, and C)’ w th n the ‘Ayurveda’ subcategory,
focus ng on abstracts. The only l m t set for these database
searches was the Engl sh language.
Data extract on
An nvest gator (KW) extracted and tabulated the follow ng
var ables: f rst author, publ cat on year, country, study des gn, sport type, gender, and age of the study populat on,
sample s ze, supplementat on, durat on, and s gn f cant
outcomes. A second nvest gator (RJ) ndependently ver f ed
the accuracy of the extracted data, and any d screpanc es
were resolved through d scuss on. Furthermore, when nterpret ng the level of stat st cal s gn f cance, as s gn f ed
by the p-value, compar sons between the test and control
groups rather than those between the pre-and post- ntervent ons of each group were cons dered.
The search strategy was ndependently carr ed out by two
co-authors (RJ and PS), and any d screpanc es were resolved by d scuss on. In the second step, the total c tat ons
collected from seven databases were consol dated, and
dupl cate entr es were el m nated. The rema n ng art cles
underwent el g b l ty assessment through success ve stages: the th rd stage nvolved rev ew ng the art cle ‘t tle’, the
fourth stage nvolved exam n ng the ‘abstract’, and the f h
stage nvolved assess ng the ‘full text’. Th s process ut l zed
the nclus on and exclus on cr ter a outl ned below. Add t onally, a manual search was executed to dent fy supplementary art cles from the reference l sts of nvolved art cles.
Assessment of qual ty
Two ndependent nvest gators conducted the qual ty assessment for the selected stud es us ng the Mod f ed Jadad
Scale. Each study was ass gned a score rang ng from 0 to 8.
Subsequently, stud es were categor zed as h gh-qual ty
(scor ng 6-8 po nts), moderate qual ty (4-5 po nts), or poor
qual ty (<4 po nts) based on a max mum poss ble score of
e ght (21).
Inclus on and exclus on cr ter a
The study employed the populat on, ntervent on, compar son, outcomes, and study (PICOS) des gn strategy to nclu-
66
R. Jayawardena, K. Weeras nghe, P. Soor yaarach
RESULTS
Data analys s
The pr mary systemat c l terature search n each database
resulted n the follow ng number of stud es: Sc Verse Sco-
The mpact of Ashwagandha on max mal oxygen consumpt on (VO2max) was evaluated and analyzed by the RevMan
pus® (n=561), PubMed® (n=145), Web of Sc ence® (n=267),
Medl ne (n=116), Embase (n=202), SPORTD scus (n=21) and
AYUSH (n=73). Follow ng the removal of dupl cates, 781 potent ally relevant art cles underwent el g b l ty assessment.
Dur ng the n t al screen ng based on t tles and abstracts, 12
art cles rema ned for further full-text evaluat on. A er retr ev ng the full-text for deta led assessment, s x stud es met
all nclus on cr ter a. Two add t onal art cles were dent f ed
through manual search, result ng n a total of e ght papers
ncluded n the current rev ew. F gure 1 prov des a summary of the search strategy.
5.3 so ware (Cochrane Collaborat on, Oxford, UK). The
meta-analys s ncluded stud es that met the el g b l ty cr ter a and nvolved a compar son between an exper mental
group and a control group concern ng VO2max. Changes
from the basel ne (mean change and SDs of the changes)
were extracted for both the exper mental and control groups. Cont nuous var ables were assessed us ng we ghted
mean d erences (WMDs) and 95% CI. Data heterogene ty
was exam ned through the X2 test and I2 test. In cases of
homogene ty (p>0.05, I2<60%), a f xed-e ects model was
appl ed (22); else, the random e ects model was used. A
p<0.05 was cons dered stat st cally s gn f cant. In add t on,
publ cat on b as was assessed by funnel plots.
F gure 1. Preferred reported tems for systemat c rev ews and meta-analys s
ow d agram deta l ng the rev ew f lter ng process
67
Turk J Sports Med
Ashwagandha and Sports Performance
d ng athlet cs (7,11), hockey (25,26), cycl ng (12,27), box ng
(24), and spr nt ng (13). D erent doses and forms of Ashwagandha supplementat on have been adm n stered, as llustrated n Table 1, w th supplementat on durat ons rang ng from 8 to 12 weeks. When exam n ng the potent al s de
e ects of Ashwagandha supplementat on, only two stud es
reported no adverse e ects (11,13). Other stud es d d not nd cate the evaluat on of s de e ects assoc ated w th the
supplement.
All e ght manuscr pts nvolved n th s systemat c rev ew
were RCTs publ shed between 2002 and 2021 n Ind a. The
qual ty of the selected tr als was assessed us ng the Mod f ed Jadad Scale, result ng n two h gh-qual ty stud es (7,11)
four of moderate qual ty (12,24-26), and two of poor qual ty
(13,27) (Supplementary Table). The age range of the athletes
nvolved n the stud es ranged from 17 to 45 years. When
cons der ng the number of athletes recru ted n the selected
RCTs, the sample s zes ranged from 15 to 50 subjects. The
ncluded RCTs nvolved a range of sports categor es, nclu-
Table 1. Ev dence of the e ects of Ashwagandha supplementat on on sports performance
Author,
year
Study
des gn,
MJS
Sport Gender,
type
age
Sample s ze, supplementat on
IG
PG/CG
Durat on,
s de
e ects
S gn f cant outcomes
1. VO2max ↑ (IG: 68.5 ml/m n/kg, CG:
58.5 ml/m n/kg); p=0.01,
2.
Basal
heart rate ↓ (IG: 57±6 bpm, CG:
n=7,
58±4 bpm); p=0.05,
Ahuja et al.
M, 21placebo
R, 4 pts Boxers
n=8, dose NM, da ly, BD
12 wk, NM 3. Heart rate recovery after exerc se at
2002 (24)
30
capsule da ly,
the end of 1st m n↓ (IG: 147 bpm, CG: 153
BD
bpm),
4. WBC ↑ (IG: 8500±10 /µl, CG: 8005±11 /
µl); p<0.05.
Mean change from basel ne,
Choudhary R, DB, P,
Both,
12 wk, 1. VO2max↑ (IG:5.67, PG: 1.86); p<0.0001,
n=25, sucrose
et al. 2015,
Athlet cs
n=25, 300 mg root extract da ly, BD
capsules
7 pts
20-45
NM
2. QoL scores for phys cal health ↑ (IG:
(7)
9.3±7.6, PG: −2.3±5.7); p<0.05.
1. VO2max ↑ (IG: 51.5±2.9, PG: 49.3±3.1);
n= 16,
8 wk,
Mal k et al. R, SB, P,
M,
500 mg of
p<0.01,
Hockey
n=16, 500 mg roots of WS; BD
2013 (25)
17.4±1.7
4.5 pts
sugar powder;
NM
2. Haemoglob n ↑ (IG: 13.9±0.7, PG:
BD
13.4±0.7); p<0.01.
n=24, 500 mg
M,
Mal k et al. R, SB, P,
Core muscle strength and stab l ty↑ (IG:
Hockey
n=24, 500 mg of WS roots ; BD
starch
8 wk, NM
2014 (26)
65.7±6.8, PG: 51.5±4.2); p<0.01.
4.5 pts
17.3±1.8
capsules; BD
1. VO2max↑ (IG: 52.0±4.8 ml/m n/kg, PG:
44.4±5.7 ml/m n/kg); p<0.001,
R,
Both, n=20, 500 mg aqueous root capsules,
n=20,
Shenoy et
Cycl sts
8 wk, NM 2. T me for exhaust on on the treadm ll↑
al. 2012 (12)
BD
5 pts
20.0±2.0
starch capsules
(IG: 16.9±1.3 m n, PG: 15.6±1.0
m n);p<0.001.
1. Peak power↑ (IG: 297.8±53.5 W, PG:
R,
Both, n=20, 500 mg aqueous root capsules,
n=20,
242.6±32.1 W); p<0.05,
Shenoy et
Cycl sts
8 wk, NM
al. 2012 (27)
BD
3 pts
20±2.0
starch capsules
2. Average power↑ (IG: 198.4±33.1 W, PG:
147.5±39.0 W); p<0.05.
1. VO2max↑ (IG: 46.8±5.0 ml/m n/kg, PG:
42.7±5.5 ml/m n/kg); (p=0.007),
2.
Exhaust on recovery rate↑ (TQR
Both, n=25, 300 mg root extract capsules
n=25,
8 wk,
T war et al. R, DB, P,
Athlet cs
scores) (IG: 17.1±1.0, PG: 15.2±1.1);
2021(11)
da ly, bd
8 pts
18-45
starch capsules None
p<0.0001,
3. Lack of energy ↑; p<0.0001,
4. Ant ox dant level↑ p<0.0001.
1. Stand ng broad jump (m) ↑ (IG; 2.68,
CG: 2.07); p<0.05,
2. 50-yard dash↑ (s) (IG: 6.28, CG: 6.67);
p<0.05),
n=10,
3. Pull-ups (/m n) ↑ (IG: 9.8, CG: 9.1);
N=10,
R, P,
M,
12 wk,
p<0.05,
Yadav et al.
For 50-59kg BW-2.5 g of WS; >60kg
Spr nt ng
None was
2014 (13)
3 pts
18-25
BW-3.0 g of WS; td alternate days
None
4. S t-ups (/m n) ↑ (IG: 39.3, CG: 40.3);
g ven
w th m lk
p<0.05,
5. Shuttle run (s) ↑ (IG: 9.67, CG: 9.98);
p<0.05,
6. 12- m n. run/walk (m n) ↑ (IG: 23.2, CG:
24.2); p<0.05.
BD: tw ce a day, BW: body we ght, CG: control group, CO: cross-over, DB: double-bl nded, IG: ntervent on group, MJS: Mod f ed Jadad Score (out
of 8), NM: not ment oned, P: parallel, PG: placebo group, QoL: qual ty of l fe, R: random zed, SB: s ngle bl nded, WS: W than a somn fera.
68
R. Jayawardena, K. Weeras nghe, P. Soor yaarach
The e ect of Ashwagandha on VO2max was stud ed n f ve
Regard ng the s gn f cant outcomes of nterest, f ve stud es
ncluded n th s rev ew conf rmed that Ashwagandha was
more e ect ve than placebo n enhanc ng VO2max
stud es (7,11,12,24,25). Out of the f ve stud es n t ally cons dered, one study had to be le out due to nadequate data
for meta-analys s, result ng n only four stud es be ng ncluded n the f nal analys s (7,11,12,25). A random-e ects
analys s was employed due to elevated I² values from the
f xed-e ects analys s, nd cat ng substant al heterogene ty
among stud es. Compar ng w th the placebo, Ashwagandha
demonstrated a s gn f cant ncrease n VO2max value
(7,11,12,24,25). Furthermore, another study nvolv ng hockey players, reported that Ashwagandha supplementat on
was super or to placebo n enhanc ng core muscle strength
and stab l ty (IG: 65.7±6.8, PG: 51.5±4.2; p<0.01) (26). T war
et al. (11) presented d rect ev dence suggest ng that Ashwagandha supplementat on pos t vely a ected stress management capab l ty (IG: 46.8±5.1 ml/m n/kg, PG: 42.7±5.5
ml/m n/kg) and the level of ant ox dants n athletes. Ashwagandha supplementat on was determ ned to be more effect ve than a placebo n enhanc ng the anaerob c capac ty
of el te cycl sts, as reported by Shenoy et al. (27). Also, Yadav observed a s gn f cant mprovement n phys cal f tness
parameters among spr nters follow ng supplementat on;
p<0.05 (13).
among athletes by 4.09 ml/m n/kg (95% CI, 2.55-5.63,
p<0.001; I²=92%, p<0.001) (F g. 2). Funnel plots revealed
symmetr cal d str but on of stud es around the aggregate
e ect s ze, suggest ng the absence of publ cat on b as (F g.
3).
F gure 2. E ect of Ashwagandha supplementat on (exper mental) on VO2max
fect ve n enhanc ng sports performance compared to the
control or placebo group. Th s ncludes mprovements n
VO2max, core muscle strength and stab l ty, peak and average power, exhaust on recovery rate, and phys cal f tness
var ables such as s t-ups, stand ng broad jumps, pull-ups,
and the shuttle run.
Our rev ew shows that Ashwagandha s gn f cantly mproves VO2max, w th an ncrease of 4.09 ml/m n/kg (95% CI,
2.55-5.63, p<0.001; I²=92%, p<0.001) compar ng to the placebo. Th s f nd ng s cons stent w th the results obta ned by
Bon lla et al. (16) n the r systemat c rev ew and metaanalys s on the e ect of Ashwagandha supplementat on on
phys cal performance n healthy nd v duals. In a separate
rev ew and meta-analys s conducted by D d o and research
team (18), the overall f nd ngs suggest that the supplementat on of Ashwagandha appears to elevate VO2max n
F gure 3. Funnel plot show ng the b as of the stud es
used n the meta-analys s
DISCUSSION
adults by 3.45 ml/m n/kg (95% CI, 0.30-6.60; I²=74%;
p=0.03), compar ng w th the control group. These results
also al gn w th the f nd ngs of a systemat c rev ew and
meta-analys s by Pérez-Gómez et al. (17), where they demonstrated a s gn f cant enhancement n VO2max n he-
To our knowledge, th s s the f rst systemat c rev ew and
meta-analys s undertaken to evaluate the mpact of Ashwagandha supplementat on on sports performance w th n the
sports populat on. In conclus on, the results of th s study
demonstrate that Ashwagandha supplementat on, at a dosage of 300 to 500 mg of aqueous root extract da ly, taken
tw ce a day for a durat on rang ng from 8 to 12 weeks, s ef-
althy adults and athletes by 3.00 ml/m n/kg (95% CI, 0.185.82). Hence, t s ev dent that Ashwagandha ncreases
69
Turk J Sports Med
Ashwagandha and Sports Performance
VO2max n athlet c populat ons, s m lar to non-athlet c po-
Beyond the enhancements n VO2max, compell ng ev dence
pulat ons. Hence, t can be cons dered an ergogen c supplement that enhances VO2max among athletes.
nd cates that Ashwagandha supplementat on pos t vely
n uences var ous var ables assoc ated w th phys cal performance. One poss ble mechan sm could be the ncrease
n muscle mass and strength due to mproved testosterone
levels upon Ashwagandha supplementat on. A study reported that Ashwagandha ntake was assoc ated w th nearly a
15% ncrease n testosterone n men (34). Another potent al
explanat on for performance mprovements s favourable
changes n body compos t on, nclud ng ncreased muscle
mass, strength, and reduced ad pos ty w th Ashwagandha
supplementat on, poss bly through elevated testosterone
levels (8). A cl n cal tr al revealed that, n compar son to the
placebo group, the Ashwagandha-treated group exh b ted
s gn f cantly greater ncreases n muscle strength, part cularly n the arms and chest. Furthermore, there was notable
growth n muscle s ze. Wh le extens ve research ex sts on
the e ects of Ashwagandha on testosterone levels n men,
the scarc ty of stud es on ts mpact n women h ghl ghts a
need for future research to better understand ts potent al
benef ts and mechan sms n female athletes.
Beyond VO2max, our rev ew also revealed s gn f cant mp-
rovements n other performance parameters. For nstance,
we noted reduct ons n basal heart rate and heart rate recovery a er exerc se (24). Add t onally, Ashwagandha supplementat on led to mprovements n wh te blood cell counts
(24), haemoglob n count (25) and qual ty of l fe scores for
phys cal health (23). Other performance parameters such as
core muscle strength and stab l ty (26), peak and average
power (27), exhaust on recovery rate (6) and var ous phys cal f tness tests were also enhanced.
Max mal oxygen uptake, o en referred to as VO2max s gn -
f es an athlete's potent al to ntake, transport, and e ect vely use oxygen, and stands out as one of the most robust
nd cators of an athlete's endurance capab l t es (17). Hav ng an opt mal VO2max s cruc al for athletes, as t ncreases the oxygen amount that can be used by the muscles.
Some sports supplements have demonstrated the ab l ty to
enhance VO2max among athletes. Notably, stud es have
The Ashwagandha-treated group also demonstrated a substant al reduct on n exerc se- nduced muscle damage,
along w th the stab l zat on of serum creat ne k nase levels
(8). Notably, b oact ve molecules n Ashwagandha, such as
w thanone, play a role n promot ng muscle d erent at on,
suggest ng the r potent al appl cat on n muscle repa r (35).
Add t onally, the pos t ve e ects of the aqueous root extract
of Ashwagandha on phys cal performance may n part be
attr buted to the ant ox dant propert es of the plant, ass st ng n safeguard ng aga nst cellular damage caused by free
rad cals (16). The ma ntenance of appropr ate phys olog cal
levels of react ve oxygen spec es fac l tated by th s supplement could be assoc ated w th the processes of phys olog cal adaptat on dur ng exerc se tra n ng (36).
h ghl ghted the e ect veness of ca e ne supplementat on n
ncreas ng VO2max among el te athletes, lead ng to mprovements n h gh- ntens ty endurance performance (28). Bes des, β-alan ne was revealed to s gn f cantly mprove
VO2max wh le s multaneously reduc ng lactate concentrat ons dur ng exerc se, thus potent ally enhanc ng exerc se
performance, espec ally n endurance athletes (29).
Research nd cates that Ashwagandha supplementat on leads to a s gn f cant r se n haemoglob n levels and red blood cell markers (25). Add t onally, Ashwagandha s l nked
to growth-promot ng and ant -anaem c propert es (30). The
ncreased concentrat on of haemoglob n and red blood cell
counts may enhance VO2max by mprov ng the capac ty to
Nevertheless, the f nd ngs of the current rev ew should be
nterpreted w th caut on, cons der ng var ous factors. In t ally, the stud es ncluded ut l zed d erent Ashwagandha
preparat ons, nclud ng aqueous extracts of the root or dry
capsules, and were adm n stered at var ed doses among a
d verse sports populat on. Add t onally, t s establ shed
that South As ans generally exh b t a lower mean VO2max
transport oxygen to muscles (17). Furthermore, Ashwagandha exh b ts ant -fat gue and ant -stress propert es (31), potent ally contr but ng to a notable mprovement n t me to
exhaust on, and consequently, enhanc ng endurance capab l t es. Certa n chem cal components n Ashwagandha,
nclud ng avono ds, alkalo ds, and stero dal lactones (w thanol des), along w th ant ox dants l ke superox de d smutase, catalase, and glutath one perox dase, may play a role
n VO2max mprovements (32). Notably, Ashwagandha pos -
compar ng to wh te Caucas ans (37). Consequently, these
f nd ngs may not be read ly general zed to other ethn c groups. Th rdly, none of the stud es ncluded el te-level athletes, and the adaptab l ty of Ashwagandha supplementat on
may d er between sem -el te and nternat onal-level athletes. Add t onally, although the results are pos t ve, none of
the stud es were conducted n a 'real-l fe' compet t ve sett ng, mak ng t challeng ng to ascerta n how these results
t vely n uences energy levels and m tochondr al funct ons,
a ect ng Mg2+ dependent ATPase act v ty and reduc ng succ nate dehydrogenase enzyme act v ty n m tochondr al
granulat on t ssue, as demonstrated n an exper mental
study (33).
70
R. Jayawardena, K. Weeras nghe, P. Soor yaarach
translate nto actual sports performance dur ng compet t ons. Lastly, only 25% (n=2) of stud es met the cr ter a for
h gh-qual ty RCTs, and th s also underscores the need for
caut on when nterpret ng the results.
outcomes were reported, restr ct ng our meta-analys s to
only VO2max. Var at ons n Ashwagandha preparat ons and
doses among the stud es, the lower mean VO2max n South
As ans compared w th other ethn c groups, and the absence of el te athletes n the ncluded stud es may a ect the general zab l ty of the results. Add t onally, the lack of stud es
conducted n compet t ve sett ngs l m ts our understand ng
of Ashwagandha’s mpact on real-world sports performance. Furthermore, another l m tat on of the study concerns
our emphas s on stud es conducted n the Engl sh language. F nally, the qual ty of ncluded RCTs was var ed, w th
only 25% meet ng h gh-qual ty cr ter a, emphas z ng the
need for further research. Nevertheless, Ashwagandha s a
trad t onal med c ne n Ind a, and all ncluded stud es or g nate from Ind a, where Engl sh s w dely used. Therefore,
the l kel hood of m ss ng h gh-qual ty stud es s m n mal.
Safety and adverse e ects
Although the major ty of stud es ncorporated n th s systemat c rev ew d d not d sclose any adverse e ects l nked to
Ashwagandha supplementat on, there s ev dence suggest ng the potent al for adverse e ects assoc ated w th Ashwagandha. A prospect ve, double-bl nd, RCT documented
by Chandrasekhar et al. (38) reported m ld adverse e ects
l nked to Ashwagandha supplementat on. The Ashwagandha supplementat on group exper enced e ects such as nasal congest on, const pat on, cough and cold, drows ness,
and reduced appet te. Add t onally, Z egenfuss and colleagues (9) also documented adverse e ects w th n the group
rece v ng the Ashwagandha, spec f cally the occurrence of
arthralg a, myalg a, and abdom nal pa n. A few case stud es have reported atrogen c thyrotox cos s w th ser ous
compl cat ons, nclud ng supraventr cular tachycard a, n
nd v duals who supplemented w th Ashwagandha (40, 41).
However, the safety of Ashwagandha supplementat on has
been exam ned across var ous dosages. Typ cally, dosages
rang ng from 300 to 500 mg of aqueous root extract da ly,
taken tw ce a day for durat ons of 8 to 12 weeks, were welltolerated. Although adverse e ects follow ng supplementat on are rare, t s adv sable for compet t ve athletes cons der ng h gher doses or prolonged use to seek med cal adv ce before n t at ng Ashwagandha supplementat on. Further research s warranted to establ sh comprehens ve safety
prof les and hazard doses for d erent populat ons.
Pract cal recommendat ons
Cons der ng the benef ts of Ashwagandha for athletes, several pract cal recommendat ons can be suggested. It's essent al for sportspersons to determ ne the best dosage suted to the r spec f c needs, cons der ng the herb's var ed
therapeut c responses. Synchron z ng supplementat on
w th r gorous tra n ng can potent ally ampl fy phys cal performance and recovery benef ts. Further, t s mportant to
be aware of any nteract ons, espec ally those that can nfluence hormone levels, g ven the var ety of supplements
that athletes frequently use. Comb n ng Ashwagandha w th
a nutr t ous d et can ncrease ts benef c al e ects. Athletes
are typ cally adv sed to speak w th sports nutr t on sts/d et t an or a med cal profess onal, to make sure the supplement supports the r un que phys olog cal needs and athlet c goals.
Strengths and l m tat ons
Nevertheless, t s mportant to conduct stud es a med at
nvest gat ng the mpact of var ous preparat ons and dosage reg mens of Ashwagandha supplementat on across d verse populat ons. To obta n a more robust est mat on of
the genu ne underly ng e ect of Ashwagandha, there s a
need for h gh-qual ty stud es w th larger sample s zes that
are followed up for an extended per od.
The current rev ew and meta-analys s have several notable
strengths. In t ally, an extens ve search was carr ed out, cover ng major health-related databases such as Sc Verse Scopus®, PubMed®, Web of Sc ence®, Medl ne, Embase,
SPORTD scus, and AYUSH. Add t onally, sport-spec f c databases were ncluded to ensure thorough coverage.
Th rdly, the largest research database for Ayurved c med c ne was thoroughly searched. Moreover, add t onal manuscr pts were dent f ed through reference l sts. Furthermore,
searches were performed us ng both MESH terms and
t tle/abstract level search cr ter a to dent fy all potent ally
relevant art cles n PubMed and Medl ne.
To conclude, results of th s systemat c rev ew and metaanalys s conf rm that Ashwagandha supplementat on s eff cac ous n mprov ng sports performance, nclud ng enhancements n card oresp ratory f tness, muscle strength,
recovery, and var ous phys cal f tness parameters. The pr mary f nd ng of the meta-analys s nd cates that Ashwagandha s gn f cantly ncreased VO2max n athletes by 4.09
The general zab l ty of these results s subject to certa n l m tat ons. One of them s the l m ted number of stud es
ava lable on th s top c and the s gn f cant heterogene ty n
study populat ons and sports var ables measured. D erent
stud es have assessed var ous parameters, and no s m lar
ml/m n/kg. Although no negat ve e ects were documented,
t s recommended to ut l ze Ashwagandha supplements
under healthcare profess onal gu dance.
71
Turk J Sports Med
Con ct of Interest / Çıkar Çatışması
The authors conf rm the absence of any f nanc al or personal relat onsh ps that could potent ally mpact the ntegr ty of the work presented n
th s paper.
F nanc al D sclosure / F nansal Destek
The authors rece ved no f nanc al support for the research and/or publ cat on of th s art cle.
Author Contr but ons / Yazar Katkıları
RJ: conceptual zat on, methodology; PS: so ware, data curat on; KW: wr t ng or g nal dra preparat on; RJ: superv s on; PS, RJ: val dat on; KW, PS,
RJ: wr t ng, rev ew ng and ed t ng. All authors contr buted to the f nal vers on of the manuscr pt and d scussed the results and contr buted to the
f nal manuscr pt.
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72
R. Jayawardena, K. Weeras nghe, P. Soor yaarach
Supplementary Table. Mod f ed Jadad scores of the ncluded stud es
Author, Year
Ahuja et al.
2002(24)
Choudhary
et al. 2015 (7)
Mal k et al.
2013 (25)
Mal k et al.
2014 (26)
Shenoy et al.
2012 (12)
Shenoy et al.
2012 (27)
T war et al.
2021(11)
Yadav et al.
2014 (13)
Descr bed as Appropr ate Descr bedAppropr ate
random zed random zat on as bl nd bl nd ng
W thdrawals &
drop-outs
represented
Incl/excl
cr ter a
represented
Adverse
e ects
descr bed
Stat st cal
approach
descr bed
Total
score
1
0
0
0
1
1
0
1
4
1
1
1
1
1
1
0
1
7
1
1
0.5
1
0
0
0
1
4.5
1
1
0.5
1
0
0
0
1
4.5
1
1
0
0
1
1
0
1
5
1
-1
0
0
1
1
0
1
3
1
1
1
1
1
1
1
1
8
1
0
0
0
0
1
0
1
3
73