What is the safety profile of Ashwagandha (Withania somnifera)?

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Last updated: April 3, 2025 • View editorial policy

From the Research

Ashwagandha is generally considered safe for most adults when used appropriately, though it's not without potential side effects and contraindications, as evidenced by a recent review published in 2023 1. The safety profile of ashwagandha has been extensively studied, and the majority of the evidence suggests that it is well-tolerated in most individuals. Standard doses typically range from 300-600mg daily of root extract, with some studies using up to 1000mg daily divided into two doses.

  • Common side effects include drowsiness, gastrointestinal discomfort, and diarrhea.
  • Ashwagandha should be avoided during pregnancy as it may cause miscarriage due to its mild uterine stimulant effects.
  • People with autoimmune conditions like rheumatoid arthritis, lupus, or Hashimoto's thyroiditis should use caution as it may increase immune system activity.
  • Those with hormone-sensitive conditions such as breast cancer, uterine fibroids, or prostate cancer should avoid it due to its potential estrogenic effects.
  • Ashwagandha may lower blood sugar and blood pressure, requiring careful monitoring in diabetics or those on blood pressure medications.
  • It can also interact with sedatives, thyroid medications, and immunosuppressants. The herb works primarily by modulating stress response systems in the body, particularly through reducing cortisol levels and regulating neurotransmitter function, as supported by a study published in 2021 2. For safety, start with lower doses, purchase from reputable sources, and consult a healthcare provider before use, especially if you have existing health conditions or take medications. Additionally, a study published in 2018 3 and another in 2019 4 demonstrated the efficacy and safety of ashwagandha in regulating thyroid profile and improving cardiovascular outcomes, respectively. A more recent review published in 2024 5 further highlights the multifaceted effects of ashwagandha on human health, including its impact on vascular endothelium, inflammation, lipid metabolism, and cardiovascular outcomes.

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