I have a patient with Hashimoto’s. Recently had lab work that came back with positive markers for rheumatoid arthritis. I haven’t actually seen the result. The patient has been on and off the autoimmune Paleo diet, has a difficult time adhering to it. Questions: Number one, do you know anything about ashwagandha and autoimmune disease? I see different ideas. It’s a nightshade so some practitioners say to stay off it.”

Dr. Amy Nett: Yes. I’m wondering what came back positive a little bit more specifically. That can be helpful because some of those markers are a little bit more nonspecific. We’ll just assume she’s unequivocally positive for RA and maybe has the joint kind. Remember that in the autoimmune Paleo diet it does exclude nightshades. Some patients with autoimmune conditions are sensitive to nightshades, but not all patients are. If I have a patient who has done a strict autoimmune Paleo diet, and then they’ve reintroduce nightshades and say, “I feel great. I do really well with tomatoes and peppers. I don’t notice anything.” Then I think it’s worth trying ashwagandha if it’s something that I want to use therapeutically. But if I have a patient who doesn’t tolerate nightshades, then I am going to be reluctant to use ashwagandha. It’s a nice herb too to be able to use in your toolkit, especially for HPA issues, but I think you can absolutely find other things to work around that. It will depend on the individual patient.