Ashwagandha

A 2026 systematic review and meta-analysis pooling 23 randomized, placebo-controlled trials (1,706 participants) of oral ashwagandha found a significant pooled increase in testosterone in men (mean difference 57.43 ng/dL) but not in women, alongside significant reductions in cortisol and increases in serotonin; no effect was found on estradiol. This pooled signal differs from any single small trial's result and should be read alongside, not instead of, individual-trial findings; it does not establish a testosterone-restoration or post-anabolic-steroid recovery use.^[2]

• Meta-analysis pooling 23 heterogeneous trials (varying extracts, withanolide content, doses and durations); reports a summary statistic, not a single trial's result, and abstract-level inspection did not review individual-trial risk-of-bias ratings, forest plots or the reported heterogeneity/publication-bias statistics in detail.
• Abstract-checked; no qualified clinical review.

In a 60-day randomized, double-blind trial of a standardized ashwagandha root extract (Shoden, 240 mg/day) in 60 stressed adults, anxiety scores improved on the Hamilton Anxiety Rating Scale versus placebo (P=.040), and morning cortisol and DHEA-S fell significantly versus placebo (P<.001 and P=.004). Testosterone rose 11.4% over time in men in the ashwagandha group (P=.038 within-group) but the change was not statistically significant compared with placebo among men (P=.158); there was no change in women (P=.989).^[1]

• Small, single-extract (Shoden) 60-day trial that was registered after participant recruitment began (retrospective trial registration); does not establish a testosterone-restoration or post-anabolic-steroid recovery effect.
• Full-text-checked; no qualified clinical review.