Skip to main content
Supplement ScienceSupplementScience

Ashwagandha Safety: What NCCIH Says

This content is for informational purposes only and does not constitute medical advice. Statements about dietary supplements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary — consult your healthcare provider before starting any supplement. Full disclaimer

According to NCCIH, some ashwagandha preparations may help with stress and sleep, but evidence for anxiety and other...

According to NCCIH, some ashwagandha preparations may help with stress and sleep, but evidence for anxiety and other uses is limited or unclear. It may be safe for short-term use (up to about 3 months); its long-term safety isn't established, rare cases of liver injury have been reported, and it should be avoided during pregnancy and breastfeeding.

Key Takeaways

  • NCCIH says some ashwagandha preparations may help stress and sleep, but evidence for anxiety and most other uses is limited or unclear.
  • Rare cases of liver injury have been linked to ashwagandha supplements — stop and seek care if signs of liver trouble appear.
  • NCCIH advises avoiding ashwagandha during pregnancy and breastfeeding.
  • It may be safe short-term (up to about 3 months); long-term safety isn't established.
  • Tell your clinician before use, especially with liver conditions, thyroid medication, sedatives, or upcoming surgery.

Get the free evidence-based Ashwagandha Safety: What NCCIH Says guide — delivered in 60 seconds.

No spam. Unsubscribe anytime.

What Ashwagandha Is

Ashwagandha (*Withania somnifera*) is an herb used in traditional Ayurvedic practice and now sold widely as a stress and sleep supplement. Here's what the U.S. government's National Center for Complementary and Integrative Health (NCCIH) actually reports about it.

What the Evidence Shows

NCCIH's read of the research is cautious [1]:

  • Stress and sleep: 'Research shows that some ashwagandha preparations may be effective for insomnia and stress.'
  • Anxiety: the evidence is unclear.
  • Testosterone and sperm quality: some limited evidence from 2-to-4-month use.
  • Most other uses (athletic performance, cognition, menopause, and more): not enough evidence to draw conclusions.

Notice that 'some preparations' is doing real work in that sentence — products vary, and results from one standardized extract don't automatically apply to another (see Standardized Extracts Explained).

Safety: What to Know

  • Liver injury: NCCIH states that 'although it is rare, there have been a number of cases that link liver injury to ashwagandha supplements' [1]. Stop use and seek care if you notice symptoms such as unusual fatigue, abdominal pain, dark urine, or yellowing of the skin or eyes.
  • Pregnancy and breastfeeding: NCCIH advises that ashwagandha 'should be avoided during pregnancy and should not be used while breastfeeding' [1].
  • Duration: it 'may be safe when taken in the short term (up to 3 months)'; long-term safety is not established [1].
  • Common side effects: drowsiness, stomach upset, diarrhea, and vomiting.
  • Thyroid and sedatives: ashwagandha may raise thyroid hormone levels and add to the effect of sedatives — talk to a clinician if you take thyroid medication or sleep aids.

Before You Take It

Tell your health care provider about ashwagandha (and any supplement), especially if you have a liver condition, take other medications, are pregnant or breastfeeding, or have an upcoming surgery (see When to Stop a Supplement Before Surgery).

Related Supplements

Related Conditions

Product Reviews

Related Articles

Frequently Asked Questions

Is ashwagandha safe?

NCCIH considers it possibly safe for short-term use of up to about 3 months in healthy adults, with side effects such as drowsiness and stomach upset. Long-term safety isn't established, and rare cases of liver injury have been reported, so it isn't risk-free.

Can ashwagandha affect the liver?

It's uncommon, but NCCIH notes a number of reported cases linking liver injury to ashwagandha supplements. Stop taking it and contact a clinician if you develop symptoms such as persistent fatigue, abdominal pain, dark urine, or yellowing of the skin or eyes.

Can I take ashwagandha during pregnancy?

No. NCCIH advises that ashwagandha should be avoided during pregnancy and should not be used while breastfeeding. If you're pregnant or nursing, talk with your clinician before using any herbal supplement.

Does ashwagandha interact with medications?

It may. Ashwagandha can raise thyroid hormone levels and may add to the effects of sedatives, so it warrants caution with thyroid medication and sleep aids. Tell your prescriber and pharmacist about it before combining.

Continue Reading

References

  1. National Center for Complementary and Integrative Health (NCCIH) (2024). Ashwagandha. NIH National Center for Complementary and Integrative Health.