How Stress Affects Your Immune System—Plus Ways to Keep Calm and Stay Healthy

How Stress Affects Your Immune System—Plus Ways to Keep Calm and Stay Healthy
How Stress Affects Your Immune System—Plus Ways to Keep Calm and Stay Healthy

Have you noticed that when you’re stressed, you often don’t feel your best? It’s no coincidence: Stress and the immune system are inextricably linked. Indeed, your mind and body are closely connected and in constant “conversation,” with your mental health able to influence your physical health.

In this article, we’ll explore the complex relationship between stress and immunity, as well as simple ways to keep calm and stay healthy.

But before we dive in, it’s important to know how the immune system works and to understand the stress response.

What Is the Immune System and How Does It Work?

Your immune system is a large network of organs, tissues, and cells that works to keep you healthy. It defends your body against potentially harmful substances known as antigens, which include germs such as bacteria and viruses, toxins, and even damaged cells.1

How? It mounts an immune response: Your immune system develops and deploys antibodies and cells to attack an antigen and keep it from causing harm. It also stores a memory of the antigen to recognize it in the future. That way when the antigen tries to invade your body again, if your immune system is working correctly, it can respond fast and efficiently, quickly sending out the right antibodies to protect you. This protection is called immunity.

There are three different types of immunity:

  • Innate immunity—protection you’re born with and your body’s first line of defense against antigens; this natural protection is provided by organs, tissues, and some cells
  • Active immunity (sometimes called adaptive or acquired immunity)—protection that develops after an infection or vaccine; you build up antibodies in response to the exposure, and the protection is typically long-lasting
  • Passive immunity—protection that occurs after you directly receive antibodies; in this case, your body does not make them itself, and this protection is usually short-lived

Unfortunately, the immune system doesn’t always function as it should. Certain conditions can impair immune function, as can some medications. Lack of sleep, poor diet, and other lifestyle choices as well as stress can all cause a weakened immune system, too. Much more on the latter in a minute.

Understanding the Stress Response

Stress Response Cycle

Although you may not immediately think of it as such, the stress response cycle is a good thing. Like the immune system, it is designed to protect you against outside threats.

Say you’re walking in the woods and have a chance meeting with a bear. You want the stress response—aka the fight-or-flight-response—to kick in!

Here’s how the cycle goes: When you encounter a stressor, your brain sounds the alarm throughout your body. This prompts your adrenal glands (part of your endocrine system) to release stress hormones, including adrenaline and cortisol, to help you flee to safety or fight back if needed. These hormones give you the boost of energy you need when threatened and alter bodily systems, including the immune system, in various ways to help you best survive or otherwise get through the stressful situation.2

Normally, once a threat has passed, these hormones return to their usual levels and your systems go back to their regular functioning. You stay well and the cycle is ready to begin again when called upon.

While you don’t likely regularly encounter bears in the woods, you do experience other stressful moments that can trigger fight-or-flight—from traffic to a difficult day at work, and the list goes on. Though our bodies don’t need to react to everyday, non-life-threatening situations in this way, they’re evolutionarily predisposed to.

That can be a problem. Let’s explore this more.

The Relationship Between Stress and the Immune System


Though we now understand that stress and immunity are connected, this wasn’t always the case. In fact, for quite some time, it was commonly accepted that the brain and immune system were separate entities that never interacted, and that one’s psychological state couldn’t affect one’s physical well-being.

But pioneering research conducted in the 1980s and early 90s changed that way of thinking and provided concrete evidence of an intricate relationship between the two.

Noticing that animal studies had begun to link stress to infections, a psychologist and immunologist teamed up to study medical students over the course of a decade. They ultimately discovered that every year during their exam period, the students’ immunity decreased. Specifically, during this stressful time, they had fewer of the important immune cells that help fight infections, and the cells they did have weren’t in prime fighting shape.3

Since then, research into the relationship between stress and immune system function has exploded. Hundreds of studies have been conducted and confirmed stress’ ability to negatively impact the immune system. An entire field dedicated to investigating the link has been created: psychoneuroimmunology.4

The breadth of literature paints a picture of an incredibly complex relationship, describing multiple ways in which the brain and the immune system communicate. But if we go back to the overviews of the immune system and stress response cycle, we can begin to piece things together for a basic understanding. Their “conversation” is one of the main pathways that allows the stress in your mind to affect your body.

Stress’ impact on immunity has a lot to do with the hormones mentioned earlier, especially cortisol. Researchers have discovered that when the stress response is triggered, the burst of cortisol and other hormones initially mobilizes the immune system so that the body is prepared to handle injury or infection. This is beneficial when there really is a threat of physical harm and when the period of stress is short-lived; after the threat is gone, all bodily systems return to baseline.5

But when stress lasts for a significant period—from days to years—the body keeps pumping out stress hormones and the immune system stays in high gear. As time passes, the immune system becomes taxed rather than mobilized. The result is suppressed immune function and weakening of both innate and active immunity.

In today’s modern world, stressors are always present. When your immune system is continuously “switched on” from everyday stress, it can’t produce adequate amounts of or powerful enough immune cells that create antibodies and otherwise fight antigens, and thus it can’t protect you as it should.

Herbs and Tips for Mind–Body Wellness*


Of course, when you don’t feel your best, it can add extra stress to your life. Not to mention, when you’re feeling off and stressed out, you may not get the rest you need—and lack of sleep can impact the immune system, too. In other words, there are many ways stress and immunity are connected, and it can be easy to get caught up in a vicious circle that leaves you depleted.

That’s why we recommend creating a mind–body wellness routine that includes herbal stress support and immune support—especially during challenging immune seasons.*

Add In Adaptogens & Other Stress-Supporting Herbs

When it comes to stress support, adaptogens deserve a place in the spotlight.* Adaptogenic herbs get their name from their ability to help you adapt to and find balance amidst life’s challenges.* They read your body’s needs in tense times and smooth out its stress response cycle so you can cope in a healthy way.*

For everyday support, our best-selling Adrenal Health® Daily Support formula in convenient capsules combines four superstar adaptogens—RhodiolaHoly Basil (pictured above), Ashwagandha, and Schisandra—to help stabilize the body and maintain well-being.*

When you need a little help finding a calm response to life’s trying moments, count on our award-winning Calm A.S.A.P.® formula, a blend of calming herbs including PassionflowerChamomile, and Vervain.*

Shop all our plant-powered stress-support supplements.*

Embrace Black Elderberry & Other Immune-Supporting Herbs

Black Elderberries have been used for centuries to support immune health.* These small, dark berries contain polyphenols, antioxidants that can support the immune system to help you stay healthy.*

Our Certified Organic Black Elderberry gummies are delicious and convenient—made from real fruit, without any added flavors, colors, or refined sugars. Adult Daily Gummies are designed for everyday, year-round immune support, while our Extra Strength Gummies offer extra support when you need it.*

We also offer Black Elderberry syrups, capsules, powders, and a tonic; browse all Elderberry products.  

When you need support at onset , turn to our Quick Defense® formula with Elderberry, Echinacea, and Andrographis.* These fact-acting capsules support your body’s natural defenses and can be used at home and on the go.*

Focus on Self-Care & Make Room for Relaxation

In addition to stress and immune supplements, it’s important to practice self-care in other ways as well. Stay active, get good rest, and enjoy a nutritious diet to stay feeling your best. Consider finding relaxation techniques that work for you and incorporate them into your routine—whether breathing exercises, visualization, or meditation.

For more ideas, check out these articles:

 

REFERENCES:

  1. “Immune System and Disorders,” MedlinePlus, accessed September 29, 2021, https://medlineplus.gov/immunesystemanddisorders.html.
  2. Mayo Clinic Staff, “Chronic Stress Puts Your Health at Risk,” Mayo Clinic, https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037.
  3. “Stress Weakens the Immune System,” American Psychological Association, February 23, 2006, https://www.apa.org/research/action/immune.
  4. Suzanne C. Segerstrom and Gregory E. Miller, “Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry,” Psychological Bulletin 130, no. 4 (2004): 601-630, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287.
  5. Jennifer N. Morey et al. “Current Directions in Stress and Human Immune Function,” Current Opinion in Psychology 5 (October 2015): 13-17, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119.

REFERENCES:

  • 1. Gustavo F. Gonzales, "Ethnobiology and Ethnopharmacology of Lepidium meyenii (Maca), a Plant from the Peruvian Highlands", Journal List Evid Based Complement Alternat Med v.2012; 2012 PMC3184420. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184420/
  • 2. Luis G Valerio Jr, Gustavo F Gonzales, "Toxicological aspects of the South American herbs cat's claw (Uncaria tomentosa) and Maca (Lepidium meyenii) : a critical synopsis", Toxicol Rev . 2005;24(1):11-35. doi: 10.2165/00139709-200524010-00002. PMID: 16042502. https://pubmed.ncbi.nlm.nih.gov/16042502/
  • 3. H. O. Meissner,1 P. Mrozikiewicz,2 T. Bobkiewicz-Kozlowska,3 A. Mscisz,2 B. Kedzia,2 A. Lowicka,2 H. Reich-Bilinska,4 W. Kapczynski,5 and I. Barchia6, "Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (I) Biochemical and Pharmacodynamic Study on Maca using Clinical Laboratory Model on Ovariectomized Rats", Journal List Int J Biomed Sci v.2(3); 2006 Sep PMC3614604. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614604/
  • 4. Eva Fries 1, Lucia Dettenborn, Clemens Kirschbaum, "The cortisol awakening response (CAR): facts and future directions", Int J Psychophysiol. 2009 Apr;72(1):67-73. doi: 10.1016/j.ijpsycho.2008.03.014.Epub 2008 Sep 30.. https://pubmed.ncbi.nlm.nih.gov/18854200/
  • 5. Nicolas C. Nicolaides 1, Alexandros N. Vgontzas 2, Ilia Kritikou 3, George Chrousos 4 Kenneth R Feingold 1, Bradley Anawalt 2, Alison Boyce 3, George Chrousos 4, Wouter W de Herder 5, Ketan Dhatariya 6, Kathleen Dungan 7, Jerome M Hershman 8, Johannes Hofland 9, Sanjay Kalra 10, Gregory Kaltsas 11, Christian Koch 12, Peter Kopp 13, Márta Korbonits 14, Christopher S Kovacs 15, Wendy Kuohung 16, Blandine Laferrère 17, Miles Levy 18, Elizabeth A McGee 19, Robert McLachlan 20, John E Morley 21, Maria New 22, Jonathan Purnell 23, Rakesh Sahay 24, Frederick Singer 25, Mark A Sperling 26, Constantine A Stratakis 27, Dace L Trence 28, Don P Wilson 29 , editors., "HPA Axis and Sleep", PMID: 25905298 Bookshelf ID: NBK279071. https://pubmed.ncbi.nlm.nih.gov/25905298/
  • 6. José Manuel Lozano Sánchez', Zoraida Axtle Serranol*, Julio Avilés Durán, Héctor Salvador Godoy Morales, Paola Berenice Merchand Álvarez, Ricardo Mera Mejía? Luis Felipe Montaño Estrada and Erika Patricia Rendón Huerta, "Peruvian Maca and Possible Impact on Fertility", Journal of Nutritional Health & Food Engineering. https://www.researchgate.net/profile/Jose-Manuel-Lozano-Sanchez/publication/317569911_Peruvian_Maca_and_Possible_Impact_on_Fertility/links/59494b03aca272a30c6cae11/Peruvian-Maca-and-Possible-Impact-on-Fertility.pdf
  • 7. A López-Fando 1, M P Gómez-Serranillos, I Iglesias, O Lock, U P Upamayta, M E Carretero, "Lepidium peruvianum chacon restores homeostasis impaired by restraint stress", Phytother Res . 2004 Jun;18(6):471-4. doi: 10.1002/ptr.1455.. https://pubmed.ncbi.nlm.nih.gov/15287072/
  • 8. Gustavo F. Gonzales *, "Ethnobiology and Ethnopharmacology of Lepidium meyenii (Maca), a Plant from the Peruvian Highlands", Evid Based Complement Alternat Med. 2012; 2012: 193496. Published online 2011 Oct 2. doi: 10.1155/2012/193496. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3184420/
  • 9. José Manuel Lozano Sánchez', Zoraida Axtle Serranol*, Julio Avilés Durán, Héctor Salvador Godoy Morales, Paola Berenice Merchand Álvarez, Ricardo Mera Mejía? Luis Felipe Montaño Estrada and Erika Patricia Rendón Huerta, "Peruvian Maca and Possible Impact on Fertility", Journal of Nutritional Health & Food Engineering. https://www.researchgate.net/profile/Jose-Manuel-Lozano-Sanchez/publication/317569911_Peruvian_Maca_and_Possible_Impact_on_Fertility/links/59494b03aca272a30c6cae11/Peruvian-Maca-and-Possible-Impact-on-Fertility.pdf
  • 10. Maria Rosales-Hartshorn*, "Maca: Botanical Medicine from the Andes", Volume 1 : Issue 2 Article Ref. #: 1000AFTNSOJ1e001. https://www.openventio.org/Volume1-Issue2/Maca-Botanical-Medicine-from-the-Andes-AFTNSOJ-1-e001.pdf
  • 11. Natália da Silva Leitão Peres 1, Letícia Cabrera Parra Bortoluzzi, Leila Larisa Medeiros Marques, Maysa Formigoni, Renata Hernandez Barros Fuchs, Adriana Aparecida Droval, Flávia Aparecida Reitz Cardoso, "Medicinal effects of Peruvian maca (Lepidium meyenii): a review", Food Funct. 2020 Jan 29;11(1):83-92. doi: 10.1039/c9fo02732g.. https://pubmed.ncbi.nlm.nih.gov/31951246/
  • 12. Office of Communications, "How common is infertility?", Home- Health- A to Z List- Infertility and Fertility- About- How common is infertility?. https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common#f1
  • 13. ASRM, American Society for Reproductive Medicine., "In approximately 40 percent of infertile couples, the male partner is either the sole cause or a contributing cause of infertility", Home Infographic Gallery. https://www.reproductivefacts.org/resources/infographic-gallery/images/in-approximately-40-percent-of-infertile-couples-the-male-partner-is-either-the-sole-cause-or-a-contributing-cause-of-infertility/
  • 14. G F Gonzales 1, A Cordova, C Gonzales, A Chung, K Vega, A Villena, "Lepidium meyenii (Maca) improved semen parameters in adult men", Asian J Androl. 2001 Dec;3(4):301-3.. https://pubmed.ncbi.nlm.nih.gov/11753476/
  • 15. José Manuel Lozano Sánchez', Zoraida Axtle Serranol*, Julio Avilés Durán, Héctor Salvador Godoy Morales, Paola Berenice Merchand Álvarez, Ricardo Mera Mejía? Luis Felipe Montaño Estrada and Erika Patricia Rendón Huerta, "Peruvian Maca and Possible Impact on Fertility", DOI:10.15406/jnhfe.2017.06.00217. https://www.researchgate.net/publication/317569911_Peruvian_Maca_and_Possible_Impact_on_Fertility
  • 16. Daniel Nedresky; Gurdeep Singh., "Physiology, Luteinizing Hormone", Treasure Island (FL): StatPearls Publishing; 2022 Jan-.. https://www.ncbi.nlm.nih.gov/books/NBK539692/
  • 17. G F Gonzales 1, A Cordova, C Gonzales, A Chung, K Vega, A Villena, "Lepidium meyenii (Maca) improved semen parameters in adult men", Asian J Androl. 2001 Dec;3(4):301-3.. https://pubmed.ncbi.nlm.nih.gov/11753476/
  • 18. G F Gonzales, M Gasco, A Córdova, A Chung, J Rubio and L Villegas, "Effect of Lepidium meyenii (Maca) on spermatogenesis in male rats acutely exposed to high altitude (4340 m)", Instituto de Investigaciones de la Altura, and Departamento de Ciencias Biolo´gicas y Fisiolo´gicas Facultad de Ciencas y Filosofı´a, Universidad Peruana Cayetano Heredia, PO Box 1843, Lima, Peru (Requests for offprints should be addressed to G F Gonzales, Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, PO Box 1843, Lima, Peru; Email: iiad@upch.edu.pe). http://eplant.njau.edu.cn/maca/publication/Effect%20of%20Lepidium%20meyenii%20(Maca)%20on%20spermatogenesis%20in%20male%20rats%20acutely%20exposed%20to%20high%20altitude%20(4340%20m).pdf
  • 19. A López-Fando, M P Gómez-Serranillos, I Iglesias, O Lock, U P Upamayta, M E Carretero, "Lepidium peruvianum chacon restores homeostasis impaired by restraint stress", Phytother Res . 2004 Jun;18(6):471-4. doi: 10.1002/ptr.1455.. https://pubmed.ncbi.nlm.nih.gov/15287072/
  • 20. G. F. Gonzales,A. Córdova,K. Vega,A. Chung,A. Villena,C. Góñez,S. Castillo, "Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men", Journal of Andrology. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1439-0272.2002.00519.x
  • 21. Byung-Cheul Shin, Myeong Soo Lee, Eun Jin Yang, Hyun-Suk Lim, Edzard Ernst, "Maca (L. meyenii) for improving sexual function: a systematic review", BMC Complement Altern Med . 2010 Aug 6;10:44. doi: 10.1186/1472-6882-10-44.. https://pubmed.ncbi.nlm.nih.gov/20691074/
  • 22. José Manuel Lozano Sánchez, Zoraida Axtle, Julio Aviles, Héctor Salvador Godoy Morales, Paola Berenice Merchand Álvarez, Ricardo Mera Mejía, Luis Felipe Montaño Estrada, Erika Patricia Rendón Huerta, "Peruvian Maca and Possible Impact on Fertility", Journal of Nutritional Health & Food Engineering. https://www.researchgate.net/publication/317569911_Peruvian_Maca_and_Possible_Impact_on_Fertility
  • 23. Hongkang Zhu, Wenqian Xu, Ning Wang, Wenhao Jiang, Yuliang Cheng, Yahui Guo, Weirong Yao, Bin Hu, Peng Du and He Qian, "Anti-fatigue effect of Lepidium meyenii Walp. (Maca) on preventing mitochondria-mediated muscle damage and oxidative stress in vivo and vitro†", Journal of Food & Function. https://pubs.rsc.org/en/content/articlelanding/2021/fo/d1fo00383f/unauth
  • 24. Mark Stone, Alvin Ibarra, Marc Roller, Andrea Zangara, Emma Stevenson, "A pilot investigation into the effect of maca supplementation on physical activity and sexual desire in sportsmen", J Ethnopharmacol . 2009 Dec 10;126(3):574-6. doi: 10.1016/j.jep.2009.09.012. Epub 2009 Sep 23.. https://pubmed.ncbi.nlm.nih.gov/19781622/
  • 25. Gustavo F Gonzales, Sara Miranda, Jessica Nieto, Gilma Fernández, Sandra Yucra, Julio Rubio, Pedro Yi & Manuel Gasco, "Red maca (Lepidium meyenii) reduced prostate size in rats", Reprod Biol Endocrinol 3, 5 (2005). https://doi.org/10.1186/1477-7827-3-5. https://rbej.biomedcentral.com/articles/10.1186/1477-7827-3-5
  • 26. C Gonzales, J Leiva-Revilla, J Rubio, M Gasco, G F Gonzales, "Effect of red maca (Lepidium meyenii) on prostate zinc levels in rats with testosterone-induced prostatic hyperplasia", Andrologia . 2012 May;44 Suppl 1:362-9. doi: 10.1111/j.1439-0272.2011.01190.x. Epub 2011 Jul 18.. https://pubmed.ncbi.nlm.nih.gov/21762188/
  • 27. G. F. Gonzales,A. Córdova,K. Vega,A. Chung,A. Villena,C. Góñez,S. Castillo, "Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men", Journal of Andrology. https://onlinelibrary.wiley.com/doi/full/10.1046/j.1439-0272.2002.00519.x
  • 28. Y Ohta, N Kawate, T Inaba, H Morii, K Takahashi, H Tamada, "Feeding hydroalcoholic extract powder of Lepidium meyenii (maca) enhances testicular gene expression of 3β-hydroxysteroid dehydrogenase in rats", Andrologia . 2017 Dec;49(10). doi: 10.1111/and.12792. Epub 2017 Mar 6.. https://pubmed.ncbi.nlm.nih.gov/28261840/
  • 29. Ángel Rodríguez-Huamán, Sandra Casimiro-Gonzales, Jorge Antonio Chávez-Pérez, Carla Gonzales-Arimborgo, Richard Cisneros-Fernández, Luis Ángel Aguilar-Mendoza, Gustavo F Gonzales, "Antioxidant and neuroprotector effect of Lepidium meyenii (maca) methanol leaf extract against 6-hydroxy dopamine (6-OHDA)-induced toxicity in PC12 cells", Toxicol Mech Methods . 2017 May;27(4):279-285. doi: 10.1080/15376516.2016.1275908. Epub 2017 Jan 8.. https://pubmed.ncbi.nlm.nih.gov/28007001/
  • 30. Bárbara Teixeira, António Marques, Cristina Ramos, Maria Carmo Serrano, Olívia Matos, Nuno R Neng, José Nogueira, Jorge M. A. Saraiva, Maria Leonor Nunes, "Chemical composition and bioactivity of different oregano (Origanum vulgare) extracts and essential oil", Journal of the Science of Food and Agriculture 93(11) DOI:10.1002/jsfa.6089. https://www.researchgate.net/publication/236104725_Chemical_composition_and_bioactivity_of_different_oregano_Origanum_vulgare_extracts_and_essential_oil
  • 31. Wesam Kooti, Zahra Hasanzadeh-Noohi, Naim Sharafi-Ahvazi, Majid Asadi-Samani, Damoon Ashtary-Larky, "Phytochemistry, pharmacology, and therapeutic uses of black seed (Nigella sativa)", Chin J Nat Med . 2016 Oct;14(10):732-745. doi: 10.1016/S1875-5364(16)30088-7. Epub 2016 Oct 31.. https://pubmed.ncbi.nlm.nih.gov/28236403/
  • 32. Łukasz Łuczaj & Wojciech M Szymański, "Wild vascular plants gathered for consumption in the Polish countryside: a review.", Journal of Ethnobiology and Ethnomedicine volume 3, Article number: 17 (2007). https://ethnobiomed.biomedcentral.com/articles/10.1186/1746-4269-3-17
  • 33. IKHLAS A. KHAN, EHAB A. ABOURASHED, "Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics.", John Wiley & Sons, Inc., Hoboken, New Jersey. https://naturalingredient.org/wp/wp-content/uploads/leungs-encyclopedia-of-common-natural-ingredients-3rd-edition.pdf
  • 34. Adom MB, Taher M, Mutalabisin MF, Amri MS, Abdul Kudos MB, Wan Sulaiman MWA, Sengupta P, Susanti D, "Chemical constituents and medical benefits of Plantago major.", Biomedecine & Pharmacotherapie, 10 Oct 2017, 96:348-360 DOI: 10.1016/j.biopha.2017.09.152 PMID: 29028587. https://europepmc.org/article/med/29028587#similar-articles
  • 35. ZOT Organic, "What is Licorice?", General Info. https://zotorganic.com/information/licorice/#:~:text=The%20plant%20is%20prized%20for,shrub%2C%20is%20officially%20a%20weed.
  • 36. Dalia Akramiene, Anatolijus Kondrotas, Janina Didziapetriene, Egidijus Kevelaitis, "Effects of beta-glucans on the immune system", Medicina (Kaunas) . 2007;43(8):597-606.. https://pubmed.ncbi.nlm.nih.gov/17895634/
  • 37. R C Rosen, "Prevalence and risk factors of sexual dysfunction in men and women", Curr Psychiatry Rep . 2000 Jun;2(3):189-95. doi: 10.1007/s11920-996-0006-2.. https://pubmed.ncbi.nlm.nih.gov/11122954/
  • 38. Natália da Silva Leitão Peres, Letícia Cabrera Parra Bortoluzzi, Leila Larisa Medeiros Marques, Maysa Formigoni, Renata Hernandez Barros Fuchs, Adriana Aparecida Droval, Flávia Aparecida Reitz Cardoso, "Medicinal effects of Peruvian maca (Lepidium meyenii): a review", Food Funct . 2020 Jan 29;11(1):83-92. doi: 10.1039/c9fo02732g.. https://pubmed.ncbi.nlm.nih.gov/31951246/
  • 39. Nicole A Brooks, Gisela Wilcox, Karen Z Walker, John F Ashton, Marc B Cox, Lily Stojanovska, "Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen content", Menopause . 2008 Nov-Dec;15(6):1157-62. doi: 10.1097/gme.0b013e3181732953.. https://pubmed.ncbi.nlm.nih.gov/18784609/
  • 40. Maria Rosales-Hartshorn*, "Maca: Botanical Medicine from the Andes", Adv Food Technol Nutr Sci Open J. 2015; 1(2): e1-e6. doi: 10.17140/AFTNSOJ-1-e001. https://www.openventio.org/Volume1-Issue2/Maca-Botanical-Medicine-from-the-Andes-AFTNSOJ-1-e001.pdf
  • 41. Sánchez JML, Serrano ZA, Durán JA, Morales HSG, Álvarez PBM (2017), "Peruvian Maca and Possible Impact on Fertility", J Nutr Health Food Eng 6(5): 00217. DOI: 10.15406/jnhfe.2017.06.00217. https://www.researchgate.net/profile/Jose-Manuel-Lozano-Sanchez/publication/317569911_Peruvian_Maca_and_Possible_Impact_on_Fertility/links/59494b03aca272a30c6cae11/Peruvian-Maca-and-Possible-Impact-on-Fertility.pdf
  • 42. Leila Mazaheri Nia, Mina Iravani, Parvin Abedi, Bahman Cheraghian, "Effect of Zinc on Testosterone Levels and Sexual Function of Postmenopausal Women: A Randomized Controlled Trial", J Sex Marital Ther . 2021;47(8):804-813. doi: 10.1080/0092623X.2021.1957732. Epub 2021 Jul 27.. https://pubmed.ncbi.nlm.nih.gov/34311679/
  • 43. G. F. Gonzales,A. Córdova,K. Vega,A. Chung,A. Villena,C. Góñez,S. Castillo, "Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men", Journal of Andrology. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1439-0272.2002.00519.x
  • 44. Byung-Cheul Shin 1, Myeong Soo Lee, Eun Jin Yang, Hyun-Suk Lim, Edzard Ernst, "Maca (L. meyenii) for improving sexual function: a systematic review", BMC Complement Altern Med . 2010 Aug 6;10:44. doi: 10.1186/1472-6882-10-44.. https://pubmed.ncbi.nlm.nih.gov/20691074/
  • 45. Ghanbarali Raeis Jalali, Jamshid Roozbeh, Azam Mohammadzadeh, Maryam Sharifian, Mohammad Mahdi Sagheb, Alireza Hamidian Jahromi, Sanaz Shabani, Fariborz Ghaffarpasand, Raha Afshariani, "Impact of oral zinc therapy on the level of sex hormones in male patients on hemodialysis", Ren Fail . 2010 May;32(4):417-9. doi: 10.3109/08860221003706958.. https://pubmed.ncbi.nlm.nih.gov/20446777/
  • 46. Tahoora Shomali, Mahnaz Taherianfard, Maryam Dalvand, Fatemeh Namazi, "Effect of pharmacological doses of niacin on testicular structure and function in normal and diabetic rats", Andrologia . 2018 Dec;50(10):e13142. doi: 10.1111/and.13142. Epub 2018 Sep 6.. https://pubmed.ncbi.nlm.nih.gov/30191583/
  • 47. Gonzales G. F., Cordova A., Gonzales C., Chung A., Vega K., Villena A., "Lepidium meyenii (Maca) improved semen parameters in adult men.", Asian Journal of Andrology. 2001;3(4):301–303.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411442/#B19
  • 48. Bogani P., Simonini F., Iriti M., et al., "Lepidium meyenii (Maca) does not exert direct androgenic activities.", Journal of Ethnopharmacology. 2006;104(3):415–417. doi: 10.1016/j.jep.2005.09.028.. ncbi.nlm.nih.gov/pmc/articles/PMC4411442/#B27
  • 49. Gonzalez G. F., Córdova A., Vega K., Chung A., Villena A., Góñez C., "Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing propeties, on serum reproductive hormone levels in adult healthy men.", Journal of Endocrinology. 2003;176(1):163–168. doi: 10.1677/joe.0.1760163.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411442/#B28
  • 50. Christina M. Dording , * Pamela J. Schettler, Elizabeth D. Dalton, Susannah R. Parkin, Rosemary S. W. Walker, Kara B. Fehling, Maurizio Fava, and David Mischoulon, "A Double-Blind Placebo-Controlled Trial of Maca Root as Treatment for Antidepressant-Induced Sexual Dysfunction in Women", Journal List Evid Based Complement Alternat Med v.2015; 2015 PMC4411442. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411442/
  • 51. Srikugan L., Sankaralingam A., McGowan B., "First case report of testosterone assay-interference in a female taking maca (Lepidium meyenii) BMJ Case Reports.", 2011 doi: 10.1136/bcr.01.2011.3781.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411442/#B26
  • 52. Olivia Remes,Carol Brayne,Rianne van der Linde,Louise Lafortune, "A systematic review of reviews on the prevalence of anxiety disorders in adult populations", Journal of Brain and Behavior, 05 June 2016. https://onlinelibrary.wiley.com/doi/10.1002/brb3.497
  • 53. Rohit Verma, Yatan Pal Singh Balhara, and Chandra Shekhar Gupta, "Gender differences in stress response: Role of developmental and biological determinants", Journal List Ind Psychiatry J v.20(1); Jan-Jun 2011 PMC3425245. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425245/
  • 54. Mohammad Hossein Mirjalili, Elisabeth Moyano, Mercedes Bonfill, Rosa M Cusido, Javier Palazón, "Steroidal lactones from Withania somnifera, an ancient plant for novel medicine", Molecules . 2009 Jul 3;14(7):2373-93.. https://pubmed.ncbi.nlm.nih.gov/19633611/
  • 55. R C Rosen, "Prevalence and risk factors of sexual dysfunction in men and women", Curr Psychiatry Rep . 2000 Jun;2(3):189-95. DOI: 10.1007/s11920-996-0006-2.. https://pubmed.ncbi.nlm.nih.gov/11122954/
  • 56. Swati Dongre, Deepak Langade, Sauvik Bhattacharyya, "Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study", Biomed Res Int . 2015;2015:284154. doi: 10.1155/2015/284154.. https://pubmed.ncbi.nlm.nih.gov/26504795/
  • 57. UT NEWS, "Stress Hormone Blocks Testosterone’s Effects, Study Shows", Journal of Science and Technology. https://news.utexas.edu/2010/09/27/stress-hormone-blocks-testosterones-effects-study-shows/
  • 58. Rashad, N.M., Samir, G.M., "Prevalence, risks, and comorbidity of thyroid dysfunction: a cross-sectional epidemiological study", Egypt J Intern Med 31, 635–641 (2019). https://ejim.springeropen.com/articles/10.4103/ejim.ejim_22_19
  • 59. Cleveland Clinic, "Thyroid: What It Is, Function and Problems", Journal of Body Systems & Organs. https://my.clevelandclinic.org/health/body/23188-thyroid
  • 60. Sharma AK, Basu I, Singh S., "Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial", J Altern Complement Med. 2018 Mar;24(3):243-248. doi: 10.1089/acm.2017.0183. Epub 2017 Aug 22. PMID: 28829155.. https://pubmed.ncbi.nlm.nih.gov/28829155/
  • 61. Chandrasekhar K, Kapoor J, Anishetty S., "A prospective, 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", Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022. PMID: 23439798; PMCID: PMC3573577.. https://pubmed.ncbi.nlm.nih.gov/23439798/
  • 62. Stephens MA, Wand G., "Stress and the HPA axis: role of glucocorticoids in alcohol dependence", Alcohol Res. 2012;34(4):468-83. PMID: 23584113; PMCID: PMC3860380.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860380/
  • 63. Centers for Disease Control and Prevention, "1 in 3 adults don’t get enough sleep", CDC.gov. https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html
  • 64. Centers for Disease Control and Prevention, "Sleep and Sleep Disorders", CDC.gov. https://www.cdc.gov/sleep/data_statistics.html
  • 65. Krishnan V, Collop NA., "Gender differences in sleep disorders", Curr Opin Pulm Med. 2006 Nov;12(6):383-9. doi: 10.1097/01.mcp.0000245705.69440.6a. PMID: 17053485.. https://pubmed.ncbi.nlm.nih.gov/17053485/
  • 66. Danielle Pacheco, Ealena Callender, "Women and Sleep", Sleep Foundation. https://www.sleepfoundation.org/women-sleep
  • 67. Langade D, Thakare V, Kanchi S, Kelgane S., "Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study", J Ethnopharmacol. 2021 Jan 10;264:113276. doi: 10.1016/j.jep.2020.113276. Epub 2020 Aug 17. PMID: 32818573.. https://pubmed.ncbi.nlm.nih.gov/32818573/
  • 68. Abhijit Deshpande, Nushafreen Irani, Ratna Balkrishnan, Irin Rosanna Benny, "A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults", Sleep Medicine, Volume 72, 2020, Pages 28-36, ISSN 1389-9457,. https://www.sciencedirect.com/science/article/abs/pii/S1389945720301246
  • 69. Mahesh K. Kaushik, Sunil C. Kaul, Renu Wadhwa, Masashi Yanagisawa, Yoshihiro Urade, "Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction", plos.org DOI:10.1371/journal.pone.0172508. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172508#abstract0
  • 70. Auddy B, Hazra J, Mitra A, et al., "A standardized Withania Somnifera extract significantly reduces stress-related parameters in chronically stressed humans: a double-blind, randomized, placebo-controlled study", J Am Neutraceut Assoc 2008;11:50–6.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750292/#R20
  • 71. Andrade C, Aswath A, Chaturvedi SK, et al., "A double-blind, placebo-controlled evaluation of the anxiolytic efficacy ff an ethanolic extract of withania somnifera", Indian J Psychiatry 2000;42:295–301.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750292/#R18
  • 72. Fries E, Dettenborn L, Kirschbaum C., "The cortisol awakening response (CAR): facts and future directions", Int J Psychophysiol. 2009 Apr;72(1):67-73. doi: 10.1016/j.ijpsycho.2008.03.014. Epub 2008 Sep 30. PMID: 18854200.. https://pubmed.ncbi.nlm.nih.gov/18854200/
  • 73. Nicolas C. Nicolaides, Alexandros N. Vgontzas, Ilia Kritikou, George Chrousos Kenneth R Feingold, Bradley Anawalt, Alison Boyce, George Chrousos, Wouter W de Herder, Ketan Dhatariya, Kathleen Dungan, Jerome M Hershman, Johannes Hofland, Sanjay Kalra, Gregory Kaltsas, Christian Koch, Peter Kopp, Márta Korbonits, Christopher S Kovacs, Wendy Kuohung, Blandine Laferrère, Miles Levy, Elizabeth A McGee, Robert McLachlan, John E Morley, Maria New, Jonathan Purnell, Rakesh Sahay, Frederick Singer, Mark A Sperling, Constantine A Stratakis, Dace L Trence, Don P Wilson, "HPA Axis and Sleep", In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. 2020 Nov 24. PMID: 25905298 Bookshelf ID: NBK279071. https://pubmed.ncbi.nlm.nih.gov/25905298/
  • 74. Bhattacharya SK, Bhattacharya A, Sairam K, Ghosal S., "Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an experimental study", Phytomedicine. 2000 Dec;7(6):463-9. doi: 10.1016/S0944-7113(00)80030-6. PMID: 11194174.. https://pubmed.ncbi.nlm.nih.gov/11194174/
  • 75. Gopal S, Ajgaonkar A, Kanchi P, Kaundinya A, Thakare V, Chauhan S, Langade D., "Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study", J Obstet Gynaecol Res. 2021 Dec;47(12):4414-4425. doi: 10.1111/jog.15030. Epub 2021 Sep 22. PMID: 34553463.. https://pubmed.ncbi.nlm.nih.gov/34553463/
  • 76. Chandrasekhar K, Kapoor J, Anishetty S., "A prospective, 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.", Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022. PMID: 23439798; PMCID: PMC3573577.. https://pubmed.ncbi.nlm.nih.gov/23439798/
  • 77. Khedgikar V, Kushwaha P, Gautam J, Verma A, Changkija B, Kumar A, Sharma S, Nagar GK, Singh D, Trivedi PK, Sangwan NS, Mishra PR, Trivedi R., "Withaferin A: a proteasomal inhibitor promotes healing after injury and exerts anabolic effect on osteoporotic bone", Cell Death Dis. 2013 Aug 22;4(8):e778. doi: 10.1038/cddis.2013.294. PMID: 23969857; PMCID: PMC3763455.. https://pubmed.ncbi.nlm.nih.gov/23969857/
  • 78. Sandi C., "Stress and cognition", Wiley Interdiscip Rev Cogn Sci. 2013 May;4(3):245-261. doi: 10.1002/wcs.1222. Epub 2013 Jan 22. PMID: 26304203.. https://pubmed.ncbi.nlm.nih.gov/26304203/
  • 79. Killgore WD., "Effects of sleep deprivation on cognition", Prog Brain Res. 2010;185:105-29. doi: 10.1016/B978-0-444-53702-7.00007-5. PMID: 21075236.. https://pubmed.ncbi.nlm.nih.gov/21075236/
  • 80. Ali SA, Begum T, Reza F., "Hormonal Influences on Cognitive Function", Malays J Med Sci. 2018 Jul;25(4):31-41. doi: 10.21315/mjms2018.25.4.3. Epub 2018 Aug 30. PMID: 30914845; PMCID: PMC6422548.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422548/
  • 81. Choudhary D, Bhattacharyya S, Bose S., "Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions", J Diet Suppl. 2017 Nov 2;14(6):599-612. doi: 10.1080/19390211.2017.1284970. Epub 2017 Feb 21. PMID: 28471731.. https://pubmed.ncbi.nlm.nih.gov/28471731/
  • 82. Dar NJ, MuzamilAhmad., "Neurodegenerative diseases and Withania somnifera (L.): An update.", J Ethnopharmacol. 2020 Jun 28;256:112769. doi: 10.1016/j.jep.2020.112769. Epub 2020 Mar 30. PMID: 32240781.. https://pubmed.ncbi.nlm.nih.gov/32240781/
  • 83. Bonilla DA, Moreno Y, Gho C, Petro JL, Odriozola-Martínez A, Kreider RB., "Effects of Ashwagandha (Withania somnifera) on Physical Performance: Systematic Review and Bayesian Meta-Analysis", J Funct Morphol Kinesiol. 2021 Feb 11;6(1):20. doi: 10.3390/jfmk6010020. PMID: 33670194; PMCID: PMC8006238.. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006238/
  • 84. GRAHAM BINDER, "Researchers with the College of AGNR study nutrient-packed microgreens", College of Agriculture & Natural Resources, September 6, 2012. https://agnr.umd.edu/news/mighty-microgreens
  • 85. GAO, "While Levels in Clothing Generally Appear to Be Low, Allergic Contact Dermatitis Is a Health Issue for Some People", United States Government Accountability Office, Report to Congressional Committees, August 2010. https://www.gao.gov/assets/gao-10-875.pdf
  • 86. Dongre S, Langade D, Bhattacharyya S., "Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study.", Biomed Res Int. 2015;2015:284154. doi: 10.1155/2015/284154. Epub 2015 Oct 4. PMID: 26504795; PMCID: PMC4609357.. https://pubmed.ncbi.nlm.nih.gov/26504795/
  • 87. Chauhan, S, Srivastava, MK, Pathak, AK., "Effect of standardized root extract of ashwagandha (Withania somnifera) on well-being and sexual performance in adult males: a randomized controlled trial", Health Sci Rep. 2022; 5:e741. doi:10.1002/hsr2.741. https://onlinelibrary.wiley.com/doi/10.1002/hsr2.741
  • 88. Langade D, Thakare V, Kanchi S, Kelgane S., "Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study", J Ethnopharmacol. 2021 Jan 10;264:113276. doi: 10.1016/j.jep.2020.113276. Epub 2020 Aug 17. PMID: 32818573.. https://pubmed.ncbi.nlm.nih.gov/32818573/
  • 89. Abhijit Deshpande, Nushafreen Irani, Ratna Balkrishnan, Irin Rosanna Benny,, "A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults,", Sleep Medicine, Volume 72, 2020, Pages 28-36, ISSN 1389-9457, https://doi.org/10.1016/j.sleep.2020.03.012.. https://www.sciencedirect.com/science/article/abs/pii/S1389945720301246
  • 90. Bhattacharya SK, Bhattacharya A, Sairam K, Ghosal S, "Anxiolytic-antidepressant activity of Withania somnifera glycowithanolides: an experimental study", Phytomedicine. 2000 Dec;7(6):463-9. doi: 10.1016/S0944-7113(00)80030-6. PMID: 11194174.. https://pubmed.ncbi.nlm.nih.gov/11194174/
  • 91. Rashad, N.M., Samir, G.M., "Prevalence, risks, and comorbidity of thyroid dysfunction: a cross-sectional epidemiological study", Egypt J Intern Med 31, 635–641 (2019). https://doi.org/10.4103/ejim.ejim_22_19. https://ejim.springeropen.com/articles/10.4103/ejim.ejim_22_19
  • 92. Durg S, Bavage S, Shivaram SB, "Withania somnifera (Indian ginseng) in diabetes mellitus: A systematic review and meta-analysis of scientific evidence from experimental research to clinical application", Phytother Res. 2020 May;34(5):1041-1059. doi: 10.1002/ptr.6589. Epub 2020 Jan 23. PMID: 31975514.. https://pubmed.ncbi.nlm.nih.gov/31975514/
  • 93. ASRM, American Society for Reproductive Medicine, "In approximately 40 percent of infertile couples, the male partner is either the sole cause or a contributing cause of infertility", Reproductivefacts.org/resources/infographic-gallery. https://www.reproductivefacts.org/resources/infographic-gallery/images/in-approximately-40-percent-of-infertile-couples-the-male-partner-is-either-the-sole-cause-or-a-contributing-cause-of-infertility/
  • 94. Tiwari S, Gupta SK, Pathak AK, "A double-blind, randomized, placebo-controlled trial on the effect of Ashwagandha (Withania somnifera dunal.) root extract in improving cardiorespiratory endurance and recovery in healthy athletic adults", J Ethnopharmacol. 2021 May 23;272:113929. doi: 10.1016/j.jep.2021.113929. Epub 2021 Feb 15. PMID: 33600918.. https://pubmed.ncbi.nlm.nih.gov/33600918/
  • 95. Chandrasekhar K, Kapoor J, Anishetty S, "A prospective, 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", Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022. PMID: 23439798; PMCID: PMC3573577. https://pubmed.ncbi.nlm.nih.gov/23439798/
  • 96. Mirjalili MH, Moyano E, Bonfill M, Cusido RM, Palazón J, "Steroidal lactones from Withania somnifera, an ancient plant for novel medicine", Molecules. 2009 Jul 3;14(7):2373-93. doi: 10.3390/molecules14072373. PMID: 19633611; PMCID: PMC6255378. https://pubmed.ncbi.nlm.nih.gov/19633611/
  • 97. Carnegie Mellon University, "Stress Contributes To Range Of Chronic Diseases, Review Shows", ScienceDaily. ScienceDaily, 10 October 2007. https://www.sciencedaily.com/releases/2007/10/071009164122.htm
  • 98. Bremner JD, "Does stress damage the brain?", Biol Psychiatry. 1999 Apr 1;45(7):797-805. doi: 10.1016/s0006-3223(99)00009-8. PMID: 10202566. https://pubmed.ncbi.nlm.nih.gov/10202566/
  • 99. Kalmbach DA, Anderson JR, Drake CL, "The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders", J Sleep Res. 2018 Dec;27(6):e12710. doi: 10.1111/jsr.12710. Epub 2018 May 24. PMID: 29797753; PMCID: PMC7045300. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045300/
  • 100. National Institutes of Health, "Poor Sleep Linked With Higher Blood Sugar", newsinhealth.nih.gov/Health Capsule/ July 2022. https://newsinhealth.nih.gov/2020/07/poor-sleep-linked-higher-blood-sugar
  • 101. Winston D, Maimes S, "Adaptogens: Herbs for Strength, Stamina, and Stress Relief", Rochester: Inner Traditions/Bear & Co. Vol. 48. Rochester: Inner Traditions/Bear & Co; 2007; p. 53. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6979308/#REF8
  • 102. Bhatnagar M, Sharma D, Salvi M, "Neuroprotective effects of Withania somnifera dunal.: A possible mechanism", Neurochem Res. 2009 Nov;34(11):1975-83. doi: 10.1007/s11064-009-9987-7. Epub 2009 May 15. PMID: 19444606. https://pubmed.ncbi.nlm.nih.gov/19444606/
  • 103. Salve J, Pate S, Debnath K, Langade D, "Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study", Cureus. 2019 Dec 25;11(12):e6466. doi: 10.7759/cureus.6466. PMID: 32021735; PMCID: PMC6979308. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6979308/
  • 104. Gopukumar, K.Thanawala, S. Somepalli, V. Rao Sathyanaryana, T. S. Thamatam, V.B. Chauhan, S., "Efficacy and Safety of Ashwagandha Root Extract on Cognitive Functions in Healthy, Stressed Adults: A Randomized, Double-Blind, Placebo-Controlled Study", Evidence-Based Complementary and Alternative Medicine/ Volume 2021/Article ID 8254344. https://www.hindawi.com/journals/ecam/2021/8254344/
  • 105. Choudhary D, Bhattacharyya S, Bose S., "Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions", J Diet Suppl. 2017 Nov 2;14(6):599-612. doi: 10.1080/19390211.2017.1284970. Epub 2017 Feb 21. PMID: 28471731. https://pubmed.ncbi.nlm.nih.gov/28471731/
  • 106. Dar NJ, MuzamilAhmad, "Neurodegenerative diseases and Withania somnifera (L.): An update", J Ethnopharmacol. 2020 Jun 28;256:112769. doi: 10.1016/j.jep.2020.112769. Epub 2020 Mar 30. PMID: 32240781. https://pubmed.ncbi.nlm.nih.gov/32240781/
  • 107. LULU XIE, HONGYI KANG, QIWU XU, MICHAEL J. CHEN, YONGHONG LIAO, MEENAKSHISUNDARAM THIYAGARAJAN, JOHN O’DONNELL, DANIEL J. CHRISTENSEN, CHARLES NICHOLSON, JEFFREY J. ILIFF, TAKAHIRO TAKANO, RASHID DEANE, AND MAIKEN NEDERGAARD, "Sleep Drives Metabolite Clearance from the Adult Brain", SCIENCE 18 Oct 2013 Vol 342, Issue 6156 pp. 373-377 DOI: 10.1126/science.1241224. https://www.science.org/doi/10.1126/science.1241224
  • 108. Bhatnagar M, Sharma D, Salvi M, "Neuroprotective effects of Withania somnifera dunal.: A possible mechanism", Neurochem Res. 2009 Nov;34(11):1975-83. doi: 10.1007/s11064-009-9987-7. Epub 2009 May 15. PMID: 19444606. https://pubmed.ncbi.nlm.nih.gov/19444606/
  • 109. Baker C, Kirby JB, O'Connor J, Lindsay KG, Hutchins A, Harris M, "The Perceived Impact of Ashwagandha on Stress, Sleep Quality, Energy, and Mental Clarity for College Students: Qualitative Analysis of a Double-Blind Randomized Control Trial", J Med Food. 2022 Aug 18. doi: 10.1089/jmf.2022.0042. Epub ahead of print. PMID: 35984870. https://pubmed.ncbi.nlm.nih.gov/35984870/
  • 110. Nayely Leyva-López, et al, "Essential Oils of Oregano: Biological Activity beyond Their Antimicrobial Properties", https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152729/
  • 111. S. Santoya et al, "Supercritical carbon dioxide extraction of compounds with antimicrobial activity from Origanum vulgare L.: determination of optimal extraction parameters", https://pubmed.ncbi.nlm.nih.gov/16496578/
  • 112. Snigdha Sacena et al, "Evaluation of Systemic Oxidative Stress in Patients with Premature Canities and Correlation of Severity of Hair Graying with the Degree of Redox Imbalance", https://pubmed.ncbi.nlm.nih.gov/32549695/
  • 113. Yunes Panahi et al, "Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial", https://pubmed.ncbi.nlm.nih.gov/25842469/
  • 114. Stephen C Barker & Phillip M Altman, "An ex vivo, assessor blind, randomised, parallel group, comparative efficacy trial of the ovicidal activity of three pediculicides after a single application - melaleuca oil and lavender oil, eucalyptus oil and lemon tea tree oil, and a "suffocation" pediculicide", https://bmcdermatol.biomedcentral.com/articles/10.1186/1471-5945-11-14
  • 115. C Hay et al, "Randomized trial of aromatherapy. Successful treatment for alopecia areata", https://pubmed.ncbi.nlm.nih.gov/9828867/
  • 116. "Synaptic Pruning", https://www.sciencedirect.com/topics/veterinary-science-and-veterinary-medicine/synaptic-pruning
  • 117. CeJpeK, K, "“Antioxidant Activity in Variously Prepared Elderberry Foods and Supplements.”", Czech J. Food Sci. Vol. 27, 2009, Special Issue. https://www.agriculturejournals.cz/publicFiles/07578.pdf
  • 118. Porter RS, Bode RF, "A Review of the Antiviral Properties of Black Elder (Sambucus nigra L.) Products", Phytother Res. 2017 Apr;31(4):533-554. doi: 10.1002/ptr.5782. Epub 2017 Feb 15. PMID: 28198157..
  • 119. Deepak Langade, Subodh Kanchi, Jaising Salve, Khokan Debnath, and Dhruv Ambegaokar, "Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study", Cureus. 2019 Sep; 11(9): e5797. Published online 2019 Sep 28. doi: 10.7759/cureus.5797 PMCID: PMC6827862PMID: 31728244. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6827862/
  • 120. Mohammad Hossein Mirjalili, Elisabeth Moyano, Mercedes Bonfill, Rosa M Cusido, Javier Palazón, "Steroidal lactones from Withania somnifera, an ancient plant for novel medicine", Molecules. 2009 Jul 3;14(7):2373-93. doi: 10.3390/molecules14072373.. https://pubmed.ncbi.nlm.nih.gov/19633611/
  • 121. Deepak Langade, Subodh Kanchi, Jaising Salve, Khokan Debnath, Dhruv Ambegaokar, "Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study", Cureus . 2019 Sep 28;11(9):e5797. doi: 10.7759/cureus.5797.. https://pubmed.ncbi.nlm.nih.gov/31728244/
  • 122. Biswajit Auddy, PhD1; Jayaram Hazra, PhD2; Achintya Mitra, MD2; Bruce Abedon, PhD3; Shibnath Ghosal, PhD1, "A Standardized Withania Somnifera Extract Significantly Reduces Stress-Related Parameters in Chronically Stressed Humans: A Double-Blind, Randomized, Placebo-Controlled Study", JANA Vol 11, No.1 2008. https://blog.priceplow.com/wp-content/uploads/2014/08/withania_review.pdf
  • 123. K Chandrasekhar, Jyoti Kapoor, Sridhar Anishetty, "A prospective, 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", Indian J Psychol Med. 2012 Jul;34(3):255-62. doi: 10.4103/0253-7176.106022.. https://pubmed.ncbi.nlm.nih.gov/23439798/
  • 124. Deepak Langade, Vaishali Thakare, Subodh Kanchi, Sunil Kelgane, "Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study", Randomized Controlled Trial J Ethnopharmacol. 2021 Jan 10;264:113276.. https://pubmed.ncbi.nlm.nih.gov/32818573/
  • 125. Abhijit Deshpandea, Nushafreen Irania, Ratna BalkrishnanaIrin, Rosanna Bennyb, "A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults", Sleep Medicine Volume 72, August 2020, Pages 28-36. https://www.sciencedirect.com/science/article/abs/pii/S1389945720301246
  • 126. Mahesh K. Kaushik ,Sunil C. Kaul, Renu Wadhwa,Masashi Yanagisawa, Yoshihiro Urade, "Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction", Published: February 16, 2017 https://doi.org/10.1371/journal.pone.0172508. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172508
  • 127. Mahesh K. Kaushik ,Sunil C. Kaul, Renu Wadhwa,Masashi Yanagisawa, Yoshihiro Urade, "Triethylene glycol, an active component of Ashwagandha (Withania somnifera) leaves, is responsible for sleep induction", Published: February 16, 2017 https://doi.org/10.1371/journal.pone.0172508. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172508
  • 128. Adrian L. Lopresti, PhD,a,b,∗ Stephen J. Smith, MA,a,b Hakeemudin Malvi, MBBS, MD,c and Rahul Kodgule, MBBSd, "An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract", Medicine (Baltimore). 2019 Sep; 98(37): e17186. Published online 2019 Sep 13. doi: 10.1097/MD.0000000000017186. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750292/#R20
  • 129. Adrian L. Lopresti, PhD,a,b,∗ Stephen J. Smith, MA,a,b Hakeemudin Malvi, MBBS, MD,c and Rahul Kodgule, MBBSd, "An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract", Medicine (Baltimore). 2019 Sep; 98(37): e17186. Published online 2019 Sep 13. doi: 10.1097/MD.0000000000017186. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6750292/#R18
  • 130. Nicolas C. Nicolaides, Alexandros N. Vgontzas, Ilia Kritikou, George Chrousos Kenneth R Feingold, Bradley Anawalt, Alison Boyce, George Chrousos, Wouter W de Herder, Ketan Dhatariya, Kathleen Dungan, Jerome M Hershman, Johannes Hofland, Sanjay Kalra, Gregory Kaltsas, Christian Koch, Peter Kopp, Márta Korbonits, Christopher S Kovacs, Wendy Kuohung, Blandine Laferrère, Miles Levy, Elizabeth A McGee, Robert McLachlan, John E Morley, Maria New, Jonathan Purnell, Rakesh Sahay, Frederick Singer, Mark A Sperling, Constantine A Stratakis, Dace L Tren, Don P Wilson, editors., "HPA Axis and Sleep", In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. 2020 Nov 24.. https://pubmed.ncbi.nlm.nih.gov/25905298/
  • 131. Eva Fries, Lucia Dettenborn, Clemens Kirschbaum, "The cortisol awakening response (CAR): facts and future directions", Int J Psychophysiol. 2009 Apr;72(1):67-73. doi: 10.1016/j.ijpsycho.2008.03.014. Epub 2008 Sep 30.. https://pubmed.ncbi.nlm.nih.gov/18854200/
  • 132. Nicolas C. Nicolaides, Alexandros N. Vgontzas, Ilia Kritikou, George Chrousos Kenneth R Feingold, Bradley Anawalt, Alison Boyce, George Chrousos, Wouter W de Herder, Ketan Dhatariya, Kathleen Dungan, Jerome M Hershman, Johannes Hofland, Sanjay Kalra, Gregory Kaltsas, Christian Koch, Peter Kopp, Márta Korbonits, Christopher S Kovacs, Wendy Kuohung, Blandine Laferrère, Miles Levy, Elizabeth A McGee, Robert McLachlan, John E Morley, Maria New, Jonathan Purnell, Rakesh Sahay, Frederick Singer, Mark A Sperling, Constantine A Stratakis, Dace L Tren, Don P Wilson, editors., "HPA Axis and Sleep", In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. 2020 Nov 24.. https://pubmed.ncbi.nlm.nih.gov/25905298/