4 Potentially Serious Side Effects of Ashwagandha

Ashwagandha (Withania somnifera), also known as winter cherry or Indian ginseng, is a plant known for its sleep-promoting properties. It also helps relieve stress, reduce anxiety and improve sports performance.

Despite its benefits, ashwagandha may not be for everyone. It can be dangerous for some people, such as those with liver disease, thyroid problems, and prostate cancer.

Ashwagandha is generally safe and well tolerated when used for a short period of time. However, some people may experience side effects such as:

• Digestive problems: Large doses of ashwagandha can cause stomach upset, nausea, and vomiting. This is likely because ashwagandha irritates the lining of your intestines.
• Drowsiness and sedation: Ashwagandha can make you feel sleepy and drowsy. As a result, you might feel more tired than usual. This effect may be worse if you take ashwagandha with anti-anxiety medications like Valium and Xanax (benzodiazepines) or anti-seizure medications.
• Headaches: Some people report experiencing headaches when taking ashwagandha. The exact reason why this happens is not yet known. However, taking higher doses or taking ashwagandha with other medications may increase this side effect.

Other, less common side effects You might experience while taking ashwagandha:

• Cough
• Weight gain
• Nasal congestion
• Night cramps
• Blurred vision

Ashwagandha may have more serious side effects, such as:

• Liver injury: There have been reports of liver damage in people taking ashwagandha, usually appearing after about two to 12 weeks of use. However, in most cases, liver damage usually disappears within one to four months after stopping the ashwagandha supplement.
• Increased thyroid function: Studies have shown that ashwagandha can increase thyroid hormone levels. This can make symptoms worse in people with hyperthyroidism (overactive thyroid).
• Increased testosterone levels: Ashwagandha can significantly increase testosterone levels. As a result, it may interfere with the treatment of people with hormone-sensitive prostate cancer.
• Allergic reactions: Although rare, some people experience allergic reactions to ashwagandha. Symptoms include itching, difficulty breathing or swallowing, rash, or swelling. Consult your healthcare professional immediately if you notice any of these side effects.

The recommended daily dose of ashwagandha varies depending on its intended use and the part of the plant used (roots or leaves). For example, doses of 250 to 1,000 milligrams per day have been shown to reduce pain, while daily doses of 300 to 600 milligrams are recommended for anxiety.

In general, many clinical trials have used ashwagandha safely in doses of 225 to 1,000 milligrams per day for up to three months. There is currently no established upper limit for ashwagandha. However, sticking to doses that have been proven safe by studies can help reduce toxic side effects associated with high doses of ashwagandha.

One study reported that some people who took doses of 450 to 1,350 milligrams of ashwagandha for a period of one week to four months had signs of liver damage. If you notice signs of liver problems, such as jaundice (yellowish discoloration of the skin or eyes), itching, nausea, constant fatigue, or stomach upset, stop taking ashwagandha and consult your healthcare professional immediately.

Ashwagandha may not be suitable for everyone. Do not use ashwagandha supplements without first talking to your healthcare professional if you belong to one of these groups:

• Pregnant people: Ashwagandha can cause spontaneous abortion (miscarriage) and should not be used by pregnant people. There aren’t enough studies to ensure its safety in breast milk, so people who are breastfeeding should also avoid ashwaganda.
• People with prostate cancer: Ashwagandha may increase testosterone levels, which intensifies the progression of cancer. So, people with hormone-sensitive prostate cancer should avoid using it.
• People with autoimmune disease: Ashwagandha can boost the immune system. This can worsen symptoms in people with overactive immune systems, such as people with autoimmune diseases like lupus, multiple sclerosis, or rheumatoid arthritis.
• People suffering from hyperthyroidism: As mentioned previously, ashwagandha may worsen symptoms in people with hyperthyroidism due to its ability to increase thyroid hormones.
• People undergoing surgery: Ashwagandha is not recommended for people who are about to have surgery because it may interfere with anesthesia or affect their blood sugar levels. It is advisable to stop taking ashwagandha at least two weeks before surgery.

Drug Interactions

Ashwagandha may interact with some prescription medications, increasing or decreasing their effects. Always talk to your doctor before using this herbal supplement if you are taking other medications. Some medications that ashwagandha may interact with include:

• Sedatives or anxiolytics: Valium (diazepam), Xanax (alprazolam)
• Thyroid hormones or antithyroid medications: Synthroid (levothyroxine), Cytomel (liothyronine), methimazole
• Hypoglycemic drugs: insulin, Glucophage (metformin), Glucotrol XL (glipizide)
• Immunosuppressants and drugs for organ transplantation: Imuran (azathioprine), Prograf (tacrolimus), corticosteroids
• Hypotensive medications: Norvasc (amlodipine), Cozaar (losartan)

Ashwagandha is generally tolerable. However, if you experience mild side effects, try these tips:

• Stomach-related side effects: If you experience stomach issues, such as nausea, consider reducing your dose and taking ashwagandha with a meal containing fat.
• Drowsiness: If ashwagandha makes you sleepy, consider taking it in the evening to prevent it from interfering with your daily activities. Reducing the dose may also help.
• Headaches: Starting with a low dose or reducing your dose may help reduce headaches associated with taking ashwagandha.

You can also minimize the side effects of ashwagandha by avoiding taking it with substances that enhance its effect, such as alcohol, sedatives, or medications that make you drowsy.

If your symptoms do not go away or worsen after reducing your dose, or if you experience an allergic reaction to ashwagandha, stop taking your supplements immediately and consult a healthcare professional.