Ashwaganda and levothyroxine Interactions The systematic review by Smith et al. looked at the effects of different herbs on testosterone levels in men. In addition to fenugreek seed extracts, Ashwagandha root and leaf extracts were found to be the most effective. The four trials included in this systematic review considered the effect of Ashwagandha on testosterone levels. Three of them showed positive effects of Ashwagandha supplementation on testosterone concentration in men, while one trial showed no effect of supplementation. The authors also point out that classic testosterone replacement therapy (TRT) has many adverse effects and contraindications, so there is a need to look for alternatives, and one of these could be herbal medicines such as Ashwagandha 54. Another study was also conducted to determine the effectiveness of the various compounds present in Ashwaganda for the treatment of insomnia. It was found that in mice, an alcoholic extract containing a high amount of active witanolides was not effective. An aqueous extract containing triethylene glycol as the main ingredient was therefore investigated. It turned out that this extract caused a significant induction of NREM (Non-Rapid Eye Movement) sleep. Commercially available triethylene glycol acted in the same way, although dose-dependently (in mice, 10–30 mg/animal was administered) 93. Ashok Kumar Sharma et al. in their double-blind, randomized, placebo-controlled study studied patients with subclinical hypothyroidism (SCH). This leads to an imbalance of dopamine, GABA, serotonin, and acetylcholine 28. Chemical structures of the main active compounds present in Ashwagandha (Withania somnifera) root. As mentioned earlier, acting on the HPG axis and thus affecting sex hormone balance appears to be an essential modulation. A plausible mechanism may be that Ashwagandha acts on GABA receptors in the hypothalamus, facilitating the expression of GnRH 49, which in turn stimulates the pituitary gland to secrete LH and FSH 50,51. In the female reproductive system, the causes of infertility can be grouped into a few broad categories such as tubal, uterine or ovarian disorders and endocrine abnormalities. Human Ethics Ashwagandha (Withania somnifera) is an evergreen shrub found in parts of India, Asia, and Africa. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports. Although most research data indicates that Ashwagandha supplementation is safe and tolerable, more data is needed to evaluate safety of higher doses and longer periods of supplementation, especially regarding its impact on hepatotoxicity. Laboratory analysis confirmed she developed hyperthyroidism and bordered on anemia. The pituitary gland produces a substance called the thyroid-stimulating hormone (TSH). Due to those factors, there’s a strong interest in strategies aimed at improving cognitive function and psychological well-being 3, 4. There was also a report of a 41-year-old woman who, while taking Ashwagandha extract and progesterone, qualified for a liver transplant due to her deteriorating condition 140. What does ashwagandha do for the thyroid? It has been used to boost energy levels, improve cognitive function, and enhance physical performance. Ashwagandha is also believed to have immune-boosting properties, which can help protect the body against infections and illnesses. Subclinical hypothyroidism is a condition in which TSH is elevated; however, thyroid hormones like T3 and T4 are usually in the normal range. People with this affliction may not experience classic symptoms of hypothyroidism, such as fatigue, hair loss, or weight gain. Surprisingly, T3 and T4 levels in synthroid composition our patient remained normal, and only TSH was elevated. It has been proved that it modulates pituitary functions 12, can improve thyroid gland homeostasis 13, regulates adrenal activity and has a multidirectional influence on the reproductive system 12,14. This means it can interfere with the action of immunosuppressive drugs and also worsen autoimmune conditions like lupus, rheumatoid arthritis, and multiple sclerosis. It’s a butterfly-shaped glandular organ that secretes the thyroid hormone in two forms — triiodothyronine (T3) and thyroxine (T4). In conclusion, Ashwagandha is a remarkable medicinal plant renowned for its diverse therapeutic properties. These properties are attributed to the wealth of active substances found within the plant, making it a subject of extensive research and interest. The potential therapeutic effects of the active substances discussed above are shown in Table 2. Blood Sugar-Lowering Medications Moreover, it also forms adducts with amines, which is a reversible process. Withanone is detoxified by glutathione (GSH), at limited levels of which it can induce DNA damage 39. Taking ashwagandha with other thyroid hormone drugs may lead to unnecessarily high levels of thyroid hormone in your body. It is important to note that there is no data available that suggests that a person can have toxicity for taking too much ashwagandha. Nonetheless, people with hyperthyroidism should avoid ashwagandha entirely to prevent thyrotoxicity unless their thyroid doctor recommends it. Another case details what happened to a 62-year-old woman who, after just two months of nighttime use, experienced anxiety, extreme fatigue, weight loss, brain fog, and elevated heart rate, as well as reduced TSH and elevated thyroxine (T4). Laboratory analysis confirmed she developed hyperthyroidism and bordered on anemia. But, what makes this case difficult to pin down is that she was also taking estrogen and several other supplements. Studies indicate that witanoside V and somniferin, isolated from Ashwagandha, may be potential inhibitors of the major SARS-CoV-2M protease 130. In addition, witanolides isolated from Ashwagandha appear to be valuable phytochemicals with antiviral activity in the context of COVID-19 treatment 131. Withanone from Ashwagandha demonstrated antiviral activity in vitro by targeting the host’s major viral protease (MPro) and transmembrane TMPRSS2 132. Due to the fact that research conducted on humans cannot deprive people of their right to effective treatment, we are not able to precisely assess the impact of substances derived from W. Somnifera on the endocrine system, but only draw conclusions about their potentially beneficial or unfavorable effect. Additional factors such as comorbidities, medications taken or potential individual differences are often not taken into account due to the lack of information in research.