Is Ashwagandha Safe for Your Liver?

Ashwagandha is a root native to Asia and Africa that has long been used in traditional medicine. Today, many people take it as an herbal supplement to help relieve stress and anxiety. Like most natural supplements, ashwagandha is processed by the liver and in some cases can cause liver problems.

The liver is your body’s filtration system, producing bile to help eliminate toxins and metabolize most supplements, medications, and herbs, explained Elisabeth Plotner, MD, a preventive medicine researcher at the University of California, San Diego.

However, in some cases, taking supplements like ashwagandha, especially in combination with other substances, can stress the liver and cause damage or inflammation, a condition called drug-induced acute hepatitis.

In a 2012 clinical trial, for example, some participants reported developing cholestatic (bile buildup) symptoms, jaundice, and itching within two to 12 weeks. These are all signs of liver damage, although researchers couldn’t determine whether ashwagandha or another ingredient was the cause.

A 2020 case study also identified five patients taking 450 to 1,350 milligrams of ashwagandha per day for one week to four months. All reported similar signs of liver damage, as well as nausea, lethargy and abdominal pain.

That said, “ashwagandha is generally considered well tolerated by most healthy adults,” says Emily LaBombard, MPH, RDN, LDN, registered dietitian nutritionist. Health. Liver damage appears to be more common in people with pre-existing liver disease.

In fact, some early animal studies even suggested that ashwagandha might help protect the liver, but these results have not yet been reproduced in humans.

As with all supplements, it’s best to talk to your doctor before trying ashwagandha. They can recommend the appropriate dosage and make sure you’re not taking medications that might interact negatively with the herb. Look for high-quality ashwagandha supplements that have been third-party tested by organizations such as the National Sanitation Foundation (NSF), says John Rinker, MD, an internal medicine physician at OSF Healthcare.

Some people should avoid ashwagandha altogether, Plotner said, including those with liver, thyroid or autoimmune diseases.

Although clinicians don’t yet know whether lower doses of ashwagandha are safer for the liver, it’s always best to start with a low dose of around 125 milligrams, Plotner recommended. If you do not experience side effects such as headache, stomach upset, dark urine, nausea, and jaundice, you can gradually increase to 300 to 600 milligrams and reevaluate after a month.

In general, it’s best to be careful when trying herbal remedies. As Plotner says: “Natural doesn’t always mean safe.”