Ginseng

Species behind the name

A review from the Kunming Institute of Botany says the genus Panax contains nine species and three varieties, nearly all used medicinally, and names Panax notoginseng, Panax ginseng and Panax quinquefolius as the most representative and valuable, each with a long history of cultivation. It places P. ginseng mainly in northeastern China (Liaoning, Jilin and Heilongjiang), Russia and North Korea, and describes P. quinquefolius as native to North America and resembling P. ginseng.

The same review says P. quinquefolius has been grown in the same Chinese regions as P. ginseng for many years, and that P. notoginseng has been cultivated for more than 400 years in Wenshan (Yunnan) and Jingxi (Guangxi). It cites a 2015 argument that P. notoginseng was first used by ethnic minority groups in the southwest and became a costly medicine during the Ming and Qing dynasties.

Early records and how they are attributed

A 2025 review of ginseng and brain aging states that the Shennong Bencao Jing (Shennong's Classic of Materia Medica) records ginseng as lightening the body and prolonging life. The text is traditionally attributed to the legendary figure Shennong. The abstract reviewed here gives no date of compilation, so the attribution should be read as a traditional account, and this page does not date it.

A market-oriented review from the Korea Ginseng Corporation Research Institute says ginseng use began about 4,500 years ago and that the first written record is about 2,000 years old. It does not attribute those figures to a specific source, so they are reported here as that review's statement and not as established dates.

Korea, North America and the modern trade

The Baeg and So review describes ginseng as an important trade good in Asia, links the Korean ginseng concept to the idea of a panacea, and dates modern scientific efficacy research in Korea to 1950. It reports that South Korea, China, Canada and the United States together produced more than 99 percent of world ginseng around 2013, and that Korea was the largest distributor.

The sources reviewed for this page do not give dates for the start of Korean cultivation, and they do not describe the history of the American ginseng trade to China. They state only that P. quinquefolius is native to North America and is also grown in China. Those parts of the history remain unsourced here.

Common names and processing terms

The National Center for Complementary and Integrative Health (NCCIH) gives the Latin name Panax ginseng and lists red ginseng, white ginseng, and Korean or Chinese ginseng among its common names. It describes the root as the part most often used and the ginsenosides (also called panaxosides) as the key active substances. The term ginseng is also used for the whole genus in some reviews.

A systematic review of red ginseng defines Korean red ginseng as unskinned P. ginseng that is steamed or otherwise heated and then dried. The Baeg and So review lists fresh, dried, boiled and dried (taekuksam) and red ginseng as distinct forms of the product. The Kunming review adds that steaming lowers bisglycosidic saponins and raises monoglycosidic ones.

Siberian ginseng and the adaptogen label

Memorial Sloan Kettering (MSK) states that Eleutherococcus senticosus, sold as eleuthero, Russian ginseng or Siberian ginseng, is not a true ginseng species and is distinct from Asian ginseng, American ginseng and P. notoginseng. A 2000 review by Davydov and Krikorian found that Eleutherococcus and Panax ginseng differ considerably in chemistry and pharmacology and cannot justifiably be treated as interchangeable.

The same review traces the word adaptogen to Soviet scientists in the late 1950s and argues the term is vague and conveys no mechanism, recommending that the name Siberian ginseng be dropped. This page uses adaptogen only to report how sources describe traditional and marketed uses.

Ginsenosides

Ginsenosides are saponins with a dammarane-type triterpenoid core, and the Kunming review calls saponins the main bioactive constituents across Panax species. In P. notoginseng they fall into protopanaxadiol (Rb) and protopanaxatriol (Rg) groups, with ginsenosides such as Rb1, Rg1, Re and Rd named as main components. Content differs by species, part of the plant and processing.

Forms in which ginseng is sold

According to NCCIH, the root is the part most often used, and oral herbal products are often sold as dietary supplements. NCCIH adds that supplements are not approved before sale and that manufacturers and distributors are responsible for evaluating safety and labeling. The Baeg and So review says ginseng is consumed as food, dietary supplements, functional food and medical supplies.

Trials often use named extracts. One example is CVT-E002, described as a proprietary extract of Panax quinquefolius, and another is a defined American ginseng preparation used in a cancer fatigue trial. Results from one extract cannot be assumed to apply to another product, and this page gives no amounts or regimens.

Place within traditional systems

The Kunming review describes Panax as an important herbal group in Traditional Chinese Medicine (TCM). The 2025 brain aging review frames ginseng through a TCM theory in which the heart, liver, spleen, lung and kidney are each linked to the brain. These are the authors' framing of traditional theory, not tested mechanisms.

For wider context, Machipedia has pages on Herbal Medicine, Traditional Chinese Medicine and Dietary Supplements, and on other botanical remedies including Ashwagandha and Medicinal Mushrooms. Ginseng is one remedy within the Herbal Medicine family and is not described here as a complete system of care.

Traditional and practitioner claims

Reviews describe ginseng as believed to improve energy, physical and emotional health and well-being. MSK says American ginseng is used in TCM and as a supplement for strength, stamina, glucose control and cancer. The same source says Siberian ginseng has been used traditionally as an adaptogen, performance enhancer and immunostimulant. These are statements about use, not findings.

Uses assessed in research

NCCIH lists cognitive function, influenza, fatigue, diabetes and metabolic markers, erectile dysfunction and athletic performance as uses that have been studied. It says there is not enough reliable information on aging, asthma and anxiety. The sections below report what the reviews and trials found for each, and which findings are limited.

Cognition

A Cochrane review (Geng and colleagues, 2010; searches to February 2009) found nine placebo-controlled randomized trials, eight in healthy participants and one in people with age-associated memory impairment. Only five had extractable data and pooling was not possible. The authors reported a lack of convincing evidence of a cognitive benefit in healthy people and no high-quality evidence in dementia. NCCIH adds that benefits were suggested in middle-aged but not young adults.

Blood glucose and erectile function

A 2014 systematic review in PLOS ONE (not a Cochrane review) pooled 16 trials of at least 30 days and found a modest fasting glucose reduction (mean difference -0.31 mmol/L), with no significant effect on insulin, glycated hemoglobin or insulin resistance. Most trials ran under 12 weeks, and the authors called for larger, longer trials with standardized preparations.

A 2008 systematic review of red ginseng for erectile dysfunction (also not Cochrane) found seven randomized trials of low average quality. Six placebo comparisons gave a risk ratio of 2.40 (95% CI 1.65 to 3.51). The authors called the evidence suggestive only, and too limited for definitive conclusions.

Fatigue

In a phase III trial of 364 fatigued cancer survivors at 40 institutions, American ginseng did not differ significantly from placebo on the primary measure at 4 weeks (P = .07) but did at 8 weeks (P = .003), with greater benefit among people still receiving treatment. Reported toxicities did not differ between groups.

A 2018 systematic review of 10 studies reported low risk of adverse events and modest evidence of efficacy for fatigue, and called for stronger studies. A 2019 review of integrative therapies said American ginseng can be considered during active cancer treatment, while noting that no therapy could be definitively recommended. NCCIH says ginseng alone was not shown to help chronic fatigue.

Respiratory infections

In a trial of 293 people with early-stage chronic lymphocytic leukemia, CVT-E002 did not significantly reduce acute respiratory illness days or severe illness days, although moderate to severe sore throat was lower. A 2020 meta-analysis of ten trials found a lower incidence of upper respiratory infections (risk ratio 0.69), but risk of bias was high or unclear in most trials and the authors said conclusions could not be drawn.

Reading the evidence across species and extracts

NCCIH notes that most ginseng trials enroll fewer than 200 people and last under 3 months, and that it found most athletic performance research showed no improvement. The Cochrane review could not pool data because outcome measures, duration and amounts differed. Findings for P. ginseng, P. quinquefolius and Eleutherococcus should not be merged. The sources reviewed cover little clinical research on P. notoginseng, and MSK describes human studies of Siberian ginseng as limited.

Reported adverse effects

NCCIH states that short-term oral use of up to 6 months in recommended amounts appears to be tolerated by most people, and that long-term safety is uncertain. It names insomnia as the most common side effect and lists severe rash, liver damage and severe allergic reactions as uncommon. It also says ginseng may worsen autoimmune disorders and may interfere with blood clotting. Topical safety is not well established, and irritation and burning are possible.

Interactions with medicines

NCCIH says ginseng may lower blood sugar, so people with diabetes should consult a provider first. MSK says American ginseng may antagonize warfarin and advises people on blood thinners to consult a provider. Controlled studies are mixed: a 12-person crossover study of healthy men and a 25-patient crossover study of Korean red ginseng in valve replacement patients found no significant INR change, and the latter authors advised close monitoring.

A review of herb-drug interactions reports, from published studies and case reports, that ginseng reduced blood levels of warfarin and alcohol and was linked to mania with phenelzine, a monoamine oxidase inhibitor. It also notes that narrow-margin drugs such as cyclosporine and tacrolimus are at high risk of herbal interactions generally. The sources reviewed did not report a ginseng-specific immunosuppressant study. MSK reports a digoxin interaction case for Siberian ginseng.

Pregnancy, hormones and specific conditions

NCCIH says some studies suggest oral use may be unsafe during pregnancy, that one of its chemicals caused birth defects in animals, and that some experts advise against use in infants, children and people who are pregnant or breastfeeding. MSK reports that American ginseng stimulated breast cancer cell growth in laboratory studies, and states that this finding has no clinical relevance at oral intake levels. The sources reviewed do not report blood pressure effects.

Product quality and authenticity

Davydov and Krikorian note inconsistencies in standardization, dosage and product labeling for herbal preparations of both Eleutherococcus and Panax ginseng. A 2026 study reports that dried flowers of P. ginseng and P. notoginseng look alike and that adulteration is prevalent. It describes a DNA test that identified mislabeled products among 30 commercial samples. These are method studies, and they do not measure how common mislabeling is in the consumer market.

A 2026 microscopy and chromatography study separated four ginseng species from two common adulterants. The adulterants contained none of the eight ginsenosides measured, and the authors note that economically motivated bulking occurs in herbal products.

Who should ask a clinician

Based on the sources above, people who take diabetes medicines, warfarin or other blood thinners, monoamine oxidase inhibitors, digoxin or immune-suppressing drugs, people with autoimmune disorders, and people who are pregnant or breastfeeding are the groups the sources flag for clinician advice. Ginseng should not delay or replace necessary medical care, and this page is information only.