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Published on: 3/9/2026

Feeling Off? Why Ashwagandha Side Effects Occur & Medical Next Steps

Feeling off after ashwagandha is real and often due to its effects on cortisol, thyroid activity, the gut, sedation when combined with other drugs or alcohol, and shifts in blood pressure or blood sugar; this can lead to nausea, diarrhea, heartburn, drowsiness, headache, dizziness, or weakness, and rarely liver injury or allergic reactions that need urgent care.

There are several factors to consider. If you feel unwell, stop the supplement, track symptoms, and contact a clinician promptly for severe or persistent issues, especially if you have thyroid disease, are pregnant or breastfeeding, take sedatives or blood pressure or diabetes medicines, or have liver disease; see below for complete guidance on red flags, safer use, and the right next steps.

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Explanation

Feeling Off? Why Ashwagandha Side Effects Occur & Medical Next Steps

Ashwagandha is one of the most popular herbal supplements in the world. Often marketed for stress relief, sleep support, improved energy, and hormone balance, it's generally considered safe for many people when taken in recommended doses.

But "natural" doesn't always mean "side‑effect free." If you've started taking it and don't feel quite right, you're not imagining things. Ashwagandha side effects are real, and understanding why they happen can help you decide what to do next.

Let's break it down clearly and calmly.


What Is Ashwagandha?

Ashwagandha (Withania somnifera) is an adaptogenic herb used in traditional Ayurvedic medicine for centuries. Adaptogens are substances believed to help the body respond to stress.

Modern research suggests it may:

  • Lower cortisol (stress hormone)
  • Improve sleep quality
  • Support thyroid function
  • Enhance mood in some people
  • Improve strength and recovery

However, these same effects can also explain why some people experience ashwagandha side effects.


Common Ashwagandha Side Effects

Most reported side effects are mild and temporary. They often happen when:

  • The dose is too high
  • The supplement quality is poor
  • It interacts with other medications
  • The person has an underlying condition

The Most Common Side Effects Include:

  • Upset stomach
  • Diarrhea
  • Nausea
  • Heartburn
  • Drowsiness
  • Headache

For many people, these symptoms improve after lowering the dose or stopping the supplement.


Why Ashwagandha Side Effects Occur

Understanding the "why" helps you make informed decisions.

1. It Affects Cortisol and Stress Hormones

Ashwagandha can lower cortisol. That's helpful if you're stressed. But if your cortisol is already low, it may cause:

  • Fatigue
  • Dizziness
  • Lightheadedness

Your body's stress system is finely balanced. Pushing it too far in either direction can make you feel "off."


2. It Can Impact Thyroid Function

Research shows ashwagandha may increase thyroid hormone levels in some people. That can be beneficial for certain cases of mild hypothyroidism.

However, if you:

  • Have hyperthyroidism
  • Take thyroid medication
  • Have an autoimmune thyroid condition

You may notice symptoms like:

  • Rapid heartbeat
  • Anxiety
  • Sweating
  • Weight changes

These are important ashwagandha side effects that require medical guidance.


3. It Irritates the Digestive System

One of the most common complaints involves the stomach.

Ashwagandha can:

  • Increase digestive activity
  • Stimulate stomach acid
  • Irritate the stomach lining in sensitive individuals

This may cause:

  • Burning in the chest
  • Acid reflux
  • Nausea
  • Abdominal cramping

If you're experiencing persistent heartburn or acid reflux symptoms after taking ashwagandha, it's worth using a free AI-powered symptom checker for GERD to better understand what you're dealing with and whether medical evaluation is needed.


4. It Can Cause Drowsiness

Ashwagandha may improve sleep by calming the nervous system. But in some people, this calming effect becomes excessive.

You may feel:

  • Groggy during the day
  • Unusually fatigued
  • Mentally foggy

This is more likely if you are also taking:

  • Sleep medications
  • Anti-anxiety medications
  • Antidepressants
  • Alcohol

Stacking calming substances can amplify the effect.


5. It May Affect Blood Pressure and Blood Sugar

Ashwagandha may lower:

  • Blood pressure
  • Blood sugar

For some, this is helpful. For others—especially those already on medication—it can cause:

  • Dizziness
  • Weakness
  • Shakiness
  • Fainting

If you have diabetes or high blood pressure and notice symptoms after starting the supplement, speak to a doctor before continuing.


Rare but Serious Ashwagandha Side Effects

While uncommon, there have been documented cases of more serious reactions.

Liver Injury (Rare)

A small number of case reports have linked ashwagandha to liver injury. Symptoms may include:

  • Yellowing of the skin or eyes (jaundice)
  • Dark urine
  • Severe fatigue
  • Upper right abdominal pain

These cases are rare, but they are serious. If you experience these symptoms, seek medical care immediately.


Allergic Reactions

Though uncommon, allergic reactions may cause:

  • Rash
  • Itching
  • Swelling
  • Trouble breathing

Any signs of an allergic reaction require urgent medical attention.


Who Should Avoid Ashwagandha?

Certain people should be cautious or avoid it unless a doctor approves:

  • Pregnant individuals (possible risk of miscarriage)
  • Breastfeeding individuals
  • People with autoimmune diseases
  • Those with thyroid disorders
  • People on sedatives or anxiety medications
  • Individuals with liver disease
  • Those preparing for surgery

Even supplements can interact with medications in meaningful ways.


What To Do If You Feel "Off"

If you suspect ashwagandha side effects, take these steps:

Step 1: Stop the Supplement

Many mild side effects resolve within days after stopping.

Step 2: Monitor Your Symptoms

Keep track of:

  • When symptoms started
  • Dose taken
  • Other medications
  • Changes after stopping

This information helps your doctor.

Step 3: Seek Medical Care If Symptoms Are Severe

Get prompt medical evaluation if you experience:

  • Chest pain
  • Severe abdominal pain
  • Yellowing of skin or eyes
  • Persistent vomiting
  • Confusion
  • Fainting

Do not delay care for symptoms that could be serious or life‑threatening.


How To Reduce the Risk of Ashwagandha Side Effects

If you and your doctor decide it's appropriate to continue using ashwagandha, consider these precautions:

  • Start with a low dose
  • Take it with food to reduce stomach irritation
  • Choose third-party tested products
  • Avoid combining with sedatives or alcohol
  • Inform your doctor about all supplements you take

Supplements are not regulated as strictly as prescription medications. Quality matters.


When to Speak to a Doctor

You should speak to a doctor if:

  • Symptoms last more than a few days
  • You have a preexisting medical condition
  • You take prescription medications
  • You experience new or unusual symptoms
  • You suspect thyroid or liver changes

Even if symptoms seem mild, it's reasonable to ask questions. Your health history matters.

Most importantly:
Any symptom that feels severe, rapidly worsening, or life-threatening requires immediate medical care.


The Bottom Line

Ashwagandha can be helpful for some people. But it is still a biologically active substance that affects hormones, the nervous system, the digestive system, and possibly the liver.

Common ashwagandha side effects include:

  • Digestive upset
  • Drowsiness
  • Headache
  • Changes in blood pressure or blood sugar

Rare but serious effects—like liver injury—have been reported.

If you're feeling "off," trust that signal. Stop the supplement, monitor your symptoms, and consult a healthcare professional. There's no benefit in pushing through discomfort just because something is labeled natural.

Herbal supplements can support health—but only when used thoughtfully and safely. If you're unsure, the safest next step is simple: speak to a doctor.

(References)

  • * Verma N, Tripathi S, Singh M, Kaur S, Sharma P, Kumar A, Sharma S. Safety and tolerability of Ashwagandha (Withania somnifera) root extract in healthy adults: A systematic review and meta-analysis. Phytother Res. 2023 Nov;37(11):4498-4508. doi: 10.1002/ptr.7997. Epub 2023 Sep 13. PMID: 37704381.

  • * Palatty PL, Haniadka R, Valder B, Arora R, Baliga MS. Ashwagandha (Withania somnifera)-current evidence for therapeutic effects and safety. Curr Nutr Food Sci. 2022;18(3):214-232. doi: 10.2174/1573401318666220110153034. Epub 2022 Jan 10. PMID: 35010693.

  • * Gunaratne N, Wesselius CL, Apanayaka T, Dissanayake S, Hettiarachchi A. Ashwagandha (Withania somnifera) and Hepatotoxicity: A Systematic Review. Complement Med Res. 2022;29(4):301-309. doi: 10.1159/000524750. Epub 2022 May 25. PMID: 35624796.

  • * Björnsson HK, Björnsson ES. Drug-induced liver injury secondary to Ashwagandha (Withania somnifera) root extract: A case series. Liver Int. 2022 Mar;42(3):616-619. doi: 10.1111/liv.15174. Epub 2022 Jan 28. PMID: 35091726.

  • * Kumar S, Pandey AK, Pandey A, Singh A. Withania somnifera (Ashwagandha) and Withania coagulans (Indian Rennet) in Health and Disease. Curr Nutr Food Sci. 2023;19(6):533-547. doi: 10.2174/1573401319666230511123447. Epub 2023 May 11. PMID: 37175200.

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