Does Ashwagandha Help With Heart Palpitations?

No clinical trial has tested ashwagandha specifically as a treatment for heart palpitations. The herb has, however, been studied for stress, anxiety, and cortisol reduction, all of which are common triggers for the sensation of a pounding or racing heart. That indirect connection is the basis for most claims you will find online, and the reality is more complicated than supplement marketing suggests. In at least one documented case, ashwagandha actually caused a dangerous heart rhythm disturbance by pushing thyroid hormone levels too high.

Why Palpitations Happen and Where Ashwagandha Fits In

Heart palpitations feel like your heart is racing, fluttering, or skipping beats. Most of the time they are harmless and fleeting. The triggers span a wide range: caffeine, dehydration, hormonal shifts during menstruation or perimenopause, thyroid disorders, low iron, and certain medications. But one of the most common triggers is psychological stress and anxiety. When your body’s stress response fires, it floods your system with cortisol and adrenaline, speeding your heart rate and sometimes producing that uncomfortable awareness of your own heartbeat.

This is the gap ashwagandha is thought to fill. Its best-supported effect in humans is lowering perceived stress and measurably reducing cortisol. If your palpitations are driven by stress or anxiety, the logic goes, calming the stress response should calm the heart. That logic is reasonable but unproven for palpitations specifically. No researcher has enrolled people with palpitations, given half of them ashwagandha, and tracked whether the episodes decreased. Everything below is about how the dots might connect, not proof that they do.

The Stress and Cortisol Connection

The strongest human evidence for ashwagandha relates to stress and the hormonal cascade that accompanies it. A 2024 systematic review and meta-analysis pooling data from multiple randomized controlled trials found that ashwagandha significantly reduced scores on the Perceived Stress Scale and the Hamilton Anxiety Scale compared to placebo, and also lowered serum cortisol levels.¹ An earlier trial in stressed but otherwise healthy adults found that ashwagandha reduced morning cortisol and another adrenal hormone called DHEA-S, suggesting it dials down the body’s stress-response system rather than just masking the feeling of being stressed.²

A review of ashwagandha’s endocrine effects concluded that the herb normalizes adrenal activity and lowers cortisol through the same central pathway, with downstream benefits for hormonal balance in both men and women.³ If your palpitations tend to arrive during periods of high stress, poor sleep, or generalized anxiety, this cortisol-lowering effect is the most plausible mechanism by which ashwagandha could help. But “plausible” is doing a lot of work in that sentence. Stress reduction through exercise, therapy, or better sleep hygiene has the same theoretical benefit, and none of those carry the supplement-specific risks discussed later.

Heart Rate Variability and the Autonomic Nervous System

Heart rate variability (HRV) is a measure of the tiny fluctuations in time between consecutive heartbeats. Higher HRV generally reflects a healthier balance between your sympathetic nervous system (the “fight or flight” branch) and your parasympathetic nervous system (the “rest and digest” branch). People with chronically low HRV tend to be more prone to stress-related cardiovascular symptoms, including palpitations.

A randomized, placebo-controlled trial in overweight, middle-to-older-age adults experiencing high stress and fatigue found that ashwagandha significantly increased HRV compared to placebo. The researchers suggested the effect may work through the autonomic nervous system, shifting the balance toward parasympathetic activity.⁴ Another trial using a different ashwagandha formulation also found early improvements in HRV measures at the two-week mark in stressed adults.⁵

This is an interesting breadcrumb for anyone with stress-driven palpitations. A shift toward parasympathetic dominance should, in theory, reduce the kind of racing or pounding heartbeat that stress triggers. But these studies were not designed to measure palpitations, and the participants were not selected because they had palpitations. The HRV improvement is a promising biomarker, not proof that episodes of heart fluttering would actually decrease.

GABA Activity and the Calming Effect

Beyond cortisol, ashwagandha appears to work through GABA, the brain’s main inhibitory neurotransmitter. GABA is essentially the nervous system’s brake pedal: when GABA signaling is strong, neural activity slows down and you feel calmer. A BMJ review of emerging anxiety treatments noted that ashwagandha is believed to enhance GABA activity, including inhibitory effects in the amygdala, the brain region central to fear and anxiety processing. In one trial cited in that review, about 88% of participants taking ashwagandha met the criteria for clinical response on an anxiety scale at six weeks, compared to 50% on placebo.

Laboratory work on mammalian nerve cells has confirmed that an aqueous ashwagandha extract directly activates GABA-type receptors, with a certain subtype of those receptors being particularly sensitive to the extract.² This dual action, dampening the stress-hormone axis while also boosting the brain’s own calming neurotransmitter, could explain why many users describe ashwagandha as producing a general sense of relaxation. And if your heart palpitations are essentially the cardiovascular echo of an anxious brain, that relaxation could reduce them. But this chain of reasoning has not been tested end to end in any human study.

When Ashwagandha Can Actually Cause Palpitations

Here is where the story takes an important turn. Ashwagandha has a well-documented ability to stimulate thyroid function. For people with sluggish thyroids, that might sound like a benefit. But if thyroid levels rise too high, the result is hyperthyroidism, and one of its hallmark symptoms is a fast or irregular heartbeat.

A published case report describes a 73-year-old woman who had been taking ashwagandha root extract for two years to self-treat her hypothyroidism. She presented to the hospital with supraventricular tachycardia, a type of abnormally fast heart rhythm originating above the heart’s lower chambers, along with classic symptoms of an overactive thyroid and very low TSH levels. Her symptoms resolved completely, and her thyroid blood work improved, after she stopped taking the supplement.⁶

This is not an isolated curiosity. The review of ashwagandha’s endocrine effects confirms that the herb can improve thyroid secretory function.³ For someone whose thyroid is already in the normal range, or who is already on thyroid medication, pushing thyroid hormones higher is a direct route to palpitations, not a cure for them. If you are taking ashwagandha and notice your palpitations getting worse rather than better, thyroid overstimulation is a real possibility worth discussing with a doctor.

Animal Studies on Cardioprotection

Some online sources cite ashwagandha’s “cardioprotective” properties as a reason it might help with palpitations. The evidence behind that claim comes almost entirely from animal research, and it addresses a different kind of cardiac problem than palpitations.

In one study, rats given ashwagandha before an experimentally induced heart attack showed significantly less heart-muscle damage, and the researchers attributed this to the herb’s ability to boost the heart’s own antioxidant defenses.⁷ A separate rat study found that ashwagandha reduced injury from blood flow being cut off and then restored to the heart, again through antioxidant pathways.⁸ These findings are interesting for researchers studying heart attacks and ischemic injury, but they have almost nothing to do with the benign palpitations most people experience. Protecting heart muscle from oxygen deprivation is not the same as stopping a fluttery heartbeat during a stressful workday.

In Ayurvedic tradition, ashwagandha has been categorized as a “rasayana,” a rejuvenating tonic, and has been described alongside other herbs as beneficial for cardiac ailments broadly. That traditional framing informs how ashwagandha is marketed today, but traditional use is not the same as clinical evidence for a specific symptom.

Palpitations During Perimenopause

Heart palpitations are surprisingly common during perimenopause, the years leading up to menopause when estrogen levels swing unpredictably. Many women are caught off guard by them because palpitations are not discussed as often as hot flashes or mood changes. The hormonal turbulence directly affects heart rhythm: estrogen has regulatory effects on cardiac ion channels, and wild fluctuations can make the heart more electrically irritable.

A randomized, placebo-controlled trial in perimenopausal women found that ashwagandha supplementation significantly reduced overall menopausal symptoms, including the “somato-vegetative” category, which covers physical symptoms like hot flashes and cardiovascular complaints. Women taking ashwagandha also had a significant increase in serum estradiol and reductions in FSH and LH compared to placebo.⁹ The hormonal shifts measured in this trial, particularly the rise in estradiol, could theoretically stabilize cardiac rhythm in women whose palpitations are linked to fluctuating estrogen. But the study measured symptom scores across broad categories, not palpitation episodes specifically, so any benefit to heart rhythm is inferred rather than demonstrated.

If you are in perimenopause and experiencing palpitations alongside other climacteric symptoms, this is probably the most relevant piece of evidence to discuss with your healthcare provider, though they will likely want to rule out thyroid problems and cardiac arrhythmias before endorsing any supplement.

Liver Safety and Other Risks Worth Knowing

Ashwagandha is generally well tolerated in clinical trials lasting up to about three months, but a growing number of case reports have flagged liver injury as a rare but serious risk. Cases of liver damage linked to ashwagandha supplements have been reported across multiple countries, and at least one case required a liver transplant.¹⁰ A separate review noted cases from Japan, Iceland, India, and the United States, and emphasized that the metabolic pathways of ashwagandha’s active compounds are still not fully understood.¹¹

These cases do not mean ashwagandha is broadly dangerous, but they do mean it is not the risk-free natural remedy some sellers imply. The unregulated supplement market adds another layer of uncertainty: ashwagandha products vary widely in the concentration and type of active compounds they contain, and contamination with heavy metals or other adulterants has been documented in herbal supplements more broadly. If you are taking ashwagandha and develop nausea, dark urine, upper-right abdominal pain, or yellowing of the skin, stop taking it and get your liver function tested.

What You Should Do If You Have Palpitations

The most important step if you are experiencing recurring palpitations is not deciding which supplement to try. It is figuring out what is causing them. Most palpitations are benign, but some reflect arrhythmias, valve problems, or metabolic disorders that need treatment. A basic workup typically includes an electrocardiogram, blood tests for thyroid function and electrolytes, and sometimes a Holter monitor that records your heart rhythm over 24 to 48 hours. That evaluation takes a day or two and can save you months of guessing.

If your palpitations turn out to be stress-related and structurally benign, the evidence for nonpharmacological stress management is actually quite reasonable. A review in JAMA noted that approaches like relaxation therapy, yoga, meditation, controlled slow breathing, and biofeedback are all appropriate to consider for managing the cardiac effects of emotional stress.¹² Ashwagandha might belong somewhere on that list, but it sits at the speculative end because it has not been tested for this specific indication. Controlled breathing, on the other hand, can slow a racing heart in minutes and carries exactly zero risk of thyroid overstimulation or liver injury.

How Ashwagandha Interacts With Heart Medications

If you are already on medication for a heart condition, adding ashwagandha introduces interaction risks that are poorly studied. Beta-blockers, commonly prescribed for palpitations and anxiety-related tachycardia, lower heart rate and blood pressure. Ashwagandha’s calming effects on the autonomic nervous system could theoretically amplify those effects, pushing heart rate or blood pressure too low. The same concern applies to calcium channel blockers and some antiarrhythmic drugs.

Ashwagandha’s thyroid-stimulating properties create a more specific conflict for anyone taking levothyroxine or other thyroid hormone replacement. As the case report of the 73-year-old woman illustrates, the herb can push thyroid levels beyond the therapeutic range, potentially destabilizing a condition your medication was designed to control.⁶ People on blood thinners like warfarin should also exercise caution, as some herbal supplements can alter drug metabolism through liver enzyme effects. Given the reports of ashwagandha-associated liver injury, anyone with existing liver compromise has an additional reason to be cautious.¹¹

None of this means ashwagandha is categorically off-limits if you take heart medication, but it does mean starting it without telling your doctor is a bad idea. The herb is pharmacologically active, and pharmacologically active substances interact with other pharmacologically active substances. Treating it as “just a supplement” underestimates what it actually does in the body.