Ashwagandha One-A-Day

Ashwagandha suits a lot of people, but it isn't for everyone. These are the questions our naturopaths ask in store every day.

A good fit if

• You're an adult looking for traditional herbal support through a stressful patch
• You want a standardised extract with the withanolide content on the label, so you know what you're taking
• Your health history is straightforward: no liver, thyroid or autoimmune concerns, and no prescription medicines
• You'd rather stir a traditional whole-root powder into food or a drink than swallow a capsule
• You're happy to give it a fair trial and check in with a practitioner, rather than expecting an overnight change

Check with us first if

• You have a thyroid condition or take thyroid hormone such as levothyroxine. Ashwagandha may change thyroid hormone levels, and there are reports of an overactive thyroid settling after people stopped it.
• You take immunosuppressant medicines. This is a known possible interaction, so don't combine them without medical advice.
• You take sedatives, anticonvulsants or anything else that makes you drowsy. Ashwagandha can cause drowsiness too, and the effects may add up.
• You take diabetes or blood pressure medicines. The effects may add up, so monitoring is advised.
• You take any prescription medicine. A quick check with your doctor, pharmacist or our naturopaths first is the sensible step.
• You're buying from an overseas website. Those products aren't regulated by the TGA for quality and safety, and some reported liver injury cases involved products bought overseas.

• Standardised root extract (generic). Best known for: The default on Australian listed medicine labels. Absorption: Concentrated, with withanolide content declared on the label, so the active dose is measurable. Typical use: Capsules or tablets, often split into two doses.
• KSM-66 (branded root extract). Best known for: A root-only, water-based extract; used in 16 of 23 trials in one systematic review. Absorption: Aqueous root extract, standardised on total withanolides. Typical use: Capsules and sports powders, most often 600 mg per day. The most frequently studied dose.
• Sensoril (branded root-and-leaf extract). Best known for: A root-and-leaf extract standardised to withanolide glycosides rather than total withanolides. Absorption: Leaf has a different phytochemical profile from root, so doses are not interchangeable with root-only extracts. Typical use: Dosed at the lower end of the range; uncommon on Australian labels.
• Whole root powder. Best known for: Traditional Ayurvedic preparation, closest to historical use, stirred into milk, water or food. Absorption: Not concentrated. Far larger amounts are needed to match an extract's withanolide dose. Typical use: 1–2 teaspoons daily, measured by volume rather than by withanolide content.
• Whole-herb or leaf-containing preparations. Best known for: Cheaper raw material; leaf and aerial parts rather than the root used in trials. Absorption: Leaf contains substantially higher withaferin A and withanone than root. Typical use: Uncommon on Australian labels; leaf material is one proposed contributing factor in reported liver injury cases.

Reference values. None. Ashwagandha is a herb, not an essential nutrient, so there's no NHMRC recommended intake for it.

Typical supplemental range. Australian labels usually provide 150–600 mg of standardised root extract a day. Combination tablets often contain 150 mg of extract, equivalent to about 1.5 g of dried root. The extract amount and the dried-root equivalent on a label are two different numbers, so don't confuse them.

Upper level. There's no NHMRC upper limit. The 12 g dried-root figure in Australia's ingredient rules is a labelling threshold, not a safety limit.

Worth knowing. Ashwagandha isn't part of everyday Australian food, so there's no dietary intake to compare against. How long you take it matters as much as how much: safety beyond about three months hasn't been established. What you need depends on your age, diet and health, so talk to one of our naturopaths.

This list is the part of the page we will not shorten. If any of it applies to you, talk to one of our naturopaths or your doctor before starting.

• Pregnancy. Avoid without professional advice; NCCIH advises avoiding ashwagandha in pregnancy.
• Breastfeeding. Avoid; safety has not been established (NCCIH).
• Existing or previous liver problems. Avoid as a precaution.
• Jaundice, dark urine, nausea, vomiting, unusual tiredness, abdominal pain or loss of appetite. Stop and seek medical advice promptly.
• Sudden nausea, vomiting or diarrhoea after only one or two doses. Stop and seek advice; reported to the TGA.
• Thyroid conditions, or thyroid hormone such as levothyroxine. May alter thyroid hormone levels; thyrotoxicosis case reports.
• Autoimmune conditions. NCCIH advises against use.
• Immunosuppressant medicines. Recognised potential interaction.
• Sedatives, anticonvulsants and other drowsiness-causing medicines. Additive drowsiness.
• Diabetes and blood pressure medicines. Possible additive effects; monitoring advised.
• Planned surgery. NCCIH advises against use beforehand.
• Hormone-sensitive prostate cancer. NCCIH advises avoiding.
• Children and adolescents. Australian labels commonly state not suitable under 15.
• Products bought from overseas websites. Not TGA-regulated for quality and safety; some reported liver injury cases involved internationally purchased products.
• If you take prescription medicines, check with your doctor, pharmacist or our naturopaths before starting.