Supplement: Panax Ginseng (Aziatische ginseng)

What It Is

Asian ginseng is the root of Panax ginseng, a slow-growing plant native to the mountains of Korea, northeastern China, and eastern Russia. Chinese medicine calls it Ren Shen. Its activity is credited to a family of saponins called ginsenosides, the compounds most of the research tracks.

Three plants are often confused with it:

• Siberian eleuthero, sometimes sold as Siberian ginseng, is not a true ginseng at all.
• American ginseng, Panax quinquefolius, is a close cousin but a distinct root.
• Korean red ginseng is the same Panax ginseng root steamed and dried, a process that changes its chemistry and how the tradition uses it.

Anatomy of the Practice

1The ginsenosides

Laboratory work traces the ginsenosides to four systems at once: stress hormones, inflammation, blood-vessel signaling, and blood sugar handling.

2Over days and weeks

Taken daily, ginseng is used for tiredness, low stamina, and recovery from illness. In the trials the effect size is modest and uneven.

What It Does

A 2018 review of 10 randomized trials of Asian and American ginseng found modest evidence the root reduced fatigue, including in people worn down by chronic illness and cancer treatment. Those trials were small and varied in design. A separate trial of 90 adults with idiopathic chronic fatigue tested Panax ginseng at 1 to 2 grams a day. It did not clearly beat placebo on the overall fatigue score. Mental fatigue improved, though, and at 2 grams a day people rated their tiredness lower on a sliding 0-to-10 scale. The broader fatigue findings show where the root ranks among the options.

A 2008 review of seven randomized trials concluded Korean red ginseng outperformed placebo for erectile function. A meta-analysis pooled six placebo-controlled trials, 349 men in total. Men taking ginseng were about 2.4 times as likely as those on placebo to report improvement. A double-blind crossover trial in 2002 recorded gains on the International Index of Erectile Function at 900 mg three times a day. These trials are small and short, several come from the same region and research groups, and larger independent trials are still lacking.

For blood sugar, a 2014 meta-analysis of 16 randomized trials found ginseng lowered fasting blood glucose by about 6 mg/dL (0.31 mmol/L). It showed no clear effect on longer-term markers like HbA1c. That blood sugar signal is small next to diet and movement, since type 2 diabetes tracks closely with ultra-processed food built on sugar, fat, and salt.

The evidence for a mental boost is weaker than the popular claim suggests. A single 400 mg dose of a standardized extract improved a working-memory task and calmness ratings in 30 healthy young adults in a 2010 study. A 2010 Cochrane review of nine longer-term trials judged them too few and too inconsistent to support ginseng for memory or thinking.

For the common cold, a 2011 review pooled five trials, four testing American ginseng and one testing Asian ginseng, the Ginsana G115 extract. The American-ginseng trials cut colds by about 25% in one and shortened them by about 6.2 days in two. The single Asian-ginseng trial showed the largest drop in the risk of catching a cold, and the review still judged the overall evidence insufficient. Direct evidence for Panax ginseng rests on that one small trial.

Most of these trials were small and mixed in design, and many were funded by companies that sell ginseng. Industry funding raises the risk of bias, and independent replication is thin.

One problem runs under all of it: in a single analysis of 25 products, the active ginsenoside content varies 15- to 36-fold between commercial products.

The Research & Studies

Everything here is based on the research we have collected and checked, sorted into groups and ordered with the strongest evidence first. Click any claim to open the studies behind it.

Energy And Fatigue

Modest fatigue relief across ten trials of Asian and American ginsengEmerging

In plain terms

Ginseng seems to ease fatigue for some people, by a small amount, with the effect building over weeks.

In detail

A systematic review of ten trials of Asian and American ginseng found modest evidence that ginseng reduced fatigue, including in people worn down by chronic illness and cancer treatment. A separate randomized trial of 90 adults with idiopathic chronic fatigue found that Panax ginseng at 1 to 2 g a day did not clearly beat placebo on the overall fatigue score, though mental fatigue improved and the 2 g dose lowered the visual-analogue fatigue score. Measured in: Adults with fatigue, including cancer-related and chronic-illness fatigue and idiopathic chronic fatigue, across small randomized trials. The trials were small and heterogeneous in design and dose, and several were funded by makers of ginseng, so the size of the effect is uncertain even though the direction is consistent.

Who this may not transfer to:The review and the antifatigue trial enrolled both men and women, so the finding applies across sexes.

The studies · 2

Arring et al., Ginseng as a Treatment for Fatigue: A Systematic Review · J Altern Complement Med 2018;24(7):624-633

Kim et al., Antifatigue effects of Panax ginseng C.A. Meyer: a randomised, double-blind, placebo-controlled trial · PLoS One 2013;8(4):e61271

Sexual Function

Better erectile function than placebo across seven trialsEmerging

In plain terms

Korean red ginseng beat placebo for erectile difficulty in small trials, with men about 2.4 times as likely to report improvement, though larger and more independent studies are still needed.

In detail

A systematic review of seven randomized trials concluded Korean red ginseng performed better than placebo for erectile function, with a meta-analysis of six placebo-controlled trials (n = 349) finding men about 2.4 times as likely to report improvement, and a double-blind crossover trial found improvement on the International Index of Erectile Function at about 900 mg three times a day. Measured in: Men with erectile dysfunction across small, mostly short randomized trials. The trials are small and short, several come from the same region and research groups, and larger independent confirmation is still lacking.

Who this may not transfer to:Erectile function is a male outcome, so the trials enrolled men by design; the finding does not transfer to another sex.

The studies · 2

Jang et al., Red ginseng for treating erectile dysfunction: a systematic review · Br J Clin Pharmacol 2008;66(4):444-450

Hong et al., A double-blind crossover study evaluating the efficacy of Korean red ginseng in patients with erectile dysfunction · J Urol 2002;168(5):2070-2073

Blood Sugar

Fasting glucose about 6 mg/dL (0.31 mmol/L) lower, with no HbA1c changeEmerging

In plain terms

Ginseng lowers fasting blood sugar a little, about 6 mg/dL (0.31 mmol/L), but it did not clearly move the longer-term measures that matter most for diabetes.

In detail

A meta-analysis of sixteen randomized controlled trials found ginseng lowered fasting blood glucose by about 6 mg/dL (0.31 mmol/L) compared with control, without a clear effect on longer-term glycemic markers such as HbA1c or on fasting insulin. Measured in: Adults with and without diabetes across randomized controlled trials of ginseng. The reduction in fasting glucose was small and the trials were heterogeneous in the ginseng type and dose used, and the absence of a clear HbA1c effect limits what it means for real diabetes control.

Who this may not transfer to:Trials enrolled adults of both sexes, so the finding applies across sexes.

The study · 1

Shishtar et al., The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials · PLoS One 2014;9(9):e107391

Cognition

One 400 mg dose improved working memory and calmness in 30 young adultsPreliminary

In plain terms

One 400 mg dose of a standardized ginseng extract slightly sharpened working memory and left 30 healthy young adults feeling calmer in a small study.

In detail

A single 400 mg dose of a standardized Panax ginseng extract (G115) improved a working-memory task (mental arithmetic) and subjective ratings of calmness among 30 healthy young adults in one small randomized crossover trial, while a 200 mg dose slowed the same task. Measured in: Healthy young adults in a single small randomized crossover trial of acute dosing. This is a single small trial of a one-off dose in young healthy people, not a test of taking ginseng over time, so it says little about lasting cognitive benefit.

Who this may not transfer to:The crossover trial enrolled healthy young adults of both sexes; it does not test older adults or people with cognitive complaints.

The study · 1

Reay et al., Panax ginseng (G115) improves aspects of working memory performance and subjective ratings of calmness in healthy young adults · Hum Psychopharmacol 2010;25(6):462-471

Nine trials, too few and inconsistent to show a memory benefitPreliminary · mixed

In plain terms

When researchers pooled the nine studies on taking ginseng over time for memory, there were too few good trials to say whether it helps.

In detail

A Cochrane review of nine randomized trials of ginseng for cognition concluded that the available trials were too few, too small, and too inconsistent to establish whether ginseng improves memory or thinking with ongoing use. Measured in: Adults across the randomized trials of ginseng for cognitive function pooled in the Cochrane review. The limitation is the thinness and inconsistency of the trials, not a demonstrated absence of effect, so this is where the literature has not yet looked well, not a settled null.

Who this may not transfer to:The pooled trials enrolled adults of both sexes; the limitation is the thinness of the evidence, not a sex difference.

The study · 1

Geng et al., Ginseng for cognition (Cochrane review) · Cochrane Database Syst Rev 2010;(12):CD007769

Respiratory Infection

Four of five cold trials tested American ginseng, one tested Asian ginsengPreliminary · mixed

In plain terms

Most trials of ginseng for colds used the American species, but one small trial did test the Asian ginseng this page is about and found a lower risk of catching a cold, so the direct evidence for Panax ginseng exists but rests on a single study.

In detail

A systematic review of ginseng for preventing the common cold found five trials in 747 adults: four tested North American ginseng (Panax quinquefolius) and one tested Asian ginseng (Panax ginseng), the Ginsana G115 extract. North American ginseng cut the number of colds by about 25% in one trial and shortened colds by about 6.2 days in two, and in a subgroup analysis the single Asian-ginseng trial showed the largest reduction in the risk of catching a cold or respiratory infection, though overall the review judged the evidence insufficient. Measured in: Healthy adults across five cold-prevention trials, four of North American ginseng and one of Asian ginseng. Only one small trial tested Asian ginseng for colds, so the direct evidence for Panax ginseng rests on a single study, and the trials varied in quality.

Who this may not transfer to:The trials enrolled adults of both sexes; four tested American ginseng and one tested Asian ginseng, so the direct evidence for Panax ginseng comes from a single trial.

The study · 1

Seida et al., North American (Panax quinquefolius) and Asian Ginseng (Panax ginseng) Preparations for Prevention of the Common Cold in Healthy Adults: A Systematic Review · Evid Based Complement Alternat Med 2011;2011:282151

How it works

Tientallen ginsenosiden werken tegelijk in op veel systemenPreliminary · mixed

In plain terms

Ginseng werkt via veel stoffen die tegelijk op veel systemen werken, wat mensen bedoelen als ze het een adaptogeen noemen.

In detail

Ginseng bevat tientallen ginsenosiden die tegelijk op veel biologische doelen inwerken, met in het laboratorium beschreven effecten die stresshormonen, ontsteking, bloedvatsignalering en glucoseverwerking omspannen, wat de basis is voor het beschrijven ervan als adaptogeen. Dit zijn mechanismen die grotendeels worden beschreven in laboratorium- en dierwerk, en een breed multi-doelprofiel voorspelt op zichzelf geen klinisch effect bij mensen.

Who this may not transfer to:These are laboratory and animal mechanisms, not a study measured in people.

The study · 1

Attele et al., Ginseng pharmacology: multiple constituents and multiple actions · Biochem Pharmacol 1999;58(11):1685-1693

How It Works

Ginseng does not work through one mechanism. A 1999 review described dozens of ginsenosides with effects spread across the body, the breadth behind the label adaptogen, a substance thought to help the body hold steady under stress. A compound acting on four or more systems is harder to test cleanly than one with a single target.

Getting It Right

Ways to Do It

Match what you take to what you want from it. For ordinary tiredness, the free basics do more than any tonic. If you do buy, product quality matters more here than for almost any supplement.

1

Cover the basics firstFreeEasy

For everyday fatigue, consistent sleep, regular movement, and whole food do more than any root. Persistent tiredness is worth a check for low iron or a thyroid problem. Ginseng adds to the basics; it does not replace them.

2

A standardized extract$Easy

The clinical trials that worked mostly used a standardized extract, such as the G115 preparation fixed at about four percent ginsenosides, at roughly 200 to 400 mg a day. A standardized extract states its ginsenoside percentage; an unstandardized one does not, so you cannot know the dose. Look for that percentage printed on the label.

3

Korean red ginseng$ to $$Easy

Korean red ginseng is the steamed and dried root, used at around one to two grams a day of the root or an equivalent extract. It is the form behind much of the fatigue and erectile-function research.

4

For erectile function, the trial dose with a clinician$$Moderate

The erectile-function trials used higher doses, commonly around 900 mg of Korean red ginseng three times a day. If this is the goal, raise it with a clinician. Treatable causes of erectile difficulty should be ruled out first, and ginseng interacts with several medicines (see Cautions).

5

Buy a product that states and verifies its content$ to $$Easy

Ginsenoside content varies widely between brands. A stated ginsenoside percentage plus an independent test mark are what tell you a product matches its label. That verified label affects the dose you actually get more than any change to the amount you take.

6

Whole root at home, or a standardized capsuleFree to $$Moderate

The traditional way is to simmer slices of the dried root into a decoction or broth, as in Korea and China for centuries. It is cheap once you have the root, but you cannot tell how strong each dose is. The modern way is a standardized capsule with a known dose.

Go Deeper

• Fatigue: where the root's modest fatigue signal sits among everything else that helps, and why a check for iron or thyroid comes first.
• Erectile dysfunction: the treatable causes to rule out, and how the seven-trial Korean red ginseng evidence compares.
• Ashwagandha: another traditional tonic with a modern evidence base, useful to compare against ginseng on stress and vitality.

The Chinese Medicine View

In Chinese medicine, Ren Shen has been used for more than 2,000 years for depletion and exhaustion. It is the chief herb for tonifying the Yuan Qi, the original or source Qi, the body's deepest reserve of vitality. Warm and sweet, it enters the Lung and Spleen channels. It is reached for in profound depletion: exhaustion, collapse, shortness of breath, a weak pulse, the aftermath of severe illness or blood loss. It is also said to calm the spirit and benefit the fluids.

Because it is a warming tonic that adds, it can aggravate heat and excess. Someone with signs of heat, high blood pressure of a full type, an acute infection, or strong agitation is a poor candidate. Classical texts warn against use in these states. The tradition reaches for it in emptiness and warns against it in a congested or overheated body.

A practitioner matches the herb to the person's constitution before prescribing it. The modern trials happen to find the clearest effects in people who are depleted, fatigued, or recovering, the same group the tradition treats, an overlap worth thinking about, not confirmation that the tradition's reasoning about Qi was correct. Healthy young adults, like the 30 in the cognition study, show the least.

Cautions For This Practice

Everything to be aware of is here, in one place. This practice suits most healthy people; a few situations call for real care.

Generally well tolerated, with headache, sleep, and stomach upset the most common effects

A systematic review of adverse effects found the rate of adverse events with Panax ginseng monopreparations is similar to placebo, the most common being headache, sleep disturbance, and gastrointestinal upset, with documented interaction concerns for the blood thinner warfarin, the antidepressant phenelzine, and alcohol; ginseng's blood-sugar-lowering effect also warrants caution with diabetes medicines. Rapportage van ongewenste effecten in de ginsenstudies is inconsistent, en het bewijs voor interacties berust deels op casuïstiek, geen gecontroleerde studie, dus voorzichtigheid rond de genoemde geneesmiddelklassen is gerechtvaardigd.Coon and Ernst, Panax ginseng: a systematic review of adverse effects and drug interactions

Ginsenosidegehalte varieerde 15- tot 36-voudig over 25 producten

Een laboratoriumanalyse van 25 commerciële ginsengproducten vond dat de concentratie van ginsenosiden 15-voudig varieerde over capsules en 36-voudig over vloeistoffen, dus de werkelijke dosis van de actieve stof die een consument ontvangt, kan vele malen verschillen tussen merken die als ginseng zijn gelabeld. De variatie betekent dat een positieve studie van één gestandaardiseerd extract niet kan worden aangenomen van toepassing te zijn op een ongestandaardiseerd product, en dat een vermeld ginsenosidegehalte hier meer van belang is dan bij de meeste supplementen.Harkey et al., Variability in commercial ginseng products: an analysis of 25 preparations

Blood thinners, especially warfarin

Ginseng may reduce the effect of warfarin, a common blood thinner, which could matter for someone relying on it. If you take warfarin or another anticoagulant, tell your prescriber before starting ginseng, so your INR can be watched.

Diabetes medication and blood sugar

Because ginseng can lower blood sugar by a small amount, taking it alongside insulin or other diabetes medicines could push blood sugar lower than intended. If you are treated for diabetes, raise it with your clinician and keep an eye on your readings when you start or stop.

Headache, sleep, and stomach upset

The most common complaints are headache, sleep disturbance, and stomach upset, and some people notice restlessness or a rise in blood pressure. Taking ginseng earlier in the day, and starting at a lower dose, are simple ways to see how it sits with you. If you have poorly controlled high blood pressure, discuss it first.

Pregnancy, breastfeeding, and hormone-sensitive conditions

Ginseng is generally not recommended in pregnancy or while breastfeeding, since it has not been established as safe in those situations. Some ginsenosides show mild estrogen-like activity in the laboratory, so anyone with a hormone-sensitive condition may want a clinician view before using it.

Other medicines and surgery

Ginseng can interact with several drug classes beyond the ones above, including some antidepressants, and its possible effect on bleeding means pausing it before planned surgery is reasonable. If you take regular medication, check with a pharmacist or clinician before adding ginseng.

Start slow, be smart, read the research, and consult a professional if you have any concerns. This is here to inform your choice, not make it for you.

Common Questions

How long before I'd notice anything?

Give it a few weeks. The effects on fatigue build gradually over that window, and they stay modest even at their best.