India's Ashwagandha Decision: Why the Leaf-vs-Root Distinction Suddenly Matters
- Joyce Knieff, ND, LAc
- Jun 5
- 8 min read
Ashwagandha has had a long run as one of the most widely used adaptogenic herbs in the wellness world. Capsules, gummies, sleep blends, energy drinks, latte powders. If you've spent any time in a supplement aisle in the last decade, you've seen it. On April 16, 2026, the Indian Food Safety and Standards Authority issued an advisory that reshaped the global ashwagandha conversation: it banned the use of ashwagandha leaves, in any form, in Indian food and supplement products. The implications travel.
TL;DR: India banned ashwagandha leaf in April 2026 over safety concerns, though standardized root extract still looks safe in trials. Choose root-only products, and check with a clinician first.
Key takeaways:
India banned ashwagandha leaf in food and supplements; root use is still allowed.
The leaf carries more withaferin A, the compound driving the safety concern.
In trials, standardized root extract showed no safety problems at studied doses.
Thyroid disease, liver disease, pregnancy, or blood thinners? Use it only with clinician oversight.
What happened, and why
India is the world's primary producer of ashwagandha, controlling the vast majority of the global supply. The Indian government's decision was based on its updated 2024 ashwagandha safety dossier, which categorically recommended root use for health benefit and flagged "possible safety concerns for ashwagandha leaves due to higher concentrations of reactive withanolides, particularly withaferin A," a compound that behaves differently in the body than the withanolides more abundant in the root. The Ministry of Ayurveda had previously directed manufacturers to use root only and to identify which plant part was being used on product labels. The April 16 advisory codified that direction across the regulatory side.
The industry response has been split. The largest standardized ashwagandha root manufacturer, Ixoreal Biomed (maker of KSM-66), publicly supported the move, noting that their extract has been root-only from the start. Other ingredient suppliers, including Sabinsa, pushed back, arguing that the published research supports the safe use of leaf material and that a more proportionate regulatory response would have been to establish acceptable limits for withaferin A rather than a categorical ban.
The Indian decision also sits inside a wider regulatory shift. Denmark banned ashwagandha use in 2023. France, Germany, Poland, and Sweden have since added warnings or restrictions. The Netherlands is considering a ban. The UK is conducting an active safety review. The European Union has prioritized ashwagandha for an Article 8 procedure, the formal pathway that can lead to an EU-wide restriction. The concerns driving the European action have been signals of liver injury, possible hormonal effects, and possible reproductive concerns.
A coordinated review of close to 140 ashwagandha clinical trials, led by Dr. Thomas Brendler of Plantaphile, concluded that the body of adverse event reports does not establish causality, and that toxicology batteries on major branded extracts show no toxicity for root, leaf, or mixed material. From the research-evidence side, the picture is less definitive than the regulatory side suggests. But regulators have to make decisions on public-health grounds even when the science is mixed, and a precautionary stance on a widely used supplement is what they have chosen.
Where the science actually lands
A 2023 paper in Pharmaceuticals, led by Goran Bokan and an international team, reviewed all published cases of ashwagandha-related liver injury, added two new cases, and applied the Roussel Uclaf Causality Assessment Method (RUCAM), a standardized tool for adjudicating drug-induced liver injury. Both new cases scored as "probable" causality. One previously reported case had resulted in liver transplantation. The total number of well-adjudicated cases is small relative to the global population using ashwagandha, but the signal is real and worth taking seriously.
On the other side of the picture, a 2020 randomized controlled trial in Complementary Therapies in Medicine by Verma and colleagues at King George's Medical University in Lucknow gave 80 healthy adults 600 mg/day of ashwagandha root extract or placebo for eight weeks. No adverse events. No abnormal lab findings. Thyroid parameters stable. A 2023 placebo-controlled trial in the Journal of Integrative and Complementary Medicine found similar safety findings in a 90-day study using a standardized root extract for anxiety and depression symptoms, with no significant biochemical or hematological changes.
In controlled clinical-trial settings using standardized root extract at studied doses for studied durations, ashwagandha appears safe. In real-world commercial use, with variable product quality, undisclosed plant parts, leaf-heavy or whole-plant material, longer durations, and use in populations not studied in the trials (people with pre-existing liver conditions, on hepatotoxic medications, with autoimmune conditions, pregnant), the risk picture is less clean. The cases of hepatotoxicity that have been reported, while small in number, are clinically meaningful when they occur.
The naturopathic perspective
This is one of those moments where the regulatory side, the trade side, and the clinical side are looking at the same data and reaching different conclusions. The clinical question for our patients is more focused. Should ashwagandha still be on the table as a tool, and if so, with what guardrails?
The picture from clinical practice has long favored root-only, well-standardized extracts for the conditions the herb is actually studied for: stress reactivity, HPA axis dysregulation, sleep quality, and adaptogenic support during prolonged stress. The studies that exist on those uses are predominantly on standardized root extract, most commonly KSM-66 (Ixoreal) or Sensoril (a different proprietary extract from leaf and root combination), at doses in the 300 to 600 mg per day range. The Indian advisory aligns with where the better clinical evidence already pointed.
The broader picture is also worth holding. Adaptogens are not a substitute for the foundational work of stress management. Sleep, nervous-system regulation, blood-sugar stability, nutrient adequacy, meaningful connection, and a manageable workload are the conditions under which the body recovers from chronic stress. An adaptogen can support that work. It cannot replace it. When patients arrive looking for an herb that will fix burnout while everything else stays the same, the herb is the smallest lever in the picture.
Thyroid disease deserves its own note, because the picture isn't one-directional. Ashwagandha tends to nudge thyroid hormone (T3 and T4) up and TSH down, which is why small trials have explored it for mild or subclinical hypothyroidism. That same hormone-raising effect is the reason for caution elsewhere: in hyperthyroidism it can add fuel to an already overactive gland, and for anyone already taking thyroid hormone replacement it can push levels too high, with case reports of ashwagandha-associated thyrotoxicosis. In autoimmune thyroid disease (Hashimoto's, Graves'), the herb's immune-stimulating activity adds another variable, so it's a monitor-and-individualize decision rather than a default yes or no. If you have any thyroid condition or take thyroid medication, ashwagandha is worth using only with a clinician watching your labs, not on your own.
Beyond the thyroid, there are people for whom ashwagandha is not a good idea regardless of which plant part is used: people on immunosuppressant medications, people with significant liver disease, people who are pregnant or trying to conceive, and people with certain bleeding disorders or on blood thinners. The interactions list is real, and the over-the-counter accessibility of the herb often outpaces awareness of those interactions.
The regulatory shift in India, and the parallel movement in Europe, are a useful prompt to revisit how ashwagandha is used in clinical practice, what product quality looks like, and which patients are appropriate candidates. The herb hasn't suddenly become unsafe. The conversation around what well-considered use looks like has just become more visible.
How to apply this now
A few practical pieces, if ashwagandha has been part of your wellness toolkit or you're considering it.
Know the plant part. Look at the label. A reputable product should specify whether it uses root or leaf and which extract is involved. If the label says only "ashwagandha" without specifying the plant part, that's a red flag for the kind of supply chain the Indian advisory is targeting.
Stick with standardized extracts that have been studied. The major branded root extracts (KSM-66, Sensoril, and a few others) have clinical trial data behind them. Generic or unbranded products vary widely in actual content and standardization.
Have the right conversation with the right clinician. If you have a thyroid condition, autoimmune disease, liver disease, are pregnant or trying to conceive, are on any medication, or have any chronic health condition, ashwagandha is a conversation, not a default. A clinician who understands botanical medicine and pharmaceutical interactions is the right person to have it with.
Don't outsource the work to the herb. Adaptogens support a system that is also being supported by the basics. Sleep. Movement. Real food. Time outside. Connection. Therapy when it's warranted. The supplement aisle isn't where stress resilience is built. The supplement aisle can be a useful piece, alongside the real work.
And finally, watch the regulatory space. Europe is moving. The UK is reviewing. The US has not yet acted, but the conversation is happening. The products available on shelves today may not be the same set available six months from now.
Frequently asked questions
Is ashwagandha still safe to take?
For most healthy adults, a standardized root extract at studied doses still has a reassuring safety record in clinical trials. The harder-to-pin-down risk shows up in real-world products of uncertain quality, in leaf-heavy or whole-plant material, and in people the trials didn't include. The reported liver-injury cases are few, but they're real, so this is a place for a little care rather than none.
What's the difference between the root and the leaf?
The leaf tends to carry higher concentrations of reactive withanolides, especially withaferin A, which behaves differently in the body than the compounds more abundant in the root. The clinical research that supports ashwagandha is overwhelmingly on root extract. India's advisory restricts the leaf and points manufacturers back toward root-only material, which is where the better evidence already pointed.
Who should avoid it?
A few groups should be cautious regardless of plant part: people on immunosuppressant medications, people with significant liver disease, anyone pregnant or trying to conceive, and people with bleeding disorders or on blood thinners. Thyroid is its own case — ashwagandha tends to raise thyroid hormone, so it may be explored in mild hypothyroidism but can be a problem in hyperthyroidism or alongside thyroid medication, and autoimmune thyroid disease calls for individualized monitoring. If any of these describe you, it's a conversation with a clinician, with lab monitoring where relevant, not a default.
What should I look for on a label?
Look for the plant part named explicitly (root, not leaf or whole plant) and a studied, standardized extract such as KSM-66 or Sensoril. A label that just says "ashwagandha" without specifying the part is exactly the kind of product the Indian advisory is targeting. Generic or unbranded products vary widely in what's actually in them.
References
Sherman A. India bans ashwagandha leaf use in any form, industry reacts. NutraIngredients-USA. April 28, 2026. https://www.nutraingredients.com/Article/2026/04/28/india-bans-ashwagandha-leaf-use-in-any-form-industry-reacts/
Bokan G, Glamočanin T, Mavija Z, et al. Herb-Induced Liver Injury by Ayurvedic Ashwagandha as Assessed for Causality by the Updated RUCAM: An Emerging Cause. Pharmaceuticals (Basel). 2023;16(8):1129. PMID: 37631044. DOI.
Verma N, Gupta SK, Tiwari S, Mishra AK. Safety of Ashwagandha Root Extract: A Randomized, Placebo-Controlled study in Healthy Volunteers. Complement Ther Med. 2020;57:102642. PMID: 33338583. DOI.
Majeed M, Nagabhushanam K, Murali A, et al. A Standardized Withania somnifera (Linn.) Root Extract with Piperine Alleviates the Symptoms of Anxiety and Depression by Increasing Serotonin Levels: A Double-Blind, Randomized, Placebo-Controlled Study. J Integr Complement Med. 2023;30(5):459-468. PMID: 37878284. DOI.
A note before you go
This is for educational purposes and is not a substitute for individualized medical care. Botanical supplements interact with medications and with underlying health conditions in ways that warrant a real clinical conversation. If you take ashwagandha or are considering it, please work with a clinician who can review your full picture and help you decide whether and how it fits.
Related reading
Reviewed by Joyce Knieff, ND, LAc on 2026-06-05.
If this resonates with what you're experiencing and you'd like to explore a naturopathic approach, book a consultation with our clinic.
Comments