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I used to start my day drinking a bright-green smoothie. I didn’t particularly enjoy the taste of pulverized kale or protein powders with mysterious ingredients, but I thought I was being healthy. My daily routine was immaculate: I exercised every day, walked 10,000 steps, got eight hours of sleep, and tried to take the right supplements. I spent my evenings scrolling online or on social media for health information to be certain I was doing all the right things.
That’s why I thought it was a great idea to add products containing spirulina, a nutrient-dense algae, and ashwagandha, a root often used in Ayurvedic healing, to my morning green potion. Herbs like these promise everything from stress reduction to a fortified immune system—the key selling point, at least on the TikToks I watched.
This past February, after months of mysterious symptoms, I was diagnosed with dermatomyositis, a rare autoimmune disease causing severe muscle weakness and skin rashes. The diagnosis came after a six-month stretch that began with unusual fatigue and brain fog and ended last November when I woke up one day unable to move. I couldn’t get up from my bed. Pain radiated through my body, my neck was immobile, and my hands turned blue. I also developed neurological symptoms, including light flashes, balance issues, and facial numbness—a confusing set of signs that ultimately pointed to an autoimmune crisis.
It was only when I met with a leading dermatomyositis expert that I learned the catalyst for my crippling symptoms. “Is ashwagandha in your protein powders? Spirulina in your smoothies? Echinacea in your tea blends?” dermatologist Victoria P. Werth asked me on one desperate visit to her Pennsylvania clinic. By answering yes, I learned a terrifying truth: Various products I thought I was consuming for my health had likely triggered my condition. I’m not alone: In one study, Werth followed 637 patients with dermatomyositis or lupus and treated them with supplements including spirulina, elderberry, ashwagandha, echinacea, chlorella, and alfalfa. For dermatomyositis patients like me, 31 percent experienced a disease onset or exacerbation after the supplement treatment.
It’s important to note that I have always lived with a genetic predisposition to autoimmunity. I have polycystic ovary syndrome, Hashimoto’s thyroiditis, and Raynaud’s syndrome, and my parents have their own autoimmune conditions. But I didn’t realize my self-care ritual was a ticking time bomb. When I felt unwell, I sought out “immune-boosting” products to make me feel better. I didn’t realize that a boosted immune system was, in fact, my entire problem.
The irony was devastating. By consuming ingredients like ashwagandha, spirulina, and echinacea, I was convincing my system to attack its own tissues. My genetics provided the foundation, but these supplements turned a predisposition into a chronic, irreversible attack on my healthy cells. Today, in order to prevent further flares, I have to live by one strict rule: total avoidance of these immunostimulatory herbs.
For me, the consequence of consuming products that contained one or all of these herbs was a life-altering autoimmune flare. But for others, the outcome is even more severe.
Naveen Kathuria, an attorney and health care consultant from West Bloomfield, Michigan, was taking 150 milligrams of ashwagandha daily to help with stress and sleep when it triggered a health crisis. Late last year, the supplement left him severely jaundiced, emaciated from losing over 40 pounds, and bedridden for months. At one point, his bloodwork showed his bilirubin—a pigment that builds up when the liver can’t properly filter waste—had skyrocketed to 38 times the normal level, and he was evaluated for a liver transplant. “I was taking a standard dosage of ashwagandha. It wasn’t like I was consuming an excessive amount, yet it affected me quite adversely,” Kathuria said. “I forgot to mention it to the first few doctors I saw, so they suspected I may have colon cancer, instead of what was going on with my liver.”
Kathuria emphasized how difficult it can be for patients to connect new or worsening symptoms to something as seemingly harmless as a supplement. Many people cycle through multiple doctor visits before anyone considers that a vitamin, powder, or herbal blend could be contributing to the issue. Often, supplements aren’t even mentioned during appointments, either because patients forget or because they don’t view them as medically relevant, which can significantly delay answers.
In two separate instances last year, New Jersey residents Katie Mohan and Robert Grafton ended up in the news for hospitalization due to turmeric supplements. Their cases have drawn increased attention to potential harm, illustrating the unpredictable nature of supplement-induced liver injuries. The issue, as Werth put it, is that unless a provider specifically “drills down and physically gives them a sheet,” patients don’t think to disclose their supplement use. As John Fontana, a leading global authority on drug-induced liver disease and a professor of medicine at the University of Michigan, told the Guardian, genetics play a crucial role in these adverse reactions. “When you take a herbal supplement, you’re playing Russian roulette with your genetic ability to tolerate it,” he says.
Ashwagandha has been around for 6,000 years. Ayurveda, the traditional medicinal system of India, considers ashwagandha to be a powerful, restorative builder herb used to increase stamina, reduce chronic inflammation, and lower cortisol levels, among other benefits. Much more recently, it’s been touted by wellness influencers, celebrities like Gwyneth Paltrow and Oprah Winfrey, and lifestyle entrepreneurs like Emily McDonald and Kunal Sood, aka Doctor Soood, as a harmless, natural panacea. Its contemporary popularity seems to have spiked during the COVID-19 pandemic, when people desperately sought ways to boost their immunity. The year 2020 alone saw herbal supplement sales jump by a record 17 percent to an unprecedented $11.3 billion. Market research estimated dietary supplements were a $74.3 billion global industry by 2024, and are expected to reach $170 billion by 2034. Today, you can find the ancient Ayurvedic herb in teas, protein powders, and trendy lattes. At The Alchemist’s Kitchen, a coffee shop in New York City, an Iced Ayurvedic Cacao—a blend of cacao, ashwagandha, ginger, chaga, reishi, and lion’s mane mushrooms—costs $8 before tax and tip.
Most wellness influencers don’t clarify any nuances when they recommend a beloved herb. For clinical herbalist Maddie Miles, when people experience negative effects, the culprit isn’t the herb at all. Instead, it’s the quality of the supplement, or the lifestyle of the user. On her podcast peace.love.hormones, she asked listeners to ponder: “Was it a standardized extract? Is the culprit more likely the person’s diet? Does the person need to detoxify?” She argues that if the body has not properly eliminated “toxins” or if a person is already dealing with chronic inflammation, poor diet, or an “anger-filled lifestyle,” a restorative builder herb like ashwagandha will only make things worse.
Even when nuance is articulated, a social media follower isn’t necessarily going to read the fine print. Sood, a double board-certified physician, posts videos detailing how ashwagandha is an adaptogen that can benefit people with anxiety and help with stress. These mentions are often framed with the positive, powerful language of “resilience” and “core defense” systems. While Sood responsibly caveats these claims—noting evidence for cognitive benefits is “inconsistent,” and warning of serious side effects like liver damage and increased thyroid hormone—the positive hook is what grabs the consumer. The positive hook is what grabbed me. Similarly, lifestyle content creators like McDonald promote entire lists of these adaptogens, including ashwagandha and elderberry, in the context of solving modern problems like burnout. The messaging is simplistic and seductive: Take this if you’re not feeling well and you’ll feel better. And who wouldn’t want to feel better?
I know I did. But it wasn’t as simple as buying a powder and calling it a day. For me, as soon as I stopped taking these herbs, my rashes faded, my energy improved, and the pins and needles across my body eased. Thanks to time, prescribed medications, and guidance from my health care team, I’ve reached a place where I can manage my autoimmune diseases effectively. For anyone navigating chronic conditions, this experience is a reminder: The safest path is often the simplest: Trust your doctors, be cautious with unregulated supplements, and give your body the care it truly needs.
