RESSNOVA: Ashwagandha-Holixer Berry Flavoured Premix

RESSNOVA: Ashwagandha-Holixer Berry Flavoured Premix is a plant-based botanical dietary supplement in drink-mix form, listed by DoctorOnCall under H&H Supplements. It is supplied as a pack of 15 sachets, with each sachet containing 10 g of berry-flavoured premix that is dissolved in water to make a daily botanical beverage. The formulation brings together ashwagandha (Withania somnifera), Rhodiola rosea, holy basil or tulsi (Ocimum tenuiflorum), cordyceps, chamomile and ginseng.

Several of these botanicals are often described as adaptogens, a term used for herbs traditionally taken to help the body cope with everyday stress. Ashwagandha is the best studied of the group, with randomised trials suggesting that some ashwagandha preparations may help with perceived stress and sleep quality, while evidence for rhodiola, holy basil, cordyceps and ginseng is more limited. Chamomile has a long history of use as a calming herbal tea. The manufacturer describes the drink as supporting calm, balance and general wellbeing as part of a healthy lifestyle.

The amount of each botanical per sachet is not stated in the available product information, so please check the product label for the full ingredient list and any added sugar, sweetener or flavouring. Although the ingredients are plant-based, they can still cause side effects and interact with medicines; ashwagandha in particular has been linked to rare cases of liver injury and may affect thyroid function. Adults who are pregnant, breastfeeding, taking medicines or living with a medical condition should check with a doctor or pharmacist before use.

Dissolve 1 sachet (10 g) in 150 ml of cool or room-temperature water. Stir well and drink immediately. Take 1 sachet daily, unless otherwise advised by a healthcare professional. Do not exceed the recommended serving, and always follow the directions on the product label.

Adults: 1 sachet (10 g) once daily, dissolved in 150 ml of water, unless otherwise advised by your doctor or pharmacist.

Do not take more than 1 sachet a day. Long-term safety of ashwagandha beyond about 3 months is not well established, so speak to a doctor or pharmacist if you wish to use it continuously. This product is not intended for children.

Keep the sachets in a dry place and protect them from excessive heat and moisture. Keep out of the reach of children. Do not prepare the drink in advance; mix and drink it immediately.

• Common: mild stomach discomfort, nausea, diarrhoea or vomiting.
• Common: drowsiness or sleepiness.
• Uncommon: difficulty sleeping, headache, dizziness or dry mouth, which have been reported with ginseng and rhodiola.
• Uncommon: changes in thyroid function, as ashwagandha may raise thyroid hormone levels in some people.
• Serious (rare): liver injury has been reported in rare cases with ashwagandha supplements; stop use and see a doctor if you notice yellowing of the skin or eyes, dark urine, itching or abdominal pain.
• Serious (rare): allergic reactions such as rash, itching, swelling or difficulty breathing, particularly in people allergic to the daisy family (chamomile); seek medical attention immediately.

• Pregnancy and breastfeeding, as ashwagandha should be avoided during pregnancy and there is not enough safety information for the other botanicals.
• Known allergy to any ingredient, or to plants in the daisy family (such as ragweed, chrysanthemum, marigold or daisy), because of the chamomile content.
• Existing liver disease, unless advised by a doctor.
• Hormone-sensitive prostate cancer, as ashwagandha may increase testosterone levels.
• Children, as the product is intended for adults.

• Thyroid medicines (e.g. levothyroxine, carbimazole): ashwagandha may affect thyroid hormone levels; consult your doctor before use.
• Sedatives and sleeping medicines (e.g. benzodiazepines, zolpidem) and alcohol: ashwagandha and chamomile may add to drowsiness.
• Immunosuppressants (e.g. ciclosporin, tacrolimus, corticosteroids): ashwagandha and cordyceps may stimulate immune activity and could reduce their effect; chamomile may also affect ciclosporin levels.
• Diabetes medicines: ashwagandha, ginseng and holy basil may lower blood sugar, increasing the risk of low blood sugar.
• Blood pressure medicines: ashwagandha may lower blood pressure, and an interaction between rhodiola and losartan has been reported.
• Blood thinners (e.g. warfarin) and antiplatelet medicines: ginseng and chamomile may affect blood clotting or warfarin levels; your doctor may need to monitor you.
• Anticonvulsants and antidepressants: ashwagandha and rhodiola may interact with these medicines; check with your doctor or pharmacist.
• Other supplements: avoid combining with other ashwagandha, ginseng or calming supplements to prevent duplicate intake.

• Mix each sachet with 150 ml of cool or room-temperature water and drink it straight away for the best taste.
• Stick to 1 sachet a day and check the labels of your other supplements for ashwagandha or ginseng.
• If the drink makes you sleepy, take it at a time when you do not need to drive.
• Tell your doctor you are taking it if you have thyroid disease, diabetes, high blood pressure or an autoimmune condition.
• Stop at least 2 weeks before planned surgery and let your surgeon know you have been taking herbal supplements.
• Keep unopened sachets dry and away from heat, such as a hot car or kitchen counter.

Precautions: Check with a doctor or pharmacist before use if you are pregnant, breastfeeding, taking any medicine, or have an existing medical condition, especially thyroid disease, autoimmune disease (such as lupus, rheumatoid arthritis or multiple sclerosis), liver disease, diabetes, high or low blood pressure, a bleeding disorder or hormone-sensitive cancer. The product may cause drowsiness, so take care when driving. Stop use at least 2 weeks before planned surgery. Plant-based ingredients can still cause side effects, and this product does not replace medical treatment for stress, anxiety or sleep disorders.

When to See a Doctor or Pharmacist: Stop using the product and seek medical advice if you develop unusual or severe symptoms, including yellowing of the skin or eyes, dark urine, persistent stomach pain, a racing heartbeat, tremor or unexplained weight change, or signs of an allergic reaction. See a doctor if stress, low mood, anxiety or sleep problems are persistent or affect your daily life.