Understanding Ayurveda
Herbal does not mean harmless: the dangers of self medication in Ayurveda
AYURVEDA & HEALTH
Just because it’s natural does not mean it’s safe
By Vaidya Amitha Rudraraju
There is a dangerous misconception that is becoming increasingly common:
“It’s Ayurvedic. It’s natural. It’s only a herb. What harm can it do?”
Quite a lot, if it is taken incorrectly.
Today, social media has made health advice incredibly accessible. We see Instagram Reels – short videos – telling us that a particular herb is good for stress, another for sleep, another for digestion, another for hormones, and another for the liver.
And the temptation is immediate:
“Let me try this.”
But a thirty-second Instagram Reel does not know your medical history. It does not know your constitution, your digestion, your existing medical conditions, the medicines you are taking, your liver or kidney health, or whether that particular herb is appropriate for you.
A medicinal herb is still medicine.
It needs to be selected carefully, prescribed appropriately and monitored when necessary.
Natural does not mean harmless
Think about something as basic as salt.
Salt is essential to life. But too much salt can be harmful.
Water is essential to life. Yet excessive water consumption can dangerously disturb the body’s sodium balance.
If even water and salt require balance, why would we assume that concentrated medicinal herbs can be taken without understanding dosage, timing, preparation and individual suitability?
The fact that something comes from nature tells us where it comes from. It does not automatically tell us that it is safe for everyone.
Ashwagandha is an important warning
Ashwagandha has become one of the most popular Ayurvedic herbs in the world. It is widely promoted online for stress, sleep, energy and general wellbeing.
But recent medical literature has documented cases of clinically significant liver injury associated with products containing Ashwagandha.
An Indian case series reported eight patients with Ashwagandha-associated liver injury. Five had underlying chronic liver disease and three developed acute-on-chronic liver failure and died. Importantly, the investigators found only natural phytochemicals in the products they analysed, meaning the cases cannot simply be dismissed as contamination or adulteration.
The US National Institutes of Health LiverTox database also recognises Ashwagandha-associated liver injury as a rare but real adverse event. It notes that most cases recover after stopping the product, but rare fatal cases and cases requiring emergency liver transplantation have been reported.
Ashwagandha – Withania somnifera
This does not mean that Ashwagandha is dangerous for everybody.
It means something much more important:
No medicinal herb should be assumed to be harmless simply because it is natural.
Ayurveda is not “take an herb and see what happens”
One of the greatest misunderstandings of Ayurveda is that it is simply a list of herbs and their benefits.
It is not.
Classical Ayurveda places considerable importance on the physician, the medicine, the patient and the person caring for the patient.
Physician
Medicine
Patient
Carer
Charaka Samhita describes these four as essential components of successful treatment. It also describes the qualities expected of a good physician, including theoretical knowledge, extensive practical experience, skill and appropriate conduct.
There is an extraordinary relevance to this teaching today.
The medicine matters.
But who selects the medicine, for whom it is selected, how it is prepared, how it is administered and how the patient is monitored also matter.
This is why taking an herb simply because it appeared in a Reel is not the same as receiving Ayurvedic treatment.
The right medicine, the right dose and the right time
In Ayurveda, treatment is individualised.
- The same herb may not be appropriate for every person with the same symptom.
- The dose matters.
- The formulation matters.
- The timing matters.
- The duration matters.
- The combination with other medicines matters.
This is why it is not enough to say:
“Ashwagandha is good for stress, so I will take it.”
The appropriate question is:
“Is Ashwagandha appropriate for me, in my present condition, in this form, at this dose and for this duration?”
That is a clinical question.
It requires a qualified practitioner.
Please check who is calling themselves an Ayurveda practitioner
This is becoming particularly important.
Before taking Ayurvedic treatment, check the practitioner’s qualifications.
In India, a recognised BAMS, Bachelor of Ayurvedic Medicine and Surgery, is a 5 year and 6 month programme under the current NCISM regulations, including a compulsory 12 month internship.
A practitioner may also have completed recognised postgraduate training in Ayurveda.
That is very different from someone completing a short online course and then presenting themselves as an Ayurveda practitioner.
A two month online course cannot replace years of structured medical education, clinical training, examination and supervised practical experience.
How can years of clinical education and experience be replaced by an online course?
They cannot.
This is not about dismissing online education. Online courses can be useful for learning about Ayurveda, understanding its principles or developing an interest in the subject.
But learning about medicine is not the same as being medically qualified to diagnose and treat patients.
Before choosing a practitioner
So before allowing someone to prescribe for you, ask:
- What is your qualification?
- Are you BAMS trained?
- Where did you study?
- Are you registered with the appropriate professional or statutory body?
- Do you have recognised postgraduate qualifications?
These are reasonable questions when somebody is going to prescribe medicines for you.
Your doctor has spent years learning what a video cannot teach you
A qualified Ayurvedic physician does not simply learn that “herb X is good for condition Y.”
They study Ayurveda systematically and learn diagnosis, pharmacology, formulations, treatment principles and clinical practice.
They learn that medicines must be selected according to the patient and the condition.
That knowledge takes years.
It cannot be replaced by social media.
And it cannot be replaced by a two month certificate.
Supplements need the same caution
The same problem exists with the enormous supplement industry.
People often assume:
“It is a supplement, so it must be safe.”
That is not necessarily true.
Supplements can contain pharmacologically active ingredients. They can interact with medicines. Products can vary in composition and quality, and regulatory requirements differ between countries.
The sheer availability of a product does not mean that it is appropriate for you.
And taking five or six supplements together makes it even more difficult to know what is helping, what is unnecessary and what might be causing an adverse reaction
Do not turn your body into an experiment
We need to move away from the culture of:
“I saw it on Instagram, so let me try it.”
Your friend taking something does not mean it is right for you.
An influencer taking something does not mean it is right for you.
A product being labelled Ayurvedic does not mean it is right for you.
A product being natural does not mean it is right for you.
And a product being sold online does not mean it has been individually assessed for you.
Respect Ayurveda by practising it responsibly
The answer is not to reject Ayurveda.
The answer is to respect Ayurveda enough to practise it properly.
The classical Ayurvedic texts themselves emphasise the importance of a knowledgeable physician, appropriate medicine and a patient who understands and follows the treatment.
Charaka specifically describes the ideal physician as someone with knowledge and extensive practical experience.
That message remains remarkably relevant today.
- Do not self prescribe simply because something is herbal.
- Do not take medicines because you saw them in a Reel.
- Do not increase the dose because you think more will work faster.
- Do not combine multiple herbs and supplements without professional guidance.
And, most importantly:
Check the qualifications of the person prescribing for you.
Ask whether they are properly trained in Ayurveda.
Ask whether they hold a recognised BAMS qualification or an appropriate recognised postgraduate qualification.
Ask where they trained and whether they are registered with the relevant professional authority.
Because when it comes to your health, years of medical education and supervised clinical experience matter.
A Reel takes thirty seconds to make.
A qualified physician takes years to train.
Your health deserves the latter.
Natural does not mean harmless.
Traditional does not mean suitable for everyone.
And an online course does not make someone a qualified physician.
Take Ayurvedic medicines under the guidance of a properly qualified practitioner, in the right form, at the right dose, at the right time and for the right duration.
Please respect the ancient tradition of Ayurveda.
References and further reading
- Philips CA et al. (2023). Ashwagandha-induced liver injury — A case series from India and literature review. Hepatology Communications.
This is the study behind the article’s eight-patient case series: five had pre-existing chronic liver disease, three developed acute-on-chronic liver failure and all three died. Chemical analysis of retrieved products found natural phytochemicals without detected adulteration or contamination.
Open the study on PubMed - National Institute of Diabetes and Digestive and Kidney Diseases. Ashwagandha — LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Updated 3 December 2024.
LiverTox describes clinically apparent Ashwagandha-associated liver injury as rare but documented, with rare fatal cases and emergency liver transplantation reported, particularly in people with pre-existing liver disease.
Open the LiverTox Ashwagandha monograph - National Center for Complementary and Integrative Health. Ashwagandha: Usefulness and Safety.
This NIH resource gives a useful general safety overview and notes that a number of liver-injury cases have been linked to Ashwagandha supplements, although such reports are rare.
Open the NCCIH Ashwagandha safety page
Educational disclaimer
This article is provided for educational information only and is not intended as a substitute for individual medical advice, diagnosis or treatment. Ayurvedic herbs, formulations and supplements should be used under the guidance of an appropriately qualified practitioner, particularly if you have an existing health condition or are taking prescribed medicines.
Vaidya Amitha Rudraraju is a qualified Ayurvedic physician who has practised Ayurvedic medicine since 2000. She completed five-and-a-half years of BAMS training, qualifying in 2001, and subsequently completed postgraduate training in emergency medical services and preventive and promotive healthcare.
Her clinical experience includes work in hospitals in India, particularly in Panchakarma and women’s health. She also completed Maharishi AyurVeda training in Delhi in 2004.
Read more about Vaidya Amitha.
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Vaidya Amitha offers in-person Ayurvedic consultations at the Panchakarma Centre in Skelmersdale, Lancs, as well as by phone or online. She also offers in-person consultations at her home near Harrow, Essex.
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