Roy Upton
President
American Herbal Pharmacopoeia
Ayurveda is the oldest system of health care and medicine on earth. This distinction of health care and medicine is critical as health care is the very thing missing from modern medicine, at least as represented in the American system that focuses primarily on disease care. The results of this one-sided disease-care-only model, at least in America, is abundantly clear. In virtually all metrics of societal wellness, the US falls far behind virtually all other similarly developed nations.
The most significant measure of societal health is reflected in the health of how children are cared for. Children when reaching adulthood, are either healthy or unhealthy, which, in turn, evolves into a healthy or unhealthy society. In all metrics of childhood wellness – pre-term babies, neonatal, infant, and maternal mortality, and childhood obesity – the US is far behind, ranking 36th out of 38th in childhood well-being in the world. This, in great part, explains the current poor US health statistics.
Ashwagandha is one of the most respected herbs in Ayurveda. It is used both for the treatment of disease and promotion of wellness, including specifically for prenatal and childhood wellbeing. This alone makes it one of the most important herbs we have. Its use was cited in the foundational text of Ayurveda, the Caraka Samhita, which means it has been in continued use for at least 1200 years. Ashwagandha was introduced into the US as early as 1885 in the American Journal of Pharmacy, which reported its use for respiratory disorders including chronic bronchitis, asthma, pulmonary tuberculosis, and to allay flatulence caused by cow’s milk. The journal noted that if taken for three months, a cure is certain…taken in this way, ashwagandha worked when other remedies failed and ashwagandha was described as ‘a valuable drug’.
The American Herbal Pharmacopoeia (AHP) recognized the importance of ashwagandha in Ayurveda and published its first Monograph & Therapeutic Compendium in 2000. This provided North America with a comprehensive review of all aspects of the botanical that included historical use, identity and quality standards, information on cultivation, harvest, and processing, and a critical review of therapeutic and safety information. It was the first publication of an ayurvedic herb in a western pharmacopoeia and the only monograph in the West on ashwagandha.
Since the publication of the AHP monograph, ashwagandha has steadily increased in the North American market, primarily due to marketing of companies dedicated to ashwagandha, ranking #34 of the top 40 best-selling herbal products in 2018 to #4 in 2023. Covid and the desire by consumers for immune and stress support further fueled the demand for ashwagandha. Almost every herb company either has a single-ingredient or combination product containing ashwagandha.
The US and global market for herbs in general and ashwagandha is growing exponentially with double-digit growth predicted over the next 5–10 years. Specific areas of consumer and researcher interest include for adaptogenic, antistress, anti-inflammatory, anti-anxiety activity as well as improved athletic performance and adjunctive cancer care. This growth is occurring despite a significant amount of antagonism and bias against herbal medicines, in the US especially but also globally.
There is a continued myth that western drugs are superior to traditional medicines and this is often not accurate, especially when it comes to health and wellness as there is no pharmaceutical medication for promoting health, vitality, and longevity like ashwagandha. Additionally, the World Health Organization (WHO) in its two Global Summits on Traditional Medicine and as articulated in the Gujarat and Delhi Declarations, clearly note that traditional medicine is critical in human health and primary health care.
There is also some specific caution regarding Ayurvedic products with a number of academic papers and reports from leading North American medical authorities expressing distrust of ayurveda in general and, legitimately, the presence of heavy metals in herbal products manufactured in India that requires addressing at the highest level of Ayurvedic medical authorities. Recently, AHP and its partners at the American Botanical Council and National Center for Natural Products Research issues Botanical Adulteration Prevention (BAPP) bulletins and Laboratory Guidance Documents for ashwagandha that are freely available through the American Botanical Council.
Another challenge is the presence of ashwagandha leaf in extract products when traditionally, only the root was used internally. In recent years, a number of case reports of potential liver toxicity have been made. There is no historical record of negative liver effects and there is some modern research demonstrating a liver protective effect. It is not known if the preparations associated with these case reports contained leaf and requires further attention.
Other safety concerns have been made by European authorities including potential negative effects on the thyroid, hormonal activity, and a claimed abortive activity that has led to restrictions against the sales of ashwagandha products in some European countries. Recent formal safety reviews conducted by AHP, the Committee of Revision of the Botanical Safety Handbook, as well as others, find no evidence that ashwagandha contains any inherent toxicity or abortifacient activity. The Ministry of Ayush, Government of India, rightfully issued a rapid response Ashwagandha Safety Dossier to help allay these concerns and further work is needed.
There is tremendous potential for Ayurveda to spread worldwide in a manner similar to the spread of traditional Chinese medicine, which is allowed in all 50 US states and in many other countries. Increasing the scientific foundation of ashwagandha, such as creating a dedicated journal to ashwagandha in the same way that has been done for Korean Red Ginseng in a Government–Industry partnership, is one way. This may be a future consideration for the World Ashwagandha Council. Introducing the benefits and practice of Pancha Karma, Marma Therapy, and Shirodhara to the West are other considerations perhaps for the Ministry of Ayush to lead.
AHP will release a revision of its ashwagandha monograph in the first quarter of 2026. The work is being developed in cooperation with Professor Pulok Mukherjee and his research team at the University of Kolkata. AHP also welcomes partnerships and collaborations on other Ayurvedic herbal monographs.
It is worthwhile to remind ourselves of the teachings of the Chandogya Upanishad (I.1.2)
• सर्वेषां भूतानां सारं पृथिवी अस्ति। पृथिव्याः सारं जलम् एव । जलस्य सारं वनस्पतयः सन्ति। वनस्पतयः सारः मानवः एव….”
• Esam bhutanam prthivi rasha, prthivya apo raso-pam osadhayo rasa, osadhinam puruso rasah…
• The essence of all beings is Earth. The essence of the Earth is Water. The essence of Water is Plants. The Essence of Plants is the Human Being.
(The author can be reached at roy@herbal-ahp.org).
