Ashwagandha liver injury: Colombian case report rates supplement 'probable' cause

Doctors in Medellin, Colombia, have reported a case of liver injury that they judged was "probably" caused by an ashwagandha supplement, in a case report published in the journal Case Reports in Hepatology and covered in the press on Thursday, 5 November 2026. The team, from the University of Antioquia, described a 27-year-old woman with no relevant past illness who developed jaundice, itching and pain in the upper right abdomen after taking a herbal supplement containing ashwagandha, and was treated in hospital from 16 to 20 July 2025.

Ashwagandha is a herb used in Ayurveda and is also sold abroad as a supplement, as this case and earlier reports show. Its popularity makes its safety a public question, both in India, where it is part of traditional practice, and abroad, where it is marketed as a supplement.

This report does not show that ashwagandha is unsafe for everyone. It describes one patient. What it adds is a careful causality assessment. RUCAM, the Roussel Uclaf Causality Assessment Method, is a scoring system doctors use to judge how likely it is that a particular drug or herb caused a liver injury, by weighing factors such as timing, other possible causes and recovery after stopping the product. A "probable" rating means the herb is the most likely explanation, but not that it has been proven beyond doubt. In this case, the patient was not given the supplement again to test the link, which the authors noted.

The report sits alongside earlier published cases. Separate case reports from other groups have described liver injury linked to ashwagandha in patients elsewhere, including a case in Libya and a case in Germany, in which liver tests took weeks to months to return to normal. The Colombian authors acknowledged that published cases tend to be the more severe ones, so the literature cannot show how common such reactions are among the many people who take the herb.

For the Ayush sector, the case shows why careful documentation matters: knowing which product was taken, what it contained and in what dose, and reporting side effects through official channels. It is a reminder that "natural" does not automatically mean free of risk, and that people with liver disease or symptoms such as jaundice should speak to a qualified doctor about any supplement they take. This is not advice to start or stop any product.

Peepals timeline: The patient began the ashwagandha supplement about three days before her symptoms appeared. She was in hospital from 16 to 20 July 2025, a stay of five days. The University of Antioquia team assessed the case with the updated 2016 RUCAM method and published it in Case Reports in Hepatology in 2026, and press coverage followed on 5 November 2026.

Short-term: The report adds to the list of documented cases that doctors and regulators consider when judging the safety of ashwagandha supplements.

Long-term: Well-documented case reports like this one support calls for clearer product labelling, quality testing and side-effect reporting for herbal supplements, which are central to building trust in traditional medicine systems.

Who is affected: People who take ashwagandha supplements, Ayurveda practitioners and manufacturers, doctors who treat liver disease, and regulators who oversee herbal products in India and abroad.

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