Adaptogens for Older Adults: Medicines, Falls and Kidney Function

Older adults often take several medicines, and that is where adaptogens matter most. The US National Institute on Aging (NIA) says dietary supplements can have unwanted side effects, such as unsafe prescription drug interactions, and that "natural" does not mean safe. [1] Before starting any adaptogen, show a doctor or pharmacist everything you take, including products you use only now and then. [2]

Who the research actually studied

Most adaptogen trials were not done in people over 65. A meta-analysis of 12 ashwagandha trials on stress and anxiety (1,002 participants) covered ages 25 to 48 and rated the certainty of evidence as low. [3] NCCIH notes that most Asian ginseng trials were small, with fewer than 200 participants, and shorter than 3 months. [4] A result in a 30-year-old does not tell us how a 78-year-old on five medicines will respond.

What research shows in older people

Medicines, sedation and falls

The NIA says some medicines raise the risk of falling because they cause dizziness or confusion, and the more medicines you take, the more likely you are to fall. [7] It advises telling a doctor or pharmacist if a drug makes you sleepy or dizzy. [7]

Adaptogen sources describe effects that could matter here. NCCIH says ashwagandha may cause drowsiness and might interact with sedatives, anticonvulsants, diabetes and blood pressure medicines, immunosuppressants and thyroid hormone medicines. [8] It lists dizziness, headache and insomnia among rhodiola effects and a reported interaction with losartan. [9] NCCIH lists insomnia as ginseng's most common side effect and says it may interfere with blood clotting and lower blood sugar. [4] In a trial of 20 healthy volunteers, American ginseng reduced the blood-thinning effect of warfarin. [10] Warfarin is one documented example from small trials. See how interactions work, adaptogen medicine interactions and older adults and supplements.

Kidney and liver

Proper evidence not found in the sources we read for safe-use rules for any specific adaptogen in kidney disease. A nephrology review of Chinese herbal medicine says some herbal medicines can cause kidney injury and that clinicians should consider herbal use in unexplained acute kidney injury or progressive chronic kidney disease. [11] A 2026 review of ashwagandha safety concluded that people with liver or kidney dysfunction, thyroid disorders and pregnant women face significant risks. [12] NIH LiverTox says ashwagandha has recently been implicated in clinically apparent liver injury. [13] For liver warning signs and when to call a clinician, see liver safety; for kidney questions, see kidney disease and supplements.

Before surgery and with chronic conditions

NCCIH says ashwagandha is not recommended before surgery or for people with autoimmune or thyroid disorders. [8] Tell the surgical team about every supplement (surgery and anesthesia).

A practical approach

• Keep one written list of medicines and supplements, with the label for each. [2]
• Ask a pharmacist whether the product could affect any medicine, and ask the prescriber before changing anything; do not stop a prescribed medicine on your own.
• Report new dizziness, confusion, falls, rashes or yellowing to a clinician.
• Choose approaches with better evidence for sleep and stress first; see sleep and healthy aging and falls and balance.