Ashwagandha is one of the most popular natural health products used to help manage stress, support energy levels, and promote overall well-being. However, Health Canada has recently completed a safety review examining a possible link between oral ashwagandha products and rare cases of liver injury (hepatotoxicity).
At Centrum Pharmacy, we believe patients should have access to balanced, evidence-based information about both the benefits and potential risks of natural health products.
What Is Ashwagandha?
Ashwagandha (Withania somnifera) is a plant commonly used in Ayurvedic medicine. It is often marketed as an adaptogen, meaning it may help the body respond to stress and fatigue. In Canada, ashwagandha is authorized in natural health products for various purposes, including:
- Supporting general health and well-being
- Supporting nervous system health
- Helping the body cope with stress
- Supporting memory and cognitive health
More than 2,000 oral ashwagandha-containing natural health products are currently authorized for sale in Canada.
Why Did Health Canada Review Ashwagandha?
Health Canada initiated its review after regulatory agencies in Australia, the Netherlands, and France issued safety alerts regarding a possible association between oral ashwagandha products and liver injury. The review examined:
- Canadian adverse event reports
- International safety reports
- Published medical literature
- Global regulatory assessments
What Did Health Canada Find?
Health Canada identified 13 reported cases of liver injury involving oral ashwagandha use — 8 Canadian cases and 5 international cases. Most reports could not be conclusively linked to ashwagandha because other factors may have contributed, including:
- Underlying liver disease
- Other medical conditions
- Prescription medications
- Additional natural health products
Health Canada also reviewed more than 100 international reports and found that ashwagandha may have contributed to serious liver injury in at least 16 cases. Importantly, these reports remain very rare considering the widespread use of ashwagandha worldwide.
What Is Hepatotoxicity?
Hepatotoxicity refers to liver injury or liver damage. Potential symptoms may include:
- Yellowing of the skin or eyes (jaundice)
- Dark urine
- Persistent nausea or vomiting
- Abdominal pain
- Unusual fatigue
- Loss of appetite
- Pale-coloured stools
Anyone experiencing these symptoms should seek medical attention promptly.
What Is Health Canada’s Conclusion?
Health Canada concluded that:
- A definite link between oral ashwagandha and liver injury has not been established
- A possible association cannot be ruled out
- Cases appear to be extremely rare
- Most individuals recovered after stopping the product
Current Canadian product monographs and labeling remain appropriate. At this time, Health Canada is not requiring warning label changes or product removals.
Centrum Pharmacy’s Advice for Patients
Natural health products can interact with medical conditions and medications, and “natural” does not always mean risk-free. Before starting ashwagandha or any supplement, patients should speak with a healthcare professional if they:
- Have liver disease
- Take prescription medications
- Use multiple supplements
- Are pregnant or breastfeeding
- Have chronic medical conditions
If you are currently taking ashwagandha and develop symptoms suggestive of liver problems, stop using the product and seek medical advice immediately.
Complete, Comprehensive, Caring, Connected Care
At Centrum Pharmacy, our pharmacists help patients make informed decisions about prescription medications, over-the-counter products, vitamins, and natural health supplements. Whether you’re considering ashwagandha, probiotics, vitamins, herbal products, or other wellness supplements, our team can review potential benefits, risks, interactions, and appropriate use based on your individual health needs.
Questions about ashwagandha or other supplements? Visit Centrum Pharmacy and speak with one of our pharmacists today.
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Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your healthcare provider first. Full Disclaimer.
