Is ashwagandha safe in South Africa?

What is the evidence on safety?

Ashwagandha (Withania somnifera) is a herbal root extract studied for stress, sleep and anxiety, usually at about 300 to 600 mg a day of standardised root extract for 8 to 12 weeks. The trials are mostly small, short and often industry-funded, so evidence is emerging, not strong.

The main safety signal is drug-induced liver injury. A 2020 case series from Iceland and the US DILIN network described five cases: onset 2 to 12 weeks after starting, a cholestatic or mixed pattern, and recovery over 1 to 5 months with no liver failure. A separate case series from India, with a literature review, reported further cases. Ashwagandha may also affect thyroid hormones.

What have regulators done?

We found no South African ban or SAHPRA action on ashwagandha as of October 2026. Regulation here is in transition: SAHPRA classifies such products as Category D complementary medicines, but as of August 2026 no complementary medicines had been registered, and unregistered products must carry a statement that SAHPRA has not evaluated them (how supplements are regulated).

Who should avoid it?

Do not use it, or speak to your doctor first, if you are:

• pregnant or breastfeeding
• living with liver disease or a history of liver injury
• being treated for a thyroid disorder or autoimmune disease
• taking sedatives or benzodiazepines, or immunosuppressants
• due for surgery
• under 18

Stop and seek medical care if you develop yellow eyes or skin, itching, dark urine or abdominal pain.

What does the South African shelf look like?

Labels vary widely, so capsule counts are not like-for-like. As of October 2026 at Faithful to Nature:

• Incredible Living KSM-66 states 500 mg of root extract at 5% withanolides (R395 for 30, R13.17 a day).
• Sfera Ashwagandha states 500 mg at not less than 7% withanolides (R311 for 60, about R10.37 per two-capsule serving).
• Soaring Free lists 500 mg of Withania somnifera without stating extract type or withanolide content (R5.32 per serving at the special price).
• PrimeSelf lists "600mg" without explaining whether this is extract or capsule weight.

Only Incredible Living and Sfera state their standardisation, which is the minimum disclosure you should expect.

Does ashwagandha suit athletes?

The AIS does not list it in Group A, and SAIDS flags herbal and "testosterone" products as higher risk. Herbal blends carry contamination risk, and drug-tested athletes remain strictly liable (see supplements and liver injury risk). Natural does not mean safe. If you want to try ashwagandha, choose a disclosed single-extract product, start short-term, and tell your doctor and pharmacist. Read also what SAHPRA Category D means.

Products mentioned