Withania somnifera and liver concerns
Jul 08, 2025
Withania somnifera
Ashwagandha = horse smell = strength of a horse
Concerns are being raised for rare cases of liver damage, cholestatic hepatitis and jaundice in people taking products with Withania (Ashwagandha)
Possible DNA damage by Withanone constituent (alkaloid).
Liver complications have been reported to be reduced with cessation of the supplement containing Withania. 12 reports have been seen, which is enough to warrant caution and not to use in patients with known liver complications.
Withanone is thought to form adducts int he DNA and interfere with functioning. This is of concern with low glutathione levels as gluathione detoxifies Withanone. If limited glutathione is present, such as liver damage, certain medications or high oxidative stress, the compromised DNA transcription can lead to reduced replication and repair which leads to mutagenesis, apoptosis and then cell death.
Keep in mind that Withania is part of the Solanaceae family, a group of plants with known alkaloid components that tend to have quite strong actions.
Considerations
- a) most reactions have been from products that also contain other ingredients.
- b) Traditional use of Ashwaghanda is low dose, not over 325mg/kg per dose.
- c) Glutathione is the main mechanism that detoxifies withanone.
- d) Look for acute-on-chronic liver signs which may present
- e) Consider liver function test alongside extensive liver related historical questioning
- f) Check that your product is listed on the ARTG and assessed for quality and safety.
- g) Always use practitioner grade high quality herbal remedies that are individually prescribed for you.
Traditionally, Withania, like most adaptogenic herbs, are to be used for short periods at a time. As an Ayurvedic herb, it was traditionally prepared as a powder in milk to drink as needed. This dosage is much lower than western preparations which are often in combination with other herbs. Some incidents have occurred after one dose in liver compromised individuals.
Look for signs of liver complications such as nausea, vomiting, strong smelling dark urine, yellowing of the eyes, fatigue, upper right quadrant pain, diarrhoea, yellow stools.
If you suspect this side effect, stop taking and symptoms have been shown to naturally resolve. However, if symptoms are severe, seek medical attention immediately. Contact the supplement provider for further advice and reporting.
Some further reading -
https://www.sciencedirect.com/science/article/pii/S2666027X21000074
https://journals.lww.com/hepcomm/fulltext/2023/10010/ashwagandha_induced_liver_injury_a_case_series.37.aspx
https://phytotherapydeskreference.com/blog-articles/withania-ashwagandha-hepatotoxicity
