Abstract Summary
Objective
To identify substances, medications, and health conditions that should not be combined with ashwagandha due to potential safety concerns involving sedation, metabolic regulation, thyroid function, immune response, and liver health.
Context
Ashwagandha (Withania somnifera) is an adaptogenic herb traditionally used to support stress regulation, sleep, and nervous system balance. Its active compounds, withanolides, influence the hypothalamic-pituitary-adrenal axis and multiple physiological systems. While these effects contribute to its benefits, they may also create adverse interactions when combined with certain medications or used in vulnerable populations.
Methods Used
Approach
This summary is based on findings from systematic reviews, randomized controlled trials, clinical safety references, and published case reports examining ashwagandha’s physiological effects and reported adverse interactions.
Data Collection
Evaluated outcomes included central nervous system sedation, blood glucose and blood pressure changes, thyroid hormone modulation, immune activity, and liver-related adverse events.
Researchers’ Summary of Findings
Impact on Health
Ashwagandha should not be combined with sedative medications or alcohol due to the risk of excessive drowsiness and impaired coordination. It may also enhance the effects of diabetes and blood pressure medications, increasing the risk of hypoglycemia or hypotension. Evidence suggests ashwagandha can influence thyroid hormone levels, which may interfere with thyroid medications. Its immune-modulating properties raise concerns for individuals using immunosuppressive therapies. Rare cases of liver injury linked to ashwagandha have been reported, warranting caution in those with liver disease or a history of supplement-related hepatotoxicity. Use during pregnancy and prior to surgery is generally discouraged due to limited safety data.
Health Implications
Ashwagandha is generally well tolerated in healthy adults, but its broad biological activity means it should not be combined indiscriminately with medications. Medical guidance is advised for individuals with metabolic, thyroid, immune, or liver-related conditions.
Sustainability
Using sustainably sourced, root-only ashwagandha extracts from reputable suppliers supports environmental responsibility while reducing the likelihood of contamination, adulteration, or inconsistent withanolide concentrations, all of which can increase safety risks.
DOI
https://www.mdpi.com/2072-6643/17/13/2143
