Be aware that the U.S. Food and Drug Administration does not strictly
regulate herbs and dietary supplements. There is no guarantee of strength,
purity or safety of products containing or claiming to contain ginseng. Decisions
to use herbs or supplements should be carefully considered. Individuals using
prescription drugs should discuss taking herbs or supplements with their
pharmacist or health care provider before starting.
Asian ginseng (Panax ginseng), also known as Korean ginseng, and American
ginseng (Panax quinquefolium) should not be confused with Siberian
ginseng (Eleutherococcus senticosus). Scientists have studied Asian
and American ginseng for the following health problems:
Cognitive and psychomotor performance
Multiple studies report that ginseng may improve reaction times, psychomotor
performance during exercise, math skills and logical thinking in healthy
individuals. However, most research in this area has been poorly designed.
It is not clear what dose may be safe or effective. Further studies are needed
to determine who may benefit most from ginseng and whether long-term therapy
continues to add benefits to performance.
Ginseng has been studied alone or in combination with other herbs, such as
ginkgo, for memory and dementia in the elderly. Further research is needed
before a conclusion can be drawn.
Several studies suggest that ginseng may improve fatigue and reduce stress.
These symptoms are difficult to measure, and most research in this area has
been poorly designed. More research that focuses on specific areas of well-being
is needed to determine which groups of people may benefit most.
Although early studies suggest that ginseng may enhance exercise performance,
results from more recent studies disagree. Therefore, it is unclear whether
there is any benefit from using ginseng to improve exercise performance.
Immune system stimulation
A small number of studies report that ginseng may stimulate activity of immune
cells in the body, improve the effectiveness of antibiotics in people with
acute bronchitis, enhance the body's response to influenza vaccines and protect
against damaging side effects of radiation. Much of the research in this
area has been published by the same lead author. Additional studies, which
examine the effects of ginseng on specific types of infections, are necessary
before a clear conclusion can be reached.
Several studies suggest that ginseng may help lower blood sugar levels in
people with type 2 (non-insulin-dependent) diabetes. Early studies suggest
that ginseng may lower both fasting blood sugar levels and glucose levels
after meals, without causing blood sugar levels to fall too low. However,
these studies have been small, and further studies, conducted for longer
periods of time, are needed to compare ginseng with other drugs commonly
used to treat diabetes.
High blood pressure
Early evidence from a small number of poorly designed studies suggests that
ginseng may lower high blood pressure and improve the vascular endothelial
dysfunction in patients with high blood pressure. However, it is not clear
what doses may be safe or effective. Further research is needed before a
recommendation can be made.
Aplastic anemia, neutropenia
Early study using ginseng in combination with other herbs found an improvement
in people with aplastic anemia. However, there have also been reports of
blood cell counts dropping with ginseng use. Further research is needed,
as study results conflict.
There is one study in adults that suggests that ginseng has positive effects
on breathing function. Further studies are needed in this area.
A small number of studies report that ginseng taken by mouth may lower the
risk of being affected by various cancers, especially if ginger powder or
extract is used. However, most of these studies have been published by the
same research group and have used a type of research design (case control)
that can only be considered preliminary. Results may have been affected by
other lifestyle choices in people who use ginseng, such as exercise or dietary
habits. Additional trials are necessary before a clear conclusion can be
Ginseng has been suggested to improve postmenopausal symptoms in women. A
small number of studies report modest improvements in depression and sense
of well-being, without changes in hormone levels. However, these studies
have had flaws in their designs. Therefore, it is not clear what effects
ginseng has on postmenopausal symptoms, and it is not clear what dose may
be safe or effective.
Congestive heart failure
One study suggests that ginseng may provide benefits for treating congestive
heart failure. Another study suggests that red ginseng and digoxin had synergism
for treatment of congestive heart failure. However, these studies were small,
with flaws in their design. Therefore it is unclear whether there is any
benefit from ginseng for this condition.
Coronary artery disease
Although several studies have evaluated the role of ginseng in the relief
of chest pain (angina) and electrocardiogram changes, it is not clear what
effect ginseng has on coronary artery disease.
Diabetic kidney damage
Ginseng has been proposed as a possible therapy for kidney damage in people
with diabetes, but the only study that is specifically evaluating this has
several flaws in its design.
Several studies suggest that ginseng may help improve erectile dysfunction,
sex drive and satisfaction with sexual activities, but these studies are
small, with flaws in their design. Therefore, it is unclear whether ginseng
is of any benefit for erectile dysfunction.
Ginseng has been proposed to have beneficial effects in some cases of liver
damage. There is only limited research specifically evaluating this use in
humans, and it is not clear what dose may be safe or effective.
Early evidence suggests that ginseng may improve male fertility by increasing
sperm numbers and movement of sperm. Further studies are needed to determine
what dose may be safe and effective.
One study that used ginseng in combination with other herbs found that
combination therapy greatly improved sexual satisfaction in men with premature
ejaculation. However, there were flaws with this study, and it is not clear
whether benefits were the result of ginseng or other herbs in the formulation.
Ginseng may safely improve some aspects of mental health and social functioning
after four weeks of therapy. Further research is needed to confirm these
Ginseng (CVT-E002) may be safe, well tolerated, and potentially effective
for preventing acute respiratory illness caused by influenza or respiratory
syncytial virus. More study is needed.
Preliminary evidence in infants with peri-anal abscess or fistula-in-ano
shows that a treatment of GTTC (ginseng and tang-kuei ten combination) may
accelerate recovery. Further research is needed to confirm these results.
Preliminiary study of Xuesaitong injection (a preparation of Panax
notoginseng) shows that it may help to decrease intracranial pressure
and benefit coma patients. Further study is needed to confirm these results.
Poorly described research of patients treated with Shenmai and Shengmai injection
(a ginseng preparation) shows that there may be some related cardiac improvement.
More in-depth and reliable studies are needed before a conclusion can be
Preliminary study of Siberian ginseng (E. senticosus) administration
to elderly patients reports that it may safely improve some aspects of mental
health and social functioning after four weeks of therapy. Alertness, relaxation,
and appetite improvements have been reported. Further well-designed clinical
trials are needed to determine possible effects of ginseng on overall quality
Ginseng has been suggested for many other uses, based on tradition or
on scientific theories. However, these uses have not been thoroughly studied
in humans, and there is limited scientific evidence about safety or
effectiveness. Some of these suggested uses are for conditions that are
potentially very serious and even life-threatening. You should consult a
health care provider before taking ginseng for any unproven use.
Attention-deficit hyperactivity disorder
Chronic renal failure
Diaphragmatic muscle fatigue
Female sexual dysfunction
Inflammation of the colon
Ischemic brain injury
Mucus membrane irritation
Myocardiac ischemic and reperfusion injuries
Physical work capacity improvement
Pseudomonas infection in cystic fibrosis
Psychological symptoms of menopause
Physiological symptoms of postmenopause
Recovery after radiation therapy
Recovery after surgery
Retinal vein occlusion
Shortness of breath
Upper respiratory infection
People should avoid ginseng if they have a known allergy to plants in the
Araliaceae family. Signs of allergy may include rash, itching or shortness
of breath. Inhalation of ginseng root dust has been associated with immediate
and late-onset asthma.
Ginseng has been well tolerated by most people in research studies when used
at recommended doses. Some people may experience skin disturbances, such
as itching or rose spots. There is a report of a serious life-threatening
skin reaction, possibly caused by contaminants in the ginseng formulation.
Ginseng may cause stomach discomfort, including diarrhea, nausea, vomiting,
throat irritation or loss of appetite, especially after long-term use. Other
side effects may include difficulty sleeping, nervousness, headache, fever,
dizziness, blurred vision and drowsiness. Rarely, ginseng may alter blood
pressure and hearth rhythm or may cause water retention and swelling, chest
pain, or rapid and pounding heartbeats. Ginseng may affect the menstrual
cycle, causing vaginal bleeding in postmenopausal women or the cessation
of menstruation in younger women.
Breast tenderness has been reported in women, and men have reported increased
breast growth. Other effects experienced by some men taking ginseng include
erectile dysfunction or increased sex drive. Additionally, ginseng cream
applied topically to the penis may cause erectile dysfunction, delayed
ejaculation, mild pain, irritation and burning.
Ginseng may alter blood clotting. If you use anticoagulants (blood thinners)
or antiplatelet drugs and are considering using ginseng, speak with your
health care provider or pharmacist. Nosebleeds have occurred. It is possible
that ginseng may alter blood cell counts. This has led to life-threatening
infections and one death. This effect may have been caused by a contaminant.
Be aware that many tinctures contain high levels of alcohol and should be
avoided when driving or operating heavy machinery.
Patients should always advise their doctor before surgery if they use herbal
medications, food supplements, or cosmetics, as well as prescription drugs.
This is of great importance for both diagnosis and avoidance of drug interactions
and side effects during anesthesia.
Pregnancy And Breast-Feeding
Although ginseng is not believed to cause birth defects, it is not clear
whether ginseng is safe during pregnancy and breast-feeding because there
is not enough scientific information. However, neonatal death and male
characteristics in a developing baby girl were reported after exposure to
ginseng. Be aware that many tinctures contain high levels of alcohol and
should be avoided during pregnancy.
Interactions with drugs, supplements and other herbs have not been thoroughly
studied. The interactions listed below have been reported in scientific
publications. If you are taking prescription drugs, speak with your health
care provider or pharmacist before using herbs or dietary supplements.
Interactions With Drugs
Ginseng may alter the ability of the blood to clot. There is one report that
the effects of warfarin (Coumadin), a blood thinner, were reduced in a patient
using ginseng. This would increase the risk of a blood clot. Another study
found no effect with coadministration. Other reports from laboratory experiments
and in humans suggest that ginseng may increase the risk of bleeding. If
you use anticoagulants (blood thinners), such as warfarin (Coumadin) or heparin,
or antiplatelet drugs, such as aspirin or clopidogrel (Plavix), and are
considering taking ginseng, speak with your health care provider or pharmacist.
Increased monitoring of blood tests may be required.
There is some evidence that ginseng may interfere with the way the liver
breaks down certain drugs (using the P450 system), although study results
conflict. As a result, ginseng may alter the levels of drugs in the body,
causing them to be either too high or too low, which could lead to serious
side effects or lack of beneficial effects. HIV drugs called protease inhibitors
are among the drugs that may be affected. If you are taking prescription
drugs, ask your health care provider and pharmacist for advice before you
Ginseng may lower blood sugar levels. Caution is advised if you are also
taking prescription drugs that may lower blood sugar levels. Patients taking
oral drugs for diabetes or using insulin should be monitored closely by their
health care provider while using ginseng. Dosing adjustments may be necessary.
It is possible that ginseng may increase the effects of digoxin (Lanoxin)
on the heart, and the combination may lead to increased side effects. In
theory, ginseng may lead to increased effects and increased side effects
when taken with heart drugs such as nifedipine (Procardia), blood pressure
drugs, over-the-counter drugs for treating cold symptoms (such as
pseudoephedrine), diuretics and central nervous system stimulants such as
methylphenidate (Ritalin). Other interactions may occur if ginseng is used
with corticosteroids, hormonal drugs or antipsychotic drugs. It is possible
that ginseng may inhibit the development of tolerance to opioids such as
morphine. Use of ginseng with phenelzine (Nardil) has caused headache, tremor,
difficulty sleeping, or mania. Be aware that many tinctures contain high
levels of alcohol and may cause nausea or vomiting when taken with metronidazole
(Flagyl) or disulfiram (Antabuse). Some hormone levels and therefore hormonal
drugs may be affected. Panax ginseng may enhance the clearance of
Interactions With Herbs And Dietary Supplements
In theory, ginseng may alter the blood's ability to clot. This could increase
the risk of bleeding if ginseng is taken with other products that are believed
to alter the ability of the blood to clot. Examples include
(Allium sativum). It is also possible that ginseng may alter the blood
levels of herbs processed by the liver, such as chasteberry (Vitex
agnus-castus). If you are taking other herbs or supplements, check with
your health care provider before starting ginseng.
Ginseng may lower blood sugar levels. People using other herbs or supplements
that may alter blood sugar levels, such as
melon (Momordica charantia), should be monitored closely by their
health care provider while using ginseng. Dosing adjustments may be necessary.
In theory, ginseng may increase the effects and adverse effects of herbs
that contain glycoside components, such as
(Nerium oleander, Thevetia peruviana); herbs that lower blood pressure,
(Crataegus oxyacantha); and herbs with stimulant effects, such as
guarana and maté. Theoretically, ginseng can potentiate the stimulant
effects of caffeine, coffee, or tea. Alternatively, it is possible that ginseng
may decrease the effects of herbs with diuretic properties, such as
Soy and ginseng have been shown to interact in the laboratory, but this has
not been proven in humans. Other herbs and supplements broken down by the
liver may be affected by ginseng. Some hormone levels and therefore hormonal
herbs and supplements may be affected.
The doses listed below are based on scientific research, publications
or traditional use. Because most herbs and supplements have not been thoroughly
studied or monitored, safety and effectiveness may not be proven. Brands
may be made differently, with variable ingredients even within the same brand.
Combination products often contain small amounts of each ingredient and may
not be effective. Appropriate dosing should be discussed with a health care
provider before starting therapy; always read the recommendations on a product's
label. The dosing for unproven uses should be approached cautiously, because
scientific information is limited in these areas.
Ginseng extracts are often standardized to 4 percent G115® or 7 percent
total ginsenosides. Tests of ginseng products have found that many brands
do not contain the claimed ingredients, and some include detectable pesticides.
It is often recommended that people should abstain for one or two weeks after
using ginseng continuously for two to three weeks. There are no standard
or well-studied doses of ginseng, and many different doses are used
Adults (Aged 18 Or Older)
Ginseng is sold in the forms of tea, capsules, tablets, chewing gum, candy,
cigarettes, elixirs, and extracts.
Ginseng tablets/capsules: A dose of 100 milligrams of ginseng extract
(4 percent ginsenosides) taken by mouth once or twice daily has been used.
Higher doses are sometimes used under the supervision of a qualified health
care provider. For short-term administration, the daily dose is 0.5 to two
grams of dry ginseng root, which is equivalent to 200 to 600 milligrams of
extract. E. senticosus dry extract in a dose of 300 milligrams per
day has been studied for eight weeks to improve quality of life in elderly
patients. Proprietary ginseng root extract (Cold-FX, CV Technologies Inc.,
Edmonton, AB) has been studied in athletes for 28 days at a dose of 400
milligrams per day. For long-term administration, one gram of dry root should
not be exceeded daily.
Ginseng liquid/fluid: Doses that have been used include a decoction
of one to two grams in 150 milliliters of water; a 1:1 (gram per milliliter)
fluid extract taken as one to two milliliters daily; or one to two teaspoons
of a 1:5 tincture (gram per milliliter).
Topical ginseng: SS-cream containing ginseng has been used is the
treatment of premature ejaculation at a dose of 0.20 grams.
Children (Younger Than 18): Preliminary evidence in infants with peri-anal
abscess or fistula-in-ano, a treatment of GTTC (ginseng and tang-kuei ten
combination) in a dose of 0.1 to 0.2 grams per kilogram of body weight twice
a day may accelerate recovery. Further research is needed to confirm these
results, and this condition should only be treated by a qualified health
care provider. Overall, there are not enough scientific data to recommend
ginseng for use in children, and ginseng is not recommended because of potential
Ginseng has been suggested as a treatment for many conditions. Some research
supports the use of ginseng in improving brain function, improving exercise
performance, reducing fatigue, increasing general feelings of well-being,
stimulating the immune system and lowering blood sugar levels. However, it
is not clear what doses may be safe and effective. There is not enough scientific
evidence to support the use of ginseng for any other medical condition.
Ginseng may alter blood clotting and may lower blood sugar levels. It should
also be avoided in pregnant or breast-feeding women and in children. Discuss
any products you are taking with your health care provider or pharmacist
to screen for possible interactions. Consult your health care provider
immediately if you have any side effects.
The information in this monograph was prepared by the professional staff
at Natural Standard, based on thorough systematic review of scientific evidence.
The material was reviewed by the Faculty of the Harvard Medical School with
final editing approved by Natural Standard.
Standard: An organization that produces scientifically based reviews
of complementary and alternative medicine (CAM) topics
for Complementary and Alternative Medicine (NCCAM): A division of the
U.S. Department of Health & Human Services dedicated to research
Selected Scientific Studies: Ginseng
Natural Standard reviewed more than 565 articles to prepare the professional
monograph from which this version was created.
Some of the more recent studies are listed below:
Allen JD, McLung J, Nelson AG, et al. Ginseng supplementation does not enhance
healthy young adults' peak aerobic exercise performance. J Am Coll Nutr
Anderson GD, Rosito G, Mohustsy Ma, et al. Drug interaction potential of
soy extract and Panax ginseng. J Clin Pharmacol 2003;43(6):643-648.
Cardinal BJ, Engels HJ. Ginseng does not enhance psychological well-being
in healthy, young adults: results of a double-blind, placebo-controlled,
randomized clinical trial. J Am Diet Assoc 2001;101(6):655-660.
Caron MF, Hotsko AL, Robertson S, et al. Electrocardiographic and hemodynamic
effects of Panax ginseng. Ann Pharmacother 2002;36(5):758-763.
Cho YK, Sung H, Lee HJ, et al. Long-term intake of Korean red ginseng in
HIV-1-infected patients: development of resistance mutation to zidovudine
is delayed. Int Immunopharmacol 2001;1(7):1295-1305.
Choi HK, Jung GW, Moon KH, et al. Clinical study of SS-cream in patients
with lifelong premature ejaculation. Urology 2000;55(2):257-261.
Choi HK, Seong DH, Rha KH. Clinical efficacy of Korean red ginseng for erectile
dysfunction. Int J Impot Res 1995;7(3):181-186.
Choi HK, Xin ZC, Choic, YD, et al. Safety and efficacy study with various
doses of SS-cream in patients with premature ejaculation in a double-blind,
randomized, placebo controlled clinical study. Int J Impot Res
Cicero AF, Derosa G, Brillante R, et al. Effects of Siberian ginseng
(Eleutherococcus senticosus maxim.) on elderly quality of life: a randomized
clinical trial. Arch Gerontol Geriatr Suppl 2004;(9)69-73.
DAngelo L, Grimaldi R, Caravaggi M, et al. A double-blind,
placebo-controlled clinical study on the effect of a standardized ginseng
extract on psychomotor performance in healthy volunteers. J Ethnopharmacol
Ding DZ, Shen TK, Cui Yz. Effects of red ginseng on the congestive heart
failure and its mechanism. Zhongguo Zhong Xi Yi Jie He Za Zhi 1995;15(6):325-327.
Donovan JL, DeVane CL, Chavin KD, et al. Siberian ginseng (Eleutheroccus
senticosus) effects on CYP2D6 and CYP3A4 activity in normal volunteers. Drug
Metab Dispos 2003;31(5):519-522.
Ellis JM, Reddy P. Effects of panax ginseng on quality of life. Ann Pharmacother
Engels HJ, Fahlman MM, Wirth JC. Effects of ginseng on secretary IgA,
performance, and recovery from interval exercise. Med Sci Sports Exerc
Engels HJ, Wirth JC. No ergogenic effects of ginseng (Panax ginseng C.A.
Meyer) during graded maximal aerobic exercise. J Am Diet Assoc
Engels HJ, Kolokouri I, Cieslak TJ, et al. Effects of ginseng supplementation
on supramaximal exercise performance and short-term recovery. J Strength
Cond Res 2001;15(3):290-295.
Gross D, Shenkman Z, Bleiberg B, et al. Ginseng improves pulmonary functions
and exercise capacity in patients with COPD. Monaldi Arch Chest Dis
Hartley DE, Elsabagh S, File SE. Gincosan (a combination of Ginkgo biloba
and Panax ginseng): the effects on mood and cognition of 6 and 12 weeks'
treatment in post-menopausal women. Nutr Neurosci 2004;Oct-Dec, 7(5-6):325-333.
Hong B, Ji YH, Hong JH, et al. A double-blind crossover study evaluating
the efficacy of Korean red ginseng in patients with erectile dysfunction:
a preliminary report. J Urol 2002;168(6):2070-2073.
Ito TY, Trant As, Polan ML. A double-blind placebo-controlled study of ArginMax,
a nutritional supplement for enhancement of female sexual function. J Sex
Marital Ther 2001;27(5):541-549.
Jiang X, Williams KM, Liauw WS, et al. Effect of St. Johns wort and
ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy
subjects. Br J Clin Pharmacol 2004;57(5):592-599.
Kennedy D, Scholey A, Wesnes KA. Dose-dependent enhancement of cognitive
performance in young volunteers by a single dose of ginseng. Int J
Neuropsychopharm 2000;3(Suppl 1):S365.
Kennedy D, Scholey AB, Wesnes K. A direct cognitive comparison of the acute
effects of ginseng, ginkgo and their combination in healthy volunteers. J
Liang MT, Podolka TD, Chuang WJ. Panax notoginseng supplementation enhances
physical performance during endurance exercise. J Strength Cond Res 2005;Feb,
Lifton B, Otto RM, Wygand J. The effect of ginseng on acute maximal aerobic
exercise. Med Sci Sports Exerc 1997;29(Suppl 5):249.
McElhaney JE, Gravenstein S, Cole SK, et al. A placebo-controlled trial of
a proprietary extract of North American ginseng (CVT-E002) to prevent acute
respiratory illness in institutionalized older adults. J Am Geriatr Soc
Ohya T, Usui Y, Okamoto K, et al. Management for fistula-in-ano with Ginseng
and Tang-kuei Ten Combination. Pediatr Int 2004;46(1):72-76.
Scaglione F, Weiser K, Alessandria M. Effects of the standardised ginseng
extract G115(R) in patients with chronic bronchitis: a nonblinded, randomised,
comparative pilot study. Clin Drug Invest 2001;21(1):41-45.
Sorensen H, Sonne J. A double-masked study of the effects of ginseng on cognitive
function. Curr Ther Res 1996;57(12):959-968.
Subiza J, Subiza JL, Escribano PM, et al. Occupational asthma caused by Brazil
ginseng dust. J Alelrgy Clin Immunol 1991;88(5):731-736.
Sung J, Han KH, Zo JH, et al. Effects of red ginseng upon vascular endothelial
function in patients with essential hypertension. Am J Chin Med
Vogler BK, Pittler MH, Ernst E. The efficacy of ginseng: a systematic review
of randomised clinical trials. Eur J Clin Pharmacol 1999;55(8):567-575.
Wiklund IK, Mattsoson LA, Lindgren R, et al. Effects of a standardized ginseng
extract on quality of life and physiological parameters in symptomatic
postmenopausal women: a double-blind, placebo-controlled trial. Swedish
Alternative Medicine Group. Int J Clin Pharmacol Res 1999; 19(3):89-99.
Yuan CS, Wei G, Dey L, et al. Brief communicationi: American ginseng reduces
warfarins effect in healthy patients: a randomized, controlled trial.
Ann Intern Med 2004;141(1):23-27.
Yuan J, Guo W, Yang B, et al. 116 cases of coronary angina pectoris treated
with poweder composed of radix notoginseng and succinum. J Tradit Chin Med
Zhan Y, Xu XH, Jiang YP. Protective effects of ginsenoside on myocardiac
ischemic and reperfusion injuries. Zhonghua Yi Xue Za Zhi 1994; 74(10): 626-8,
Zhao XZ. Antisenility effect of ginseng-rhizome saponin. Zhong Xi Yi Jie
He Za Zhi 1990; 10(10): 586-9, 579.
Ziemba AW, Chmura J, Kaciuba-Uscilko H, et al. Ginseng treatment improves
psychomotor performance at rest and during graded exercise in young athletes.
Int J Sport Nutr 1999;9(4):371-377.
Zuin M, Battezzati PM, Camisasca M, et al. Effects of a preparation containing
a standardized ginseng extract combined with trace elements and multivitamins
against hepatotoxin-induced chronic liver disease in the elderly. J Int Med
Last updated June 30, 2005