Who Should Not Take Ashwagandha? Pregnancy, Thyroid, Liver and Medications
Most healthy adults can take ashwagandha, but a few groups shouldn't. The National Center for Complementary and Integrative Health (NCCIH) says to avoid it during pregnancy and breastfeeding, before surgery, with hormone-sensitive prostate cancer, and with autoimmune or thyroid disorders. If you take medication for diabetes, blood pressure, seizures, your thyroid or your immune system, or a sedative, talk to your doctor first. And although it's rare, stop and get checked if you notice yellowing skin or eyes.
Ashwagandha is one of the better-studied herbs, and in trials it's generally well tolerated, which is why so many people take it every day. That makes it easy to forget that "natural" doesn't mean "right for everyone." This is the full list, the reason behind each one, and what to watch for if you do take it. For the bigger picture of what ashwagandha is and what it does, start there and come back.
Who should not take ashwagandha
| Who | What NCCIH says | Why |
|---|---|---|
| Pregnant | Should be avoided | Its safety in pregnancy hasn't been shown |
| Breastfeeding | Should not be used | Not enough is known about its safety for nursing babies |
| About to have surgery | Not recommended | It can cause drowsiness, and your surgical team needs to know about everything you take |
| Autoimmune or thyroid disorders | Not recommended | It may affect the immune system and thyroid hormone levels |
| Hormone-sensitive prostate cancer | Should avoid | It may increase testosterone levels |
| Liver problems | Rare cases of liver injury reported | Ask your doctor first, and know the warning signs |
| Taking certain medications | Might interact | Diabetes, blood pressure, immune, seizure, sedative and thyroid medications |
The NCCIH wording above comes from its ashwagandha fact sheet, which is the plainest official summary there is and worth reading in full.
Can you take ashwagandha while pregnant or breastfeeding?
No. NCCIH says ashwagandha should be avoided during pregnancy and should not be used while breastfeeding. This isn't a blanket disclaimer copied onto every herb. There simply isn't evidence that it's safe for a developing baby, and with so many other ways to support yourself through a stressful season, it isn't worth the gamble.
If you're trying to conceive, talk to your doctor before taking it, and mention it at your first prenatal appointment if you'd been taking it.
Ashwagandha and your thyroid
This is the caution people most often miss. In an eight-week trial in people whose thyroid ran slightly low, the group taking ashwagandha root extract saw their thyroid hormone levels (T3 and T4) rise compared with the placebo group.
That matters in two directions. If you take thyroid hormone medication, ashwagandha could add to its effect, so your doctor may want to check your levels. And if your thyroid already runs high, anything that nudges it further is a bad idea. That's why NCCIH lists thyroid disorders and thyroid medication among its cautions.
Autoimmune conditions and immune medications
NCCIH doesn't recommend ashwagandha for people with autoimmune disorders, and lists immunosuppressants, the medicines that dial the immune system down, among the drugs it might interact with. If you take one, the combination could change how well that medicine works. This is one to clear with the doctor who manages your condition, not one to try and see.
Is ashwagandha bad for your liver?
For the vast majority of people, no, but it isn't zero. NCCIH notes that, although rare, a number of cases have linked liver injury to ashwagandha supplements.
The clearest description comes from a 2020 case series from Iceland and the US Drug-Induced Liver Injury Network. It described five people who developed jaundice, with symptoms like nausea, tiredness, itching and stomach discomfort, between two and twelve weeks after starting an ashwagandha supplement. None developed liver failure, and liver tests returned to normal within one to five months in the four who were followed up. Four of the five were also taking other supplements.
Given how many people take ashwagandha, that's rare. But if you already have a liver condition or drink heavily, talk to your doctor before starting it. And whoever you are, stop taking it and get checked if you notice any of these:
- Yellowing of your skin or the whites of your eyes
- Dark urine or pale stools
- Itching all over that you can't explain
- Nausea, stomach pain or tiredness that doesn't go away
Hormone-sensitive prostate cancer
Because ashwagandha may increase testosterone levels, NCCIH says people with hormone-sensitive prostate cancer should avoid it. The rise in the trials was modest, and what ashwagandha does for men covers those studies in detail, but for this group even a modest rise is the wrong direction.
Before surgery
NCCIH says ashwagandha isn't recommended for people who are about to have surgery. Tell your surgeon and anesthetist that you take it, along with any other supplements, and ask how far ahead of the date they'd like you to stop.
Medications that need your doctor's OK first
NCCIH lists six kinds of medication that ashwagandha might interact with:
- Diabetes medications
- Blood pressure medications
- Immunosuppressants
- Sedatives, including sleep medication and benzodiazepines
- Anti-seizure medications (anticonvulsants)
- Thyroid hormone medications
"Might interact" doesn't mean you can never take both. It means the combination should be your doctor's call, because they know your dose and what else you take. Bring the jar to the appointment so they can see exactly what's in it.
Supplements count too. Ashwagandha generally pairs fine with the everyday ones, and you can take ashwagandha with magnesium or with L-theanine without any known interaction. The thing to avoid is stacking several calming products at once.
Ashwagandha and alcohol
There's no research on ashwagandha and alcohol together. But drowsiness is one of ashwagandha's known side effects and alcohol is a sedative, so the two can add up, and the rare liver reports are another reason not to combine ashwagandha with heavy drinking. An occasional drink isn't the main worry. Taking ashwagandha to unwind and then drinking on top of it is.
Children and teenagers
Almost all of the research on ashwagandha is in adults. Don't give it to a child or teenager unless their pediatrician says it's appropriate.
Side effects for everyone else
For healthy adults who don't fall into any group above, side effects are uncommon and mild. In a 2020 review of the human studies, the ones reported by more than 5 percent of people were drowsiness, stomach discomfort and loose stools, with no serious adverse events. NCCIH also mentions vomiting.
- Stomach upset: take it with a meal rather than on an empty stomach
- Drowsiness: move it to the evening. Feeling sleepy and sleeping better are different things, and whether ashwagandha makes you sleepy depends a lot on the person
- Taking too much: stick to the serving on the label. More isn't better
How long is it safe to take ashwagandha?
NCCIH says ashwagandha may be safe when taken in the short term, up to about three months, and that its long-term safety hasn't been established. That's a gap in the research rather than a known risk: most trials simply haven't run longer. If you plan to take it for months at a time, mention it at your next checkup, and take one serving a day, not more.
Our ashwagandha gummies
Our Ashwagandha Gummies have 225 mg of ashwagandha and 200 mg of L-theanine in each gummy, taken once a day with a meal, and every amount is printed on the label so you or your doctor can see exactly what's in them. Each gummy also has vitamins B6, D3 and B12 and 30 mg of zinc, so if you take a multivitamin or a separate zinc supplement, add the zinc up: the upper limit for adults is 40 mg a day from all sources. They're made by hand in small batches in Holmes County, Ohio, and sit in our calm and focus range.
Frequently asked questions
Is ashwagandha safe?
For most healthy adults taking it at the label serving, the trials show it's generally well tolerated, with mild side effects like drowsiness or stomach upset. It isn't right for everyone, though: avoid it if you're pregnant or breastfeeding, and check the list above before you start.
Can you take ashwagandha while pregnant?
No. NCCIH says ashwagandha should be avoided during pregnancy.
Can you take ashwagandha while breastfeeding?
No. NCCIH says it should not be used while breastfeeding.
Can I take ashwagandha with thyroid medication?
Only with your doctor's OK. In a trial, ashwagandha raised thyroid hormone levels, so it could add to what your medication does. Your doctor may want to recheck your levels after you start.
Can I drink alcohol while taking ashwagandha?
A drink now and then isn't the main concern, but both can make you drowsy, so go easy, especially in the evening. If you drink heavily or have a liver condition, talk to your doctor before taking ashwagandha.
What are the warning signs to stop taking ashwagandha?
Yellowing of the skin or eyes, dark urine, pale stools, unexplained itching, or nausea and tiredness that won't go away. Stop and see a doctor if you notice any of them.
Who should not take ashwagandha gummies?
The same people who shouldn't take ashwagandha in any form, since the gummy is just a different way of taking it. Also check the other ingredients on the label, such as zinc or vitamins, against anything else you take.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. This article is general information and not medical advice. Talk to your healthcare provider before starting any supplement, particularly if you are pregnant or nursing, or take prescription medication.