Ashwagandha and Liver Health: What You Should Know

Ashwagandha, also known as Withania somnifera, is quite popular these days. It comes in gummies, capsules, powders, and teas. People use it for stress relief, better sleep, more energy, and even extra strength at the gym. It has been used for centuries in Ayurvedic medicine, so most people think it’s safe. And for the most part, it is.

But here’s something to consider: there are reports linking ashwagandha to liver problems. Some of these problems are serious, and in rare cases, even fatal.

Can Ashwagandha Cause Liver Damage?

It might sound surprising, but there’s growing evidence. According to LiverTox, a database run by the NIH, there have been real cases of liver injury linked to ashwagandha. Most people didn’t notice anything until about 2 to 12 weeks after they started taking it. Then, symptoms like yellowing of the skin (jaundice), dark urine, and intense itching showed up.

A study from India between 2019 and 2022 reported 23 people who developed liver issues after taking ashwagandha. Eight of them were using single-ingredient products. Most of them got better once they stopped taking it, but sadly, three people with pre-existing liver problems died from acute-on-chronic liver failure.

What’s Happening?

Experts aren’t entirely sure why ashwagandha affects the liver in some people. The current theory points to certain compounds in the herb called withanolides, especially one called withanone. In high doses or over long periods, these may interfere with the liver’s detox system, particularly the glutathione system. Basically, it’s like overloading your liver’s cleanup crew until they can’t keep up.

Liver damage tied to ashwagandha isn’t only happening in one place. Reports from Iceland, the U.S., and Europe have all confirmed cases. Some were serious enough to require hospitalization, and at least one person needed a liver transplant.

European health agencies have flagged at least 22 severe liver injury cases, and that’s likely just the beginning. Herb-related liver damage makes up about 20% of all liver injuries caused by drugs and supplements, and ashwagandha is on that list.

Understanding Liver Toxicity

Liver toxicity means your liver is overwhelmed. Your liver filters out toxins like alcohol, medications, processed food chemicals, pollution, and even herbal supplements. But when you overload it with too much of anything, it starts to struggle.

Liver toxicity doesn’t mean your liver fails overnight. It can build up slowly and quietly. Some common signs include:

• Feeling very tired all the time
• Yellowing skin or eyes (jaundice)
• Stomach pain
• Dark urine
• Itchy skin
• Loss of appetite

What causes it? Heavy alcohol use is a classic culprit. But even over-the-counter painkillers like acetaminophen can harm your liver if taken in high doses. Natural substances like ashwagandha, kava, or green tea extract in supplement form can also trigger toxicity in some people.

The good news is that the liver is a tough organ and can often heal itself if you catch the problem early. Cut down on alcohol, avoid unnecessary supplements, eat clean, and drink plenty of water. And if you feel “off” for too long, get a liver function test.

Should You Be Concerned?

Not necessarily. Millions of people use ashwagandha regularly and never have a problem. Critics point out that, with over a million U.S. users as of 2020, 23 reported cases is still a very small risk.

That said, it’s a good reminder that “natural” doesn’t always mean “harmless.” Like anything else you put in your body, moderation and awareness are key.

What You Can Do

If you’re using ashwagandha or thinking about trying it, here’s your game plan:

• Keep your dose reasonable. Most studies use between 150 mg to 600 mg per day. Don’t go overboard.
• Skip it if you have liver problems. If you’ve had any kind of liver issue in the past, it’s best to steer clear.
• Don’t mix it with everything under the sun. Taking ashwagandha with other supplements or medications can increase the risk.
• Listen to your body. If you start noticing signs like yellow skin, nausea, dark urine, or unusual fatigue, stop taking it and check in with your doctor.
• Consider getting liver tests. If you’ve been using it long-term or at high doses, it might be worth getting some basic blood work done.

Ashwagandha has a good reputation for lowering stress, improving sleep, and boosting mood. But it’s not a magic pill, and recent liver injury cases are a solid reminder that even the most hyped “natural” supplements can come with side effects.

You don’t need to swear off ashwagandha forever. Just be smart about how you use it. Stick to recommended doses, avoid mixing it with other liver-impacting substances, and stay alert to how your body reacts.

Respect the herb. Use it wisely. And don’t fall into the trap of thinking “herbal” automatically means “risk-free.”