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Myth or fact: ashwagandha is a safe, natural stress remedy

Updated Well Day Media Editorial Team
The short answerPartly myth. A meta-analysis of 12 small trials found that ashwagandha may lower stress and anxiety scores, but the quality of evidence is low. Cases of liver injury have also been reported. "Natural" does not mean "safe".

Key points

Myth: ashwagandha is a natural, safe antidote to stress

Ashwagandha (Withania somnifera) is marketed as an “adaptogen” that lowers cortisol and anxiety and improves sleep, and it is one of the fastest-growing supplements in the U.S.

Fact: the evidence is limited and risks have been reported

Effectiveness. A systematic review and meta-analysis of 12 randomized trials found lower anxiety and stress scores in people taking ashwagandha. But the trials were small, short and used different doses and products, so the authors urged caution (Akhgarjand et al., 2022).

Safety. Researchers from Iceland and the U.S. Drug-Induced Liver Injury Network described a case series of liver injury linked to ashwagandha supplements, including jaundice and prolonged recovery in some patients (Björnsson et al., 2020).

What to do

If you want to try it, talk to your doctor first, especially if you take other medications. And remember: supplements do not address the causes of chronic stress.

Frequently asked questions

Can I take ashwagandha with antidepressants?

Not without talking to your doctor: interactions and added sedation are possible.

Are supplements regulated in the U.S.?

Dietary supplements do not need FDA approval for safety or effectiveness before they are sold, and quality varies. Look for third-party testing seals.

Sources

  1. Akhgarjand et al. (2022). Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta‐analysis of randomized controlled trials. Phytotherapy Research 36(11):4115-4124. doi:10.1002/ptr.7598
  2. Björnsson et al. (2020). Ashwagandha‐induced liver injury: A case series from Iceland and the US Drug‐Induced Liver Injury Network. Liver International 40(4):825-829. doi:10.1111/liv.14393

Prepared according to our evidence methodology and the principles of lifestyle medicine. For education only; it does not replace advice from your doctor.

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