The long-term safety of Ashwagandha (Withania somnifera) has been studied in several clinical trials and case reports with mixed results.

1. Clinical Trials: A study involving 80 healthy participants consuming Ashwagandha root extract (300 mg twice daily) for 8 weeks found no severe side effects or abnormalities in vital signs or biochemical parameters, including liver function^1^. Another study also concluded that Ashwagandha was well-tolerated over a prolonged period, confirming its safety in reducing stress and improving cognitive functions^2^.

2. Liver Safety: Despite these positive outcomes, there have been increasing reports of ashwagandha-induced liver injury (HILI). Multiple cases of liver damage, including severe jaundice and hepatocellular injury, have been documented in various countries^3^^4^. A comprehensive case series from India highlighted this concern, indicating the herb's potential hepatotoxic effects in certain individuals^3^.

3. Narrative Reviews: Reviews of Ashwagandha's health benefits and risks emphasize potential neuroprotective, anti-inflammatory, and adaptogenic effects, along with risks of liver injury and other adverse effects. The need for careful monitoring and further research into the herb's long-term safety and varying dosages is frequently highlighted^5^.

In conclusion, while Ashwagandha is generally considered safe for short-term use, there are potential risks of liver injury with long-term or high-dose use. Individuals should consult with healthcare providers before starting any new supplement, especially if they have pre-existing health conditions or liver issues.