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Ashwagandha for Stress and Sleep: What Research Says and Liver Safety

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Ashwagandha: stress, sleep and safety, what research says

Reviewed by the Beseha pharmacist team · Updated 14 November 2026 · The numbers come from published PubMed studies and the product pages · 8-minute read

The 30-second answer

Ashwagandha is a herbal supplement: an analysis of 9 trials in 558 patients found better stress and anxiety scores and cortisol, and an analysis of 5 trials in 400 people found a small effect on sleep, clearer at 600 mg or more and for 8 weeks or more. But long-term safety data are limited, cases of jaundice and liver injury are rare but documented, it may raise the thyroid hormone T4 slightly, and the Dozova and Organic Nation pages bar it in pregnancy and breastfeeding. And there is no study on any of the four products we sell, so ask your doctor if you have liver or thyroid disease or take medicines.

Four products: what is in each?

#1Dozova Ashwagandha KSM-66 – 600 mg
Root extract 600 mg5 percent withanolides

Dozova Ashwagandha KSM-66 – 600 mg

Gelatin capsules: 30 capsules (the lower price) or 60

EGP 249

30 capsules · current price from the product page

  • The page: one capsule twice a day with food (so 1200 mg a day), adults over 18
  • The page: a 4 to 6 week trial
  • The page: a supplement, not a treatment for anxiety or depression

Heads-up: The page warns: liver, thyroid, pregnancy, breastfeeding, sedatives and surgery

Buy at Beseha →

#2Ashwagandha Tablets 60 by Organic Nation
Ashwagandha rootSold as «600»

Ashwagandha Tablets 60 by Organic Nation

One tablet a day after a meal

EGP 375

60 tablets · current price from the product page

  • The page: one tablet a day after a meal, and do not raise the dose
  • The page: immunity, muscle and hormone claims are not well proven

Heads-up: The page does not state the extract amount or withanolide percent, and the pack is the reference

Buy at Beseha →

#3Vertex Ashwagandha 500 mg with Vitamin C
Extract 500 mgVitamin C 500 mg

Vertex Ashwagandha 500 mg with Vitamin C

60 coated tablets: ashwagandha extract with vitamin C

EGP 500

60 tablets · current price from the product page

  • The page: each serving has 500 mg ashwagandha extract and 500 mg vitamin C
  • The page: coated tablets taken as part of a daily routine

Heads-up: The page does not state the withanolide percent, and the serving size and warnings are on the pack

Buy at Beseha →

#4Life Extension Ashwagandha Plus Calm & Focus – 60 Capsules
Sensoril 250 mgSpearmint 900 mg

Life Extension Ashwagandha Plus Calm & Focus – 60 Capsules

Vegetarian capsules, caffeine-free

EGP 1140

60 capsules · current price from the product page

  • The page: the daily dose (2 capsules) has 250 mg Sensoril ashwagandha (10 percent withanolide glycoside conjugates) and 900 mg spearmint
  • The page: for calm and focus, and caffeine-free

Heads-up: Its ashwagandha dose is 250 mg, below the 600 mg mentioned in the sleep analysis

Buy at Beseha →

Dose, duration and the best time

  • No standard dose: the extracts differ (the withanolide percent is known in Dozova at 5 percent and in Life Extension at 10 percent, and not stated for the others), so comparing by milligrams alone misleads.
  • The sleep analysis (Cheah 2021): the effect on sleep was clearer at 600 mg a day or more and for 8 weeks or more, and clearer in people with insomnia. The Dozova page says a 4 to 6 week trial, so the period is shorter than where the effect appeared.
  • With food: Dozova and Organic Nation are taken with or after food per their pages. We opened no study comparing times of day, so morning versus evening is not proven.
  • Maximum: do not exceed what is on the pack, and there are no long-term safety data (Cheah 2021).

What does the research say?

Study Type Result
Arumugam 2024 A meta-analysis of 9 randomised trials, 558 patients Better Perceived Stress Scale (a 4.72-point difference), Hamilton Anxiety Scale (2.19 points) and cortisol; 4 trials reported mild to moderate adverse events; and long-term safety needs more information
Cheah 2021 A meta-analysis of 5 trials, 400 people, on sleep A small but significant effect (standardised difference 0.59), clearer at 600 mg or more, 8 weeks or more and in people with insomnia; no serious effects were reported but safety data are limited
Fornalik 2026 A review and analysis of 23 trials, 1706 people, on hormones Cortisol fell (standardised difference 1.18); testosterone rose in men by 57.43 ng/dL but not in women; thyroid: TSH and T3 did not change and T4 rose slightly (0.61 µg/dL); and the authors note large heterogeneity
Björnsson 2020 A series of 5 cases from Iceland and the US Jaundice, itching and nausea after 2 to 12 weeks, cholestatic or mixed liver injury, and liver tests normalised within 1 to 5 months in 4 patients, with no liver failure
Philips 2023 A case series from India: 8 patients on a single-ingredient ashwagandha product Cholestatic hepatitis; 5 of them had chronic liver disease, and 3 died of liver failure on top of it; in the others the injury was prolonged but improved
Ashwagandha numbers
Sources on PubMed: Arumugam 2024 · Cheah 2021 · Fornalik 2026 · Björnsson 2020 · Philips 2023.

All the numbers are for ashwagandha extracts of different doses and kinds, and there is no study on any of the four products. And we opened no source on the right dose for children or the elderly.

Side effects and warnings

  • Liver: cases of jaundice and liver injury are rare but documented (Björnsson 2020 and Philips 2023); stop and call the doctor if yellowing, dark urine, itching or belly pain appears (the pages say so).
  • Thyroid: T4 rose slightly in the analysis (Fornalik 2026), and the Dozova page says it may raise thyroid hormones, so thyroid patients and those on levothyroxine should ask a doctor.
  • Pregnancy and breastfeeding: the Dozova and Organic Nation pages bar it in pregnancy and breastfeeding; for the other two, check the pack and a pharmacist.
  • Sedatives and diabetes and blood pressure medicines: the Dozova page says it may add to their effect; and we opened no study on interactions.
  • Autoimmune disease and immunosuppressants: consult the doctor (from the Dozova page).
  • Before surgery: stop two weeks before or as the doctor says (from the Dozova page).
  • Mild effects: stomach upset and drowsiness in some people (from the Dozova page), and 4 trials in the Arumugam analysis reported mild to moderate effects.
Ashwagandha caveats
Sources: the product pages · Cheah 2021 · Björnsson 2020 · Fornalik 2026.

Ask a doctor or pharmacist first if

  • You have liver disease or raised liver tests, or take medicines that affect the liver.
  • You have thyroid disease or take levothyroxine.
  • You are pregnant, breastfeeding or planning a pregnancy.
  • You take sedatives, sleeping pills, antidepressants, or diabetes, blood pressure or immunosuppressant medicines.
  • You have persistent anxiety, depression or insomnia: those need a diagnosis, not a supplement.
  • You are having surgery soon.

Want to ask?

Beseha pharmacists answer on WhatsApp. Tap the “Ask a pharmacist” button and tell them your medicines and tests before you start.

FAQ

Does ashwagandha help stress?

An analysis of 9 trials in 558 patients found better stress and anxiety scores and cortisol, but the trials are small and short and there is no study on our products.

Does it help sleep?

An analysis of 5 trials in 400 people found a small effect, clearer at 600 mg or more for 8 weeks or more and in people with insomnia.

Does it have side effects?

Stomach upset and drowsiness in some people, and rare but documented cases of jaundice and liver injury; it may raise the thyroid hormone T4 slightly, and it is barred in pregnancy and breastfeeding per the Dozova and Organic Nation pages.

What is the best time to take it?

Dozova and Organic Nation with or after food per their pages. We opened no study comparing times of day.

Which product should I choose?

There is no study on any of them. Compare the extract amount and the stated withanolide percent (5 percent in Dozova and 10 percent in Life Extension), and ask a pharmacist if you have a condition or take medicines.

Does it raise testosterone?

An analysis of 23 trials found a rise in men of 57.43 ng/dL but not in women, with large heterogeneity; and the Organic Nation page says hormone claims are not well proven.

Read next: supplements for sleep and stress: melatonin and ashwagandha, types of magnesium for sleep and muscles and Immuniphar Plus and Mega Multi Sport.

The bottom line

Ashwagandha has a small effect on stress and sleep in small trials, but long-term safety data are limited, liver injury is rare but documented, and there is no study on our products. If you try it, stick to the pack, do not take it if you are pregnant or have liver disease, and ask your doctor if you take medicines or have a thyroid condition.

Dozova Ashwagandha at Beseha → Life Extension Ashwagandha Plus at Beseha →

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