NutriStack
Ashwagandha and Propranolol, a caution.
Ashwagandha lowers cortisol and dampens sympathetic activity, which can modestly reduce heart rate and blood pressure. Combined with propranolol, the effect can be additive, especially in patients using propranolol for anxiety, performance, or tremor.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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At a glance
- Substances
- Ashwagandha and Propranolol
- Pair type
- Caution
- Evidence (highest tier)
- Emerging
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Emerging evidence
Caution
What is happening. Ashwagandha lowers cortisol and dampens sympathetic activity, which can modestly reduce heart rate and blood pressure. Combined with propranolol, the effect can be additive, especially in patients using propranolol for anxiety, performance, or tremor.
Mechanism. Withanolides in ashwagandha modulate HPA-axis output, lowering cortisol and sympathetic tone. This complements propranolol's beta-receptor blockade, producing additive reductions in heart rate and stress reactivity.
Recommendation. Ashwagandha 300-600 mg/day is generally compatible with propranolol but check resting heart rate and blood pressure when starting. Reduce the dose if HR drops below 50 bpm or you become dizzy.
Sources (2)
- Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019;98(37):e17186. PMID 31517876
- Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med. 2012;34(3):255-62. PMID 23439798
Stack Score
How this pair moves the number.
Effect on the composite score
If both Ashwagandha and Propranolol are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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