Stress has many ways to manifest in the body that eventually destroys our innate immune system, making us sick. According to experts, our system initially reacts to stress by overproducing and if working hard eventually doesn’t solve the problem, then the system underproduce. The primary function of the immune system is to distinguish self from non-self, and when it fails to do so (due to toxic overload), autoimmune disorder develops. In autoimmune diseases, the immune system overacts, and mistakes healthy cells as harmful ones, and attacks them.  Thus, there is increased inflammation and oxidative stress from free radicals. These toxins create obstacles for the normal functioning and self-healing capabilities of our bodies.

Hashimoto’s thyroiditis is one of such conditions in which thyroid gland under-performs due to chronic damage. The basic function of thyroid is to make thyroid (T3 & T4) hormones, which are secreted into the blood and then carried to every tissue in the body. These hormones help the body use energy, regulate body temperature, and maintain optimum functioning of brain, heart, muscles, and other organs.  In conventional medicines, Hashimoto’s is typically treated with synthetic medication. However, now a day, people are seeking natural alternatives, such as ashwagandha, considering the risks with Synthroid.

Ashwagandha is a well-known herb widely used for its stress-relieving and anti-inflammatory properties and is reportedly safe; still all given science-based information on dosage, contraindications, and efficacy must be studied well before using it.

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 In this article, we will discuss the benefits ashwagandha in improving Hashimoto’s thyroiditis and related health condition, and possible risks associated if not administered correctly.

What is Ashwagandha?

Ashwagandha (Withania somnifera) is an ancient ayurvedic herb used to treat various health conditions.  Some active compounds of this herb include flavonoids and antioxidants, such as catalase, superoxide dismutase and glutathione. The root of Ashwagandha is regarded as anthelmintic, adaptogenic, thermogenic and stimulant tonic. Evidence suggests that ashwagandha is a powerful adaptogenic herb which enhances the body's resilience to stress. Additionally, research notes that ashwagandha is an immunomodulator that helps boost immunity and shows strong antioxidant activity, which helps to decrease oxidative stress.  Yet another benefit of ashwagandha is its prebiotic nutrition that nurtures the diversity of gut microbiome (Erin et. al., 2022).

Benefits of Ashwagandha for Hashimoto’s Disease

Hashimoto’s disease refers to an autoimmune disorder that causes hypothyroidism. In this condition, the immune system makes antibodies that attack thyroid gland; thus, thyroid become damaged and can’t make sufficient thyroid hormones. According to science experts, autoimmunity generated by gluten creates antibodies against proteins of our thyroid system, called thyroglobulin. In the early stage, thyroid damage may lead to release of excess thyroid hormones into blood, causing symptoms of hyperthyroidism. But as the stress persists, thyroid function slows down. As per literature, Hashimoto’s disease is more prevalent in women than men. Usually, people suffering with Hashimoto’s experience fatigue, weight gain, constipation, dry skin, slow heart rate, joint and muscle pain etc.

A growing literature has hinted at beneficial effects of ashwagandha in normalizing thyroid indices in Hashimoto thyroiditis patients. It is well acknowledged that ashwagandha stimulates the endocrine system, boosting thyroid hormone levels by reducing cortisol. Additionally, ashwagandha may help increase muscle strength in patients struggling with Hypothyroid myopathy. This condition is characterized by myalgia and weakness and affects almost 80 percent of patients with hypothyroidism (Sindoni et. al., 2016).  Yet another issue with Hashimoto’s thyroiditis is the increased risk of depression and insomnia (Surya et. al., 2022). Studies show that ashwagandha boosts serotonin levels in the brain. Serotonin is a neurotransmitter that plays a role in emotional and mood regulation. Although, ashwagandha effects are slow and take weeks to show complete result, still it’s a powerful solution to heal thyroid depression. Yet another study published in The Indian Journal of Pharmacology journal stated, “A clinical trial in patients of non-insulin-dependent diabetes mellitus with hypercholesterolemia reported a decrease in blood glucose with ashwagandha extract.”

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Ashwagandha and Weight-Loss in Hashimoto’s Sufferers

Thyroid gland helps control metabolism, and it regulates our appetite. When thyroid levels are low, our metabolism slows down and are also less likely to burn fat for energy, which can lead to weight gain. There is increasing evidence that thyroid dysfunction affects lipid and glucose metabolism, aggravating components of metabolic syndrome. In addition, this butter-fly shaped gland also controls how our body uses energy, therefore, affects body’s homeostasis.  A clinical trial conducted by Jiaji et. al., 2021, confirms hypothyroidism is associated with an increased risk of metabolic syndrome.  Conversely, according to American thyroid association, most of the extra weight gained in hypothyroid individuals is due to excess accumulation of salt and water. 

Particularly, ashwagandha is rich in antioxidants (withanolides, flavonoids and phenolics) that speed up metabolism, decrease inflammation and thus help in burning the stored fat in the body. Additionally, ashwagandha effectively manages stress and anxiety, thus controls stress-induced binge eating in Hashimoto’s sufferers.  Furthermore, ashwagandha promotes deep sleep and helps maintain healthy hormonal balance. Therefore, ashwagandha can be the most preferred natural treatment for Hashimoto’s related health issues.

Certainly, diet plays a significant role if one is taking immune boosting herbs. A hospitable environment for friendly microbes is essential to make them survive and grow. Prefer taking nutrient rich diet while treating Hashimoto’s naturally.

Ashwagandha for Gut health

It is a well-established fact that around 80% of our immune cells are in the gastrointestinal tract; thus, gut health is closely linked to immune function. With this understanding, holistic health practitioners believe that healing gut can help reverse autoimmune disorders. A research study by Erin et. al. 2022, was conducted to track changes to the gut microbiota in response to some nervine herbs (Ashwagandha, Guduchi, Shankha Pushpi etc.) The results of the trial showed profound changes in many diverse gut microbes with all herbs including ashwagandha. This signifies ashwagandha’s effectiveness as prebiotic nutrition. Ashwagandha is reported to alter gut microbiota via the potent prebiotic effects of the herbs’ fibers and sugars, fostering the growth of healthy gut bacteria to positively affect gut metabolism and production of gut-healing compounds such as short chain fatty acids (SCFAs).

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Fermented Ashwagandha

In traditional ayurveda, Arishtas and Asavas are self-generated herbal fermentations. These are alcoholic extracts prepared by allowing herbal juices or their concoction undergo fermentation with the addition of sugar. This process of fermenting medicines results into transformation of several phytochemical compounds present in the herbs used to prepare it and thereby either rendering them less toxic or more potent (Mishra et. al., 2010). For instance, ashwagandharishta or dashmularishta can be more effective in treating diseases. In essence, fermentation process makes certain compounds of ashwagandha more bioavailable and promotes easy assimilation due to low-level alcohol (less than 1%). Furthermore, Ambika et. al., 2017 formulated fermented ashwagandha kalp using dhataki flower and yeast medium.  The phytochemical analysis of secondary metabolites revealed higher concentration of alkaloids, saponins and tannins which exhibit strong antimicrobial and antioxidant properties.

Therefore, while health practitioners are exploring the benefits of ashwagandha for Hashimoto’s disorder, it is important to conduct clinical trials to evaluate efficacy of fermented ashwagandha extract for hypothyroidism linked problems.

The study revealed

the presence of highest percentage of alkaloids in YAK, tannins in DAK and saponins in YAK. Total solid content was found to the h

Synthroid or Levothyroxine Sodium

This medicine is a synthetic version of thyroid hormone that is used to treat hypothyroidism in adults and children, including infants. Essentially, the right dose of Synthroid mimics normal thyroid function. The dosage depends on the age, weight, medical condition, and use of other medications.  Some foods and supplements (iron, calcium, antacids etc.) affect how well levothyroxine is absorbed in the body. A serious allergic reaction to this drug is rare, but a patient may experience minor side effects such as heat intolerances, a fast heart rate, diarrhea, hair loss.

As per literature, there are two major long-term side effects of Levothyroxine. Too much or too little dose of levothyroxine can cause issues with heart and bone thinning. A clinical study from Korea (Ko et. al, 2014) claims that high levels of levothyroxine can speed up bone loss. They found that women (above 65) who were already at a risk for osteoporosis experienced more bone fractures if they took higher doses of levothyroxine.

Seemingly, monitoring levothyroxine dosage is crucial, as too much thyroid hormone (hyperthyroidism), can lead to heart problems over time. A racing heartbeat, chest pain, tightness, or even a heart attack is possible due to excess thyroid hormone. Researchers had declared that high levels of thyroid hormone can also lead to heart failure (Klein et al., 2007).

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Is it harmful to take Ashwagandha for Hashimoto’s Thyroiditis?

There is hardly any study available on the adverse effects of ashwagandha in Hashimoto’s sufferers. In fact, thyrotoxicosis associated with ashwagandha is rarely reported in the literature. Yet, ashwagandha may have undesirable side effects, if there are no set “doses,” and some unknown herb–drug or food–herb interactions occur. In a recent study (Kamal. H et. al, 2022), it is reported that a 73-year-old female who was using ashwagandha as a self-administered treatment for hypothyroidism, presented with supraventricular tachycardia and significantly low TSH levels, after two years of treatment.

On the contrary, for subclinical thyroiditis treatment, studies claim that ashwagandha acts systemically to boost immune system and reduce inflammation (Sharma et al., 2017). It is inherently safe without side effects and that efficacy can be obtained over a wide range of doses. Moreover, clinical research in humans has shown ashwagandha to be safe and useful in treating in a range of conditions, including stress/anxiety, athletic performance, cognition, diabetes, insomnia, and male infertility (Elgar K, 2021).

Therefore, it is advised that Hashimoto’s patients shouldn’t take ashwagandha without doctor supervision. Ashwagandha effects are not felt instantly, as it works by reviving the whole system. Prolonged treatment with ashwagandha can resolve health problems related to Hashimoto’s disorder.

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References-

• Narendra Singh, Mohit Bhalla, Prashanti de Jager, and Marilena Gilca (2011), “An Overview on Ashwagandha: A Rasayana (Rejuvenator) of Ayurveda”, Afr J Tradit Complement Altern Med.  8(5 Suppl): 208–213.
• Jiaji He1, Yaxin Lai1, Jing Yang, Yongli Yao, Yongze Li1, Weiping Teng and Zhongyan Shan, (2021) “The Relationship Between Thyroid Function and Metabolic Syndrome and Its Components: A Cross-Sectional Study in a Chinese Population”, Front. Endocrinol., 31 March 2021 Sec. Thyroid Endocrinology, Volume 12.
• Elgar K. (2021) “Ashwagandha: A Review of Clinical Use and Efficacy”. Nutr Med J., 1 (1): 68-78
• Hawra I Kamal, Kunjal Patel,1 Alexandra Brdak, Jeremy Heffernan, and Naseer Ahmad (2022), “Ashwagandha as a Unique Cause of Thyrotoxicosis Presenting with Supraventricular Tachycardia”. Cureus. Mar; 14(3): e23494.
• Ko, Y. J., Kim, J. Y., Lee, J., Song, H.J., Kim, J.Y., Choi, N.K., et al. (2014). Levothyroxine dose and fracture risk according to the osteoporosis status in elderly women. Journal of Preventive Medicine & Public Health, 47(1), 36–46. doi: 10.3961/jpmph.2014.47.1.36/.
• Klein, I. & Danzi, S. (2007). “Thyroid disease and the heart”. Circulation, 116(15), 1725–1735. doi: 10.1161/CIRCULATIONAHA.106.678326.
• Ashok Kumar Sharma, Indraneel Basu, Siddarth Singh. (2017) “Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial”. J Altern Complement Med 2018 Mar;24(3):243-248. doi: 10.1089/acm.2017.0183. Epub 2017 Aug 22.
• Erin Smith and Tikka Kumar, AP, “Research Study Exploring the Prebiotic Potential of Nervines and Nootropic Herbs”. SCIENCE AND RESEARCH, Updated 2022
• Alessandro Sindoni, Carmelo Rodolico, Maria Angela Pappalardo, Simona Portaro, Salvatore Benvenga (2016). "Hypothyroid myopathy: A peculiar clinical presentation of thyroid failure. Review of the literature".Rev Endocr Metab Disord. Dec;17(4):499-519. doi: 10.1007/s11154-016-9357-0.
• Surya P Nuguru,corresponding author1 Sriker Rachakonda, Shravani Sripathi, Mashal I Khan, Naomi Patel, and Roja T Meda ( 2022),"Hypothyroidism and Depression: A Narrative Review". Cureus. Aug; 14(8): e28201. Published online 2022 Aug 20. doi: 10.7759/cureus.28201
• Ambika thakur, Renuka thakur, Dilip Singh Baghel,(2017) "Impact of fermenting agents on marketed patent proprietary formulation Ashwagandha Kalpa September 2017Asian Journal of Pharmaceutical and Clinical Research 10(16):63 DOI:10.22159/ajpcr.2017.v10s4.
• Ak Mishra, Amit Gupta, Vishali Gupta, Rajesh Sannd (2010), "Asava and Aristha: An Ayurvedic Medicine – An Overview", VL  - 1,JO  - Int J Pharm Biol Arch.

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