Is It Safe to Take Ashwagandha During Pregnancy?

I’m pregnant and have been pretty stressed lately. I’m trying to keep things “all natural” and have been doing some reading about ashwagandha. It’s in a lot of drinks and supplements that claim to lower stress. Is it safe to take when pregnant?

—Trying to chill out

Ashwagandha, for the uninitiated, is a plant commonly used in Ayurvedic medicine. It is an “adaptogen,” which is, loosely, anything that is thought to help the body adapt to stressors. In the case of ashwagandha, typically the root is used in supplements or teas, but the leaf can also be used (the compounds in them are different).

These compounds are cited as improving mental health, reducing stress, improving sleep, and many other health outcomes. I will not dive into that here, only say that there is some small randomized trial evidence in support of at least some of these claims. Various online influencers credit these products with enormous changes in their cortisol levels.

At this point, there is no data about taking ashwagandha when trying to conceive or while breastfeeding, but the discussion about the use of it in pregnancy is somewhat fraught. In 2023, Denmark banned the use of ashwagandha in products because of (among other things) concerns that it might lead to miscarriage. France has issued warnings about this possibility as well. But the authors of the studies on which these warnings are based have, in some cases, pushed back, noting that some of the evidence of risk is based on claims from traditional medicine that have no empirical support.

There are entire papers criticizing Denmark’s decision and the report on which it was based, arguing that this compound might actually have fertility benefits. The debate is difficult to settle because there is very little concrete or systematic evidence on this question. Having said that, this seems to me a case in which avoidance is probably prudent, at least until we know more.