5 Surprising Ashwagandha (Withania somnifera) Drug & Supplement Interactions. What You Need To Know

Ashwagandha, also known as Indian Ginseng and Dunal root, is a traditional Indian medicine that has gained widespread popularity recently as a natural remedy for stress, anxiety, and various health concerns due to its alleged adaptogen effects. While generally regarded as safe, ashwagandha can interact with certain medications, potentially leading to adverse effects. Understanding these interactions is crucial for ensuring this herbal supplement's safe and effective use.

Why Do People Take Ashwagandha?

While there are studies revealing the herb may have a spectrum of effects, most often, ashwagandha is used to help these three health problems:

1. Improve insomnia
2. Reduce chronic stress
3. Reduce anxiety

How Much Ashwagandha Works?

The effective dose would depend on what you are taking it for. Studies have used up to 1000 mg per day. Splitting it up into smaller amounts is likely preferable to taking one large dose.

As a rule of thumb, take less for the first week or so to give your body time to adjust. Also, if side effects are going to occur, taking less than a company recommends should help minimize adverse reactions.

The active ingredients in ashwagandha are thought to be compounds called withanolides. There are over 900 types of withanolides. One of those types – called Withaferin A- has received considerable attention from researchers. Thus, you may see this form listed on the Supplement Facts labels.

In addition, supplement companies may refer to the percentage of withanolides their products contain. Supplements often contain between 1% and 10% of total ashwagandha withnolides.

KSM-66 refers to a patented form of ashwagandha that has been the subject of over 20 clinical trials. The company that makes KSM-66 licenses it out to others to use in their ashwagandha supplements.

Ashwagandha's Impact on Blood Sugar Regulation

Ashwagandha's potential to lower blood sugar levels has raised concerns about its interaction with diabetes medications. Studies suggest that ashwagandha may enhance insulin sensitivity, and promote glucose uptake by cells. This effect might enhance the action of antidiabetic medications such as metformin, leading to hypoglycemia or excessively low blood sugar levels.

While obviously concerning, most of this evidence stems from research involving laboratory animals and isolated cells. Definitive proof that the herb is dangerous to people with diabetes requires more study.

Possible Medication Interactions: metformin, insulin, sulfonylurea drugs, Ozempic, and others.

Ashwagandha's Influence on Blood Pressure

Ashwagandha's hypotensive effects have been observed in clinical trials, with some studies demonstrating a significant reduction in both systolic and diastolic blood pressure. This property raises concerns about its interaction with antihypertensive medications, as the combined effect could lead to an excessive drop in blood pressure, causing dizziness, lightheadedness, and even fainting.

While this is very alarming, these side effects have not been confirmed to occur in people who take ashwagandha supplements.

Possible Medication Interactions: diuretics (e.g. hydrochlorothiazide), beta-blockers (e.g. Lopressor), calcium channel blockers (e.g diltiazem), and others.

Ashwagandha and the Immune System: A Delicate Balance

Ashwagandha's immunomodulatory properties, while beneficial in some contexts, can pose a risk when interacting with immunosuppressants, medications used to suppress the immune system in conditions like autoimmune diseases and organ transplants.

In one clinical trial 60 mg of ashwagandha was demonstrated to boost various immune system defenses, including natural killer cells, antibodies, and cytokines, after just 30 days of use. This immune system stimulation could counteract the desired effects of immunosuppressants, potentially leading to adverse consequences.

Possible Medication Interactions: cyclosporine, cyclophosphamide, and others.

Potential Interactions with Sedatives and Anticonvulsants

Ashwagandha's sedative effects, including drowsiness and sleepiness, have been reported in some studies. This property raises concerns about its interaction with sedatives and anticonvulsants, medications used to treat seizures and anxiety disorders.

The combined sedative effects could lead to excessive drowsiness, impaired coordination, and even respiratory depression.

Possible Medication Interactions: benzodiazepines (e.g., valium), barbiturates (e.g., phenobarbital), anti-seizure drugs, alcohol, melatonin, glycine, CBD, and others.

Ashwagandha's Influence on Thyroid Hormones

Ashwagandha's potential impact on thyroid hormones has been suggested in some research, with some studies indicating an improvement in thyroid hormone levels in humans. This effect raises concerns about its interaction with thyroid hormone replacement medications, as it could potentially interfere with the desired hormonal balance. Ashwagandha might interfere with the TSH blood test analysis.

Possible Medication Interactions: Synthroid (levothyroxine), vitamin D, black seeds (Nigella sativa), and others.

Video: Ashwagahdna Hypothyroidism Research

Watch on my YouTube channel

Navigating Ashwagandha Medication Interactions Responsibly

While ashwagandha appears to offer a range of potential health benefits, it is crucial to approach its use with caution if you take medications. Before initiating ashwagandha supplementation, consulting with a healthcare professional is essential to assess potential interactions and ensure its safe and effective use.

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