Ashwagandha, a staple in Ayurvedic medicine, is widely used today for stress relief, sleep support, and general vitality. Its roots are valued as an adaptogen that helps the body cope with physical and mental strain, while its leaves have historically been used in traditional preparations as well. In recent years, however, both international and Indian regulators have raised safety concerns, particularly around the use of ashwagandha leaves and their extracts in food and health supplements. As of April 2026, the Food Safety and Standards Authority of India has formally banned the use of ashwagandha leaves and their extracts in health supplements and food products, while still permitting root‑based preparations. Around the same time, Denmark banned ashwagandha‑containing products as food supplements in 2023, citing potential thyroid and reproductive‑system effects. These regulatory actions reflect a growing consensus that certain parts of the plant, especially the leaves, carry a higher risk profile than the roots.

The core of this concern lies in the chemical composition of ashwagandha’s different plant parts. The leaves contain notably higher levels of reactive withanolides, particularly withaferin‑A, which is a more cytotoxic and potentially hepatotoxic compound. Studies from phytochemical and toxicology research show that leaves and stems often accumulate several‑fold more withaferin‑A than roots, while roots contain a different mix of withanolides such as withanolide A and withanone, which are generally associated with more favourable neuroprotective and adaptogenic effects. This does not mean the roots are inert; they still contain some of these reactive withanolides, albeit at lower concentrations and in a more balanced profile. The practical implication is that leaf‑based products are likely to expose consumers to a higher load of potentially toxic compounds, which is why regulators have moved to restrict or ban their use in food and supplements.

Given this background, the question naturally arises whether ashwagandha root preparations themselves should be treated with caution. The evidence suggests that they should be. While root extracts are generally considered safer than leaf‑based ones, they are not entirely risk‑free. Modern clinical trials and safety reviews indicate that standard doses of root extract—typically in the range of about 300–600 mg per day, standardized to around 5–10% withanolides for a few weeks to a few months—can be well tolerated in many healthy adults. However, data on long‑term use are limited, and there are well‑documented case reports of liver injury linked to ashwagandha products, even when only the roots were used. These cases underscore that “natural” does not automatically mean “harmless,” and that dose, duration, and individual susceptibility all matter.

Liver‑related adverse effects are one of the most serious risks associated with ashwagandha. The signs of liver damage are similar to those seen with other drug‑induced liver injuries and typically appear weeks to a few months after starting the supplement. Early warning symptoms include persistent fatigue, loss of appetite, nausea, and a feeling of being generally unwell. More specific signs are jaundice—yellowing of the skin or the whites of the eyes—often accompanied by dark‑coloured urine and sometimes pale or clay‑coloured stools. Pain or a feeling of heaviness in the upper right abdomen, just under the ribs, can also occur. In documented cases, blood tests reveal elevated liver enzymes (ALT, AST), increased bile‑duct markers (ALP, GGT), and raised bilirubin, reflecting a cholestatic or mixed pattern of liver injury. Importantly, these changes often improve after stopping ashwagandha, reinforcing the need for prompt recognition and discontinuation.

Because of these risks, anyone using ashwagandha root supplements should take a cautious, informed approach. It is wise to avoid very high doses or prolonged continuous use without medical supervision, especially if there is any pre‑existing liver condition, fatty liver, or ongoing treatment with other medications that can affect the liver. People with pregnancy, breastfeeding, autoimmune disorders, or thyroid disease should also be particularly cautious, since ashwagandha can influence hormone pathways and interacting with thyroid medications. Before starting or continuing any ashwagandha regimen, discussing the dose and formulation with a healthcare provider and, if possible, checking baseline liver‑function tests are prudent steps. If symptoms such as jaundice, dark urine, persistent nausea, or right‑upper‑abdominal pain appear, ashwagandha should be stopped immediately and medical evaluation sought. In this regulatory and safety context, the plant’s traditional benefits need to be weighed against its potential risks, with an emphasis on using root‑based preparations in moderate, time‑limited doses rather than as indefinite, high‑intensity supplements.