The Rise of Ashwagandha and The Importance of Caution
Ashwagandha (Withania somnifera), also known as Indian ginseng or winter cherry, is an evergreen shrub used for centuries in traditional Ayurvedic medicine. Its root and leaves are formulated into supplements, powders, and teas, celebrated for their adaptogenic properties—meaning they may help the body manage and adapt to stress. Proponents claim benefits ranging from reduced anxiety and improved sleep to enhanced cognitive function and athletic performance.
However, despite its popularity, ashwagandha is not suitable for everyone. The very mechanisms that give this herb its potential benefits can also pose risks for certain individuals and interact negatively with various medications. The German Federal Institute for Risk Assessment (BfR) and other health agencies have highlighted that the health risks have not been fully investigated and advise caution. Before incorporating ashwagandha tea into your wellness routine, it is essential to understand the specific groups of people who should avoid it and the potential adverse effects.
Individuals Who Should Avoid Ashwagandha Tea
Several specific populations should avoid consuming ashwagandha due to potential health complications:
- Pregnant and Breastfeeding Individuals: Ashwagandha is considered likely unsafe during pregnancy. Some evidence suggests it may cause uterine contractions and could potentially lead to miscarriage. Due to a lack of sufficient safety information, breastfeeding women are also advised to avoid its use.
- People with Autoimmune Diseases: Ashwagandha may cause the immune system to become more active. For individuals with autoimmune conditions such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), and rheumatoid arthritis (RA), this immune-stimulating effect could increase symptoms. It may also interfere with immunosuppressant medications.
- Individuals with Thyroid Disorders: The herb can increase thyroid hormone levels (T3 and T4). While this might be beneficial for some with hypothyroidism (underactive thyroid), it can be dangerous for those with hyperthyroidism (overactive thyroid) by potentially causing thyrotoxicosis, a serious condition marked by excessively high thyroid hormone levels. People with Hashimoto's should consult a doctor, as the herb has both immune-boosting and anti-inflammatory properties that could have complex effects.
- Those Scheduled for Surgery: Ashwagandha may slow down the central nervous system, which could enhance the effects of anesthesia and other medications used during and after surgery. It is recommended to stop taking ashwagandha at least two weeks before a scheduled surgery to avoid this interaction.
- People with Certain Cancers: Because ashwagandha may increase testosterone levels, men with hormone-sensitive prostate cancer are advised to avoid it.
- Individuals with Liver Disease: Although rare, there have been multiple reports of ashwagandha causing liver injury, ranging from mild elevation of liver enzymes to severe cases requiring a liver transplant. The National Institutes of Health's LiverTox database classifies ashwagandha as a likely cause of clinically apparent liver injury. People with pre-existing liver conditions should avoid it.
- Those with Nightshade Sensitivities: Ashwagandha is part of the Solanaceae family, also known as the nightshade family, which includes tomatoes, potatoes, and eggplants. Individuals with a known allergy or sensitivity to nightshades may experience an adverse reaction.
Critical Medication Interactions
Ashwagandha tea can interact with a wide array of common medications, altering their effects and potentially causing harm. It is crucial to consult a healthcare provider if you are taking any of the following:
| Medication Type | Nature of Interaction with Ashwagandha | Example Medications |
|---|---|---|
| Sedatives | Increases drowsiness and may cause excessive sleepiness or breathing problems. | Benzodiazepines (Xanax, Klonopin), Barbiturates, Opioids, Sleep aids (Ambien). |
| Antidiabetes Drugs | May lower blood sugar levels, potentially causing them to drop too low when combined. | Insulin, Metformin, Glipizide, Semaglutide (Ozempic). |
| Antihypertensive Drugs | Can lower blood pressure, which may lead to hypotension (blood pressure dropping too low) when combined. | ACE inhibitors, ARBs, Beta-blockers, Calcium channel blockers, Diuretics. |
| Immunosuppressants | May increase immune activity, potentially decreasing the effectiveness of medications designed to suppress the immune system. | Cyclosporine, Tacrolimus, Prednisone, Corticosteroids. |
| Thyroid Hormones | May increase the body's production of thyroid hormones, leading to an excess when taken with thyroid medication. | Levothyroxine (Synthroid), Liothyronine (Cytomel). |
| Hepatotoxic Drugs | May increase the risk of liver damage when combined with other medications known to potentially harm the liver. | Pain relievers and anti-inflammatories. |
General Side Effects and Supplement Considerations
Even for individuals who do not fall into the high-risk categories, ashwagandha can cause side effects. These are generally mild and may include drowsiness, stomach upset, diarrhea, and nausea. Taking large amounts may increase the likelihood of gastrointestinal issues.
Ashwagandha has been studied in various amounts, depending on the intended effect. However, the long-term safety of ashwagandha has not been well-studied, with most research lasting up to three months. Due to the lack of regulation in the supplement industry, the actual concentration and purity of products can vary.
Conclusion: Prioritize Safety and Professional Advice
While ashwagandha tea offers potential benefits for stress management and overall well-being, it is not without risks. Its effects on hormones, the immune system, and major bodily functions mean that specific groups, including pregnant individuals, those with autoimmune or thyroid disorders, and people on a wide range of common medications, should avoid it. Given the potential for serious adverse effects and medication interactions, it is crucial to consult with a healthcare provider before starting any new supplement, including ashwagandha tea. This ensures that it is a safe choice for your individual health profile and won't interfere with your existing treatments. For more information from an authoritative source, you can visit the National Institutes of Health (NIH) fact sheet on Ashwagandha.
