Stress and Anxiety Relief: A study investigated its stress-relieving properties, involving 40 adults (aged 25–50) with mild-to-moderate stress. Over 8 weeks, participants were divided into two groups, one receiving 500 mg of Moringa oleifera leaf extract daily and the other a placebo. Stress levels were assessed using the Perceived Stress Scale (PSS) and salivary cortisol measurements. Results showed that the Moringa group experienced a 30% reduction in PSS scores, indicating improved stress resilience, and a 20% decrease in cortisol levels, suggesting better regulation of the HPA (hypothalamus-pituitary-adrenal) axis. Participants also reported feeling calmer and more focused, suggesting Moringa's adaptogenic properties help regulate cortisol levels, reducing the physiological effects of stress.

Antioxidant Capacity: In a randomized trial, Moringa extract significantly increased antioxidant markers in the blood, reducing oxidative stress markers by 25% within 4 weeks. Involving 60 adults (aged 20–60) with elevated oxidative stress markers, this 4-week study had participants consume 7 grams of Moringa leaf powder daily. Oxidative stress markers, such as malondialdehyde (MDA), and antioxidant enzymes like superoxide dismutase (SOD) were measured. The results revealed a 28% reduction in MDA levels, indicating decreased oxidative stress, and a 35% increase in SOD activity, suggesting enhanced antioxidant defense. Participants also reported improved energy levels and less fatigue. These findings support the idea that Moringa's high antioxidant content, including quercetin and chlorogenic acid, helps combat free radicals and oxidative damage, promoting cellular health.

Nutritional Intervention: A double-blind placebo-controlled study demonstrated that Moringa supplementation improved energy levels, reduced inflammation, and enhanced immune response in individuals with chronic fatigue. Fifty adults (aged 30–55) participated in a 6-week trial, where one group received 10 grams of Moringa leaf powder daily, while the other received a placebo. Fatigue levels were assessed using the Fatigue Severity Scale (FSS), and inflammatory markers like C-reactive protein (CRP) were tracked. The Moringa group showed a 40% reduction in FSS scores and a 25% decrease in CRP levels, indicating reduced fatigue and inflammation. Participants also experienced enhanced nutrient intake, particularly vitamins A, C, and E. This study suggests that Moringa supports energy production, reduces inflammation, and replenishes essential nutrients, making it a promising intervention for chronic fatigue and inflammation.

Generalized Anxiety Disorder:

• The study aimed to assess the efficacy of a 70% hydro-ethanolic extract of Centella asiatica (CA) in treating generalized anxiety disorder (GAD) in humans. Thirty-three participants, comprising 18 males and 15 females with an average age of 33 years, were administered CA capsules twice daily (500 mg/capsule) after meals for 60 days. The subjects were evaluated at baseline (day 0), mid-term (day 30), and final (day 60) using Hamilton’s Brief Psychiatric Rating Scale (BPRS) and other standard psychological questionnaires. The findings demonstrated that CA significantly
  alleviated anxiety-related symptoms (p<0.01), reduced stress levels, and correlated depression (p<0.01). Moreover, CA improved willingness for adjustment and cognition (p<0.01). These results suggest that Centella asiatica could be a promising therapeutic option for GAD, exhibiting potential as an anxiolytic agent in the future.
• This double-blind, placebo-controlled study aimed to assess the anxiolytic effects of Gotu Kola (Centella asiatica) in
  healthy subjects. Gotu Kola, a plant used in Ayurvedic and traditional Chinese medicine for centuries to alleviate depression and anxiety symptoms, was investigated for its potential to modulate cholecystokinin (CCK) receptors, which are implicated in anxiety pathophysiology. Subjects were randomly assigned to receive a single oral dose of either Gotu Kola or placebo. Results showed that Gotu Kola significantly reduced the amplitude of the acoustic startle response (ASR) at 30 and 60 minutes post-treatment compared to placebo. However, Gotu Kola had no notable effects on self-rated mood, heart rate, or blood pressure. These initial findings suggest that Gotu Kola may possess anxiolytic properties in humans, as demonstrated by ASR attenuation, warranting further investigation into its therapeutic potential for anxiety disorders.
  

Phlebotonics: In this study, the effects of phlebotonics on reducing time-to-stop bleeding and anal irritation were evaluated in 130
patients with hemorrhoidal disease (HD), bleeding and pain after hemorrhoidectomy, and hemorrhoidal thrombosis over a short period. Patients were divided into three groups: one receiving routine treatment (control Group C), another treated with flavonoids (Group A), and the third treated with Centella (Group B). Time-to-stop bleeding was assessed at baseline and follow-up visits, while healing was estimated using the Kaplan-Meier method. The HD median time-to-stop bleeding was 2 weeks for Groups A and B, and 3 weeks for Group C. Visual Analogue Scale (VAS) scores showed significant differences in anal irritation between Group A vs C and Group B vs C. Operated hemorrhoids also showed improved time-to-stop bleeding in Groups A and B compared to Group C. Histopathology revealed an association between flavonoids and fibrosis of piles. Overall, phlebotonics, particularly flavonoids, demonstrated significant beneficial effects in treating HD and post-surgery hemorrhoids.

Overcome Stress & Anxiety:

• This study examined whether kava or valerian could mitigate the effects of psychological stress in healthy volunteers. Fifty-four participants performed a standardized mental stress task twice, one week apart, with blood pressure (BP), heart rate (HR), and subjective pressure ratings measured at rest and during the task. After the first session,
  participants took kava (n = 18), valerian (n = 18), or nothing (control, n = 18) for seven days. At the second session, both the kava and valerian groups showed a significant decrease in systolic BP responsivity, though diastolic BP did not significantly change. HR reactivity decreased in the valerian group but not in the kava group. Both kava and valerian groups reported less subjective pressure during the task at the second session, while the control group showed no significant changes. Behavioral performance on the task remained unchanged across all groups. These findings suggest that kava and valerian may help reduce physiological reactivity to stress.
  

• A 4-week double-blind, randomized, placebo-controlled clinical trial with 64 volunteers suffering from psychological stress investigated the effects of valerian root extract (VRE) on functional brain connectivity using EEG. Participants received 100 mg of VRE or a placebo three times daily. Both groups showed significant improvements in anxiety and stress-related symptoms, with no significant differences between the groups in clinical outcomes. However, the VRE group exhibited significantly greater increases in frontal brain region alpha coherence and decreases in theta coherence, which were correlated with reduced anxiety. These results suggest that VRE alters functional brain connectivity related to anxiety. Further EEG studies are needed to confirm these neurophysiological effects.

Metabolism of cortisol: In a post-hoc analysis of a randomized trial, forty-nine overweight men and women aged 45 to 70 years were allocated to receive either a magnesium supplement (350 mg/day) or a placebo for 24 weeks. Urinary cortisol, cortisone, and their metabolites were measured in 24-hour urine samples, and enzymatic activities were estimated. Results showed that after 24 weeks, urinary cortisol excretion decreased in the magnesium group compared to the placebo group (-32 nmol/24-h, 95% CI: -59; -5 nmol/24-h, p = .021). Ratios of certain metabolites were also decreased following magnesium supplementation, indicating an increased activity of 11β-HSD type 2. However, no effects were observed on A-ring reductase activity. These findings suggest a beneficial effect of magnesium supplementation in reducing 24-hour urinary cortisol excretion and potentially lowering cardiovascular disease risk through altered enzyme activity.

Reducing stress: In this randomized, controlled, double-blind trial involving patients with fibromyalgia, the efficacy of once-daily oral magnesium supplementation (100 mg of Chronomag®, magnesium chloride technology formula) was compared to placebo over a period of one month. The primary endpoint was the level of stress measured on the DASS-42 scale, while secondary endpoints included pain, sleep, quality of life, fatigue, catastrophism, social vulnerability, and magnesium blood concentrations. Results indicated that while the DASS-42 scores decreased in both the magnesium and placebo groups after one month, the reduction was not statistically significant (21.8 ± 9.6 vs. 21.6 ± 10.8, respectively, p = 0.930). However, magnesium supplementation notably reduced stress levels in the mild/moderate stress subgroup (DASS-42 stress score: 22.1 ± 2.8 to 12.3 ± 7.0 in magnesium vs. 21.9 ± 11.9 to 22.9 ± 11.9 in placebo, p = 0.003) and significantly diminished pain severity (p = 0.029). Other parameters such as sleep, quality of life, fatigue, catastrophism, and social vulnerability did not significantly differ between the two groups. These findings suggest that daily magnesium supplementation may be beneficial in alleviating stress and reducing pain experienced by fibromyalgia patients, warranting further investigation through larger clinical trials.

• Depression: A retrospective, 12-month, open-label, observational, controlled trial was conducted by Francesco Di Pierro of the Department of Scientific Research and Development, Velleja Research, Italy to study the antidepressant clinical activity of a Hypericum Perforatum. The study administered that hypericum extract gave better clinical outcomes in volunteers with depression without determining an increased risk of toxicity or reduced tolerability.

• Depression and menopausal symptoms: Randomized controlled study was conducted on 80 postmenopausal women aged 45-60 in Izeh, Iran by Alieh Eatemadnia of Midwifery Department, Menopause & Andropause Research Centre. Two groups received 270-330 μg of Hypericum perforatum(n = 40) or placebo (n = 40) tablets three times a day for two months. Seventy women
  completed the study and the results show that the treatment with Hypericum perforatum is an efficient way of reducing hot flashes, menopausal symptoms, and depression in postmenopausal women.

• Depression and tiredness: A randomized, placebo-controlled, double-blind study was conducted by W D Hübner , S Lande, H Podzuweit from Lichtwer Pharma GmbH, Berlin, Germany. The study was done on 39 patients with depression with somatic symptoms who were treated with Hypericum perforatum extract LI 160. The volunteers were administered with hypericum extract 300 mg dose thrice a day for 4 weeks. Seventy percent of the patients treated with LI 160 were free of symptoms after 4 weeks. Typical symptoms of depression such as lack of activity, tiredness, fatigue, and disturbed sleep, were especially responsive. In no case were any undesirable side effects observed.

• Fatigue: A randomized, double-blind, parallel-group comparison was done among 240 subjects with mild-moderate depression was done by E Schrader from Praxis Klinische Arzneimittelforschung, Pohlheim, Germany. The patients were treated with hypericum and fluoxetine. After 6 weeks' treatment, it was concluded that hypericum and fluoxetine are equipotent with respect to all main parameters used to investigate antidepressants in this population, although hypericum may be superior in improving the responder rate.

• Sleep Inducing: A study was conducted by A.L. Sharpley, C.L. McGavin, R. Whale P.J. Cowen of the University Department of Psychiatry, Warneford Hospital, UK using healthy volunteers having no history of psychiatric or sleep disorders. They were administered with two doses (0.9 mg and 1.8 mg) of Hypericum perforatum (St John's wort) on the sleep polysomnogram using a placebo-controlled, cross-over design. Both doses of hypericum significantly increased the latency to rapid eye movement (REM) sleep without producing any other effect on sleep architecture.
  
  
  
  

• Reduction in Cortisol: In an open-label clinical trial involving 45 subjects diagnosed with Generalized Anxiety Disorder (GAD), salivary cortisol levels were assessed over three days before and after treatment at specific intervals throughout the day. Mixed model analyses revealed a significant association between symptomatic improvement during treatment and changes in cortisol levels. Subjects experiencing greater symptomatic improvement showed significant increases in morning salivary cortisol and a greater decrease in cortisol levels throughout the day. Previous research indicated elevated methylation of the NR3C1 promoter gene in GAD patients, correlating with diminished glucocorticoid receptor transcription, suggesting desensitization of the cortisol system in GAD. Minimal research has explored cortisol indicators in GAD treatment, particularly in adults. In this study, salivary cortisol was measured to investigate its association with symptomatic improvement in GAD treatment using chamomile extract. It was hypothesized that increases in morning cortisol and changes in diurnal cortisol slope post-treatment would correlate with superior symptomatic change, controlling for baseline symptom severity and cortisol levels. Additionally, baseline cortisol levels were explored as predictors of treatment response.
• Generalized Anxiety Disorder: In a study, 180 subjects with moderate to severe Generalized Anxiety Disorder (GAD) will receive pharmaceutical-grade chamomile extract in an initial open-label phase for 8 weeks, with doses ranging from 500 to 1,500 mg daily. Responders to the treatment will undergo an additional 4 weeks of consolidation therapy. Subsequently, they will be randomized to double-blind continuation therapy with either chamomile extract or placebo for 26 weeks. The primary outcome measure will be the time to relapse during continuation therapy, with secondary outcomes including the proportion of subjects experiencing relapse and the incidence of treatment-emergent adverse events. Quality of life ratings will also be assessed during short and long-term therapy. This study aims to evaluate the safety and efficacy of chamomile extract in the long-term treatment of GAD, building upon prior findings demonstrating its superiority over placebo in reducing GAD symptoms.
• Anxiety disorder: In a study, 180 subjects with moderate to severe Generalized Anxiety Disorder (GAD) will receive chamomile extract for 8 weeks. Responders will undergo an additional 4 weeks of consolidation therapy and then be randomized to either chamomile extract or placebo for 26 weeks of double-blind continuation therapy. The primary outcome is time to relapse during continuation therapy. Secondary outcomes include the proportion of subjects experiencing relapse, treatment-emergent adverse events, and quality of life ratings. This study aims to evaluate the long-term safety and efficacy of chamomile extract for GAD, building on previous findings of its effectiveness compared to placebo.
• Depression: A three-armed, parallel, randomized, controlled trial involved 183 participants divided into lavender, chamomile, and control groups (n=61 each). The experimental groups inhaled three drops of 1.5% lavender or chamomile essential oils for 30 nights, while the control group inhaled distilled water. Depression, anxiety, and stress levels were measured using the Depression, Anxiety, and Stress Scale (DASS) at baseline, immediately after the intervention, and one month later. Statistically significant improvements in depression, anxiety, and stress were observed in the lavender and chamomile groups compared to the control group both immediately and one month after the intervention (p<0.01). The study concluded that inhalation aromatherapy with lavender and chamomile essential oils effectively reduced depression, anxiety, and stress levels in community-dwelling older adults.
  
  

The roots of Withania somnifera consist primarily of compounds known as Withanolides, which are steroidal and bear a resemblance, both in their action and appearance, to the active constituents of Asian ginseng (Panax ginseng) known as ginsenosides.

Subclinical Hypothyroidism: Subclinical hypothyroidism, a thyroid disorder without obvious symptoms, affects 3%–8% of the global population. Ashwagandha (Withania somnifera), a traditional Ayurvedic medicine, is often used for thyroid dysfunctions. This pilot study aimed to evaluate the efficacy and safety of ashwagandha root extract in subclinical hypothyroid patients.
Conducted at Sudbhawana Hospital in Varanasi, India, from May to September 2016, the study was a prospective, randomized, double-blind, single-center placebo-controlled trial. Fifty subjects aged 18 to 50 with elevated serum thyroid stimulating hormone (TSH) levels (4.5–10 mIU/L) were randomized into treatment (n = 25) or placebo (n = 25) groups for 8 weeks. The treatment group received ashwagandha root extract (600 mg daily), while the placebo group received starch.
Results showed that ashwagandha significantly improved serum TSH (p < 0.001), T3 (p = 0.0031), and T4 (p = 0.0096) levels compared to placebo. Four subjects (two from each group) withdrew before the second visit. Ashwagandha treatment normalized thyroid indices significantly over the 8-week period. Mild and temporary adverse effects were reported by four subjects (8%)—one from the ashwagandha group and three from the placebo group.
The study concluded that ashwagandha may be beneficial for normalizing thyroid indices in subclinical hypothyroid patients.
https:// doi.org/10.1089/acm.2017.0183

Stress and anxiety reduction: A Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults at Ashwins Health Care and Research Centre - Hyderabad, India, using a total of 64 subjects with a history of chronic stress, each enrolled into the study after performing relevant clinical examinations and laboratory tests. These included a measurement of serum cortisol, and assessing their scores on standard stress-assessment questionnaires. They were randomized to either the placebo control group or the study drug treatment group, and were asked to take one capsule twice a day for a period of 60 days. In the study drug treatment group, each capsule contained 300 mg of high-concentration full-spectrum extract from the root of the Ashwagandha plant. The treatment group that was given the high-concentration full-spectrum Ashwagandha root extract exhibited a significant reduction on all the stress-assessment scales on Day 60 than the placebo group. The serum cortisol levels were substantially reduced in the Ashwagandha group, than the placebo group.

Spermatogenic Activity: A two-arm, double-blind, randomized, placebo-controlled, parallel-group study with random allocation was conducted at five infertility centres in India under the guidelines of the Indian Council for Medical Research (ICMR-GCP), using 46 infertile men, all having a history of regular sexual intercourse over a one-year period with a gynecologically normal female partner with no apparent female infertility. The study subjects were randomized to either: (i) the placebo-treated group (25) or (ii) the Ashwagandha-treated group (21) that were administered one capsule (containing 225 mg of a high-concentration full-spectrum root extract of the Ashwagandha plant with a withanolide content of 5%) orally, thrice daily for a period of 12 weeks. The ashwagandha treated group testing with higher parameters of semen concentration and increased serum hormone levels than the placebo group.
https://www.hindawi.com/journals/ecam/2013/571420/

Male sexual health: There have been several studies on the effect of ashwagandha in male sexual health. The results have demonstrated that treatment of infertile men (with suboptimal levels of testosterone) with 5 grams per day of ashwagandha root extract significantly increased serum testosterone and luteinizing hormone levels and reduced the levels of follicle-stimulating hormone and prolactin compared to the control group. There was also a substantial increase in sperm count, concentration, and motility among infertile men. Another experimental study from 2016 also reported increased testosterone with M-A-T combo (Mucuna Pruriens, Ashwagandha and Tribulus Terrestris). M-A-T 1 group received 10 mg Mucuna, 10 mg Ashwagandha and 10 mg Tribulus, while M-A-T 2 received 20g of each. Both groups had considerable increased testosterone, follicle-stimulating hormone and luteinizing hormone levels.