{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T23:14:40Z","timestamp":1783638880399,"version":"3.55.0"},"reference-count":90,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Planta Med"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hormonal imbalances, particularly involving the hypothalamic\u2013pituitary\u2013adrenal and gonadal axes, contribute to chronic conditions such as stress-related disorders, infertility, and metabolic dysregulation. Ashwagandha (Withania somnifera L.) has been proposed as a potential oral modulator of endocrine function due to its adaptogenic properties. This review aims to systematically evaluate the effects of oral ashwagandha supplementation on circulating hormone levels in adults. Our literature search included MEDLINE, Embase, and ClinicalTrials.gov. The protocol was registered in PROSPERO (CRD42024611576). We included randomized, placebo-controlled trials in adults assessing oral ashwagandha versus placebo that reported changes in hormone levels. Two reviewers independently screened studies, extracted summary data, and assessed risk of bias using the Cochrane tool. Meta-analyses were conducted using a random-effects model to calculate mean differences (MD) or standardized\n          mean differences (SMD), with heterogeneity and publication bias assessed using I\u00b2 and Egger\u02bcs test, respectively. Twenty-three trials were included, encompassing 1706 patients. Ashwagandha significantly reduced cortisol (SMD =\u2212\u20091.18, p\u2009&lt;\u20090.04) and increased serotonin (MD\u2009=\u200931.75\u2009ng\/ml, p\u2009&lt;\u20090.01). Subgroup analyses suggested possible dose-response effects based on withanolide content. No effect was found on TSH or T3, but T4 levels increased modestly (MD\u2009=\u20090.61\u2009\u00b5g\/dL, p\u2009=\u20090.02). Ashwagandha increased testosterone in men (MD\u2009=\u200957.43\u2009ng\/dl) but not in women (MD\u2009=\u20095.09\u2009ng\/dl), with a significant gender difference. This treatment did not influence E2 levels in either gender. Ashwagandha supplementation appears to modulate key hormonal pathways, particularly cortisol and sex hormones. However, heterogeneity and limited data on some endpoints warrant further standardized trials.<\/jats:p>","DOI":"10.1055\/a-2802-8363","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:28:18Z","timestamp":1772065698000},"page":"790-805","source":"Crossref","is-referenced-by-count":0,"title":["Hormonal Modulation with Withania somnifera: Systematic Review and Meta-Analysis of Randomized-controlled Trials"],"prefix":"10.1055","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0369-6981","authenticated-orcid":false,"given":"Michal","family":"Fornalik","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Malkiewicz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominika","family":"Adamczak","sequence":"additional","affiliation":[{"name":"Department of Cancer Immunology, Chair of Medical Biotechnology, Poznan University of Medical Sciences, Poznan, Poland"},{"name":"Doctoral School, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Nawrocki","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Zielinska","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Phytochemistry, Institute of Natural Fibres and Medicinal Plants, National Research Institute, Plewiska, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samim Ali","family":"Mondal","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/S0301-0511(01)00092-8","article-title":"Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: The role of the hypothalamus\u2013pituitary\u2013adrenal axis","volume":"57","author":"U Ehlert","year":"2001","journal-title":"Biol Psychol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1038\/nrendo.2015.163","article-title":"Endocrine disruptors and obesity","volume":"11","author":"J J Heindel","year":"2015","journal-title":"Nat Rev 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