I am not a science kinda gal. I like many things about science, but not necessarily digging deep into the labyrinth of technical jargon that goes along with it. I attempted to avoid it while in college while I pursued other endeavors, like human resources, psychology, and environmental studies. I nearly failed my college chemistry class because I absolutely abhorred it! Not my cup of tea, for sure.

But this one is near and dear to me. This was an herbal supplement I was taking until I started on Acalabrutinib in May. The pharmacist told me it was not to be taken, as it would interfere with the efficacy of an extremely expensive and important medication. Therefore, I am being very good, and I am not taking it. I am feeling the effects of not having it, as it really helped me with focus, yet I was challenged to do the proper research for people who may be able to benefit from it. I am happy to share with you, with the expectation that you would also check with your main doctor (oncologist, hematologist, generalist) prior to taking to make sure it is a good and safe fit for you. Happy medical journal reading as you come to your own conclusions. I pray I got it “right”.

Ashwangandha. Scientific name: Withania somnifera. Alternative names are Ashwanghanda, Indian ginseng, and winter cherry. There are many ginseng variations that produce similar results in laboratory studies, but I an focusing on a study of Withania somnifera. It is an adaptogen, which by definition means that the herbal is “nonspecific, nontoxic, and normalizing. This means the effect they produce varies according to the physiopathologic state.” definition taken from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4294537/

Per an article from Memorial Sloan Kettering Cancer Center at https://www.mskcc.org/cancer-care/integrative-medicine/herbs/ashwagandha the following credit was given to this herb:

An article by Marie Winters, ND titled “Ancient Medicine, Modern Use: Withania somnifera and its Potential Role in Integrative Oncology” goes deeper into these topics from the point of view that this herbal has many potential uses for cancer patients. I quote, “WS modulates the immune response, increasing the expression of T-helper 1 (Th1) cytokines, as well as CD4 and CD8 counts, and natural killer (NK) cell activity. Several studies also support Withania’s ability to increase circulating cortisol, decrease fatigue, increase physical performance, and decrease refractory depression in animals subjected to stress.” It is especially useful in increasing white blood cell counts following chemotherapy. The study results for this are listed under the header “Chemotherapy Interactions” on page 274 of the article. On page 275 it mentions that WS “increased cytokine productions in combination with CTX [cyclophosphamide]”. The entire article may be found here: http://archive.foundationalmedicinereview.com/publications/11/4/269.pdf

An article by Biswa Mohan Biswal, MD, DNB, Siti Amrah Sulaiman, M Med et al titled “Effect of Withania somnifera (Ashwagandha) on the Development of Chemotherapy-Induced Fatigue and Quality of Life in Breast Cancer Patients” conducted a human clinical study between 2007 and 2010 and determined that fatigue and many other positive factors were improved upon over those on the control arm of the study. Below is an abstract of Table 4 of that article.

The entire research article may be found here: https://journals.sagepub.com/doi/full/10.1177/1534735412464551?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

This is very encouraging news for some of us in the blood cancer realm. There is definitely evidence to support the increase of the white blood count and cytokines which can assist you in rebuilding your strength. This is especially helpful when receiving chemotherapy treatments and the negative effects to the immune system following these harsh methods. The following article covers other reasons why WBC might be low: https://my.clevelandclinic.org/health/symptoms/17706-low-white-blood-cell-count/possible-causes.

Finally, I draw your attention to this last article talks specifically about CRF (cancer related fatigue) and in particular, Wisconsin Ginseng: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888141/ .

I like this study in addition to the other study (Effect of Withania somnifera (Ashwagandha) on the Development of Chemotherapy-Induced Fatigue and Quality of Life In Breast Cancer Patients) was done with a different mix of ethnic groups and yet the results were similar.

An excerpt from the article states: “Although many herbs have been touted through folklore and through traditional use as remedies for fatigue, none has probably enjoyed as much worldwide reputation and interest as ginseng. Within the context of traditional Chinese medicine, ginseng is generally viewed as an “adaptogen,” a substance that can help restore balance to the body by bringing it back to a point of homeostasis (22). There are two major species of ginseng, Asian (Panax ginseng) and American (Panax quinquefolius) (22,23). Both have a common mixture of active ingredients, the most important being ginsensosides. Between species of ginseng, there are varying amounts, strengths, and varieties of ginsensosides (22,24,25).

Substantial objective evidence supporting that ginseng may be helpful for fatigue comes from preclinical data. Specifically, in vitro data demonstrate anti-inflammatory and cortisol modulating effects (26–28) consistent with the currently established physiology of CRF. Animal studies have reported improved endurance and swimming duration time with ginseng, specifically ginsenosides Rb1 and Rg1, both of which are present in both Asian and American ginseng (25,29,30,31).”

Table 2.

Secondary endpoints change from baseline*

* MFSI = Multidimensional Fatigue Symptom Inventory–Short Form; POMS = Profile of Mood States; SD = standard deviation.

† n = 147 in the ginseng arm and n = 152 in the placebo arm at 4 weeks.

‡ n = 138 in the ginseng arm and n = 132 in the placebo arm at 8 weeks.

§ n = 139 in the ginseng arm and n = 142 in the placebo arm at 4 weeks.

|| n = 132 in the ginseng arm and n = 128 in the placebo arm at 8 weeks.

In closing, there are multiple studies on Indian Ginseng and its cousin ginseng like the Wisconsin variety that purport the pharmacological effects of ginseng in general. The final article cited summarizes ginseng in general https://www.sciencedirect.com/science/article/pii/S1226845320300592

The article credits the herb with antioxidant activity, anti-inflammatory activity, anti-microbial activity, anticardiovascular disease activity, antiobesity, antidiabetes-effect, anticentral nervous system disorder effect, enhancing energy and libido, and anticancer activity.

My focus on presenting this information is to highlight its energy building, fatigue busting capabilities. These potential effects may help you through your cancer journey and improve your quality of life. The largest negative fact I discovered potentiallly is that it is proven to raise the white blood cell count; and this is most likely the reason my practitioner stated I should stop taking it, since I am in active non-chemo treatment.

But for others who are going through chemotherapy or are post treatment and in remission yet still struggling with sluggish energy and lack of focus, this may be a viable option for you. And as I stated earlier, please do not add a regimen of Ashwagandha without speaking to your trusted oncologist, hematologist, or generalist. Finally, how to find the trusted product? I consulted with https://www.consumereview.org/reviews/ashwagandha/home.php?utm_source=bing&utm_medium=cpc&utm_campaign=US%20-%20DSK%20-%20Product&utm_term=best%20ashwagandha&utm_content=Product%20-%20Exact AND https://consumerssurvey.org/lp/ashwagandha?tr=peOqeLZ&msclkid=12a8d8c994711571ad5c863b337f5c96 and here is a source in the UK https://www.hollandandbarrett.com/the-health-hub/vitamins-and-supplements/herbal-licensed/ginseng/what-is-ginseng/