Ashwagandha (aka Withania somnifera) is having a serious moment. It’s in gummies, capsules, powders, and teas—promising everything from stress relief and better sleep to more energy and even extra strength at the gym. People love it. It’s been around for centuries in Ayurvedic medicine, so most folks figure it’s safe. And for the most part, it is.
But here's the plot twist no one saw coming: more and more reports are linking ashwagandha to liver problems—some of them pretty serious, and in rare cases, even fatal.
What? Liver damage from Ashwagandha?
Yeah, it sounds wild, but there’s growing evidence. According to LiverTox (a database run by the NIH), there have been real, documented 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—bam—symptoms like yellowing of the skin (jaundice), dark pee, and intense itching showed up.
A study out of India between 2019 and 2022 reported 23 people who developed liver issues after taking just ashwagandha—nothing else. Eight of those 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.
So what’s going on?
Experts aren’t 100% sure why ashwagandha affects the liver in some people, but 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 mess 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 scratching the surface. To put it in perspective, herb-related liver damage makes up about 20% of all liver injuries caused by drugs and supplements, and yep—ashwagandha is on that list.
Should You Freak Out?
Not necessarily. Millions of people use ashwagandha regularly and never have a problem. Critics of the scare point out that, with over a million U.S. users as of 2020, 23 reported cases is still a pretty tiny 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.
Here’s 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 just because you think “more = better.” That’s not how herbs work.
Skip it if you have liver problems. If you’ve had any kind of liver issue in the past, it’s probably best to steer clear, at least until you talk to a doctor.
Don’t mix it with everything under the sun. Taking ashwagandha along with other supplements or medications—especially those that affect the liver—can increase the risk.
Listen to your body. If you start noticing signs like yellow skin, nausea, dark urine, or weird 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 just to be safe.
Ashwagandha’s got a lot of reputation for it—lowering stress, improving sleep, 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.”