Health experts are raising alarms about the potential liver risks associated with Ashwagandha supplements, following reports of serious injuries documented across multiple countries.
Young User Hospitalized After Four Months of Daily Use
A 21-year-old individual who consumed 500-1,000 mg of Ashwagandha daily for four months experienced severe liver damage, with bilirubin levels reaching 50 mg/dL—significantly above the normal range of under 1.2 mg/dL. The patient’s liver enzymes (SGOT/SGPT) exceeded 400-600 U/L, leading to jaundice, severe itching, hospitalization, and months of recovery on IV fluids.
U.S. Health Network Identifies Ashwagandha as Top Herbal Risk
The U.S. Drug-Induced Liver Injury Network has identified Ashwagandha as one of the leading herbal products causing liver damage. The LiverTox database confirms at least 23 published cases of clinically apparent liver injury linked to the supplement since 2017.
Global Cases Show Consistent Pattern of Injury
Cases have been documented across seven countries including India, Iceland, the United States, Japan, Libya, Ireland, and Australia. The pattern remains consistent across reports:
- Timeline: Liver injury appearing two to twelve weeks after starting use
- Symptoms: Jaundice and severe itching (pruritus)
- Diagnosis: Hepatocellular damage confirmed through biopsy
- Recovery: Average of 3.5 months after discontinuing use
Some patients required emergency plasma exchange, while others were evaluated for liver transplantation.
Fatal Outcomes in Pre-Existing Liver Conditions
According to the largest Indian case series, patients with pre-existing liver disease who developed acute-on-chronic liver failure after taking Ashwagandha had a 100% mortality rate.
Limited Safety Data Despite Popularity
While short-term studies suggest potential benefits for stress, anxiety, and testosterone levels, experts emphasize these clinical trials are often:
- Small in scale
- Poorly designed
- Frequently funded by the supplement industry
No large-scale, independent, long-term safety data currently exists for Ashwagandha.
Regulatory Gap in Supplement Industry
Unlike pharmaceutical drugs, Ashwagandha is not regulated and does not require proof of safety or efficacy before being sold. The supplement is widely marketed by influencers as a natural remedy for anxiety and low energy, despite documented risks.
Expert Recommendations
Health professionals urge anyone taking high-dose Ashwagandha or daily herbal supplements to:
- Get liver function tests done regularly
- Consult a doctor before starting use
- Be aware of symptoms like jaundice and severe itching
- Choose high-quality products from reputable sources
- Avoid use if pre-existing liver conditions exist
Medical experts warn that the term “natural” should not be equated with “safe,” particularly for compounds capable of causing liver failure requiring hospitalization.
The growing number of documented cases has prompted calls for increased awareness and stricter safety monitoring of herbal supplements in the global market.
