Thyrotoxicosis with Ashwagandha: A Case Report

A 62-year-old female, in otherwise good health, was diagnosed with thyrotoxicosis after self-medication with Withania somnifera (Ashwagandha). She began supplementing with Ashwagandha root extract for stress and anxiety relief. After about two months of consistent daily dosing at 1950 mg, she experienced worsened anxiety, hysteric behaviors, extreme physical fatigue, unintentional weight loss, lack of concentration, poor memory, and increased resting heart rate. A physical examination determined her thyroid was uniformly enlarged, with tenderness to palpation and odynophagia. Laboratory results revealed low thyroid-stimulating hormone and elevated thyroxine, confirming hyperthyroidism, and borderline anemia evidenced by low hematocrit and red blood cell distribution width. After discontinuation of Ashwagandha, the patient's symptoms resolved, weight normalized, and subsequent laboratory values displayed normal thyroid functioning. To our knowledge, there have been only two human case reports on the relationship between thyrotoxicosis and the use of Ashwagandha. Additionally, data from animal studies suggests that Ashwagandha increases serum concentrations of thyroid hormones. This case report recognizes the potential of thyrotoxicosis following Ashwagandha supplementation.