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What is it?

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.

Since ashwagandha is traditionally used as an adaptogen, it is used for many conditions related to stress. Adaptogens are believed to help the body resist physical and mental stress. Some of the conditions it is used for include insomnia, aging, anxiety and many others, 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.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for ASHWAGANDHA are as follows:

Possibly effective for…

  • 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.

Is it safe?

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 might occur.

When applied to the skin: There isn’t enough reliable information to know if ashwagandha is safe or what the side effects might be.

Special precautions & 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.

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.

Are there interactions with medications?

Moderate
Be cautious with this combination.
Medications for diabetes (Antidiabetes drugs)
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)
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 decrease the immune system (Immunosuppressants)
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)
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)
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
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.

Are there interactions with herbs and supplements?

Herbs and supplements that might lower blood pressure
Ashwagandha might lower blood pressure. Taking it with other supplements that have the same effect might cause blood pressure to drop too much. Examples of supplements with this effect include andrographis, casein peptides, L-arginine, niacin, and stinging nettle.
Herbs and supplements with sedative properties
Ashwagandha might cause sleepiness and slowed breathing. Taking it along with other supplements with similar effects might cause too much sleepiness and/or slowed breathing in some people. Examples of supplements with this effect include hops, kava, L-tryptophan, melatonin, and valerian.

Are there interactions with foods?

There are no known interactions with foods.

How is it typically used?

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.

Other names

Ajagandha, Amangura, Amukkirag, Asan, Asana, Asgand, Asgandh, Asgandha, Ashagandha, Ashvagandha, Ashwaganda, Ashwanga, Asoda, Asundha, Asvagandha, Aswagandha, Avarada, Ayurvedic Ginseng, Cerise d’Hiver, Clustered Wintercherry, Ghoda Asoda, Ginseng Ayurvédique, Ginseng Indien, Hayahvaya, Indian Ginseng, Kanaje Hindi, Kuthmithi, Orovale, Peyette, Physalis somnifera, Samm Al Ferakh, Samm Al Rerakh, Sogade-Beru, Strychnos, Turangi-Ghanda, Vajigandha, Winter Cherry, Withania, Withania somnifera.

Methodology

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

References

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