Comparison
Ashwagandha vs Low-Dose Naltrexone
Side-by-side of Ashwagandha and Low-Dose Naltrexone. Every row below is pulled from the compound schema and will update as our data grows. For deeper reads, follow through to each compound page.
Ashwagandha
Ashwagandha supplement guide: KSM-66 and Sensoril extracts at 300-600 mg/day cut morning cortisol and stress in RCTs. Dose, side effects, testosterone data.
Low-Dose Naltrexone
Low dose naltrexone at 1.5 to 4.5 mg, one-tenth the 50 mg addiction dose. Compounded Rx. Small trials in fibromyalgia, Crohn's, Hashimoto's.
Effects at a glance
Ashwagandha
- •Reduces morning serum cortisol by ~20 to 30% at 300 to 600 mg/day standardized extract over 8 weeks
- •Lowers subjective stress on DASS-21 and PSS scales versus placebo in chronically stressed adults
- •Modest grip-strength and 1-RM gains of ~5 to 8% in trained men when paired with resistance training
- •Improves self-reported sleep quality and onset latency in adults with insomnia symptoms
- •Small testosterone increases (~10 to 15%) reported in stressed or subfertile men, less clear in healthy populations
- •May raise free T3 and T4; can interact with levothyroxine and unmask subclinical hyperthyroidism
Low-Dose Naltrexone
- •Off-label use at 1.5 to 4.5 mg, roughly one-tenth the FDA-approved 50 mg addiction-treatment dose
- •Proposed mechanisms include brief opioid receptor blockade triggering rebound endogenous opioid release, plus TLR4 antagonism
- •Compounded prescription only; insurance rarely covers; cash prices 20 to 80 USD per month
- •Younger 2013 reported ~30% pain reduction in fibromyalgia at 4.5 mg in a small crossover trial
- •Smith 2011 reported endoscopic improvement in active Crohn's disease (n=40 placebo-controlled)
- •Vivid dreams affect 20 to 40% in first 2 weeks; manageable by switching to morning dosing
Side-by-side
| Attribute | Ashwagandha | Low-Dose Naltrexone |
|---|---|---|
| Category | natural | pharmaceutical |
| Also known as | Withania somnifera, KSM-66, Sensoril | LDN, naltrexone (low dose) |
| Half-life (hr) ↗ | 10 | 4 |
| Typical dose (mg) ↗ | 600 | 4.5 |
| Dosing frequency | daily | once daily, typically at bedtime |
| Routes | oral | oral |
| Onset (hr) | 2 | 1 |
| Peak (hr) | - | 1.5 |
| Molecular weight | - | 341.4 |
| Molecular formula | - | C20H23NO4 |
| Mechanism | GABAergic modulation and HPA-axis attenuation; withanolides reduce cortisol secretion and inhibit NF-kB signaling. | Brief mu-opioid receptor antagonism proposed to trigger compensatory upregulation of endogenous opioids; secondary TLR4 antagonism on microglia and immune cells contributes to anti-inflammatory effect. |
| Legal status | Dietary supplement in most jurisdictions; regulated in Denmark | Off-label compounded prescription (naltrexone is FDA approved for opioid and alcohol use disorder at 50 mg) |
| WADA status | allowed | allowed |
| DEA / Rx | OTC supplement | Rx only (not a controlled substance) |
| Pregnancy | Not recommended | Insufficient data; not routinely recommended |
| CAS | - | 16590-41-3 |
| PubChem CID | - | 5360515 |
| Wikidata | Q310109 | Q426444 |
Safety profile
Ashwagandha
Common side effects
- mild GI upset
- drowsiness
- headache
Contraindications
- pregnancy
- autoimmune disease (theoretical immune stimulation)
- hyperthyroidism
- concurrent sedative use
Interactions
- benzodiazepines: additive CNS depression(moderate)
- thyroid hormone (levothyroxine): may raise T3/T4, altering dose requirements(moderate)
- immunosuppressants: theoretical antagonism via immune stimulation(moderate)
Low-Dose Naltrexone
Common side effects
- vivid dreams
- sleep disruption
- headache
- mild GI upset
- fatigue (early)
Contraindications
- concurrent opioid use
- acute hepatitis or liver failure
- opioid dependence
- pregnancy (insufficient data)
Interactions
- opioid analgesics (oxycodone, morphine, codeine): blocks analgesic effect; precipitates withdrawal in dependent users(major)
- tramadol: blocks opioid component of analgesia(major)
- thyroid hormone replacement: may alter dose requirements after immune modulation; monitor TSH(minor)
Which Should You Take?
Ashwagandha comes out ahead for most readers on the criteria we weight: 3 catalogued goals, OTC dietary supplement, oral dosing, with a Tier-B outcome catalogued. Low-Dose Naltrexone is the right call when one of the conditionals below applies.
- → If your priority is stress and HPA-axis regulation, pick Ashwagandha.
- → If your priority is focus or working memory, pick Ashwagandha.
- → If your priority is immune support, pick Low-Dose Naltrexone.
- → If your priority is pain modulation, pick Low-Dose Naltrexone.
Edge case: If you want to avoid prescription-only, Ashwagandha is the more accessible choice.
Default choice: Ashwagandha. Lower friction to source, and broader goal coverage. Reach for Low-Dose Naltrexone only if your priority sits squarely in the goals it owns above.
This verdict is generated from each compound's schema (goals, legal status, evidence outcomes, dosing route). It updates automatically as our compound data evolves; the deeper read sits on each individual compound page.
Common questions
What is the difference between Ashwagandha and Low-Dose Naltrexone?
Ashwagandha and Low-Dose Naltrexone differ in category (natural vs pharmaceutical), mechanism, and typical dosing. See the side-by-side table for full details.
Which has a longer half-life, Ashwagandha or Low-Dose Naltrexone?
Ashwagandha half-life is 10 hours; Low-Dose Naltrexone half-life is 4 hours.
Can you stack Ashwagandha with Low-Dose Naltrexone?
Stack compatibility depends on mechanism overlap, legal status, and individual response. Check each compound page for specific interactions and contraindications before combining.
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