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Last updated July 10, 2020. 4 minute read

Who should not take ashwagandha? These groups of people

Certain groups of people should avoid using ashwagandha, including those who are pregnant or breastfeeding and those who have a medical condition like diabetes, high or low blood pressure, stomach ulcers, autoimmune disease, or thyroid disorders.

Linnea Zielinski Written by Linnea Zielinski
Reviewed by Dr. Mike Bohl, MD, MPH

Ashwagandha (Withania somnifera) is sometimes referred to as “Indian ginseng” or “winter cherry.” Withania somnifera belongs to the nightshade family of plants, and its suspected active ingredients include alkaloids, steroidal lactones, saponins, and withanolides.

Ashwagandha is commonly used in the form of traditional Indian medicine known as Ayurvedic medicine or simply, Ayurveda, and is a member of the family of medicinal plants known as adaptogens. Adaptogen herbs and roots may help balance physical, mental, and emotional stresses in the body—in short, they may aid your body in adapting to various stressors.

Vitals

  • Ashwagandha (also called “Indian ginseng” or “winter cherry”) is traditionally used in alternative medicine, like traditional Indian Ayurvedic medicine.
  • As a member of the adaptogen family of medicinal plants, it may help your body adapt to physical, mental, and emotional stressors.
  • Ashwagandha is generally considered safe and has been used for stress, anxiety, low testosterone, and other medical conditions.
  • Certain groups of people should avoid using ashwagandha, including those who are pregnant or breastfeeding and those who have a medical condition like diabetes, high or low blood pressure, stomach ulcers, autoimmune disease, or thyroid disorders.

Ashwagandha has been used to help with stress, anxiety, low testosterone, diabetes, skin diseases, epilepsy, and autoimmune diseases, among other health problems (NIDDK, 2019). However, the scientific data is limited and more research is needed to determine the health benefits and appropriate use of ashwagandha.

Is ashwagandha safe?

Ashwagandha is considered to be generally safe. However, since research on herbal medications is limited and formulations vary depending on where you buy it from, you should be careful and consult your healthcare provider before starting herbal supplements. 

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While side effects are uncommon, some may experience gastrointestinal upset, diarrhea, nausea, vomiting, and drowsiness in large doses (NIDDK, 2019). Unfortunately, the use of ashwagandha by certain people may lead to serious side effects. Groups of people who should NOT use ashwagandha include:

  • Women who are pregnant or breastfeeding: If you are pregnant or breastfeeding, be sure to check with your healthcare provider before starting any herbal supplements. Ashwagandha is LIKELY UNSAFE to use during pregnancy because there is some evidence to suggest that it may cause miscarriages (MedlinePlus, 2020). There is not enough reliable information on ashwagandha and breastfeeding to know, so err on the side of caution and avoid it.
  • People with diabetes: Animal studies suggest that Withania somnifera might lower blood sugar levels, which seems like a good thing for people with diabetes (Noshahr, 2015). However, since people with diabetes are usually on blood sugar lowering medications, the addition of ashwagandha could cause blood sugar levels to drop too low unexpectedly, and this can be very dangerous (MedlinePlus, 2020).
  • People with high or low blood pressure: Animal studies suggest that ashwagandha has a blood pressure-lowering effect (Mishra, 2000). This effect could potentially be a problem for people with either high or low blood pressure. People with high blood pressure, especially those on prescription medications for this condition, may experience an interaction between their prescribed drugs and ashwagandha, or have an unexpected drop in their blood pressure (MedlinePlus, 2020). Those with naturally low blood pressure may have a further reduction in their blood pressure while taking ashwagandha, creating a potentially dangerous situation. 
  • People who have just undergone surgery: Data from animal trials shows that Withania somnifera has a sedating or tranquilizing effect, which slows down the central nervous system (Mishra, 2000). When combined with ashwagandha, drugs used during and after surgery may increase this nervous system slowdown. You should stop taking ashwagandha at least two weeks before having surgery, and be sure to let your surgeon know about any medications and supplements that you are taking (MedlinePlus, 2020).
  • People with stomach ulcers: This herb may irritate your gastrointestinal tract; therefore, you should avoid ashwagandha if you have stomach ulcers (MedlinePlus, 2020). 
  • People with autoimmune conditions: Many people use ashwagandha to boost their immune system as research shows that it can increase immune activity (Vetvivka, 2011). While this may be beneficial for some, it can be detrimental to others, especially people suffering from autoimmune diseases like multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis (MedlinePlus, 2020). By activating the immune system, this ayurvedic herb can worsen autoimmune symptoms. 
  • People with thyroid disorders: Thyroid abnormalities can be frustrating for those dealing with them. Clinical studies have shown that ashwagandha may increase thyroid hormone levels in people with decreased thyroid function that is not low enough to warrant medical therapy (subclinical hypothyroidism) (Sharma, 2018). However, if someone is taking thyroid hormone medications to treat abnormal thyroid activity, combining them with ashwagandha may cause thyroid hormone levels to rise above normal. Similarly, if you have elevated thyroid activity (hyperthyroidism), taking ashwagandha could still cause rising thyroid hormone levels. If levels increase beyond a certain point, you could develop thyrotoxicosis, a serious medical condition.

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In conclusion

Most people consider ashwagandha to be a relatively safe herbal supplement that can help with conditions like anxiety, stress, low testosterone, among other diseases. However, the research is limited, and scientists don’t know the exact health benefits or the optimal doses. Talk to your healthcare provider before starting herbal supplements like ashwagandha, especially if you have any of the medical conditions mentioned.