Overview

Ashwagandha is an evergreen shrub that grows in Asia and Africa. It is commonly used for stress. There is little evidence for its use as an "adaptogen."

Ashwagandha contains chemicals that might help calm the brain, reduce swelling, lower blood pressure, and alter the immune system.

People commonly use ashwagandha for anxiety, insomnia, and stress. It is also used for asthma, athletic performance, back pain, and many other conditions, but there is no good scientific evidence to support most of these uses. There is also no good evidence to support using ashwagandha for COVID-19.

Don't confuse ashwagandha with Physalis alkekengi. Both are known as winter cherry. Also, don't confuse ashwagandha with American ginseng, Panax ginseng, or eleuthero.



Uses & Effectiveness

Possibly Effective for

  • Anxiety. Taking ashwagandha by mouth might reduce anxiety.
  • A type of persistent anxiety marked by exaggerated worry and tension (generalized anxiety disorder or GAD). Taking ashwagandha by mouth seems to improve anxiety in people with persistent anxiety.
  • Insomnia. Taking ashwagandha by mouth seems to improve overall sleep and sleep quality in some people.
  • Stress. Taking ashwagandha by mouth seems to help reduce stress in some people. It might also help reduce stress-related weight gain.

There is interest in using ashwagandha for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: Ashwagandha is possibly safe when used for up to 3 months. The long-term safety of ashwagandha is not known. Large doses of ashwagandha might cause stomach upset, diarrhea, and vomiting. Rarely, liver problems, including severe liver failure and a need for liver transplantation, might occur.

When applied to the skin: Lotion containing ashwagandha is possibly safe when used for up to 2 months.

Special Precautions and Warnings

Pregnancy: It is likely unsafe to use ashwagandha when pregnant. There is some evidence that ashwagandha might cause miscarriages.

Breast-feeding: There isn't enough reliable information to know if ashwagandha is safe to use when breast-feeding. Stay on the safe side and avoid use.

"Auto-immune diseases" such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Ashwagandha might cause the immune system to become more active, and this could increase the symptoms of auto-immune diseases. If you have one of these conditions, it's best to avoid using ashwagandha.

Liver disease: Ashwagandha might cause liver damage in some people. But it isn't clear how often this occurs. Until more is known, people with liver disease should avoid taking ashwagandha.

Surgery: Ashwagandha may slow down the central nervous system. Healthcare providers worry that anesthesia and other medications during and after surgery might increase this effect. Stop taking ashwagandha at least 2 weeks before a scheduled surgery.

Thyroid disorders: Ashwagandha might increase thyroid hormone levels. Ashwagandha should be used cautiously or avoided if you have a thyroid condition or take thyroid hormone medications.

Interactions

    Moderate Interaction

    Be cautious with this combination

  • Medications that decrease the immune system (Immunosuppressants) interacts with Ashwagandha

    Ashwagandha can increase the activity of the immune system. Some medications, such as those used after a transplant, decrease the activity of the immune system. Taking ashwagandha along with these medications might decrease the effects of these medications.

  • Sedative medications (Benzodiazepines) interacts with Ashwagandha

    Ashwagandha might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking ashwagandha with sedative medications might cause breathing problems and/or too much sleepiness.

  • Sedative medications (CNS depressants) interacts with Ashwagandha

    Ashwagandha might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking ashwagandha with sedative medications might cause breathing problems and/or too much sleepiness.

  • Thyroid hormone interacts with Ashwagandha

    The body naturally produces thyroid hormones. Ashwagandha might increase how much thyroid hormone the body produces. Taking ashwagandha with thyroid hormone pills might cause too much thyroid hormone in the body, and increase the effects and side effects of thyroid hormone.

  • Medications for diabetes (Antidiabetes drugs) interacts with Ashwagandha

    Ashwagandha might lower blood sugar levels. Taking ashwagandha along with diabetes medications might cause blood sugar to drop too low. Monitor your blood sugar closely.

  • Medications for high blood pressure (Antihypertensive drugs) interacts with Ashwagandha

    Ashwagandha might lower blood pressure. Taking ashwagandha along with medications that lower blood pressure might cause blood pressure to go too low. Monitor your blood pressure closely.

  • Medications that can harm the liver (Hepatotoxic drugs) interacts with Ashwagandha

    Ashwagandha might harm the liver. Some medications can also harm the liver. Taking ashwagandha along with a medication that can harm the liver might increase the risk of liver damage.

    Minor Interaction

    Be watchful with this combination

  • Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates) interacts with Ashwagandha

    Some medications are changed and broken down by the liver. Ashwagandha might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with Ashwagandha

    Some medications are changed and broken down by the liver. Ashwagandha might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Dosing

Ashwagandha has most often been used by adults in doses up to 1000 mg daily, for up to 12 weeks. Speak with a healthcare provider to find out what dose might be best for a specific condition.
View References

CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is licensed from Therapeutic Research Center, LLC. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
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