59 | Thoughts on an ashwagandha thyrotoxicosis case report

As I was preparing for a lecture on ashwagandha (Withania somnifera), I came across a case report sharing information about a women who went to the ER with tachycardia, palpitations and other symptoms of hyperthyroidism.

Her TSH was almost absent, while T4 and T3 were within normal limits. The doctors there ruled out other causes and eventually determined that she had been taking ashwagandha root extract daily instead of her regular thyroid medication for approximately 2 years after a diagnosis of hypothyroidism. They suspected this might be causing her hyperthyroid symptoms.

She was asked to discontinue the ashwagandha root, and at two follow-ups her TSH began to rise, while her T3 and T4 started dropping, suggesting a return to her hypothyroid state. The physicians suspected that she was in the early stages of hyperthyroidism when she presented in the ER, due to her T3 and T4 being WNL.

Here is a copy of the case (open access!) if you'd like to check it out: Kamal HI, Patel K, Brdak A, Heffernan J, Ahmad N. Ashwagandha as a Unique Cause of Thyrotoxicosis Presenting With Supraventricular Tachycardia. Cureus. 2022 Mar 25;14(3):e23494. doi: 10.7759/cureus.23494. PMID: 35475098; PMCID: PMC9035336.

In this episode, I discuss what we can learn from this case report, and what I wish the authors had included in their case presentation.

I hope you find this discussion helpful. If you have thoughts or clinical observations regarding ashwagandha and thyroid disease, I'd love to hear them!

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