{"id":"ashwagandha","name":"Ashwagandha","safety_from_source":{"toxicity":"Generally well-tolerated for up to 3 months; however, rare cases of clinically apparent liver injury have been reported.","side_effects":["Stomach upset","Loose stools","Nausea","Drowsiness","Increased heart rate variability"],"contraindications":["Pregnancy (potential abortifacient effects)","Breastfeeding","Hormone-sensitive prostate cancer (due to potential testosterone increase)","Pre-existing liver disease","Endocrine disorders"]},"safety_from_studies":"Generally well-tolerated, but common side effects include somnolence (drowsiness) and GI upset. Contraindicated in individuals with pre-existing liver disease due to reports of fatal acute-on-chronic liver failure. Use with caution in those with hyperthyroidism or autoimmune thyroid conditions as it may increase T4 levels. Rare reports of cardiac toxicity exist. May interact with sedative medications due to GABAergic modulation.","interactions":[{"drug":"Antidiabetes medications","effect":"Potential interaction; may affect blood glucose levels."},{"drug":"Antihypertensive drugs","effect":"Potential interaction; may affect blood pressure."},{"drug":"Immunosuppressants","effect":"Potential interaction; may interfere with therapy due to immune-modulating effects."},{"drug":"Sedatives (Benzodiazepines, CNS depressants)","effect":"Potential additive effect on drowsiness."},{"drug":"Thyroid hormone medications","effect":"May interact with thyroid hormones by increasing T3 and T4 levels."}],"fda_adverse_events":{"total_reports":162,"top_reactions":[{"reaction":"Diarrhoea","count":25},{"reaction":"Nausea","count":21},{"reaction":"Pruritus","count":15},{"reaction":"Headache","count":13},{"reaction":"Vomiting","count":12},{"reaction":"Rash","count":11},{"reaction":"DIARRHOEA","count":10},{"reaction":"Pyrexia","count":10}],"top_outcomes":[{"outcome":"Other Serious or Important Medical Event","count":90},{"outcome":"Hospitalization","count":50},{"outcome":"Visited Emergency Room","count":34},{"outcome":"Visited a Health Care Provider","count":30},{"outcome":"Disability","count":20}]},"upper_limit":{"amount":"","notes":"No tolerable upper intake level has been established by the ODS."},"source_url":"https://ods.od.nih.gov/factsheets/Ashwagandha-HealthProfessional/"}