Side Effects by Ingredient
A table of side effects reported for ashwagandha, ginseng types, rhodiola, eleuthero, schisandra, astragalus, licorice, maca and others, with the NIH, EMA or LiverTox source for each.
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.
This page answers one question: what side effects do health agencies and reference summaries report for each commonly sold adaptogen ingredient? It lists reports, not how often they happen. Many summaries say frequency is not known. For medicine interactions, pregnancy and other situations, follow the links at the end. Nothing here is a reason to start or stop a medicine: ask a pharmacist or clinician.
How to read the table
Sources differ in kind. NCCIH (part of the US National Institutes of Health) writes consumer summaries. Memorial Sloan Kettering (MSK) lists reported side effects including single case reports. The European Medicines Agency (EMA) herbal committee (HMPC) lists effects for licensed traditional herbal medicines. LiverTox (NIH) focuses on liver injury. A case report shows something happened to one person after use, not that the herb caused it. "Not described in the sources we read" means exactly that, not that an ingredient is free of side effects.Side effects by ingredient
| Ingredient (plant part used in most products) | Reported side effects | Source and year |
|---|---|---|
| Ashwagandha, Withania somnifera (root, sometimes leaf) | Drowsiness, stomach upset, diarrhea and vomiting in some people; rare liver injury reports [1]. Case reports include thyrotoxicosis that resolved after stopping [2]. | NCCIH 2023; MSK; LiverTox 2024 [3] |
| Asian ginseng, Panax ginseng (root) | Insomnia is most common; uncommon reports of severe rash, liver damage and severe allergic reactions [4]. MSK lists dry mouth, fast heart rate, nausea, vomiting, diarrhea, insomnia and nervousness and case reports of mania [5]. EMA lists stomach discomfort, nausea, diarrhoea and skin hypersensitivity reactions, frequency not known [6]. | NCCIH 2025; MSK; EMA [6] |
| American ginseng, Panax quinquefolius (root) | MSK states there are no reports of side effects from taking it [7]. This is a different plant from Asian ginseng and the results do not transfer. | MSK |
| Eleuthero (Siberian ginseng), Eleutherococcus senticosus (root) | Insomnia, irritability, tachycardia and headaches may occur; frequency not known [8]. MSK says human studies are quite limited [9]. | EMA/HMPC monograph (EMA/HMPC/680618/2013); MSK |
| Rhodiola, Rhodiola rosea (root and rhizome) | Dizziness, headache, insomnia, and dry mouth or extra saliva [10]. EMA lists headache among effects of unknown frequency [11]. | NCCIH 2025; EMA/HMPC (EMA/HMPC/24177/2023) |
| Schisandra, Schisandra chinensis (fruit) | MSK reports no serious side effects, but notes it is not well studied in humans [12]. | MSK |
| Astragalus, Astragalus mongholicus / A. membranaceus (root) | MSK lists fatigue, malaise, headache and lowered blood pressure in a study [13]. NCCIH says a thorough safety evaluation has not been done [14]. | NCCIH 2025; MSK |
| Licorice, Glycyrrhiza species (root) | Serious effects such as irregular heartbeat and cardiac arrest from glycyrrhizin, especially in large amounts or long term [15]. MSK calls hypokalemic hypertension the most common side effect [16]. | NCCIH 2025; MSK |
| Maca, Lepidium meyenii (root) | Subjective reports of altered menstrual cycles, moodiness, cramps, gastritis and insomnia [17]; may interfere with testosterone lab tests [17]. | MSK |
| He shou wu, Polygonum multiflorum (root) | Numerous reports of acute liver injury, which can be severe and even fatal [18]. | LiverTox 2020 |
| Guduchi, Tinospora cordifolia (stem, leaf, root) | Reports of clinically apparent liver injury with long-term use [19]; a multicenter study from India described acute hepatitis with autoimmune features [20]. | LiverTox 2025; Hepatology Communications 2022 |
| Holy basil, amla, codonopsis, jiaogulan, shatavari, cistanche and others | Not described in the sources we read this session. | n/a |
Where sources disagree
Liver effects of ginseng are described differently. NCCIH lists liver damage among uncommon reported effects of Asian ginseng. [4] LiverTox (entry dated 2018) says ginseng has not been implicated in causing liver injury, though it may cause herb-drug interactions that could lead to it. [21] Both can be true of different products, doses and cases, and they are different kinds of review, so we report both rather than choose.LiverTox says licorice and astragalus have not been reported to cause clinically apparent liver injury. [22][23] Licorice has other serious effects, as above.
Limits
Case reports and consumer summaries cannot give rates, and supplement products vary a lot between brands. NIH notes that what is on a label may not be in the product. [24] For ashwagandha liver reports in detail, see ashwagandha side effects and liver injury reports.Next steps
Check the label for the plant name and part, then ask a pharmacist about your medicines. See documented versus theoretical medicine interactions, reading side effects and when to stop, and the safety overview. To report a reaction, see side effects and reporting.Frequently asked questions
Which adaptogen has the most side effects?
The sources do not rank them, and we do not either. They describe different effects: insomnia with Asian ginseng [4], heart and blood pressure effects with licorice [15], and liver reports with ashwagandha, He shou wu and guduchi. [3][18][19]
Is "no reported side effects" the same as safe?
No. MSK says American ginseng has no reported side effects [7], but that reflects what was reported, and lack of reports is not proof of safety.
Do side effects depend on the form?
They can. Results for one plant part, extract or product do not transfer to another. Ashwagandha supplements may contain root, leaf or both. [1]
What should I do if I get side effects?
NCCIH advises that if you have side effects you stop taking the supplement and contact your health care provider. [24]
Where do I report a reaction?
In the US, see side effects and reporting. Call 911 for an emergency or Poison Help at 1-800-222-1222 for a possible overdose.