Adaptogen Safety Quick Reference: Warning Signs and Whom to Call
A one-page quick reference to warning signs reported with adaptogen supplements, who to call in the US (911, Poison Help, 988), and what to tell a clinician or pharmacist.
Content last updated . This page has not been medically reviewed.
Safety first. Natural products can cause side effects and interact with medicines. Read who should be careful, by situation before you use anything on this page.
If someone is in danger right now (US)
- Call 911 if the person collapses, has a seizure, has trouble breathing or cannot be awakened. This is the instruction on the Poison Control website. [1]
- Poison Help: 1-800-222-1222. You can call a poison center; the site says the call is free, expert and confidential. [1]
- 988 Suicide & Crisis Lifeline (US). Call or text 988 for emotional crisis, 24 hours a day, 7 days a week, free and confidential. [2]
Outside the US, see Poison Help by country. This page is information only. It cannot diagnose a problem or replace a clinician.
Warning signs reported in the sources
This table lists signs that sources link to specific adaptogen ingredients. A sign can have many causes, and a report is not proof that a supplement caused it. If you notice one of these signs and you have used a supplement, contact a clinician or pharmacist and bring the product label.
| Sign | What the source reports | Who to contact |
|---|---|---|
| Yellow skin or eyes (jaundice), nausea, unusual tiredness, itching, belly discomfort | In a case series of five people with liver injury attributed to ashwagandha supplements, all developed jaundice and symptoms such as nausea, lethargy, itching and abdominal discomfort after 2 to 12 weeks. [3] NIH says liver injury is rare but has been linked to ashwagandha. [4] Liver injury reports also exist for guduchi and he shou wu. [5][6] | A clinician promptly. Tell them about every supplement. |
| Severe rash, swelling or other signs of severe allergic reaction | NIH lists severe rash, liver damage and severe allergic reactions as uncommon reported side effects of Asian ginseng. [7] | 911 if breathing is affected; otherwise a clinician. |
| Trouble sleeping | NIH says insomnia is the most common side effect of Asian ginseng. [7] Rhodiola side effects may include dizziness, headache and insomnia. [8] | A pharmacist or clinician if it persists. |
| Irregular heartbeat | NIH says the glycyrrhizin in licorice root can cause serious adverse effects such as irregular heartbeat and cardiac arrest, especially with large amounts or long-term use. [9] | 911 for chest symptoms with fainting or collapse; otherwise a clinician. |
| Drowsiness, stomach upset, diarrhea, vomiting | NIH says ashwagandha preparations may cause these in some individuals. [4] | A pharmacist or clinician. |
| Unusual elevated mood or behavior change | Memorial Sloan Kettering cites a case report of mania in a 26-year-old man with no history of mental illness after chronic consumption of Asian ginseng. [10] | A clinician. 988 if there is a crisis. |
| Dizziness or fainting, low blood pressure or severe weakness in someone who recently stopped a steroid medicine | NIDDK says the most common cause of adrenal insufficiency is suddenly stopping corticosteroids after long use, and that symptoms can first appear during adrenal crisis. [11] | 911 if severe. Never stop a prescribed steroid on your own; ask the prescriber. |
| Low mood, hopelessness or thoughts of self-harm while using a "stress" supplement | NIH advises anyone who has or whose family may have depression to consult a health care provider when considering rhodiola. [8] | 988 (US) or a clinician. |
Overdose and "too much"
Proper evidence not found for a defined overdose threshold for adaptogen herbs. We looked at NIH NCCIH herb pages, Memorial Sloan Kettering herb pages and PubMed review and case-report abstracts. If someone took much more than a label says, or a child swallowed a supplement, call Poison Help or 911 as above rather than waiting for symptoms. [1]
What to tell a clinician or pharmacist
- The exact product name and label, and the amount and how long you have used it.
- Every medicine and other supplement you take. NIH says supplements can interact with medicines or pose risks if you have certain medical problems or are going to have surgery. [12]
- If you are pregnant, breastfeeding or planning surgery. NIH says to tell your providers about all supplements as far in advance of an operation as possible. [12]
- Any liver, kidney, thyroid or autoimmune condition. NIH says ashwagandha is not recommended for people with autoimmune or thyroid disorders. [4]
- Which medicines you take that could interact: for ashwagandha, NIH lists sedatives, anti-seizure medications and thyroid hormone medications. [4] Rhodiola has a reported interaction with losartan. [8]
Do not stop or change a prescribed medicine on your own because of anything on this page.
Persistent tiredness is not a reason to self-treat
The Endocrine Society says doctors urge people not to accept an unproven diagnosis such as adrenal fatigue if they feel tired, weak or depressed, because the real cause may be adrenal insufficiency, depression, obstructive sleep apnea or other health problems. [13] A supplement is not a substitute for finding the cause.
Reporting a bad reaction and reading more
See side effects, allergic reactions and reporting for how to report. For ingredient-specific detail, read side effects by ingredient, when to stop and seek advice and when to seek medical help. For the full overview, see adaptogen safety.
Frequently asked questions
What number do I call if a child swallowed an adaptogen supplement?
In the US, Poison Help at 1-800-222-1222, or 911 if the child collapses, has a seizure, has trouble breathing or cannot be awakened. [1]
What are the warning signs of liver trouble with ashwagandha?
A case series reported jaundice, nausea, lethargy, itching and abdominal discomfort after 2 to 12 weeks. NIH says liver injury is rare. Contact a clinician if these appear. [3][4]
Which number is for emotional crisis?
In the US, 988, the Suicide & Crisis Lifeline, available 24/7 and free and confidential. [2]
Should I stop my medicine if I use an adaptogen?
No. Never stop or change a prescribed medicine on your own. Ask the prescriber or a pharmacist about the combination. [12]
Is there a safe amount of adaptogens?
Proper evidence not found for a universal safe amount. NIH describes short-term use periods for some herbs, such as up to 3 months for ashwagandha and possibly up to 12 weeks for rhodiola, but a clinician or pharmacist decides what is right for a person. [4][8]
References
- Poison Control (America's Poison Centers). Poison Control. Read 2026-10-23.
- 988 Suicide & Crisis Lifeline. 988lifeline.org. Read 2026-10-23.
- Bjornsson HK, et al. Ashwagandha-induced liver injury: a case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020. PubMed 31991029. Abstract read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH). Ashwagandha: Usefulness and Safety. Last updated March 2023. Read 2026-10-23.
- Nnamani I, et al. Tinospora cordifolia (Guduchi/Giloy)-induced liver injury: a case review. Cureus. 2023. PubMed 37273324. Abstract read 2026-10-23.
- Liu Y, et al. Polygonum multiflorum Thunb.: a review on chemical analysis, processing mechanism, quality evaluation, and hepatotoxicity. Front Pharmacol. 2018. PubMed 29713283. Abstract read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH). Asian Ginseng: Usefulness and Safety. Last updated February 2025. Read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH). Rhodiola: Usefulness and Safety. Last updated April 2025. Read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH). Licorice Root: Usefulness and Safety. Last updated April 2025. Read 2026-10-23.
- Memorial Sloan Kettering Cancer Center. Asian Ginseng. Read 2026-10-23.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIH). Symptoms & Causes of Adrenal Insufficiency & Addison's Disease. Read 2026-10-23.
- National Center for Complementary and Integrative Health (NIH). Using Dietary Supplements Wisely. Read 2026-10-23.
- Endocrine Society. Adrenal Fatigue. Patient resource, January 25, 2022. Read 2026-10-23.