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CBD vs Ashwagandha: Better Stress Data, and a Liver Safety Signal

On stress, ashwagandha has better trial data than CBD, with meta-analyses reporting large effect sizes. It also has a liver injury signal serious enough that the US National Institutes of Health rates it a highly likely cause of clinically apparent liver injury, and at least one EU member state has banned it from food supplements outright. Both of those facts belong in the same conversation.

About this page. This is editorial science writing, not product information. It describes what published research has reported and what European regulation says. Under Regulation (EC) No 1924/2006 no health claim for any cannabinoid is authorised in the EU, so nothing here states or implies that any product will produce a health effect for you. Descriptions of trial results are reports of what researchers measured in their study populations, at the doses they used. Where a compound is discussed alongside an Endoca product, see the applicable product page for the information EU law permits us to give.

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At a glance

Property
Ashwagandha
CBD
What it is
Root extract of a nightshade-family shrub
A cannabis plant compound
Active constituents
Withanolides
Cannabidiol
Proposed mechanism
HPA axis and cortisol modulation, GABAergic activity. Not firmly established
ENT1 transporter, TRPA1, 5-HT1A, GPR55
Stress and anxiety evidence
12 RCTs, 1,002 participants, large effect sizes, certainty rated low
8 trials, 316 participants, modest effect at 300 to 800 mg
Liver safety
NIH LiverTox likelihood score B, highly likely. Reported deaths in people with existing liver disease
Transaminase elevations in around 9 percent of epilepsy trial patients
Denmark
Banned in food supplements since 2023
Unauthorised novel food, as EU-wide
Authorised EU health claims
None. Ten claims sit on the transitional on-hold list
None
EU medicine
None. No EMA herbal monograph could be established
Epidyolex

The evidence on stress, weighed honestly

Ashwagandha
A 2022 meta-analysis of 12 randomised controlled trials in 1,002 participants found a standardised mean difference of minus 1.55 for anxiety and minus 1.75 for stress, both statistically significant, with a favourable dose response between 300 and 600 mg daily.
Heterogeneity was very high, above 93 percent for anxiety, meaning the trials disagreed substantially with one another.
And the authors rated the certainty of the evidence as low for both outcomes.
CBD
CBD's anxiety evidence is a meta-analysis of eight trials in 316 participants showing a significant effect, with a confidence interval nearly crossing zero and doses typically of 300 to 800 mg given acutely.
Ashwagandha has more supportive trial data for stress than CBD does.

Under EU law neither of us may present either of those as a benefit of a product, and we are not doing so. We are describing published research.

What people get wrong

01 Ashwagandha is safe because it is traditional.
Traditional use is not a safety dataset. The liver cases involved products verified to contain ashwagandha and nothing else.
02 It lowers cortisol, so it reduces stress.
The mechanism is proposed rather than established, and trial heterogeneity is very high.
03 CBD and ashwagandha work better together.
No trial has tested that combination. Both are metabolised hepatically and both carry liver signals.
04 If it were unsafe it would be banned.
In Denmark it is.

How Endoca tests for this

We do not put ashwagandha in our products. Given the liver injury case series, the NIH likelihood score, and the position taken by several European regulators, we are not comfortable adding it to a supplement. In at least one of the markets we sell into, we could not lawfully do so in any case.

We would rather explain that than quietly leave it out.

Frequently asked questions

There is no harmonised position. Denmark has banned it in food supplements. Poland caps the dose. Several member states have issued avoidance advice for specific groups. It remains on sale in others.

On the basis of a national risk assessment citing liver damage cases, effects on sex and thyroid hormones, and the conclusion that no safe intake could be determined.

Ashwagandha, and that has to be weighed against its safety profile.

No trial has tested it, and both are metabolised in the liver.

No. Ashwagandha has claims on hold, which is not authorisation. CBD has none.

References

01

NIH LiverTox. Ashwagandha. NIDDK, updated 3 December 2024.

02

Bjornsson HK et al. Liver Int 2020;40:825-829.

03

Philips CA et al. Hepatol Commun 2023;7:e0270.

04

Akhgarjand C et al. Meta-analysis of 12 RCTs on ashwagandha, stress and anxiety, 2022.

05

Han B et al. Psychiatry Res 2024;339:116049.

06

Brendler T et al. Ashwagandha: Is It Safe? Part 1: A Regulatory Review. Phytother Res 2026;40:4845-4857.

07

Williamson EM, Brendler T. Ashwagandha: Is It Safe? Part 2. Phytother Res 2026;40:4792-4801.

08

EFSA Journal 2026;24:9862.

Last reviewed 1 September 2026.

Educational information about published research and European regulation. Not a health claim.