Ashwagandha (Withania somnifera L) Dosing and Safety

safety

Allergies

Avoid if allergic or sensitive to ashwagandha products, any of their parts or ingredients, or members of the Solanaceae family.

Side Effects and Warnings

Ashwagandha is likely safe when taken by mouth in suggested amounts in otherwise healthy people.
Ashwagandha may increase the risk of bleeding. Caution is advised in people with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Ashwagandha may lower blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
Ashwagandha may cause low blood pressure. Caution is advised in people taking drugs or herbs and supplements that lower blood pressure.
Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.
Use cautiously in people who take agents that may affect the nervous system or heart.
Use cautiously in people who have peptic ulcers or thyroid disorders.
Avoid using in large doses, especially with other agents that may affect breathing. Large doses may cause breathing difficulty or diarrhea.
Avoid using in pregnant women. Ashwagandha may cause abortion.
Avoid if allergic or sensitive to ashwagandha products, any of their parts or ingredients, or members of the Solanaceae family.
Ashwagandha may also cause anemia, antidepressant effects, changes in the immune system, increased sodium in the urine, increased urination, kidney lesions, nausea, skin irritation (burning, changes in color, itching, or rash), and stomach pain.

Pregnancy and Breastfeeding

There is a lack of scientific evidence on the use of ashwagandha during pregnancy or breastfeeding. Avoid in pregnant women, as ashwagandha may cause abortion.

dosing

Adults (18 years and older)

The following doses of ashwagandha have been taken by mouth daily: 1-6 grams in capsule form; 3 grams of powder taken twice daily in boiled warm milk; a tea made from boiling the root in water for 15-30 minutes, then taken twice daily; 1-6 grams daily of the whole herb as a tea; 2-4 milliliters of tinctures or fluid extracts, three times daily; and 5 teaspoons of dried herb in one cup of boiling liquid, taken as 2-4 cups daily with raw sugar or honey.
To treat type 2 diabetes, powdered roots of ashwagandha have been taken by mouth for 30 days.
To improve urine flow, powdered roots of ashwagandha have been taken by mouth for 30 days.
As an anti-aging agent, two tablets of powdered ashwagandha root (0.5 grams each) have been taken by mouth three times daily with milk.

Children (under 18 years old)

To promote childhood growth, 2 grams of ashwagandha has been taken by mouth daily in milk for 60 days.

interactions

Interactions with Drugs

Ashwagandha may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Ashwagandha may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.
Ashwagandha may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Ashwagandha may increase the amount of sedation or drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
Ashwagandha may also interact with agents that may affect heart rate, agents that may affect the immune system, agents that may affect muscle contractions, agents that may affect the nervous system (including anticholinergic agents and cholinesterase inhibitors), agents that may improve sex performance, agents that may promote urination, agents that may protect against radiation side effects, agents that may treat Parkinson's disease, amphetamines, androgens, anticancer agents, anti-inflammatory agents, blood thinners, central nervous system (CNS) depressants, cholesterol-lowering agents, cyclophosphamide, digoxin, fertility agents, haloperidol (Haldol®), heart agents, hormonal agents, iron salts, kidney agents, lung agents, narcotics, paclitaxel (Taxol®), pain relievers, steroids, stimulants, stomach agents, and thyroid agents.

Interactions with Herbs and Dietary Supplements

Ashwagandha may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Ashwagandha may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.
Ashwagandha may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Ashwagandha may increase the amount of sedation or drowsiness caused by some herbs or supplements.
Ashwagandha may also interact with 5-hydroxytryptophan (5-HTP), anti-androgens, anticancer herbs and supplements, anti-inflammatory herbs and supplements, antioxidants, arginine or L-arginine, blood thinners, cholesterol-lowering herbs and supplements, fertility herbs and supplements, herbs and supplements that may affect heart rate, herbs and supplements that may affect the immune system, herbs and supplements that may affect muscle contractions, herbs and supplements that may affect the nervous system (including anticholinergic agents), herbs and supplements that may improve sex drive, herbs and supplements that may promote urination, herbs and supplements that may protect against radiation side effects, herbs and supplements that may treat heart disorders, herbs and supplements that may treat kidney disorders, herbs and supplements that may treat lung disorders, herbs and supplements that may treat Parkinson's disease, herbs and supplements that may treat stomach disorders, hormonal herbs and supplements, iron, ornithine, pain relievers, potassium, saw palmetto, steroids, stimulants, and thyroid herbs and supplements.