Is Ashwagandha Bad for Autoimmune Disease?

ashwagandha

Last Updated on 12 July 2024

Recently, scientific research showed a remarkable interest in the curative uses of a plant called Ashwagandha. Even though it is a food supplement, this plant is, in fact, considered as a medication that can treat several clinical and critical conditions, such as autoimmune diseases. But is Ashwagandha really safe to treat this particular class of diseases?

As regards autoimmune disorders, the results of the medical research are not so encouraging. Rather, they show that Ashwagandha may be extremely harmful in case of autoimmune diseases. Why? This article explored the downsides of this popular plant and the intricate, controversial relationship with autoimmunity.

Overview

Ashwagandha is a shrub cultivated in East Asia, particularly in India, where it is called Indian Ginseng or winter cherry.

ashwagandha plant

Its therapeutic usage dates back to 3000 years ago. The plant is also the main pillar of Ayurvedic medicine, a sort of holistic science that combines spirituality with physical wellness.

The active compounds of the plant are contained in the root, which is often powdered or turned into pills and tablets.

The botanic name of Ashwagandha is Withania Somnifera, name deriving from the anti-anxiety properties of the plant, that seems to be helpful to treat sleeplessness, fatigue, and improve the nervous system.

Traditionally, indeed, Indian Ginseng is considered adaptogenic, and anti-stress, for the property to boost the levels of physical energy. The Indian name of Ashwagandha describes just these properties. Ashwa means horse, because in ancient times, it was believed that the consumption of the raw root gave a strong energy like the one of a horse. Gandha, instead, means fragrance, and refers to the smell of the root.

The energizing properties of this plant help cope with stressors which are commonly bad tolerated by people with autoimmune disorders.

However, Ashwagandha belongs to the family of Solanaceae, the same of eggplants and potatoes.

This class of vegetables is known to trigger inflammatory reactions in people with autoimmune diseases, and that is one of the reasons explaining why Ashwagandha is bad when one has autoimmune conditions. There are other reasons that make this plant harmful for autoimmunity. They are closely linked to its benefits. Let’s discover them one by one.

Immune System Modulation Risks

The root of Ashwagandha exerts a function of modulation of the immune system, providing a strong defense from infections, and cancer cells.

The active substances of Indian ginseng have the power to increase the white cells, namely the cells that the immune system uses to combat tumors, bacterial, viruses, and fungal infections. In short, the plant boosts the immune system, triggering the inflammation which cures us from maladies caused by external pathogens.

That is why the plant is used to treat immune system weakness, such as the one of people affected by HIV.

The process of immune system boosting, namely the inflammation, occurs also when one has autoimmunity, a condition in which the cells become unable to recognize their own tissues, and attack them mistakenly.

While the Ashwagandha induced inflammation protects from external pathogens, it simultaneously exacerbates the autoimmunity that occurs in several diseases, such as lupus, rheumatoid arthritis, multiple sclerosis, and autoimmune thyroiditis.

Many autoimmune diseases are treated with immunosuppressant, and the concurrent administration of Ashwagandha may cause adverse reactions, or make the medications ineffective.

As regards autoimmune thyroiditis, the matter is much more serious and complicated, and deserves a further and separated explanation.

Warnings for Autoimmune Thyroiditis

Even though autoimmune thyroiditis gives troubles with symptoms of stress and fatigue, Ashwagandha is not so beneficial for this autoimmune condition.

When one has Hashimoto’s thyroiditis, indeed, the thyroid gland is extremely inflamed, and can cause hypo or hyperthyroidism. Usually, the powder of the plant is used as a supplement in case of hypothyroid, because this condition is generally accompanied by extreme sensation of fatigue and lack of energy. But in the case of hyperthyroid, or even autoimmune euthyroid, the usage of the Ashwagandha root is not recommended.

The active compounds of this plant, indeed, tend to increase the level of T4 hormone, which, in turn, can exacerbate the symptoms of hyperthyroidism, such as anxiety, agitation, and tachycardia.

In the case of autoimmune euthyroid, things may go much worse, because the immune system boosting induced by the plant tends to increase the levels of inflammatory cytokines, escalating the attack against the thyroid, and the consequent inflammation.

Moreover, in all the conditions of autoimmune thyroiditis, a common symptom is the one of food sensitivities, and allergies, and the substances of a plant belonging to the Solanaceae contain alkaloids, chemical compounds that may interact with the immune system. This system is impaired in those with autoimmune thyroiditis, and the toxic effect of alkaloids may trigger allergic reactions.

However, dieticians affirm that the levels of alkaloids in Solanaceae is too low to be harmful, and the major risk of adverse reactions depends on the concentration of pests used to cultivate these plants, and pollutants they have adsorbed in the environment.

Autoimmune people are notoriously sensitive to toxic substances, and pollutants, but it is also true that plants such as Ashwagandha contain flavonoids, as well, organic compounds with elevated antioxidant effects.

And so, why is the root of Indian ginseng not recommended for autoimmunity? There is a little-known bad effect that could answer this question. Let’s discover it below.

Adverse Effects on Adrenals

Another property of Indian ginseng is the cortisol suppression, the adrenal hormone that triggers inflammatory processes and combats infections and tumors. High cortisol is also involved in the symptoms of anxiety, stress, and insomnia.

Ashwagandha lowers cortisol thanks to the combined action of its main compounds, withanolides and alkaloids, bioactive steroidal substances that plants develop to protect themselves from environmental stressors.

To exert this effect, the active compounds of Ashwagandha must suppress the function of adrenals, and according to a British clinical trial, withanolides and alkaloids may have a direct (bad) impact on adrenal function.

The steroidal function of adrenals, indeed, requires a complex action of enzymes to be properly performed, and according to this clinical trial, the root of Indian ginseng interrupts the positive action of these enzymes, with the risk of adverse effects.

Adrenal glands, in fact, play an important role in people with autoimmunity, and the blockage of the adrenal hormones may cause further issues, such as extreme fatigue, and even adrenal dysfunction, or rather, hyper or hypofunction. These are conditions that exacerbate pain, and inflammation.

The British clinical study cited the case report of a 41-year-old woman, who, in 2021, bought Indian ginseng pills online, started taking 2 tablets per day for 10 weeks, and experienced adrenal dysfunction.

On the basis of this, researchers involved in the study, affirmed that cortisol reduction should indeed be interpreted as an adverse effect of ashwagandha rather than benefit. The subnormal adrenal response observed in our patient could potentially lead to serious health consequences due to the inability of the patient to mount a response to an acute stress, such as a major illness or infection.

I experienced the same adverse effect last year. To ease the symptoms of my Hashimoto’s disease, I took the powder of Indian ginseng for two weeks. During this self-treatment, I felt an awful fatigue I had never had in my life. I was not even able to move a finger or raise a spoon!

In short: I had adrenal dysfunction. Moreover, according to my blood test, the levels of cortisol were normal, and the symptoms I had depended on Ashwagandha.

Fortunately, adrenal dysfunction can be reversed after two weeks of discontinuation of the herbal therapy, but it is not always like this, because it has also been discovered that Ashwagandha can alter neuroendocrine centers controlled by the hypothalamus and pituitary.

It is plausible that the steroidal withanolides – researchers affirm – and alkaloids from ashwagandha could suppress the hypothalamic–pituitary–adrenal (HPA) axis, in a similar way that exogenous corticosteroids (used to treat chronic inflammatory conditions) do to the HPA axis, leading to hypoadrenalism, a severe endocrine dysfunction known as Addison disease.

Adrenals also contain dopamine, which may be blocked along with cortisol. And if the transmission path of dopamine between the endocrine system and the brain is impaired, the supposed protective effect of ashwagandha on neurons and neurodegenerative diseases lessens. Among the other things, dopamine is a neurotransmitter that increases stress resistance. If stress goes up, autoimmune disorder and the related inflammation worsen.

I have had first-hand experience with all that. The adrenal suppression induced by the extract of Indian ginseng exacerbated the neurological disorder induced by my autoimmunity.

Adverse Effects on Internal Organs, and Hormones

Several studies reviewed by pharmacists and researchers on rats found that repeated injections of ashwagandha extract, at a dose of 100 mg/kg body weight for 30 days, led to reduction in the weights of adrenals, thymus and spleen, while humans can experience effects of hepatotoxicity.

Keeping the liver healthy is essential when one has autoimmunity, because this condition makes people sensitive to the toxic substances absorbed by this organ. Moreover, hepatotoxicity may exacerbate the autoimmune inflammation.

The harmful effects in the liver have also been confirmed by physicians in the Netherlands, in an article published in March of 2024 on the website of RIVM, the National Institute for Public Health and the Environment, which reported cases of poisoning among people who had consumed this supplement.

Since the effects may be serious, RIVM advised against consuming food supplements that contain Ashwagandha. Due to the little research and the lack of further information, RIVM assumed that warnings also apply to tea containing Ashwagandha.

ashwagandha root

According to the article, in some countries, such as China and India, Ashwagandha was also used in the past to induce abortion.

In April 2023, this revelation induced Denmark to ban ashwagandha from the national market. Another article published on the website of McGill University in Canada, by the Office for Science and Society, reported that the ban was based on a finding in 2020 by the Danish Technical University (DTU), according to which ashwagandha has a possibly harmful effect on thyroid and sex hormones.

The article also reveals that even with no clear clinical evidence, the European Medicines Agency and FDA, two of the largest pharmaceutical regulating agencies, are about to follow in Denmark’s footsteps by restricting or prohibiting ashwagandha.

However, the only document, written in the Danish language, found online on the website of the Danish Technical University (DTU), is a study published in 2021 in collaboration with the Norwegian Food Institute, where samples of ashwagandha extract containing residues of ethylene oxide were evaluated as genotoxic.

Ethylene oxide, in fact, is a pesticide that, for its carcinogenic properties, is not approved for use in the EU. Even though, in the study, it was impossible to determine the threshold of risk in the residual substance of a plant, the Danish authorities decided to restrict the usage of ashwagandha, as well.

Ethylene oxide is also used to sterilize medical devices, and as reported by Thermofisher Scientific, global leader in autoimmune disease diagnostics, it is proved that this pesticide can trigger allergies and stimulate IgE antibodies.

Furthermore, on the website of Nutraingredients Europe, an article by Nikki Hancocks​, titled Growing concerns over safety of ashwagandha in EU member states, published in May 2023, reported that Ashwagandha may be banned in Finland, Sweden and further EU member states in the near future if scientific concerns are not dispelled, as a growing number of authorities show signs of concern following the ban in Denmark.

Conclusion

Despite the bad effects on autoimmune diseases and other medical conditions, ashwagandha remains a popular food supplement around the world. Many websites highlight the benefits, and the magic properties of this plant, and little bit side effects.

It is possible that the phenomenon is linked to a marketing strategy to sell this product, but health safety is not a merchandise, and deserves more information about risks and side effects of supplements and medications.

The right conclusion is just the one you read in the aforementioned British clinical trial:

Ten weeks of ashwagandha supplementation was associated with adrenal hypofunction, which was reversible after a two-week break. Individuals taking ashwagandha should be aware of this potentially detrimental effect. Future studies are suggested to assess whether long-term treatment with ashwagandha could lead to permanent suppression of adrenal function, and to elucidate the effects of ashwagandha compounds on adrenal steroidogenic pathway and hypothalamic–pituitary–adrenal axis.

This axis must remain healthy, especially when you have autoimmune disorders.

All the rest is only marketing, and not health.

Rosalba Mancuso is a medical journalist, an international writer credited at the University of Washington and a blogger born in Sicily. She is internationally appreciated for founding three online magazines in English. On Modernhealthinfo.com, Rosalba writes well researched and detailed health content backed by her experience as a medical content writer for pharma companies and as a PR assistant for a clinical analysis laboratory. She is also a member of the AHCJ, American Association of Health Care Journalists and Center for Excellence in Health Journalism. This magazine survives thanks to your help. Feel free to send a spontaneous donation to support the efforts that Rosalba makes to produce her articles.