A S H WA G A N D H A

L A S T U P D AT E D N OV E M B E R 1 4 , 2 0 1 9 .
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Does ashwagandha have side effects?

This Ayurvedic herb acts especially on cortisol levels in the body, which are tied to other key

functions. That means this supplement may not be right for everyone. Ashwagandha may

interact with some prescription medications, so you should always talk to a medical

professional before beginning a regimen.

Written by Linnea Zielinski

Reviewed by Mike Bohl, MD, MPH

DISCLAIMER

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on

Health Guide are underpinned by peer-reviewed research and information drawn from medical

societies and governmental agencies. However, they are not a substitute for professional medical

advice, diagnosis, or treatment.

Adaptogens are a family of medicinal plants such as herbs and roots popular in alternative

medicine that help the body adapt to or deal with all kinds of stressors, from physical to

mental. That’s a powerful concept and one that’s recently caught the attention of the

mainstream wellness industry in the United States. But it’s actually been around for

centuries, and these plants have been popular mainstays of Ayurvedic, Indian, and African

traditional medicine. One of these essential herbs is ashwagandha or Withania somnifera,

also called Indian ginseng or winter cherry. But more stress is the last thing you want from an

herbal remedy for stress, so it’s worth getting familiar with the potential side effects.

V I TA L S

Ashwagandha is a medicinal plant traditionally used in alternative medicine practices such as

Ayurveda.

As an adaptogen, it might be able to help your body adjust to different types of stressors, from

physical (like inflammation) to mental (like anxiety).

This Ayurvedic herb acts especially on cortisol levels in the body, which are tied to other key

functions. That means this supplement may not be right for everyone.

Ashwagandha may interact with some prescription medications, so you should always talk to a

medical professional before beginning a regimen.

Pregnant women should avoid this herbal supplement.

Ashwagandha health benefits

It’s worth noting that ashwagandha is generally well-tolerated, and its potential health

benefits are wide-ranging. It gets many of its health benefits from its withanolides, steroids

that are naturally-occurring in nightshades. Withania somnifera could potentially boost

testosterone levels (Ahmad, 2010) and improve male infertility (Mahdi, 2011) in certain

populations, and ease cortisol levels (Chandrasekhar, 2012) in people with chronic stress.

Although it gets its name from its ability to boost strength but also its unique smell, the herb

comes as capsules as well as powder if you find it off-putting. But since it’s as easy to get as

ordering online or running to a supplement store, you should do your homework to make

sure you’re buying from a trust-worthy brand.

Possible ashwagandha side effects

Even if you’re buying from the best sources, everyone reacts to supplements differently.

Though most research shows that many people handle Withania somnifera without a

problem, that might not be the case for you. That’s why you should know about the

potential ashwagandha side effects before beginning supplementation and also discuss it

with your healthcare provider.

May increase thyroid function

This may sound like welcome news for some, like those suffering from conditions

characterized by low thyroid function such as hypothyroidism and Hashimoto’s, but it can

be dangerous for people with already elevated thyroid function, or hyperthyroidism.

Participants with subclinical hypothyroidism saw normalization of both of the main thyroid

hormones triiodothyronine (T3) and thyroxine (T4) when given ashwagandha root extract in

a 2018 study (Sharma, 2018). Researchers believe that this effect may happen due to

ashwagandha’s cortisol-lowering effect, but more work needs to be done to confirm that. 

This study sparks hope that Withania somnifera may prove helpful in the treatment of

subclinical hypothyroidism, suppressed thyroid function that isn’t low enough to meet the

blood level cutoffs of true hypothyroidism but can still cause lethargy, weight gain, and hair

loss. But people whose thyroids are already working overtime are treated with medicine

that lowers their thyroid hormone output, so this side effect of ashwagandha could

potentially be dangerous for them or interact poorly with their medicine. Left untreated,

rising thyroid hormone levels in someone with hyperthyroidism can lead to a serious

condition called thyrotoxicosis that can lead to a number of conditions, including heart

failure.

Can decrease blood pressure levels

Although some people would welcome a supplement that lowers blood pressure to their

routine with open arms, this side effect of Withania somnifera can be dangerous for others.

Many people with hypertension, or high blood pressure, are on a prescription medication

monitored by their primary care physician. This Ayurvedic herb can interfere with these

drugs’ actions in the body. Alternatively, people with naturally low blood pressure are at risk

of potentially driving this too low with this supplement. That’s why you should always seek

out medical advice before adding something new to your regimen.

May irritate GI tract

Ashwagandha is adaptogenic, meaning that in some people, it’s a Swiss Army knife for

treating stress. Along with its anxiolytic (anti-anxiety) and anti-inflammatory properties,

Withania somnifera may also act as a protectant against stress-induced gastric ulcers and

even aspirin-induced gastric ulcers. The study (Singh, 1982) was done on mice, and animal

studies don’t always translate to us, so human studies are needed to confirm that these

protective qualities hold true.

But our gastrointestinal (GI) tracts can also get too much ashwagandha. Constipation and

decreased appetite were side effects observed in one study (Chandrasekhar, 2012), and

large amounts can even cause enough gastrointestinal distress to cause ulcers (not the same

kind it helps prevent). Although some participants in the placebo-controlled study also

mentioned experiencing abdominal pain and diarrhea, they were in the placebo group, and

their side effects cannot be attributed to the use of ashwagandha.

Can induce early pregnancies or miscarriages

First things first: pregnant women should always seek medical advice from a healthcare

professional before starting any supplement, so matter how benign it seems. While

pregnancy can be both joyous and stressful, ashwagandha isn’t the answer for stress-relief

in this case. Despite its many benefits, ashwagandha contains compounds that may cause

miscarriage, premature birth, or uterine contractions, according to the National Institutes of

Health (NIH, 2020.). If you’re feeling stressed, talk to your healthcare provider about

potential treatment plans.

May decrease blood sugar

More research does need to be done in this area, but several studies done in rats have

indicated that ashwagandha can lower blood sugar (Noshahr, 2014). For example, both

glucose tolerance and insulin sensitivity were improved in diabetic rats through

supplementation with ashwagandha extract in one study (Anwer, 2008). But research in

humans is limited, for now. One study (Andallu, 2000) one in humans also showed blood

sugar-lowering effects of the Ayurvedic herb, however, the study size was very small, so we

cannot be sure of the true effects.

May increase immune activity

Having a strong immune system that’s working hard for you is good, right? Not always. For

people with autoimmune diseases such as rheumatoid arthritis, systemic lupus

erythematosus, or multiple sclerosis, this can make their symptoms worse. Autoimmune

diseases are characterized by the body attacking itself, so the more immune function, the

harder it will fight. Since ashwagandha has been shown to boost immune response

(Vetvicka, 2011), it’s advised that people with autoimmune diseases avoid this herbal

supplement.

Not all manufacturers of ashwagandha powder

or ashwagandha root extract are FDA-regulated

Unfortunately, there’s a low barrier to entry for some herbal supplements looking to hit the

market—and quality may be the cost. It seems benign enough to buy any supplement,

especially if it has good reviews from other buyers, but it can actually be quite dangerous.

Ashwagandha specifically isn’t free from incidents of poor quality products harming people,

either. Several cases of liver injury have been reported about ashwagandha. When the

products in question were investigated, it turned out that many contained contaminants

(NIDDKD, 2019). Avoid these safety concerns by buying from a company you can trust.

References

Ahmad, M. K., Mahdi, A. A., Shukla, K. K., Islam, N., Rajender, S., Madhukar, D., … Ahmad, S. (2010). Withania

somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of

infertile males. Fertility and Sterility, 94(3), 989–996. doi: 10.1016/j.fertnstert.2009.04.046

https://pubmed.ncbi.nlm.nih.gov/19501822/

American Pregnancy Association. (n.d.). Herbs and Pregnancy: Risks, Caution & Recommendations. Retrieved from

https://americanpregnancy.org/pregnancy-health/herbs-and-pregnancy/ https://americanpregnancy.org/pregnancy-

health/herbs-and-pregnancy/

Andallu, B., & Radhika, B. (2000). Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania

somnifera, Dunal) root. Indian Journal of Experimental Biology, 38(6), 607–609. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/11116534 https://pubmed.ncbi.nlm.nih.gov/11116534/

Anwer, T., Sharma, M., Pillai, K. K., & Iqbal, M. (2008). Effect of Withania somnifera on Insulin Sensitivity in Non-Insulin-

Dependent Diabetes Mellitus Rats. Basic & Clinical Pharmacology & Toxicology, 102(6), 498–503. doi: 10.1111/j.1742-

7843.2008.00223.x https://onlinelibrary.wiley.com/doi/full/10.1111/j.1742-7843.2008.00223.x