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Ashwagandha

Also known as: Withania somnifera, KSM-66

Limited evidenceHerbalSource-reviewedHigh cautionMood & StressSleep & RelaxationFitness & Muscle

Ashwagandha is a traditional adaptogenic herb people commonly explore for everyday stress and calm. Some short studies are encouraging, but research is still developing and product quality varies. It is commonly avoided in pregnancy.

Not medical advice. SuppSafety and StackWise are informational only. Talk to a qualified healthcare professional before starting, stopping, or combining supplements.

Snapshot

Evidence levelLimited evidence
Caution levelHigh caution
Source reviewSource-reviewed
Last reviewed2026-07-02

What this page can tell you: What NCCIH says about ashwagandha's preliminary sleep/stress evidence and its liver, surgery, thyroid, pregnancy, and medication-interaction cautions.

What it cannot: That ashwagandha treats anxiety, insomnia, or any condition — NCCIH describes the evidence as limited and unclear for anxiety. Informational only.

🧩 Stack insights — how this fits into a schedule

Evidence comparisonOfficial fact sheet

Evidence status (sleep / stress)NCCIH: research shows some ashwagandha preparations may be effective for insomnia and stress, though effects on anxiety are unclear. Safety data mostly cover short-term use (up to about 3 months). Not a treatment claim.

Worth reviewing with a clinician/pharmacist
Context that may change the scheduleOfficial fact sheet

Liver, surgery, thyroid/autoimmuneNCCIH: rare liver-injury cases have been linked to ashwagandha; it is not recommended before surgery or for people with autoimmune or thyroid disorders, and it should be avoided in pregnancy and breastfeeding.

Higher-caution categories — review with a clinician if any apply.

Worth reviewing with a clinician/pharmacist
Context that may change the scheduleOfficial fact sheet

Sedatives, thyroid, diabetes, BP, immunosuppressants, anticonvulsantsNCCIH: ashwagandha may interact with sedatives, anti-seizure medicines, and medicines for diabetes, high blood pressure, immune suppression, and thyroid. Review with a clinician or pharmacist if you take any.

Worth reviewing with a clinician/pharmacist
Timing note — with foodNeeds source review

Evening / bedtime timing (user pattern)Because it is commonly discussed for sleep/stress and can cause drowsiness, many people take ashwagandha in the evening. This is a user scheduling pattern; a specific timing claim is pending source review.

Commonly taken with a meal

Relationship insights are informational only — they describe what is commonly discussed or studied, not what you should take. Not medical advice; review your routine with a clinician or pharmacist.

🕒 Timing

When: Evening, With a meal

Food: With food

Commonly taken with food; some prefer the evening. Extracts vary in strength.

💊 Common use range

300–600 mg extract

Follow product-specific guidance; more is not necessarily better.

Ranges are informational, not a recommended dose. Talk to a professional about what is right for you.

🤔 Worth considering?

Evidence vs. effort: Limited evidence relative to burden

Commonly used for stress and sleep with limited, mixed evidence. Rare liver-injury cases are documented; NCCIH advises avoiding it in pregnancy and breastfeeding, before surgery, and with thyroid or autoimmune conditions. Worth a professional conversation.

A general summary, not a recommendation. Whether something fits your situation is worth discussing with a healthcare professional.

⚠️ Commonly noted interactions (supplements)

None listed.

Often about absorption or timing rather than danger — separating doses is common. This list is not exhaustive.

🧭 Caution level

High caution

Ask a clinician or pharmacist before use.

  • Thyroid caution category
  • Commonly discussed as relaxing/sedating
  • Higher caution if you take thyroid medication (space doses apart)
  • Sedative / CNS-depressant interaction
  • Immunosuppressant interaction
  • Glucose-lowering / diabetes medication interaction
  • Higher caution if you take blood-pressure medication

Caution level is an informational summary of commonly discussed caution categories and doses — not a safety rating, approval, or medical advice. Low caution does not mean safe for you.

🩺 Medication caution categories

  • Thyroid medication
  • Sedatives / CNS depressants
  • Immunosuppressants
  • Diabetes medication
  • Blood pressure medication

🏥 Surgery & procedure caution

Anesthesia / sedation

May add to sedation and affect thyroid or blood sugar; commonly paused before surgery. Confirm with your care team.

If you have a procedure scheduled, bring your full supplement list to your surgical and anesthesia team. Do not stop prescribed medication unless your clinician tells you to. Do not start or stop supplements based only on this app.

✅ Quality checklist

  • Prefer products with third-party testing or a certificate of analysis (COA) — commonly recommended for this ingredient.
  • Commonly discussed quality checks: Heavy metals, Botanical misidentification.
  • Check the label for the exact form and the elemental or active amount per serving.

🧩 Commonly paired with

🔁 Alternatives

🗣️ Questions for a professional

  • Is Ashwagandha appropriate alongside my medications and health history?
  • Is there a test or check that would tell us whether I actually need it?

🛡️ Safety notes (source-reviewed)

  • NCCIH: rare liver-injury cases have been linked to ashwagandha supplements.
  • Not recommended before surgery or for people with autoimmune or thyroid disorders; avoid in pregnancy and breastfeeding.
  • May interact with sedatives, anti-seizure medicines, and medicines for diabetes, blood pressure, immune suppression, and thyroid.
  • Side effects: drowsiness, stomach upset, diarrhea, vomiting. Safety data mostly cover short-term use (up to ~3 months).

⚖️ Evidence limitations

  • NCCIH: some preparations may help insomnia and stress, but effects on anxiety are unclear and long-term safety is not well characterized.

❓ Frequently asked

Does ashwagandha help sleep or stress?

NCCIH says research shows some ashwagandha preparations may be effective for insomnia and stress, while effects on anxiety are unclear. This page makes no treatment claim — review it with a clinician, especially given the cautions.

Who should be cautious with ashwagandha?

NCCIH advises against use before surgery and for people with autoimmune or thyroid disorders, and says to avoid it in pregnancy and breastfeeding. It may also interact with several medications.

Can ashwagandha affect the liver?

NCCIH notes rare cases of liver injury linked to ashwagandha supplements. Worth a clinician conversation, especially with liver concerns.

🔬 Evidence snapshot

Evidence is limited and mixed. NCCIH notes some preparations may help with insomnia and stress, effects on anxiety are unclear, and there is not enough evidence for other uses.

🚦 Commonly noted cautions (auto)

Thyroid caution category. This item carries a thyroid caution category. If you have a thyroid condition or take thyroid medication, consider discussing it with a healthcare professional. This is a general caution, not a diagnosis or medical instruction.

🧪 Forms & quality

Source type: Botanical

Extracts are often standardized to withanolide content; standardization percentages differ between products, so amounts are not directly comparable.

See the supplement glossary for what form names like "L-", chelated, or standardized extract mean.

📏 Dose & monitoring

No established UL noted by the sources reviewed.

Evidence vs. burden: Limited evidence relative to burden

Labs that may be worth discussing: Thyroid

These are discussion prompts, not required tests. A healthcare professional can advise what makes sense for you.

😐 Commonly reported side effects

  • Digestive upset, drowsiness; rare liver-related reports

Non-exhaustive and individual.

🔄 Cycling & breaks

Some people cycle it (e.g., several weeks on, then a break); evidence is limited.

📅 Daily use notes

Avoid in pregnancy. People with thyroid or autoimmune conditions should talk to a professional first.

📋 Source review status

Source-reviewed — last reviewed 2026-07-02

Placeholder — verify liver-caution and pregnancy wording.

📚 References

  • NCCIH — AshwagandhaNCCIHVerified insomnia/stress evidence, rare liver-injury cases, surgery/thyroid/pregnancy cautions, and medication interactions.

Verified against the source shown. See the research-status page for how review works.

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Not medical advice. SuppSafety and StackWise are informational research and tracking tools. They are not medical advice and do not diagnose, treat, cure, or prevent any condition. Supplement research is often limited or mixed, and individual needs vary. Always talk to a qualified healthcare professional before starting, stopping, or combining supplements — especially if you take medication, have a health condition, are pregnant or breastfeeding, or have a procedure scheduled.