Asparagus racemosus is known as shatavari and satawar in India,1 satamuli in Bangladesh,2 chattavari3 and hathawariya in Sri Lanka,4 kurilo in Nepal,5 and ni-shing in Bhutan.6 The genus Asparagus, which is a member of the asparagus family (Asparagaceae), includes about 120 species.7 Asparagus racemosus is a perennial, climbing vine that reaches 1-3 m (3.3-9.8 ft) in height. Numerous tuberous roots, which are the parts harvested for medicinal use, cluster below the basal end of the stem.5 Clusters of tiny, fern-like leaves are green in summer and turn pale yellow in late autumn, which indicates that the roots are ready to be harvested (usually from November to December in India). The flowers are white, fragrant, and tiny. In India, flowering and fruiting occur from December to January,8 although in the early 21st century, flowering and fruiting were observed to occur from January to February. One study reported that climate change impacts have advanced the species’ flowering and fruiting time in India by 15 to 30 days in recent years.9
Asparagus racemosus is xerophytic (adapted to surviving with little water) and prefers semiarid to subtropical and cool environments.8 It occurs in southern Asian countries, including Bangladesh10; Bhutan11; India, in seven of 15 defined agro-climatic zones; Nepal12; northern Pakistan13,14; and Sri Lanka.4 The species also occurs partly in eastern Asia (in southern parts of Tibet, China),15 southeastern Asia (Malaysia15 and Myanmar16), Oceania (north to northeastern coastal areas of Australia),7 and parts of eastern Africa (Kenya17 and Uganda18).
In terms of volume, shatavari root ranks among the most highly traded medicinal plants in southern Asia, especially in India,19 Nepal,12 and Bangladesh.2,10 Much of the global supply comes from wild collection in India and Nepal, but cultivation has been increasing. Since at least the 1990s, more than 90% of wild shatavari from Nepal has been exported to India.5,20 In recent years, shatavari cultivation also has been successful in some parts of Nepal, especially in Makwanpur District, Bagmati Province.5 In Bangladesh, cultivation of shatavari began in about 2002, and, since then, it has ranked among the top five medicinal plant crops, primarily for use in domestic medicines.2 In Bhutan, the Institute of Traditional Medicine Services, which is responsible for the supply of medicines used in the traditional Bhutanese gSo-ba Rig-pa (also spelled Sowa Rigpa) system of medicine, cultivates A. racemosus.6
In India, an estimated 5 million kg (5,000 metric tons) of shatavari root can be traded annually for domestic and export markets. Of that, the Indian herbal medicine industry has been estimated to consume about 2,723 metric tons annually, of which 58% is used by medium and large companies and 42% is used by small and very small licensed herbal medicine processing units. Rural households use an additional estimated 675.56 metric tons.19
In Nepal, shatavari ranks among the top four medicinal plants in trade. In the 1990s, licensed wild collection of shatavari root in Nepal was estimated at about 391 metric tons annually,21 of which anywhere from 110 to 359 metric tons were exported to neighboring India.22 In 2009, Nepal’s annual trade volume of shatavari root that was wild harvested on government land was estimated broadly from 355 up to 1,256 metric tons.23 In 2014, Nepal’s Ministry of Forests and Soil Conservation listed A. racemosus among 30 prioritized species for cultivation and economic development.5
Shatavari is used mainly in the nationally recognized traditional medicine systems of southern and southeastern Asia, namely Ayurveda,1 gSo-ba Rig-pa,6 and Unani,24 but also is used widely in non-codified regional, tribal, and folk medicines of India.25 In recent decades, shatavari also has become a popular component of dietary supplement products in the United States (US) as well as of food supplement products in the European Union (EU).
HISTORY AND CULTURAL SIGNIFICANCE
Swedish botanist Carl Linnaeus (1707–1778) assigned the Latin genus name Asparagus in his 1753 work Species Plantarum.26 Asparagus was borrowed from the Greek asparagos, which derived from the Persian asparag, meaning “sprout” or “shoot,” referring to the spears that emerge in the spring.27 German botanist and plant taxonomist Carl Ludwig Willdenow (1765–1812) named the species A. racemosus in 1799 and stated that the species was distributed in India.28 The Latin term racemosus means “with clusters.”
The common name shatavari comes from the Sanskrit language, from which variations like satavar are used in the Hindi and Punjabi languages, satavari in the Gujarati and Urdu languages, and satamuli in the Bengali language.1,24 Shatavari means “100 below”; shat means “100” in Sanskrit and avar means “below” in Hindi, referring to the numerous tuberous roots. In Sanskrit, vri means “roots” and vari means “husband,” which can lead to various translations, including “she who has 100 husbands” (Sebastian Pole, co-founder of Pukka Herbs, email to T. Smith, January 11, 2022). In that regard, shatavari is considered to be a female reproductive tonic to enhance fertility and vitality.29
Traditional medical uses of shatavari-containing formulations were first documented in ancient Sanskrit treatises, for which there is disagreement on the compilation dates. The earliest complete Ayurvedic treatise, the Charaka Samhita, was compiled from about 150 BCE to about 100 CE30,31; the detailed surgical text Sushruta Samhita from about 100 BCE to about 500 CE; Dhanvantari Niganthu from about 500 CE; and Ashtanga Hridaya Samhita from about 600 CE (S. Pole email to T. Smith, January 11, 2022).31 A recent review of the Brihatrayi (Major or Great Trio of Compositions) found shatavari as a component of 179 formulations, many of which were indicated as rasayana formulations (rejuvenative therapies).32
A study by Thomas et al (2020) on the identities of medicinal plants in Ayurvedic classical literature found that the Sanskrit basonym (original or earliest name) shatavari had six common name synonyms in the Brihatrayi, one of which, Rishyaprokta, was shared with three other medicinal plants: Mucuna pruriens (Fabaceae), Sida cordifolia (Malvaceae), and Teramnus labialis (Fabaceae).31 Another ancient Indian Sanskrit treatise, the Kautilīya Arthaśāstra (fourth century BCE), described the preparation of a smoke mixture for causing blindness in one’s enemies. The mixture was prepared by burning A. racemosus and four other plants (parts not specified) — Datura metel (Solanaceae), Ipomoea paniculata (Convolvulaceae), Shorea robusta (Dipterocarpaceae), and Solanum surattense (Solanaceae) — with two unspecified insects and one unspecified fish.33
Healers of the Deb Barma clan of the Tripuri people in Bangladesh reportedly believe shatavari possesses special magical properties that are useful for appeasing the evil god Bura debta. Clan healers aim to appease Bura debta through pujas (worship) and archanas (offerings). In this context, shatavari is placed inside an amulet, which is worn around the waist until the wearer is cured, irrespective of the disease that is being treated or of other medicinal plants that may be prescribed.34 Pastoralist nomadic yak herders of Mustang, Nepal, use shatavari therapeutically as a tonic, for kidney and liver problems, and for sore throat. Shatavari root powder is taken orally with yak milk. For the treatment of mastitis (inflammation of breast tissue), a paste is made from the roots and applied topically. The herders also use shatavari in medicines for yaks.35
In central Bhutan, healers cook the fresh young shoots, but also dry and powder the roots, and mix with warm water for treating constipation, diarrhea, and ulcers, as well as diabetes and tuberculosis.36 In the Naran Valley in the Western Himalaya of Pakistan, a paste of shatavari powder is applied as an antiseptic for wound healing. Shatavari powder also is taken orally as a sexual stimulant.14 For treating spermatorrhea (excessive, involuntary ejaculation), elders and healers of the Kaniyakaran tribes who live in the forests of the South Western Ghats of India report oral ingestion of powdered shatavari root (20 g daily) mixed with cow milk.37 People of the Bhil tribe in the Thar Desert of Rajasthan, India, mix powdered shatavari root with milk to treat hemorrhoids.38
In the Himalayas of Sikkim in northeastern India, shatavari root mixed with hay or grain is used in ethnoveterinary medicine as a galactagogue (a substance that promotes lactation).39 The Tamang people of central Nepal also cook shatavari roots and give them to animals to enhance milk production.40 Aboriginal people of Northern Territory, Australia, boil the roots in water to make a wash for scabies (an itchy skin condition caused by a burrowing mite) and skin infections or skin ulcers.41
In the 21st century, monographs for shatavari have been admitted to official compendia, mainly in India. In 2004, a quality standards monograph for shatavari entered Volume 4 of The Ayurvedic Pharmacopoeia of India,42 which was revised and updated in Volume 8 in 2011.1 In 2007, shatavari also was admitted into the fifth edition of the Indian Pharmacopoeia.43 Also in 2007, a monograph entered Volume 2 of Medicinal Plants of Myanmar.16 In 2009, a monograph entered Volume 6 of The Unani Pharmacopoeia of India.24
CURRENT AUTHORIZED USES IN COSMETICS, FOODS, AND MEDICINES
In India and other countries that recognize the Ayurvedic and/or Unani systems of medicine, shatavari-containing preparations are regulated as medicines and dispensed in clinics, pharmacies, and hospitals. In the Ayurvedic system of medicine, shatavari is used in preparations indicated for treating a range of conditions, including (in the order they appear in the pharmacopeia) inflammation, phthisis (pulmonary tuberculosis), duodenal ulcers, abdominal lumps, diarrhea, diarrhea with blood, disorders of blood as well as bleeding disorders, hematuria (blood or blood cells in the urine), hyperacidity, hemorrhoids, hoarseness, night blindness, gout, erysipelas (bacterial infection of the upper layers of the skin), puerperal (postpartum) disorders, various disorders involving breast milk, and decrease in breast milk.1 In the Unani system of medicine, shatavari is used mainly for treating diarrhea, spermatorrhea, excessive nocturnal emission, premature ejaculation, leukorrhea (whitish, yellowish, or greenish vaginal discharge), and dysentery.24
In the United States, where shatavari is used as a component of dietary supplement products, the US Food and Drug Administration requires notification within 30 days of marketing if a structure-function claim is made.44 In Canada, shatavari is regulated as a medicinal ingredient of licensed natural health products (NHPs), which require pre-marketing authorization from the Natural and Non-prescription Health Products Directorate (NNHPD). Licensed NHPs containing shatavari root, or extracts made from it, may carry claim statements to the effect of “Used in Herbal Medicine as an Adaptogen to help increase energy and resistance to stress (e.g., in case of mental and physical fatigue related to stress),” and/or “Traditionally used in Ayurveda as Rasayana (rejuvenative tonic).”45
In the EU, roots of A. racemosus (and their aqueous and hydroalcoholic extracts) have been used only in food supplement products since before May 15, 1997. This means that access to the EU market is not subject to the Novel Food Regulation.46 In 2010, the European Food Safety Authority (EFSA) issued a negative opinion on a proposed health claim (“supports the health of the kidneys”) for labeling and marketing of shatavari root food products because the claim was insufficiently defined, too general, and non-specific and therefore did not meet the EU regulatory requirements for a specific health claim.47 While it should be possible for an applicant to receive authorization to market a Traditional Herbal Medicinal Product (THMP) that lists shatavari as an active ingredient, at the time of this writing (October 2021), no products that list A. racemosus were found in the European Medicines Agency database of all medicines authorized in the European Economic Area.48 For use in cosmetic products in the EU, the defined ingredient “Asparagus Racemosus Root Powder” is authorized for skin-conditioning function, and “Asparagus Racemosus Root Extract” is authorized for antimicrobial, skin-conditioning, and emollient (skin-softening) functions.49
Constituents and Pharmacological Effects
The major bioactive constituents of shatavari root are phytosterols and steroidal saponins, such as shatavarins I-X and sarsasapogenin.29,50-54 Other constituent classes in the roots are flavonoids and other phenols (e.g., racemosol), and polysaccharides.51,53-57 Shatavari roots have demonstrated a range of pharmacological effects in various animal, in vitro, and in vivo studies.29,52,58-66 Adaptogenic,67-70 analgesic,71 anthelmintic,72 antibacterial,73 antidiabetic,74-76 antidiarrheal,77 anti-inflammatory,29,78 antioxidant,79-82 antitumor,83 anti-ulcer,84,85 aphrodisiac,86,87 diuretic,88 galactagogue,89 hepatoprotective,90,91 hypolipidemic,82 immunomodulatory,67,92 neuroprotective,93,94 and oestrogenic95 effects are reported in the literature.
Ethnoveterinary and Veterinary Studies
A study from 1969 reported that fresh shatavari root supplementation increased milk production in water buffaloes.96 More recent studies investigated shatavari feed supplementation to assess galactopoietic (inducing the formation and secretion of milk) properties and found comparable improvements in milk production in buffaloes.97,98 Multiple veterinary studies also have evaluated shatavari as one of several herbal galactagogues found in polyherbal combinations for dairy and livestock management.99-105
An oral acute toxicity study in animals found no mortality, behavioral, or neurological changes using high doses of an aqueous shatavari root extract.88,94 An additional acute and subacute oral toxicity study by Bhandary et al (2017)106 evaluated both a shatavari syrup and an ethanol extract. No acute toxicity signs, biochemical or histopathological changes, or mortalities were noted in this animal study. The authors established the maximum tolerable dose at 2,000 mg/kg body weight in mice.94,106 Based on traditional uses in Ayurveda, shatavari root generally is considered to be well-tolerated.55,94
Human Clinical Studies
Overall, human clinical studies on shatavari have focused mainly on women’s health and gastrointestinal conditions, and more recent studies have evaluated ergogenic performance effects in exercise training and musculoskeletal system strength changes in postmenopausal women. Many clinical trials have investigated various traditional tonic effects and health conditions that involve multi-ingredient preparations in which shatavari is one component. However, Table 1 is limited to studies on shatavari mono-preparations.
From traditional Ayurvedic herbal knowledge, shatavari often is recommended as a galactagogue107 and widely used in postpartum care in India.108-110 Only a few shatavari studies, however, are specific to its effects on breastfeeding.111,112 Nonetheless, shatavari often is reviewed as one of the main herbal galactagogues in breastfeeding studies.113-118 Shatavari is also known traditionally as a female reproductive tonic,107 and a few studies have evaluated shatavari-containing polyherbal formulas for treatment of abnormal uterine bleeding119 and menopausal symptoms.120
A review by Goyal et al (2003)58 summarized shatavari uses from earlier gastrointestinal studies, including a small study that showed shatavari was comparable to metoclopramide with a similar response on gastric emptying time121 and other studies that showed improvement of duodenal ulcers.122,123 More recently, a systematic review of 34 clinical studies of herbal medicines for functional dyspepsia listed shatavari as one of the 15 herbs found to be effective.124
ADULTERATION AND SUBSTITUTION
Substitution with roots of other Asparagus species, such as A. adscendens (native range: Pakistan to western Himalaya and northwestern India) and A. curillus (native range: western-central and central Himalaya to Punjab in northwestern India), reportedly occurs in north Indian markets,131 and substitution with A. gonoclados (native range: southern India and Sri Lanka) occurs in southern markets.132 The Indian Pharmacopoeia has included a DNA barcode test for shatavari to use as a final alternative in the event that other traditional pharmacognosy identification tests in the monograph fail or are inconclusive.133 Stemona species (Stemonaceae) have been mistaken for shatavari because of the similar appearance and shape of their tuberous roots. It is also possible that previous reports of the presence of the alkaloid asparagamine A in roots of A. racemosus were due to the misidentification of Stemona roots.134 On the other hand, shatavari apparently is accepted in India as an “official substitute” for the roots of Polygonatum cirrhifolium and/or P. verticillatum (Asparagaceae).135
Two shatavari types are described in classical Ayurvedic texts. Shatavari (A. racemosus) and mahashatavari (A. sarmentosus, a larger climber with long, tuberous roots) are included in the 13th-century Raj Nighantu, or Rajanighantu, and Dravyaguna Vijnana. Both shatavari and mahashatavari are bitter and considered to be very good rasayana drugs. As both species may be referred to as shatavari, there is chance of mix up in commerce (Lal Hingorani, director of Pharmanza India Pvt. Ltd., email to T. Smith, January 14, 2022).
SUSTAINABILITY AND FUTURE OUTLOOK
A Conservation Assessment and Management Prioritization (CAMP) process in Nepal resulted in a threat status assessment of vulnerable (VU) for wild A. racemosus.12,136,137 The threat in Nepal is mainly the result of decades of unsustainable harvesting of root tubers for export trade.13 In India, A. racemosus has a threat status of endangered (EN)9 and is therefore a prioritized species recommended for resource management intervention in the areas where it is wild collected.19 Sub-regionally, A. racemosus was assessed as near threatened (NT) in the Indo-Burma biodiversity hotspot region in Mizoram, a state in northeastern India that borders Bangladesh and Myanmar.138 In China, where A. asparagus occurs only in southern Tibet, the plant’s threat status has been assessed as least concern (LC).139 Asparagus racemosus also has been assessed as LC in Sri Lanka.3
Commercial use of wild-collected A. racemosus may be subject to the Access and Benefit Sharing provisions of the Convention on Biological Diversity Nagoya Protocol. India’s National Biodiversity Authority, which has 29 State Biodiversity Boards and was established in 2003 to implement India’s Biological Diversity Act, is responsible for conservation, sustainable use of biological resources, and fair and equitable sharing of benefits that arise from the use of biological resources.140
When shatavari is wild collected for the conventional market, destructive harvesting methods often are used (e.g., uprooting the entire plant rather than taking only a certain percentage of root tubers and leaving the vine standing to facilitate regeneration). This is further exacerbated by loss of shatavari habitat from deforestation and land-use change. Therefore, in situ and ex situ conservation, with selection of superior genotypes, and conservation-oriented agricultural methods are recommended for this species.141
The sustainable production of shatavari has become a high priority in some southern Asian countries where it ranks among the most important medicinal plants for use in the traditional systems of medicine and for rural economies and trade. Sustainable production and trade of shatavari apparently are increasing, as evidenced by listings of certified operations in the databases of voluntary sustainability standards organizations and independent third-party inspection and certification bodies. These include Cultivator Natural Products Pvt. Ltd. (Rajasthan, India), a Fair for Life-certified shatavari producer142; Nature Connect India Pvt. Ltd. (Maharashtra, India), a FairWild-certified producer143; and Organic India Farmers Producer Co. Ltd. (Uttar Pradesh, India), a FLOCERT fair trade-certified operation.144 Operations that process certified organic shatavari include HDDES Extracts Pvt. Ltd. (Western Province, Sri Lanka),145 Herb Artizan Pvt. Ltd. (Karnataka, India),146 and Phalada Agro Research Foundations Pvt. Ltd. (Karnataka, India),147 among others.148
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