Unexpected Side Effects of Ashwagandha: What You Need to Know

Even natural remedies can pose hidden health hazards without expert oversight.

By Medha deb

Created on Sep 18, 2025

Even natural remedies can pose hidden health hazards without expert oversight.

Ashwagandha (Withania somnifera), commonly known as Indian ginseng or winter cherry, has been used for centuries in traditional herbal medicine to promote vitality, manage stress, and improve overall well-being. While generally considered safe and well-tolerated for most people, recent studies and case reports have highlighted several unexpected side effects, some of which can be serious or require medical attention. Understanding these risks is crucial before starting ashwagandha supplementation.

Overview of Ashwagandha and Its Uses
Common Side Effects of Ashwagandha
Serious and Rare Adverse Reactions
Potential Drug Interactions
Precautions for Special Populations
Possible Withdrawal and Discontinuation Symptoms
Guidelines for Safe Use
Frequently Asked Questions (FAQs)

Overview of Ashwagandha and Its Uses

Ashwagandha is an adaptogenic herb valued in Ayurveda for its ability to help the body resist physical and mental stress. It is widely marketed for benefits including:

Reducing anxiety and stress
Improving sleep quality
Boosting energy levels and stamina
Enhancing immune function
Promoting muscle growth
Supporting cognitive function

Despite its popularity as a natural remedy, not all consumers are aware of the potential risks that may accompany regular or high-dose use.

Common Side Effects of Ashwagandha

For most users, ashwagandha is safe when taken in small to moderate amounts for short durations. However, several mild side effects have been reported, typically resolving without medical intervention:

Gastrointestinal discomfort (nausea, diarrhea, stomach upset, or loose stools)
Drowsiness or sedation, especially at higher doses or when taken with other sedatives
Headache in some individuals

These effects are more likely when starting ashwagandha or increasing the dose, and generally subside as the body adapts.

Serious and Rare Adverse Reactions

Although most side effects are mild, several rare but potentially serious reactions have been documented in medical literature and clinical practice. These require prompt medical attention and immediate cessation of ashwagandha use:

Liver Injury

Acute liver injury: Case reports have linked ashwagandha supplementation to episodes of liver dysfunction, including jaundice, elevated liver enzymes, pruritus (itchiness), and in rare cases, acute hepatitis. Problems may occur after taking moderate to high doses over weeks or months. Symptoms tend to improve once ashwagandha is stopped, but severe cases may require medical treatment or hospitalization.
Pre-existing liver disease: Individuals with underlying liver problems are at greater risk and should avoid ashwagandha unless supervised by a physician.

Allergic and Hypersensitivity Reactions

Rash and itching
Swelling of lips, tongue, or throat (angioedema)
Difficulty breathing (rare, but potentially life-threatening)

Any signs of allergy should prompt immediate discontinuation and a visit to a healthcare professional.

Thyroid and Hormone Disturbances

Thyrotoxicosis (excess thyroid hormones): Isolated case reports describe temporary thyroid gland inflammation and unusually high thyroid hormone levels in adults following regular ashwagandha consumption. Symptoms may include rapid heartbeat, sweating, anxiety, and weight loss.
It may alter thyroid hormone levels or interfere with thyroid medications.

Heart, Blood Pressure, and Blood Sugar Fluctuations

Irregular heart rate or palpitations: Some users have reported tachycardia (fast heart rate) or heart palpitations, sometimes as part of withdrawal symptoms.
Unstable blood pressure: Ashwagandha may lower or raise blood pressure unpredictably, posing risks to those already on antihypertensive or blood thinning medications.
Blood sugar fluctuations: Blood glucose can decrease or increase suddenly, especially in people with diabetes taking other glucose-lowering agents.

Potential Drug Interactions

Ashwagandha’s interactions with certain medications may amplify risks or lead to new complications. Consult your healthcare provider before combining ashwagandha with any of the following:

Medication/Class	Potential Interaction
Alcohol	Increased sedation, risk of respiratory depression
Benzodiazepines (sleep/sedative drugs)	Excess sedation, risk of coma
Immunosuppressants	Possible reduction of intended immune suppression
Blood pressure medications	Sudden changes in blood pressure
Blood-thinning medications	Altered clotting risk, increased bleeding possibility
Anti-diabetic agents	Unpredictable drops in blood sugar levels
Thyroid medications	Interference with hormone regulation

Precautions for Special Populations

Pregnant and breastfeeding women: There is insufficient evidence for safety during pregnancy and lactation. Animal studies suggest potential risks to fetal health. Ashwagandha is NOT recommended for use during pregnancy and breastfeeding.
Small children and infants: Herbal remedies, including ashwagandha, are not recommended due to unknown safety profiles and metabolism in neonates and young children.
People with digestive issues: Those prone to gastrointestinal disturbances may experience worsening nausea, diarrhea, or stomach upset.
Individuals with autoimmune diseases: Ashwagandha may stimulate the immune system, potentially aggravating autoimmune conditions such as lupus, rheumatoid arthritis, or multiple sclerosis.
Patients with prior liver or kidney conditions: Due to the risk of liver injury, individuals with previous hepatic or renal concerns should consult a specialist before use.

Possible Withdrawal and Discontinuation Symptoms

While dependence on ashwagandha is rare, abrupt discontinuation—especially after prolonged, high-dose supplementation—may produce temporary withdrawal effects in some people:

Insomnia
Tachycardia (rapid heart rate)
Increased anxiety or restlessness
Irritability or mood swings

These symptoms are most often reported in sensitive individuals or those with a history of mood disorders. Gradual tapering is advised rather than sudden cessation, especially after long-term use.

Guidelines for Safe Use of Ashwagandha

Start with the lowest effective dose and increase only as needed.
Limit duration of use—avoid continuous use for more than a few months without professional guidance.
Monitor closely for new symptoms—stop immediately if significant side effects occur.
Talk to your doctor before starting ashwagandha, particularly if you have pre-existing health conditions or take prescription medications.
Opt for standardized extracts from reputable brands to reduce variability and contamination risks.
Never use ashwagandha as a substitute for prescribed medication or established medical care.

Frequently Asked Questions (FAQs)

Q1: Can ashwagandha cause liver damage even at recommended doses?

Reports of liver injury have mainly involved people using moderate to high doses for weeks or months, occasionally in combination with other medications. However, susceptibility can vary, and even standard doses are not entirely risk-free. Always monitor for signs of jaundice or abdominal pain and consult a healthcare provider if these develop.

Q2: Is ashwagandha safe to take every day?

Short-term, daily use is generally regarded as safe for healthy adults. Long-term safety has not been conclusively established—prolonged daily use should only occur under medical supervision.

Q3: Should I stop taking ashwagandha before surgery?

Yes. Stop ashwagandha at least two weeks before any planned surgery due to potential interactions with anesthesia and effects on blood pressure and sedation.

Q4: Can children or teenagers use ashwagandha supplements?

Ashwagandha should be avoided in children and adolescents unless prescribed by a qualified practitioner, as there is insufficient research on safety in these age groups.

Q5: Are there withdrawal symptoms if I stop using ashwagandha suddenly?

While uncommon, some sensitive individuals may develop symptoms like restlessness, anxiety, or insomnia after abrupt discontinuation, particularly following long-term use. Gradual reduction is recommended if stopping after extended periods.

Q6: Can ashwagandha interact with vitamins or herbal supplements?

Ashwagandha may interact with other herbs and supplements that affect mood, sedation, blood pressure, or immunity. Always consult your healthcare provider about the combination of ashwagandha with other natural products.

Key Takeaways

Ashwagandha is widely used for stress reduction, energy, and sleep improvement, but carries risks of side effects ranging from mild stomach upset to rare but severe liver injury and hormonal disturbances.
Drug interactions and unsupervised use can increase the risk of adverse effects, especially in people with pre-existing health conditions or those taking other medications.
Pregnant women, breastfeeding mothers, children, and individuals with autoimmune, liver, or kidney disorders should generally avoid ashwagandha unless recommended by their healthcare provider.
Regular monitoring and communication with a healthcare professional can minimize risks and help maximize benefits.

Please note: This article is for informational purposes only. It is not intended to diagnose, treat, cure, or prevent any disease. Always consult a qualified health professional before beginning any new supplement regimen.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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