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Herbal Medicine                                            


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.
Memory, dementia
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.
Fatigue, stress
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.
Exercise performance
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.
Cancer prevention
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 reached.
Postmenopausal symptoms
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.
Erectile dysfunction
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.
Liver protection
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.
Male infertility
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.
Premature ejaculation
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.
Mental health
Ginseng may safely improve some aspects of mental health and social functioning after four weeks of therapy. Further research is needed to confirm these results.
Respiratory illness
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.
Intracranial pressure
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.
Viral myocarditis
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 drawn.
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 of life.

Unproven Uses    

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.

Adrenal disorders
Aerobic capacity
Alzheimer's disease
Appetite stimulant
Athletic stamina
Attention-deficit hyperactivity disorder
Bleeding disorders
Cerebrovascular deficits
Chemotherapy support
Chronic renal failure
Cold limbs
Craniocerebral injury
Diaphragmatic muscle fatigue
Disease development
Female sexual dysfunction
Fistula-in-ano recovery
Geriatric rehabilitation
High cholesterol
Hot flashes
Inflammation of the colon
Ischemic brain injury
Liver cancer
Liver detoxification
Long-term debility
Malignant tumors
Menopausal symptoms
Mood enhancement
Morphine tolerance
Mucus membrane irritation
Myocardiac ischemic and reperfusion injuries
Nerve pain
Oxidative damage
Oxygen uptake
Pain relief
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
Stomach problems
Upper respiratory infection
Weight loss

Potential Dangers    


Side Effects

Pregnancy And Breast-Feeding


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

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 Ginkgo biloba and garlic (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 bitter 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 oleander (Nerium oleander, Thevetia peruviana); herbs that lower blood pressure, such as hawthorn (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 horsetail (Equisetum arvense).

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 traditionally.

Adults (Aged 18 Or Older)

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 side effects.


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.


  1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
  2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Ginseng

Some of the more recent studies are listed below:

  1. Allen JD, McLung J, Nelson AG, et al. Ginseng supplementation does not enhance healthy young adults' peak aerobic exercise performance. J Am Coll Nutr 1998;17(5):462-466.
  2. 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.
  3. 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.
  4. Caron MF, Hotsko AL, Robertson S, et al. Electrocardiographic and hemodynamic effects of Panax ginseng. Ann Pharmacother 2002;36(5):758-763.
  5. 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.
  6. 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.
  7. Choi HK, Seong DH, Rha KH. Clinical efficacy of Korean red ginseng for erectile dysfunction. Int J Impot Res 1995;7(3):181-186.
  8. 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 1999;11(5):261-264.
  9. 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.
  10. D’Angelo 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 1986;16(1):15-22.
  11. 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.
  12. 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.
  13. Ellis JM, Reddy P. Effects of panax ginseng on quality of life. Ann Pharmacother 2002;36:375-379.
  14. Engels HJ, Fahlman MM, Wirth JC. Effects of ginseng on secretary IgA, performance, and recovery from interval exercise. Med Sci Sports Exerc 2003;35(4):690-696.
  15. Engels HJ, Wirth JC. No ergogenic effects of ginseng (Panax ginseng C.A. Meyer) during graded maximal aerobic exercise. J Am Diet Assoc 1997;97(10):1110-1115.
  16. 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.
  17. Gross D, Shenkman Z, Bleiberg B, et al. Ginseng improves pulmonary functions and exercise capacity in patients with COPD. Monaldi Arch Chest Dis 2002;57(5-6):242-246.
  18. 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.
  19. 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.
  20. 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.
  21. Jiang X, Williams KM, Liauw WS, et al. Effect of St. John’s wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2004;57(5):592-599.
  22. 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.
  23. Kennedy D, Scholey AB, Wesnes K. A direct cognitive comparison of the acute effects of ginseng, ginkgo and their combination in healthy volunteers. J Psychopharm 2001;15(Suppl):A56.
  24. Liang MT, Podolka TD, Chuang WJ. Panax notoginseng supplementation enhances physical performance during endurance exercise. J Strength Cond Res 2005;Feb, 19(1):108-114.
  25. Lifton B, Otto RM, Wygand J. The effect of ginseng on acute maximal aerobic exercise. Med Sci Sports Exerc 1997;29(Suppl 5):249.
  26. 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 2004;52(1):13-19.
  27. 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.
  28. 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.
  29. Sorensen H, Sonne J. A double-masked study of the effects of ginseng on cognitive function. Curr Ther Res 1996;57(12):959-968.
  30. Subiza J, Subiza JL, Escribano PM, et al. Occupational asthma caused by Brazil ginseng dust. J Alelrgy Clin Immunol 1991;88(5):731-736.
  31. 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 2000;28(2):205-216.
  32. 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.
  33. 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.
  34. Yuan CS, Wei G, Dey L, et al. Brief communicationi: American ginseng reduces warfarin’s effect in healthy patients: a randomized, controlled trial. Ann Intern Med 2004;141(1):23-27.
  35. 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 1997;17(1):14-17.
  36. 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, 648.
  37. Zhao XZ. Antisenility effect of ginseng-rhizome saponin. Zhong Xi Yi Jie He Za Zhi 1990; 10(10): 586-9, 579.
  38. 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.
  39. 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 Res 1987;15(5):276-281.

Last updated June 30, 2005