Cortisol has become the word of the year on social media. It's blamed for a puffy face, stubborn belly fat, 3 a.m. wake-ups, and people promise to "lower it" with routines, herbal teas, and capsules. Part of this is false, part is poorly formulated, and a small part is true. This article sorts through it based on what the literature has actually measured.
Three things to know before reading. The puffy "cortisol face" is a sign of a disease affecting 2 to 8 people per million, not a difficult week. What chronic stress actually disrupts is the rhythm of cortisol, and a meta-analysis of 80 studies shows that this flattening is what impacts health. And among supplements, only one has meta-analyses showing a decrease in blood cortisol: ashwagandha. The others work on something else, and we'll say so.
The myth. The "cortisol face" is a sign of Cushing's syndrome, a prolonged and pathological excess of cortisol with an incidence of 2 to 8 per million per year according to JAMA, and whose primary cause is corticosteroid use. Ordinary stress does not produce this picture. The real problem. Cortisol follows a rhythm, high in the morning and low in the evening. A meta-analysis of 80 studies shows that a flattened slope is associated with poorer health in 10 out of 12 categories, with the strongest effect on immunity and inflammation.
Supplements, by evidence. <<<27>>> Ashwagandhaashwagandha has two meta-analyses on stress and anxiety, one meta-analysis measuring a decrease in serum cortisol, and a landmark double-blind trial with KSM-66 at 600 mg daily; low certainty of evidence, no long-term data. Magnesium acts on perceived stress in people with deficiency, not on cortisol. Rhodiola acts on fatigue, and international guidelines do not support it for mood disorders. The main lever remains the clock: morning light, regular bedtime.
- What cortisol is, and why we don't want to eliminate it
- "Cushing's face": what medicine actually says
- The real problem: a flattened rhythm, not an elevated level
- What regulates the rhythm, before any supplement
- Ashwagandha: the only one with cortisol data
- Magnesium and rhodiola: what they do, and what they don't
- What supplements will never do
- The reasonable protocol
- Frequently asked questions
What cortisol is, and why we don't want to eliminate it
Cortisol is a hormone glucocorticoid produced by the adrenal glands, two small organs sitting on the kidneys. Its release is controlled by a three-tiered chain, thehypothalamic-pituitary-adrenal axis, itself piloted by the brain's biological clock. A 2023 review in Cells summarizes it: cortisol release is finely orchestrated by the suprachiasmatic nucleus, which governs circadian rhythm and activates the HPA axis, a vital neuroendocrine system responsible for the stress response and maintenance of internal balance.
What it does is essential: mobilize glucose to provide energy, modulate immunity and inflammation, support blood pressure, and wake you up. Without cortisol, you don't get out of bed in the morning. A reference review in Endocrine Reviews clarifies a point often overlooked: cortisol is not secreted continuously but in pulses, whose amplitude varies throughout the day, and it is this oscillating signal that cells must decode. Suppressing these oscillations, as a long-acting synthetic corticosteroid does, disrupts many systems dependent on cortisol.
The goal is therefore never to "lower cortisol" the way you lower a fever. Low cortisol is a disease, adrenal insufficiency, potentially life-threatening. The goal, when there is one, is to restore a rhythm : high upon waking, in steady decline, low in the evening. The rest of this article is structured around this distinction.
The "cortisol face": what medicine actually says
Cushing's syndrome is defined as a prolonged increase in plasma cortisol that is not due to a physiological cause. Although the most frequent cause is the use of exogenous corticosteroids, the estimated incidence of Cushing's syndrome from endogenous cortisol overproduction is 2 to 8 people per million per year. It characteristically presents with cutaneous changes such as facial flushing, easy bruising and purple stretch marks, and metabolic manifestations such as hyperglycemia, hypertension, and excessive fat deposition on the face, neck, and visceral organs. Screening is based on 24-hour urinary free cortisol, late-evening salivary cortisol, or the dexamethasone suppression test.
Reincke M, Fleseriu M. JAMA 2023;330(2):170-181. DOI: 10.1001/jama.2023.11305
That's where the image comes from. The rounded, flushed face, with fat deposited on the neck, is the picture of Cushing's syndrome. It is a real disease, it is serious, and it is rare : 2 to 8 people per million each year when the body produces too much cortisol on its own. And its most common cause is not stress: it is the use of corticosteroid medications, prednisone or equivalents, over a long duration.
What the stress of a busy week does not do is produce this picture. A swollen face upon waking is far more often due to salt from the night before, alcohol, a short night, an allergy, or simply from lying down. Attaching the word cortisol to it is a diagnostic error made by people who have no right to make it, and it leads to wrong answers.
When presented with a complete and evolving picture: rapid central weight gain, wide purple stretch marks, bruising from the slightest impact, weakness in the thigh and shoulder muscles, recent-onset hypertension or diabetes, mood disturbances. In that case, a doctor will prescribe the tests described by JAMA. Cortisol measurements sold online for wellness have no such value: an isolated cortisol reading at any given time means almost nothing, precisely because the hormone varies greatly throughout the day.
A review from Nature Reviews Endocrinology adds a caveat reserved for doctors: some incidentally discovered adrenal adenomas secrete cortisol somewhat autonomously, without Cushing's syndrome presentation, and this is diagnosed by a suppression test. This is an endocrinologist's subject, not a supplement matter.
The real problem: a flattened rhythm, not an elevated level
Variations in cortisol from morning to evening are called cortisol diurnal slopes. Flatter slopes have been proposed as a mediator between chronic psychosocial stress and poorer physical and mental health. The analyses examined 179 associations from 80 studies. Results indicate a significant association between flatter diurnal slopes and poorer health across all studies, with an average effect size of 0.147. Flatter slopes were associated with poorer health in 10 of 12 emotional and physical outcome subtypes examined. Among these, the effect size was largest for immune and inflammatory outcomes, at 0.288. The authors propose that flatter slopes may both reflect and contribute to stress-related dysregulation of central and peripheral circadian mechanisms.
Adam EK, Quinn ME, Tavernier R, McQuillan MT, Dahlke KA, Gilbert KE. Psychoneuroendocrinology 2017;83:25-41. DOI: 10.1016/j.psyneuen.2017.05.018
This is the most important result in the entire article, and it never appears in cortisol videos. What is associated with poorer health is not highcortisol. It is flat cortisol: a morning peak that blunts and, especially, an evening that no longer drops. The difference between morning and evening shrinks, and this reduction is what accompanies sleep disturbances, repeated infections, baseline inflammation, and fatigue.
This explains why some stressed people have a morning cortisol that is rather low, which is confusing when you believe that stress equals elevated cortisol. And the review fromEndocrine Reviews confirms it from another angle: even subtle alterations in system dynamics, during chronic stress or certain diseases, can modify metabolism, behavior, mood, and cognition in sensitive individuals.
| What we believe | What the data shows | The consequence |
|---|---|---|
| Stress raises cortisol | Chronic stress flattens the rhythm: dulled morning peak, evening that no longer drops | The target is the rhythm, not the level |
| Cortisol must be lowered | Low cortisol is a disease; low morning cortisol is common in exhaustion | Restore the slope, not lower the curve |
| A test tells if I have too much cortisol | Pulsatile and circadian secretion; a single point tells nothing | Only 24-hour medical tests or suppression tests make sense |
| Puffy face comes from cortisol | The picture described is Cushing's syndrome, 2 to 8 cases per million | Look for salt, alcohol, sleep, allergy |
What regulates the rhythm, before any supplement
If cortisol is controlled by the suprachiasmatic nucleus, then what regulates the suprachiasmatic nucleus regulates cortisol. And what regulates this clock is known: the light, first and foremost, then the regularity of sleep and meal times. This is basic physiology, and it has a practical consequence that few videos mention: the most powerful levers on cortisol rhythm are not sold in capsules.
It is only after these adjustments that a supplement makes sense. And this is where the hierarchy of evidence becomes interesting, because it does not match what marketing claims.
Ashwagandha: the only one with data on cortisol
Twelve randomized controlled trials totaling 1,002 participants aged 25 to 48 years were included. Ashwagandha supplementation significantly reduced anxiety, with a standardized mean difference of 1.55, and stress levels, with a difference of 1.75, compared to placebo. Nonlinear dose-response analysis indicates a favorable effect on stress at doses of 300 to 600 mg per day. The authors identified that the certainty of evidence was low for both outcomes and conclude that additional high-quality studies are necessary to firmly establish the clinical efficacy of the plant.
Akhgarjand C, Asoudeh F, Bagheri A, et al. Phytother Res 2022;36(11):4115-4124. DOI: 10.1002/ptr.7598
A second meta-analysis, published in 2024 and examining nine trials and 558 patients, is the only one to have pooled cortisol measurements: it finds a significant reduction in serum cortisol compared to placebo, with a mean difference of 2.58, along with a reduction in perceived stress of 4.72 points on the PSS scale and anxiety of 2.19 points on the Hamilton scale. Four of the included trials reported mild to moderate adverse effects.
Sixty-four subjects with a history of chronic stress were included after serum cortisol measurement and assessment using standardized stress questionnaires, then randomized between placebo and treatment, one capsule twice daily for 60 days, each capsule in the treatment group containing 300 mg of high-concentration, full-spectrum ashwagandha root extract. On day sixty, the treatment group showed a significant reduction in scores on all stress assessment scales compared to placebo. Serum cortisol levels were substantially reduced in the ashwagandha group compared to placebo. Adverse effects were mild and comparable between groups.
Chandrasekhar K, Kapoor J, Anishetty S. Indian J Psychol Med 2012;34(3):255-262. DOI: 10.4103/0253-7176.106022
This trial is the one that launched modern literature on ashwagandha and cortisol, and its extract is identified: it is KSM-66, root-only extract, at 300 mg twice daily. A second double-blind trial published in Medicine in 2019, using another standardized extract at 240 mg per day for 60 days in 60 stressed adults, measured a significantly greater reduction in morning cortisol and DHEA-S than placebo, and a decrease in anxiety on the Hamilton scale. Its authors conclude that the effect likely works through moderation of the hypothalamic-pituitary-adrenal axis.
An institutional framework also exists. The 2022 recommendations from the World Federation of Societies of Biological Psychiatry and the Canadian CANMAT network, established by 31 experts from 15 countries, classify ashwagandha among the phytotherapies provisionally recommended for anxiety disorders, based on grade A evidence.
A 2023 systematic review specifically devoted to cortisol, which retained nine studies out of 4,788 identified, concludes that ashwagandha decreases cortisol secretion without significant adverse effects. But its authors add this: none of the studies evaluated the potential impact of cortisol reduction on adrenal function or long-term effects, and ashwagandha supplements should be used under medical supervision. The trials lasted 30 to 112 days.
This sentence should be taken seriously. Lowering an essential hormone for months without knowing what it does to the glands that produce it is not trivial. This is an argument for two- to three-month courses with a break, not for continuous use. The certainty of evidence, let us recall, is judged as low by the largest meta-analysis.
Three things matter. Theextract : KSM-66 is the one from the landmark trial, root-only extract; Shoden is the one from the 2019 trial, more concentrated and dosed lower. The dose : the effective window identified is 300 to 600 mg of extract per day, and the meta-analysis on sleep finds a more pronounced effect from 600 mg. The duration : effects are measured at eight weeks and beyond. Our complete guide to ashwagandha details the extracts, and our article on its dangers and contraindications covers the thyroid and liver.
Magnesium and rhodiola: what they do, and what they don't
A systematic review of 18 studies concludes with a suggestive effect on subjective anxiety in people already vulnerable, mildly anxious, in premenstrual syndrome or hypertensive, with evidence quality deemed weak and, importantly, no study having used a validated stress measure. A 2024 review covering 15 trials finds a majority of positive results on anxiety and sleep and judges magnesium probably useful in mild anxiety and insomnia, especially in case of low baseline status. A trial in magnesium-deficient stressed adults measured stress reduction, more pronounced with vitamin B6. A trial in insomniac diabetics observed a decrease in serum cortisol, but in a very specific population. The 2022 international recommendations do not support magnesium in depression. Honest assessment: magnesium corrects a condition in those who lack it, and deficiency is common. It does not act on cortisol.
A trial in 80 mildly anxious people, with 2 times 200 mg per day for 14 days, measured a decrease in self-reported anxiety, stress, anger, confusion and depression. But there was no placebo group, only an untreated group, and the authors themselves write that they cannot establish a causal relationship. A review of plant adaptogens notes a benefit in chronic fatigue and cognitive decline. And the 2022 international recommendations do not support rhodiola in mood disorders. It is the adaptogen for fatigue and exhaustion, not for cortisol. Our comparison la rhodiola dans les troubles de l'humeur. C'est l'adaptogène de la fatigue et de l'épuisement, pas celui du cortisol. Notre comparatif rhodiola or ashwagandha details both profiles.
The amino acid from green tea has data on perceived stress and attention, detailed in our matcha guide, where we learn that its effect depends on its balance with caffeine. It does not target cortisol, but it is one of the rare documented options for daytime use, when ashwagandha is rather an evening active ingredient.
What supplements will never do
The Cushing syndrome, excess, andadrenal insufficiency, deficiency, are the two recognized cortisol diseases. Both are rare, diagnosed by precise tests and treated by surgery or medication, never by a plant. A presentation suggestive of either calls for a consultation, not a treatment course.
"Adrenal fatigue" is not a diagnosis. The term is everywhere, but it corresponds to no recognized entity in endocrinology: the adrenal glands do not become "exhausted" under stress. The exhaustion described by this name is real for those who experience it, and it deserves a response. But it corresponds to chronic stress, degraded sleep, sometimes depression or another medical cause, and naming it this way leads to seeking a hormonal answer to a problem that is not one.
Persistently low mood and pervasive anxiety are not within the scope of adaptogens. The meta-analysis on ashwagandha focuses on healthy stressed adults. Anxiety that interferes with work, sleep or relationships for weeks, persistent sadness, require professional care, and international guidelines actually position herbal therapies as adjunctive to standard treatment, especially in severe cases.
Microencapsulated magnesium Magshape providing 96% of reference values per capsule, combined with magnesium malate, 125 mg of taurine and vitamin B6, the combination tested in stressed adults with deficiency. To correct a low status, which is common, before seeking a hormonal response. One capsule in the evening.
View Magnesium+Magnesium acts on stress perception in people with deficiency; it has no data on cortisol itself.
The reasonable protocol
Choose what resonates most with you: the answer appears just below.
This is exactly the picture of an evening that doesn't come back down. The clock first: regular bedtime, screens and caffeine away from evening, light in the morning. Then magnesium if you're deficient, and ashwagandha as a course in the evening, in the 300 to 600 mg range, eight weeks before judging. Our ashwagandha guide details the protocol.
The face of cortisol is that of Cushing's, 2 to 8 people per million, and it's not limited to the morning. A puffy face upon waking comes much more often from the previous evening's salt, alcohol, a short night, an allergy, or lying down position. Look in that direction first. If the puffiness is accompanied by signs from Profile D, consult a doctor.
This picture is what is wrongly called adrenal fatigue. It is real, but it is not due to a hormone. First check your ferritin, thyroid, and vitamin D, which account for a large share of persistent fatigue. If the results are normal, rhodiola has data on fatigue, and persistent low mood warrants seeing a professional.
Rapid central weight gain, purple stretch marks, bruising from minor trauma, muscle weakness, recent high blood pressure: this is the picture that JAMA describes for Cushing's syndrome, and it is diagnosed by specific tests. No supplement has a place here. Also check if you are taking corticosteroids, the most frequent cause.
This test provides guidance; it does not replace the advice of a healthcare professional.
Frequently asked questions
Understanding
What is cortisol?
A glucocorticoid hormone produced by the adrenal glands under the control of the hypothalamic-pituitary-adrenal axis. It mobilizes energy, modulates immunity and inflammation, and regulates blood pressure. Its secretion is not constant: it follows a circadian rhythm, high upon waking and low in the evening, governed by the biological clock of the suprachiasmatic nucleus, and it is released in pulses. It is an essential hormone, not a poison to be eliminated.
Does cortisol face exist?
Not in the way social networks understand it. The puffy and rounded face attributed to cortisol is a sign of Cushing's syndrome, a disease defined by a prolonged and non-physiological excess of cortisol. According to a review in JAMA, the incidence of endogenous Cushing's is 2 to 8 people per million per year, and its most frequent cause is the use of corticosteroid medications. A stressful busy week does not produce this picture. A puffy face in the morning much more often stems from salt, alcohol, sleep, or an allergy.
What are the true signs of excess cortisol?
Those of Cushing's syndrome described by the JAMA : facial redness, easy bruising, purple stretch marks, fat deposits on the face, neck and internal organs, hyperglycemia, hypertension, weight gain, mood and cognitive disturbances. When this picture is complete and progressive, it calls for medical evaluation with 24-hour urinary cortisol, late evening salivary cortisol, or dexamethasone suppression test. This is not ordinary stress.
What does chronic stress really disrupt?
The rhythm rather than the level. A meta-analysis of 80 studies and 179 associations shows that a flattened diurnal cortisol slope—that is, a reduced gap between the morning peak and the evening trough—is associated with poorer physical and mental health in 10 of the 12 categories examined, with the strongest effect on immune and inflammatory markers. A review inEndocrine Reviews adds that even subtle alterations in cortisol dynamics during chronic stress can modify metabolism, behavior, mood, and cognition in sensitive individuals. The problem is not too much cortisol; it's cortisol that no longer falls.
Does adrenal fatigue exist?
It is not a recognized diagnosis in endocrinology. The cortisol disorders that do exist are excess, Cushing syndrome, and deficiency, adrenal insufficiency or Addison's disease, both rare and diagnosed by precise tests. The exhaustion described as adrenal fatigue is real for those experiencing it, but it corresponds to chronic stress, degraded sleep, or depression—not depleted adrenal glands. Naming it as such leads to wrong answers.
Should you have your cortisol tested?
A single measurement at any random time means almost nothing, because cortisol varies greatly throughout the day and from pulse to pulse. The useful medical tests are those that capture either the 24-hour total, the evening low point, or the response to suppression. They make sense when a doctor suspects Cushing syndrome or adrenal insufficiency, not to objectify everyday stress. Cortisol tests sold online for wellness have no such value.
The levers
What regulates cortisol rhythm daily?
Cortisol is driven by the biological clock, itself regulated by light. Waking at a fixed time, exposure to daylight in the morning, regular bedtime, and an evening without bright light are the direct levers of this rhythm. Night work, shifted schedules, and short nights flatten it. No supplement replaces these adjustments: they act on the conductor; supplements act on an instrument.
Does ashwagandha really lower cortisol?
It is the most well-documented supplement on this point. A meta-analysis of nine randomized trials totaling 558 patients measures a significant drop in serum cortisol compared to placebo, with a mean difference of 2.58, along with a decrease in perceived stress and anxiety. A systematic review devoted to cortisol, covering nine studies of 30 to 112 days, concludes that supplementation decreases cortisol secretion without significant adverse effects. The landmark trial, double-blind in 64 stressed adults with 300 mg of KSM-66® extract twice daily for 60 days, measured a substantial drop in serum cortisol and all stress scores.
What dose of ashwagandha?
The dose-response meta-analysis of 12 trials and 1,002 participants places the favorable effect on stress between 300 and 600 mg of extract per day. The landmark trial used 600 mg per day of KSM-66® root extract in two doses. On sleep, another meta-analysis finds a more marked effect from 600 mg per day and beyond eight weeks. Two capsules providing 660 mg of KSM-66® therefore fall within the trial window.
Can you take ashwagandha long-term?
Trials last from 30 to 112 days. The systematic review on cortisol emphasizes that no study has evaluated the impact of cortisol reduction on adrenal function or long-term effects, and recommends use under medical supervision. This is an honest limitation: lowering an essential hormone for months without knowing what it does to the glands that produce it is not trivial. Two to three-month courses with breaks remain the documented framework.
Does magnesium lower cortisol?
The data mainly concern perceived stress and anxiety, less cortisol itself. A systematic review of 18 studies concludes a suggestive effect on subjective anxiety in vulnerable people, with weak quality of evidence. A 2024 review of 15 trials finds a majority of positive results and judges magnesium probably useful in mild anxiety and insomnia, especially if baseline status is low. A trial in magnesium-deficient stressed adults showed stress reduction, more marked with vitamin B6. Magnesium corrects underlying terrain; it does not target cortisol.
And rhodiola?
Its data concern fatigue and exhaustion rather than cortisol. A trial in 80 mildly anxious people measured a decrease in anxiety, stress and confusion in 14 days, but without a placebo group, which limits the conclusion. The 2022 international recommendations of biological psychiatry do not support its use in mood disorders. It is the adaptogen for fatigue, not for cortisol, and we prefer to say so.
The limitations
When to consult rather than supplement?
In the presence of a picture suggestive of Cushing syndrome: rapid central weight gain, purple stretch marks, easy bruising, recent hypertension, muscle weakness. In the face of exhaustion that does not yield to rest, persistent low mood, or anxiety that takes over daily life, which call for a doctor, not an adaptogen. And if you take corticosteroids, thyroid treatment, a sedative, or an immunosuppressant, before adding any ashwagandha.
What to remember about cortisol?
That it is an essential hormone for marked circadian rhythm. That cortisol facies is a sign of Cushing syndrome, a disease affecting 2 to 8 people per million, not ordinary stress. That chronic stress flattens the rhythm and it is this flattening that weighs on health. That the biological clock is set by light and sleep above all. That ashwagandha is the only supplement with meta-analyses showing a drop in cortisol, in the 300 to 600 mg window, without long-term data. And that magnesium and rhodiola act on perception and fatigue, not on cortisol.
Glossary
- HPA axis
- Hypothalamus, pituitary, adrenals: the three-tier command chain that triggers cortisol secretion.
- Suprachiasmatic nucleus
- Central biological clock of the brain, regulated by light, which governs the circadian rhythm of cortisol.
- Diurnal slope
- Difference between morning and evening cortisol; its flattening is the marker associated with poorer health.
- Cushing syndrome
- Prolonged and non-physiological excess of cortisol; incidence of 2 to 8 per million per year in endogenous production.
- Adrenal insufficiency
- Cortisol deficiency, potentially life-threatening; the other true cortisol disorder, opposite to Cushing syndrome.
- Pulsatile secretion
- Cortisol release in successive waves rather than continuously; which makes an isolated measurement poorly informative.
- Dexamethasone suppression test
- Medical test verifying whether cortisol decreases normally after taking a corticosteroid; one of three screening tests for Cushing's syndrome.
- KSM-66®
- Ashwagandha root extract used in the landmark cortisol study, at 300 mg twice daily.
- Adaptogen
- Plant believed to improve the body's resistance to stress; a heterogeneous category whose evidence varies considerably from one plant to another.
- Certainty of evidence
- Degree of confidence in a meta-analysis result; judged low for ashwagandha in the largest meta-analysis.
Sources
The studies cited below were identified via PubMed.
- Reincke M, Fleseriu M. Cushing's syndrome: a review. JAMA, 2023;330(2):170-181. DOI
- Adam EK, Quinn ME, Tavernier R, McQuillan MT, Dahlke KA, Gilbert KE. Diurnal cortisol slopes and criteria for mental and physical health: a systematic review and meta-analysis. Psychoneuroendocrinology, 2017;83:25-41. DOI
- Lightman SL, Birnie MT, Conway-Campbell BL. Dynamics of ACTH and cortisol secretion and implications for disease. Endocrine Reviews, 2020;41(3):bnaa002. DOI
- Knezevic E, Nenic K, Milanovic V, Knezevic NN. The role of cortisol in chronic stress, neurodegenerative diseases, and psychological disorders. Cells, 2023;12(23):2726. DOI
- Prete A, Bancos I. Mild autonomous cortisol secretion: pathophysiology, comorbidities and management. Nature Reviews Endocrinology, 2024;20(8):460-473. DOI
- Akhgarjand C, Asoudeh F, Bagheri A, et al. Does ashwagandha supplementation have a beneficial effect on anxiety and stress management? A systematic review and meta-analysis of randomized trials. Phytotherapy Research, 2022;36(11):4115-4124. DOI
- Arumugam V, Vijayakumar V, Balakrishnan A, et al. Effects of ashwagandha on stress and anxiety: a systematic review and meta-analysis. Explore, 2024;20(6):103062. DOI
- Della Porta M, Maier JA, Cazzola R. Effects of Withania somnifera on cortisol levels in stressed human subjects: a systematic review. Nutrients, 2023;15(24):5015. DOI
- Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized, double-blind, placebo-controlled study of the safety and efficacy of a high-concentration, full-spectrum ashwagandha root extract in reducing stress and anxiety in adults. Indian Journal of Psychological Medicine, 2012;34(3):255-262. DOI
- Lopresti AL, Smith SJ, Malvi H, Kodgule R. A randomized, double-blind, placebo-controlled trial of the anti-stress and pharmacological actions of an ashwagandha extract. Medicine, 2019;98(37):e17186. DOI
- Cheah KL, Norhayati MN, Husniati Yaacob L, Abdul Rahman R. Effect of ashwagandha extract on sleep: a systematic review and meta-analysis. PLoS One, 2021;16(9):e0257843. DOI
- Sarris J, Ravindran A, Yatham LN, et al. Clinical guidelines for the treatment of psychiatric disorders with nutraceuticals and herbal remedies: WFSBP and CANMAT task force. World Journal of Biological Psychiatry, 2022;23(6):424-455. DOI
- Boyle NB, Lawton C, Dye L. Effects of magnesium supplementation on anxiety and subjective stress: a systematic review. Nutrients, 2017;9(5):429. DOI
- Rawji A, Peltier MR, Mourtzanakis K, et al. Effects of magnesium supplementation on self-reported anxiety and sleep quality: a systematic review. Cureus, 2024;16(4):e59317. DOI
- Noah L, Dye L, Bois De Fer B, Mazur A, Pickering G, Pouteau E. Effect of magnesium and vitamin B6 supplementation on mental health and quality of life in healthy stressed adults. Stress and Health, 2021;37(5):1000-1009. DOI
- Cropley M, Banks AP, Boyle J. Effects of a Rhodiola rosea extract on anxiety, stress, cognition and other mood symptoms. Phytotherapy Research, 2015;29(12):1934-1939. DOI
