Is ashwagandha safe for your liver?
Ashwagandha can cause liver damage, including in people without known liver disease, and regulators see wider risks. The RIVM advises against it, Denmark has banned it and an EU procedure is under way. If you have a liver condition, avoid it; if you use it anyway, watch for jaundice or unusual fatigue and stop immediately if these occur.
Ashwagandha can damage the liver. This is not a single anecdote but a pattern that has emerged from multiple independent case series and review studies. Herbal supplements as a group now account for roughly 20% of all cases of drug- or supplement-induced liver injury in the American liver injury registry network, and ashwagandha is listed there as one of the most frequently cited causes.
The typical presentation is what is known as cholestatic hepatitis: bile flow becomes blocked, leading to jaundice and itching. In a European and American patient series of five cases, this occurred after two to twelve weeks of use. In all five patients the damage resolved on its own within one to five months after they stopped. The situation was more serious in an Indian series of eight patients: three of the five people who had a pre-existing liver condition did not survive.
In healthy people without liver disease, a short-term randomised study of eight weeks found no measurable abnormalities in liver function measurements. That sounds reassuring, but it comes with an important caveat: the study was small (80 participants) and the researchers themselves emphasised that long-term use and higher doses have not been studied.
The concern moreover is not limited to the liver, and regulators are now sounding the alarm. Denmark banned ashwagandha in food supplements in 2023 because no safe intake could be established, with effects on the thyroid and sex hormones also playing a role. The Dutch RIVM advised against it in 2024, especially during pregnancy. France and Sweden impose restrictions, and at EU level a procedure (Article 8) is under way that could lead to a ban or restriction. So this is not just a supplement with a small chance of liver injury, but a herb to which several European authorities attach warnings or bans.
The conclusion is that liver injury from ashwagandha is not rare enough to ignore, and the wider safety concerns reinforce that picture. If you have a pre-existing liver condition, do not use ashwagandha. If you notice symptoms such as jaundice, dark urine or fatigue during use, stop and consult your doctor.
Based on multiple case series (India, Iceland, USA), two review articles, a registry database (DILIN), a population estimate and one small RCT in healthy individuals. Legal context: the Danish ban (2023), the RIVM warning (2024) and the ongoing EU Article 8 procedure. No large randomised safety studies are available.