Ashwagandha for stress: evidence, safety and the UK review

Ashwagandha, scientific name Withania somnifera, is a plant used for thousands of years in the Indian system of medicine. The researchers behind a 2025 systematic review describe it as having anti-inflammatory, neuroprotective, adaptogenic and immunomodulatory activities. "Adaptogenic" is a marketing term for substances said to help the body cope with stress, rather than an established medical classification.

In the UK it is sold mainly as a food supplement, as capsules, powders or gummies, made from the root or from an extract. The FSA call for evidence asked about the plant part used, the type of extract and the product specification, which hints at why results from one trial cannot simply be applied to every product on the market.

A systematic review and meta-analysis presented in BJPsych Open in 2025 searched trials up to September 2024. It included 15 randomised studies with a combined 873 participants who had stress or anxiety, comparing ashwagandha with placebo or other treatments. The authors reported that ashwagandha reduced anxiety on the Hamilton Anxiety Rating Scale, and at 8 weeks also reduced perceived stress and cortisol levels, with no improvement in quality of life.

Some caution is appropriate. The abstract carries a note that it was reviewed by the Royal College of Psychiatrists Academic Faculty rather than by standard peer review, and the authors are not UK-based. The conclusion that ashwagandha is safe and effective in reducing stress and anxiety is the authors' own, and a short abstract cannot show how consistent the trials were, how products differed or how long people were followed.

In practice this means ashwagandha has some research suggesting small benefits for self-reported stress and anxiety, but not the depth of evidence that supports first-line treatments such as CBT.

The Food Standards Agency launched a call for evidence in July 2024 asking for toxicological data, testing results, sourcing and specification information, contaminant levels, product types on the market and consumer information, including any information on use by pregnant women or children. The FSA published a summary of responses on 25 June 2026.

It states that responses will be thoroughly reviewed and provided to the Committee on Toxicity, an independent expert committee that advises the FSA and government departments. A risk assessment will then be conducted and the outcome published, and the assessment and evidence package will be reviewed on a four-country basis to inform future risk management advice.

Until that assessment is published there is no UK-specific safe level or formal advice in the sources read for this page. That is itself a reason for care, especially for people who are pregnant or breastfeeding, who have liver or thyroid conditions, or who take regular medicines.

The NHS advises that herbal medicines are not recommended for children, should not be taken if you are pregnant or breastfeeding or have kidney or liver problems, and may not mix well with medicines such as statins, antidepressants, diabetes medicines, blood pressure medicines, warfarin and hormonal contraception. It recommends asking a pharmacist before taking a herbal medicine with other medicines and telling any doctor treating you.

It also suggests checking for a traditional herbal registration (THR) mark and avoiding unlicensed herbal medicines bought online. Many ashwagandha products are sold as food supplements rather than registered medicines, so a THR mark may not be present.

Persistent stress or anxiety is worth discussing with a GP, particularly if it affects sleep, work or relationships. The NHS describes talking therapies such as CBT as the main treatment for generalised anxiety disorder, with medicines and mental health team referral where appropriate, and adults can self-refer to an NHS talking therapies service.