Public knowledge, safety perceptions, and use patterns of ashwagandha (Withania somnifera) among Saudi adults: a...

Withania somnifera, commonly known as ashwagandha, is a widely used herbal remedy with reported anxiolytic and adaptogenic properties. Despite its growing use globally and regionally, comprehensive public understanding of its pharmacological benefits, safety, and potential risks remains limited within the Saudi Arabian context. This study aimed to evaluate knowledge, safety perceptions, pharmacological awareness, and patterns of ashwagandha use among Saudi adults using a mixed-methods approach.

A convergent mixed-methods design was employed, incorporating a cross-sectional survey of 508 participants and semi-structured interviews with 20 participants. Data were collected over a 6-month period from August 2025 to January 2026. Quantitative data were analyzed using descriptive statistics, inferential tests, and multiple linear regression analyses to identify predictors of knowledge and attitudes. Qualitative data were thematically analyzed to explore participants' experiences, motivations, and safety concerns. Quantitative and qualitative findings were integrated during the interpretation phase.

Overall knowledge and pharmacological awareness of ashwagandha were limited, with nearly half of the participants demonstrating low knowledge levels. Social media and informal networks were the primary sources of information, whereas healthcare professionals were rarely consulted. Positive perceptions of ashwagandha were associated with previous use, frequent use, and a self-reported history of anxiety-related symptoms or conditions. Qualitative findings indicated that ashwagandha use was generally sporadic and motivated by stress management. Participants commonly described cautious, self-regulated use because of concerns about side effects and long-term safety. Some participants also reported using ashwagandha concurrently with other herbal supplements or dietary supplements, raising concerns about potential supplement-supplement interactions and cumulative adverse effects.

Ashwagandha use among Saudi adults appears to be influenced primarily by personal experience and psychological factors rather than formal knowledge or professional guidance. Reliance on informal information sources, limited pharmacological awareness, and concerns regarding the safety of combining herbal supplements highlight the need for targeted public health education and greater involvement of healthcare professionals. These findings emphasize the importance of improving public understanding of the pharmacological properties, potential risks, interactions, and safe use of herbal medicines.