Adaptogen

Ashwagandha (KSM-66)

The most clinically studied adaptogen. KSM-66 is the highest-concentration ashwagandha root extract, backed by 12+ RCTs demonstrating significant cortisol reduction, testosterone support, and sleep quality improvement.

stress-resiliencesleephormonal-optimizationrecovery
Tier AWell-tolerated — strong human evidence
Evidence gradeAMultiple RCTs / Meta-analysis
JS

Reviewed & fact-checked by

Dr. Jane Smith, MD, PhD

Chief Medical Reviewer · Last updated: March 1, 2026

Verified

Mechanism of Action

Ashwagandha (Withania somnifera) is an Ayurvedic herb with the most extensive evidence base among all adaptogens. The standardised KSM-66 extract contains ≥5% withanolides and is the gold standard among commercial formulations.

Key mechanisms:

  • HPA axis inhibition — reduces activity of the hypothalamic-pituitary-adrenal axis, lowering cortisol secretion in response to stress
  • GABA receptor modulation — withanolides bind to GABA-A receptors, explaining the anxiolytic and sedative effects
  • Testosterone support — cortisol reduction indirectly raises testosterone (cortisol competitively inhibits steroidogenesis in Leydig cells) []

Clinical Evidence

A 2021 meta-analysis (5 RCTs, n=400) confirmed significant cortisol reduction and improved subjective stress scores at 300–600 mg/day of KSM-66. []

A separate RCT demonstrated improved sleep quality scores (PSQI) and a 72% reduction in time to fall asleep compared to placebo at 600 mg before bed. []

Stacking Interactions

How Ashwagandha (KSM-66) interacts with other compounds

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Magnesium ThreonateSynergisticmoderate evidence

Both improve sleep architecture via different mechanisms. Ashwagandha reduces cortisol; Magnesium Threonate crosses the blood-brain barrier and supports NMDA receptor function. Excellent evening stack.

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Tongkat AliSynergisticmoderate evidence

Complementary hormonal stack: Ashwagandha reduces cortisol (which suppresses testosterone), while Tongkat Ali directly supports LH and testosterone production.

Safety Profile — Tier A

Well-tolerated — strong human evidence

Contraindications

  • Thyroid disorders — may alter thyroid hormone levels
  • Autoimmune conditions (Hashimoto's, MS, lupus)
  • Pregnancy — may cause uterine contractions

Side Effects

  • Drowsiness (dose-dependent, often desirable for sleep protocols)
  • Gastrointestinal upset at high doses
  • Rare: liver toxicity at very high doses (>1000mg/day long-term)

Drug Interactions

Benzodiazepines and sedatives (additive CNS depression)Thyroid medicationsImmunosuppressants