Liver & Kidney Conditions

Urgent first. Yellowing of the skin or eyes, dark urine, or marked tiredness with nausea or belly pain after starting any supplement are signs the FDA lists among serious reactions. [1] The FDA advises anyone who thinks a supplement caused a serious reaction to stop using the product and report it. [1] Contact a clinician promptly and bring the bottle. For a life-threatening emergency in the US, call 911. See Liver injury warning signs.

"Adaptogen" is a contested label from Soviet-era research, and regulators do not treat it as a category. This page is about specific plants, not the label. It is information only, not medical advice.

Why the liver and kidneys deserve a separate page

The liver processes many herbal compounds and the kidneys clear many of them. The National Kidney Foundation says some herbal supplements leave the body through the kidneys, so toxic levels can build up in people with kidney disease, and that this is not always clear on the label. [2] NCCIH adds that "natural" does not always mean "safe," and that more cases of sudden liver damage in people taking dietary supplements are being reported. [3]

Liver: what the sources found

Two cautions on reading this table. These are reports and reviews of individual people, not measures of how often it happens. And one of the ashwagandha case series noted that four of five patients were also taking other supplements, and in one case rhodiola was a possible cause along with ashwagandha. [5] So the plant, the extract, a contaminant or a second product can each be hard to separate. Details are on the pages for ashwagandha liver reports, he shou wu and guduchi.

A 2026 review of ashwagandha as a food additive concluded that people with liver or kidney dysfunction are among those at significant risk. [12] We did not find, in the sources we read, a safe amount for people with existing liver disease for any adaptogen. Proper evidence not found for that question; we looked in NCCIH summaries, the case series above and PubMed searches on these plants.

Kidney: what the sources found

• The National Kidney Foundation says herbal supplements can worsen kidney disease, interact with prescription medicines, or raise the risk of complications in chronic kidney disease. [2]
• It lists licorice root and astragalus among examples with a high risk for people with kidney disease, with astragalus singled out for kidney transplant recipients and people with lupus nephritis. [2]
• NCCIH says even small amounts of glycyrrhizin from licorice products have been linked to severe adverse effects in people with heart or kidney conditions. [13]
• American ginseng (Panax quinquefolius) appears on the National Kidney Foundation's list of herbal supplements that can be high in potassium, a mineral some people with kidney disease must limit. [2]
• For astragalus, NCCIH says a thorough safety evaluation has not been done and that it may interact with medicines that suppress the immune system. [14] The kidney foundation notes that an interaction can lower the effect of anti-rejection medicines. [2]
• Some products contain ingredients known to damage kidneys, such as aristolochic acid, described as banned in many countries but still present in some traditional remedies. [2]

What a reader can do

Ask a nephrologist, hepatologist, pharmacist or transplant team before using any adaptogen if you have liver or kidney disease, have had a transplant, or take many medicines. The kidney foundation suggests bringing the actual bottle or a photo of the label to the appointment. [2] Avoid combination products where possible, because using them raises the chance of taking something harmful to you. [2] Read the liver safety guide and kidney disease and supplements, and see medicine interactions.