Does ashwagandha help with stress and sleep?

Many trials have been run, but they tend to be small or have other limitations, so they do not settle the question.

Does ashwagandha help with use in pregnancy, or with a thyroid or autoimmune condition?

NCCIH says to avoid it in pregnancy and while breastfeeding, and that it is not recommended for people with thyroid or autoimmune conditions.

Ashwagandha: what the evidence says

The short answer

For stress and sleep: not proven: Many trials have been run, but they tend to be small or have other limitations, so they do not settle the question.
For use in pregnancy, or with a thyroid or autoimmune condition: avoid: NCCIH says to avoid it in pregnancy and while breastfeeding, and that it is not recommended for people with thyroid or autoimmune conditions.

What it is

An evergreen shrub from India, Africa and the Middle East, used for a long time in Ayurvedic medicine. Supplements contain root, leaf or a root and leaf extract.

What the studies say

NCCIH says many clinical trials have looked at ashwagandha for various conditions, and that many of the studies had small numbers of participants or other limitations.
It is promoted for stress, anxiety, sleep and athletic performance.
It may be safe when taken for up to 3 months. There is not enough information to say anything about taking it for longer.
None of this is specific to menopause. The trials were not designed around women in perimenopause.

What a label is allowed to say

No approved claim. Claims for plant extracts like this one are on hold in the UK.

In the US the rules are looser. A label may say how a nutrient supports the body if the company holds evidence for it. The FDA does not check the claim first, which is why US labels carry the line saying the FDA has not evaluated it.

Safety

It can cause drowsiness, stomach upset, diarrhoea and vomiting in some people.
Rare cases of liver injury have been linked with ashwagandha supplements.
Avoid it in pregnancy and while breastfeeding, and stop before surgery.
It may interact with medicines for diabetes and blood pressure, with sedatives, anti seizure medicines, immune suppressing medicines and thyroid hormone.

Ask your doctor first if

You have a thyroid condition or take thyroid hormone.
You have an autoimmune condition or take medicine that lowers your immune response.
You have liver disease, or take medicines for diabetes, blood pressure, seizures or sleep.
You have surgery booked.

This is general information, not medical advice. Check with your doctor or pharmacist, especially if you take medication.

Sources

Checked against these sources on 2026-09-19.

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