Moderate interactionModerate

Ashwagandha (KSM-66) and Levothyroxine: interaction, severity and spacing

Ashwagandha (KSM-66) and Levothyroxine interact because ashwagandha can raise circulating thyroid hormone levels, which stacks with levothyroxine and risks iatrogenic hyperthyroidism. Take them with care. Moderate risk.

Last reviewed: 2026-09-20Reviewed by: StackingRight clinical review

The interaction in detail

Summary of the Ashwagandha (KSM-66) and Levothyroxine interaction
PairAshwagandha (KSM-66) and Levothyroxine
TypeNutrient–drug interaction
SeverityModerate
Required spacingNone specified
OnsetAt the time of dosing

Mechanism

Ashwagandha can raise circulating thyroid hormone levels, which stacks with levothyroxine and risks iatrogenic hyperthyroidism.

What to do

Avoid or monitor thyroid labs closely if combining.

How to fit both into one day

Ashwagandha (KSM-66)
eveningflexible

Ashwagandha lowers cortisol and is mildly sedating, so evening dosing suits it. Avoid with thyroid medication without lab monitoring.

Levothyroxine
morningempty stomach

Levothyroxine needs an empty stomach and gastric acid for full absorption. Take it 30-60 minutes before breakfast with plain water, and keep calcium, iron and coffee at least 4 hours away.

Putting Ashwagandha (KSM-66) in the evening and Levothyroxine in the morning satisfies the 0-hour separation without disrupting either one's absorption window.

Ashwagandha (KSM-66) and Levothyroxine: common questions