Ashwagandha lowers a stress hormone, and regulators are now splitting root from leaf

Key takeaways

• In April 2026, India’s Ministry of Ayush told makers of traditional medicines to use only ashwagandha root, citing higher levels of a compound called withaferin A in the leaves, though a court has paused the order for companies that challenged it⁴⁶.
• A 2025 review of trials found that ashwagandha lowered cortisol, a stress hormone, but people’s own ratings of their stress didn’t change significantly¹³.
• In a trial paid for by an extract maker, men’s testosterone ran about 15% higher on ashwagandha, yet they felt no less tired than on a placebo¹².
• NIH’s LiverTox database rates ashwagandha a likely cause of liver injury, which usually starts 2 to 12 weeks after people begin taking it³.
• Skip ashwagandha if you’re pregnant or have thyroid, autoimmune or advanced liver disease, and check with a pharmacist if you take thyroid, diabetes, blood pressure or sedative medicines¹²³.

On April 15, 2026, India’s Ministry of Ayush sent a short letter to the country’s makers of traditional medicines⁴. It said the use of ashwagandha leaves “in crude, extract, or any other form” was strictly prohibited. Only the root could be used⁴.

The next day, India’s food safety regulator issued a matching advisory for food products, trade press reported⁵.

India is the home of Ayurveda, the traditional medicine system that made ashwagandha famous. And the rule landed on two branded extracts widely tested in trials, which blend root and leaf¹⁵.

In May 2026, the Karnataka High Court in Bengaluru put both directives on hold for eight companies that had challenged them, the Nutrition Business Journal reported⁶. As of that magazine’s September 2026 report, the outcome of a follow-up hearing was unclear⁶.

Ashwagandha is now one of the most-used herbal supplements among U.S. adults, according to a 2024 study cited by LiverTox³.

The root-versus-leaf fight opens a bigger story: what this plant is, what its trials show, who paid for them, and the liver and thyroid problems behind the regulators’ worries. Our sleep-aid scorecard covers ashwagandha for sleep and Denmark’s 2023 ban, so this profile covers the rest.

A strong-smelling root that Ayurveda has prized for centuries

Ashwagandha is Withania somnifera, an evergreen shrub that grows in parts of Asia, Africa and Europe¹. It’s sometimes sold as Indian ginseng or winter cherry, but it isn’t related to true ginseng¹.

The Sanskrit name refers to the smell of the root, and somnifera points to the plant’s reputation for bringing sleep¹.

In India, the root has long been used in Ayurveda and in Unani medicine, another traditional system¹. LiverTox calls it the most frequently used Ayurvedic medicine, taken as a general tonic to raise energy and ease stress and anxiety³. A 2021 review on NCCIH’s reference list describes it as “an ancient Rasayana from Ayurveda,” the tradition’s group of rejuvenating remedies².

Today it’s often called an adaptogen, a loose term for something that helps the body resist many kinds of stress¹. That’s a traditional idea, not a proven effect.

What’s inside. The root holds more than 100 compounds³. The best known are withanolides, steroid-like molecules that most extracts are standardized to¹³. No one knows which compound causes ashwagandha’s effects or its side effects³.

Root and leaf have different chemistry¹. India’s 2026 letter said leaves carry more reactive withanolides, especially withaferin A⁴.

What’s sold. Most products use root extract, and some use root plus leaf¹. Three branded extracts show up again and again in trials¹⁵:

• KSM-66, root only, made by Ixoreal Biomed;
• Sensoril, root and leaf, supplied by Kerry;
• Shoden, root and leaf, made by Arjuna Natural, which added a root-only version in 2025.

Extracts are standardized in very different ways, which makes it hard to compare trials or name a best dose¹.

The root-versus-leaf fight has spread to Europe

Europe’s food safety agencies have circled ashwagandha for years. Here is where things stood as of October 2026.

• The EU. A working group of the heads of Europe’s national food safety agencies recommended starting an EU process known as Article 8, which the Nutrition Business Journal describes as a listing mechanism rather than a safety review⁶. Ashwagandha isn’t recognized as a traditional herbal medicine in the EU⁶.
• France. The national food safety agency, ANSES, advised in 2024 that certain groups avoid it, including pregnant and breastfeeding women and people with hormone disorders¹.
• Poland and Hungary cap daily amounts (Poland at 3 grams of powdered root or 10 milligrams of withanolides, Hungary at 250 milligrams of dried root), and Finland, the Netherlands and Sweden have weighed limits or bans, the Nutrition Business Journal reported in September 2026⁶.
• The Netherlands. A Dutch draft rule, sent to the EU for review, would ban ashwagandha leaf and allow root products only with a caution statement⁷. Other countries and the European Commission can comment until December 7, 2026, and the draft could still change⁷.
• The U.K. The Food Standards Agency collected evidence in 2024 and said it would share the responses with the Committee on Toxicity, a panel of independent experts⁸. On September 8, 2026, the committee discussed a third draft statement on ashwagandha, which hadn’t been published when we checked in October⁹.

The industry is split. Thomas Brendler of Plantaphile told trade press that adverse event reports don’t show enough proof of cause for either root or leaf, and he called a leaf ban out of proportion⁵. Kerry said it is appealing India’s decision, while Ixoreal said its root-only extract already complied⁵.

The plant part on the label matters, and these rules may change by the time you read this.

What the stress trials show, and who paid for them

A 2012 trial in India. Researchers in Hyderabad gave 64 adults with chronic stress either 600 milligrams a day of a full-spectrum root extract or a placebo for 60 days¹⁰. Trade press, quoting a director of the maker, Ixoreal, identified the extract as KSM-66 and reported big drops in stress scores and a 27.9% fall in cortisol¹⁰.

A 2019 trial of Shoden. Sixty stressed but healthy adults took 240 milligrams a day of the extract or a placebo for 60 days¹¹. Anxiety ratings by clinicians improved more on the herb, and morning cortisol fell more¹¹. On a self-rated scale of depression, anxiety and stress, the gap fell just short of statistical significance¹¹.

Reviews. ODS summarizes a 2021 review of seven studies with 491 adults in India¹. Benefits for stress, anxiety, fatigue and cortisol looked bigger at 500 to 600 milligrams a day, taken for six to eight weeks¹.

A 2025 review in the journal Nutrition and Health split the picture in two¹³. Pooling trials of at least 250 milligrams a day, it found ashwagandha lowered cortisol by about 1.2 micrograms per deciliter¹³. But on the Perceived Stress Scale, a questionnaire where people rate their own stress, the effect wasn’t statistically significant¹³.

In a 2023 trial of 120 overweight adults, a root extract called Witholytin eased fatigue but didn’t lower perceived stress, ODS reports¹.

A lower cortisol number in a blood or saliva test isn’t the same as feeling calmer. When a product promises stress relief, ask which result the claim rests on.

NCCIH says some preparations may help with stress, and it calls the evidence for anxiety unclear². A 2022 task force from two psychiatry groups, WFSBP and CANMAT, gave root extract at 300 to 600 milligrams a day only a provisional nod for generalized anxiety¹.

Who paid. Many ashwagandha trials test one company’s branded extract, so read the funding note. In the men’s trial described below, the authors wrote that Arjuna Natural funded the study and supplied the extract, and that the company had no role in the design, analysis or writing¹². That doesn’t make the result wrong, but an independent team should repeat it.

Testosterone and strength: hormones moved, but feelings didn’t always follow

Ashwagandha is also marketed to men for testosterone, fertility and gym gains. A 2019 trial shows why the details matter.

Researchers enrolled 57 overweight men aged 40 to 70 who had mild to moderate fatigue¹². Each man took Shoden for eight weeks and a placebo for eight weeks, in random order¹². On the herb, testosterone in saliva ran about 15% higher than on placebo, and DHEA-S, another hormone, ran 18% higher¹².

Yet the men’s fatigue and vigor scores were no better than on placebo¹². Both groups felt better over time, which is common in trials. Only 43 of the 57 men finished all 16 weeks¹².

A 2026 review in Frontiers in Pharmacology pooled 20 trials with 1,249 adults, 14 of them run in India¹⁴. It found a small rise in testosterone (the paper rates its certainty as moderate in one place and low in another) and low-certainty strength gains, mostly in people who already exercised¹⁴. Weight and body fat didn’t budge, and many trials didn’t report their products’ withanolide content¹⁴.

NCCIH says limited evidence suggests that two to four months of ashwagandha may raise testosterone and sperm quality². It calls the evidence for athletic performance insufficient².

A testosterone bump has a flip side: NCCIH says men with hormone-sensitive prostate cancer should avoid ashwagandha².

The evidence at a glance

Use	What was studied	Rating
Stress	Root or root-and-leaf extracts, about 240 to 600 mg a day for 6 to 8 weeks; cortisol fell, self-rated stress results mixed11113	Promising but early
Anxiety disorders	Small trials; NCCIH calls the evidence unclear; task force support was provisional12	Promising but early
Testosterone and sperm	Extracts for 2 to 4 months; hormone rises in small trials, at least one funded by the extract’s maker21214	Promising but early
Memory and thinking	A 2026 review found gains of moderate to very low certainty; NCCIH calls the evidence insufficient214	Promising but early
Strength and exercise	Gains mostly in active people; low certainty214	Not enough evidence
Fatigue and energy	No gain over placebo in one trial, less fatigue in another112	Not enough evidence
COVID-19, diabetes, asthma	Too little good evidence, says NCCIH2	Not enough evidence
Sleep	Covered in our sleep-aid scorecard	See scorecard

Liver and thyroid harms are rare but documented

Liver injury can be slow to fade and sometimes severe

Clinical trials of ashwagandha haven’t turned up liver damage³. But since the first published case in 2017, doctors have reported a growing number of liver injuries in people taking it³.

LiverTox, the NIH database on liver injury from drugs and supplements, gives ashwagandha a “B” score. That means it’s a likely cause of liver injury that shows up as illness³. Here’s the pattern it describes³:

• Timing. Trouble tends to appear within the first three months, between weeks 2 and 12.
• Type. Bile backs up, so the skin and eyes turn yellow (jaundice) and the skin itches.
• Recovery. Once people stop, most heal within one to four months, though jaundice can linger.

The typical case is mild or moderate³. The rare fatal ones, and the few that ended in an emergency transplant, have clustered in people whose livers were already scarred or diseased³. A 2023 report from three Indian hospitals described eight patients; three of them died of sudden liver failure on top of long-standing liver disease³. LiverTox advises people with cirrhosis or advanced liver disease to avoid ashwagandha³.

A 2024 review counted 23 such cases, a small number next to the many people who take the herb³. Could a tainted product be to blame? In several cases, labs tested the actual bottles and found ashwagandha and nothing else³.

Thyroid hormone can climb too high

Ashwagandha can push thyroid hormones up. Fifty people with slightly slow thyroids (subclinical hypothyroidism) took 300 milligrams twice a day or a placebo for eight weeks¹. On the herb, T3 and T4 rose and TSH, the pituitary’s signal to the thyroid, fell¹. A separate study of three men found small T4 increases¹.

That can sound like good news for a sluggish thyroid, but it cuts both ways.

Doctors have published three reports of thyrotoxicosis, a state of too much thyroid hormone, in ashwagandha users¹. All three were women, ranging in age from 32 to 73, and one had been taking an unusually large 1,950 milligrams a day for over two months¹. Each recovered once she quit the herb¹. One woman lost her appetite and weight, felt shaky and had a racing heart³.

If you take thyroid medicine, ashwagandha might interact with it, ODS warns¹. Don’t use it to treat a thyroid problem on your own.

Who should skip ashwagandha

Federal health agencies flag these groups¹²³:

• Pregnant or breastfeeding people. NCCIH says to avoid it in pregnancy and not to use it while breastfeeding². The miscarriage worry traces partly to a 2000 American Herbal Pharmacopoeia monograph, whose authors have since said their work was misread and that the root has not been shown to cause abortion¹. With safety unproven either way, skip it.
• People with thyroid or autoimmune disorders².
• Anyone scheduled for surgery².
• Men with hormone-sensitive prostate cancer¹².
• People with liver disease, especially cirrhosis³.

Possible drug interactions include medicines for diabetes, blood pressure, seizures and thyroid disease, drugs that calm the immune system, and sedatives¹². Safety beyond about three months of use hasn’t been established¹².

Respecting the tradition means respecting the root

Many people come to ashwagandha through Ayurveda, and that tradition deserves care. India’s 2026 letter described the root as the part widely used in Ayush systems and pointed to a 2024 expert safety dossier⁴. Trade press reported that India’s food regulator also said leaf use doesn’t fit the classical Ayurvedic texts⁶. A leaf-extract maker countered that limiting products to one plant part could narrow their benefits⁵.

For now, the cautious choice that honors both the tradition and today’s regulators is the root, at a studied dose, for a limited time.

Another natural-health value applies: knowing exactly what you put in your body. A root powder, a concentrated root extract and a root-and-leaf extract are different products.

A buying checklist, and the signs that mean stop

Before you buy:

1. Check the plant part. Choose a product labeled as root, with no leaf. India’s rules require labels on Ayush medicines to name the plant part⁴.
2. Find the extract name and withanolide content, so you can match the product to a trial¹.
3. Match the dose to what was studied, roughly 240 to 600 milligrams of extract a day¹.
4. Skip multi-herb blends. LiverTox notes that combination products can be mislabeled or contaminated³.
5. Look for a third-party quality seal, which checks contents, not effectiveness.
6. Set a stop date. Most studies ran 6 to 12 weeks, and safety beyond about three months is unknown¹.
7. Tell your clinician and pharmacist, especially if you take thyroid, diabetes, blood pressure, seizure, immune or sedative medicines¹².

Stop taking it and call your doctor if you notice:

• yellow skin or eyes, or itching that won’t let up¹³;
• nausea, unusual tiredness or belly discomfort¹;
• a pounding heart, shakiness, weight loss or poor appetite³.

Ashwagandha liver injury has, rarely, been fatal³, so if you feel very ill, get emergency care. Report a bad reaction to a supplement through the FDA’s Safety Reporting Portal at safetyreporting.hhs.gov. If a child swallows supplements, call Poison Control at 1-800-222-1222¹⁵.

Questions readers ask

The bottom line

Ashwagandha carries a long Ayurvedic history and a modern research record that is promising but early. Its trials are small, many test one company’s extract, and the clearest result is a lower stress hormone rather than a clearly calmer mind.

Its risks are rare but real: liver injury that can take months to heal, and thyroid hormone that can climb too high. If you try it, choose a labeled root extract at a studied dose, set a time limit, skip it if you’re pregnant or have thyroid, autoimmune or advanced liver disease, and stop at the first sign of jaundice.

Related reading

• The sleep aid with the clearest warning is the drugstore antihistamine
• Who paid for the study matters, even when the science is real
• Third-party tested says what’s in the bottle, not that it works
• What happens when you don’t tell your doctor about supplements
• Europe recognizes valerian as medicine, and it still carries a driving warning

Sources

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3. National Institute of Diabetes and Digestive and Kidney Diseases. “Ashwagandha.” LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, last updated December 3, 2024. ncbi.nlm.nih.gov
4. Ministry of Ayush, Government of India (Drug Policy Section). Letter to all Ayush drug manufacturers on use of ashwagandha roots only, File No. T-13020/4/2022-DCC-Part(2), April 15, 2026 (posted by FSSAI). fssai.gov.in on non use of ashwagandha leaves in crude or extract or any other form in food products- reg.pdf
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8. Food Standards Agency (U.K.). “Summary of Responses to Call for Evidence on Ashwagandha.” GOV.UK, June 25, 2026. gov.uk
9. Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (U.K.). “8th September 2026 Committee on Toxicity Meeting.” GOV.UK, September 4, 2026. gov.uk
10. NutraIngredients. “Ashwagandha Ayurvedic Herb Shows Stress-Busting Potential: Study” (on Chandrasekhar K, Kapoor J, Anishetty S, Indian Journal of Psychological Medicine, 2012;34(3):255–262). February 4, 2013. nutraingredients.com
11. Lopresti AL, Smith SJ, Malvi H, Kodgule R. “An Investigation Into the Stress-Relieving and Pharmacological Actions of an Ashwagandha (Withania somnifera) Extract: A Randomized, Double-Blind, Placebo-Controlled Study.” Medicine, 2019;98(37). Murdoch University record. researchportal.murdoch.edu.au
12. Lopresti AL, Drummond PD, Smith SJ. “A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (Withania somnifera) in Aging, Overweight Males.” American Journal of Men’s Health, 2019;13(2). pubmed.ncbi.nlm.nih.gov
13. Albalawi AA. “Dual Impact of Ashwagandha: Significant Cortisol Reduction but No Effects on Perceived Stress. A Systematic Review and Meta-Analysis.” Nutrition and Health, 2025;31(4):1395–1408 (abstract). pubmed.ncbi.nlm.nih.gov
14. Zhu X, Zeng Q, Lei Y, Xu D. “Effects of Withania somnifera (L.) Dunal (Ashwagandha) on Cognitive and Physical Function in Adults: A Systematic Review and Meta-Analysis.” Frontiers in Pharmacology, 2026;17. frontiersin.org
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