Encyclopedia/Botanical/TCM/encyclopedia-ginseng

Ginseng

Panax ginseng C.A.Mey.

Sources

6 listed

Best forFor adults considering traditional use of ginseng root for fatigue and weakness. Preparation and dose must match the product. Discuss use first if taking medicines; not recommended during pregnancy or breastfeeding.

Clinical evidence

Emerging

Real World Significance

65Established historical significance

Breadth 46 Depth 91 Density 47 Convergence 62 Continuity 85

SafetyUse with cautionGinseng is generally well tolerated by healthy adults at the recommended doses for the specific preparation. Insomnia, gastrointestinal symptoms and allergic reactions are possible. Discuss use when taking medicines because some potential interactions remain uncertain. Use during pregnancy, breastfeeding and under age 18 is not recommended owing to insufficient data. EMA provides for up to three months of use for the covered medicines.

Tradition

TCM

Common preparations

Standardised extractCapsuleTinctureTeaRoot powder

In short

Summary of findings for quick reference

Ginseng (Panax ginseng), the man-root of East Asian medicine, has a long written tradition. Ren Shen appears in the upper class of the Shennong Bencao Jing. In Korea it is known as Insam; cultivation also has a long history, whose beginnings cannot be dated precisely. Chinese, Korean and Japanese medicine use it as a restorative root, often in formulas with other plants. Traditional ideas of restoration and recovery must be distinguished from modern evidence of efficacy.

That long use is reflected in the modern monographs. The German Commission E gives Ginseng radix a positive assessment as a tonic for fatigue, reduced work capacity and convalescence, and the European Medicines Agency (EMA HMPC) lists the root for the symptomatic treatment of asthenia such as fatigue and weakness on the basis of traditional use. Two points of care belong here. Ginseng in TCM and kampo is usually one ingredient in a multi-herb formula, so the effect of a classical preparation cannot be attributed to ginseng alone. And true ginseng is Panax: Siberian ginseng (Eleutherococcus) is a different genus and not a true ginseng, while American ginseng (Panax quinquefolius) is a related but distinct species.

Clinical findings are inconsistent. The Cochrane review found no convincing evidence of improved cognition in healthy people. Small, short trials show effects on individual tasks that vary by preparation and dose. The EMA indication rests on longstanding use. Users should follow the product leaflet and discuss combinations with blood-pressure, anticoagulant or diabetes medicines first.

Clinical evidence ↔ Historical significance

We display two separate evidence categories: clinical evidence from modern trials and historical significance from documented healing tradition. Both are valuable, but they answer different questions.

In every encyclopedia entry we evaluate two distinct categories of evidence. Clinical evidence as used in trials meets a narrower but scientifically essential bar. At the same time, the hundreds of thousands of plant species worldwide have only partially been captured and tested in modern studies.

Alongside the trial picture our researchers compile a comprehensive overview of where and since when a plant has been used across different traditions of natural medicine. When a plant has been used as a medicinal plant in many cultures across many generations, that historical significance deserves to be visible too.

Our position: a truly informative overview emerges only when both categories sit side by side. We communicate transparently what counts as what.

Overview

Ginseng (Panax ginseng) is a slow-growing perennial in the Araliaceae family, native to Korea, Northeast China and the Russian Far East. Its fleshy, often humanlike branching root has a long history in East Asian medicine. The genus Panax includes Asian ginseng (P. ginseng) and American ginseng (P. quinquefolius), among other species. Their constituent profiles and traditional uses differ; studies of one species cannot automatically be applied to the other.

Characteristic constituents include ginsenosides, a group of triterpenoid saponins. Rb1, Rg1 and Re are among the analytical markers. The 2024 EMA Ginseng radix monograph describes traditional herbal medicines for fatigue and weakness. This indication rests on longstanding use; a well-established-use indication based on established clinical efficacy is not recognised. The monograph concerns medicines and cannot be transferred as an efficacy claim to food supplements. So-called Siberian ginseng (Eleutherococcus senticosus) belongs to another genus.

History

Ginseng has a written tradition of around two thousand years in Chinese medicine. In the received Shennong Bencao Jing, Ren Shen belongs to the upper class of medicines and is described as sweet and slightly cold. The familiar description as a warming tonic therefore cannot be applied uniformly to all classical texts and preparations. The root is traditionally used for restoration and in formulas for exhaustion. Its branching shape can resemble a human figure, reflected in the name Renshen, or man-root.

Linnaeus named the genus Panax in the eighteenth century, drawing on the Greek term for a cure-all. A documented contribution to European knowledge of the plant is the Jesuit Pierre Jartoux’s report of 12 April 1711 on Northeast Asian ginseng. The root later entered European phytotherapy. German Commission E assessed it positively as a tonic for fatigue, declining work capacity and concentration, and convalescence. The 2024 EMA Ginseng radix monograph lists traditional use for symptoms of asthenia such as fatigue and weakness. It supports assessment of relevant medicines and is not itself a product registration. It contains no well-established-use indication.

Mechanism

The characteristic constituents in Panax ginseng root are a family of triterpenoid saponins called ginsenosides. More than twenty individual ginsenosides have been described in the root; the major analytical markers are Rb1, Rg1, and Re, with characteristic ratios that distinguish Panax ginseng from Panax quinquefolius (American ginseng). G115 is a frequently studied clinical extract standardised to four per cent ginsenosides. Other constituents include polysaccharides, polyacetylenes, and small amounts of essential oil.

Research describes ginseng as an adaptogen and investigates stress regulation through the hypothalamic-pituitary-adrenal axis, neurotransmitter signalling and energy metabolism. Individual ginsenosides show different effects in laboratory and animal studies. These findings do not yet provide a unified explanation of effects in humans. No specific ginsenoside has been established as responsible for a proven clinical benefit.

Clinical research on Panax ginseng is inconsistent. Geng et al. (2010) found no convincing evidence of cognitive enhancement in healthy people; heterogeneous preparations and measures prevented pooling. Reay et al. (2010) studied G115 in 30 healthy young adults over eight-day periods: some arithmetic performance improved at 400 milligrams, while 200 milligrams slowed processing. Such task- and dose-dependent findings do not establish a general concentration benefit. G115 is standardised to four per cent ginsenosides; its findings cannot automatically be applied to other extracts or root tea.

Studies of blood glucose, immune function and physical performance also have inconsistent results; a reliable general benefit has not been established. The 2024 EMA monograph describes ginseng root as a traditional herbal medicine for fatigue and weakness. It contains no well-established-use indication and does not authorise health claims for food supplements.

Evidence

4 Outcomes evaluated. Sorted by grade.

Outcome	Class	Grade	Effect	Refs
Mental fatigue and cognitive performanceHealthy adults; adults with subjective fatigue	Emerging	C	Mixed Effect	[1][2]
Physical fatigue and invigoration (traditional)Adults under fatigue or convalescence	Traditional	D	Traditional Use	[4][5]
Acute cognitive functionHealthy adults, small trials	Emerging	D	Mixed findings	[2]
Drug interactions (warfarin, antidiabetics, MAO inhibitors)Adults on common prescription medications	Emerging	I	Caution Indicated	[3][5][6]

Usage

Forms and preparation

Ginseng is available as extracts in capsules or tablets, among other forms. G115, containing four per cent ginsenosides, is frequently studied. Other extracts differ in manufacture and composition. White ginseng is the dried root; red ginseng is steamed before drying, which changes the ginsenoside profile. Liquid preparations, root powder and root pieces for decoctions are also available. These preparations are not equivalent gram for gram or solely on the basis of ginsenoside content. Follow the administration instructions for your product. If ginseng affects your sleep, stop taking it and discuss further use with a doctor or pharmacist. When switching products, consider the ginseng species, root processing, extract type and dose. Buy loose root only from a reliable source with clear botanical identification.

Dosage

Dose depends on preparation. Reay et al. studied 200 or 400 milligrams of G115; this is not a general dose for ginseng products. For a decoction of comminuted white ginseng root, the EMA monograph specifies one to two grams in 150 millilitres of water, two or three times daily. Powders and individual extracts have their own doses. Follow the leaflet for the particular medicine. EMA specifies up to three months of use for the covered ginseng medicines. Seek medical advice if fatigue or weakness persists beyond two weeks or worsens. If symptoms continue, seek medical advice on whether another course is appropriate. Do not increase the dose beyond the product instructions on your own.

Safety

Safety profile

Ginseng can cause insomnia and gastrointestinal symptoms. Do not use it if you have a known allergy to ginseng. Use during pregnancy, breastfeeding and in children and adolescents under 18 is not recommended because adequate safety data are lacking. If you have hypertension or take blood-pressure medicines, discuss use with a doctor or pharmacist first. If you take warfarin or other anticoagulants, discuss ginseng with your doctor before starting or stopping it. Data on Panax ginseng and warfarin are inconsistent; small controlled studies did not confirm the case reports. A well-known American ginseng study concerns a different species. Ginseng may lower blood glucose, so monitoring should be agreed upon when diabetes medicines are used. Possible interactions with antidepressants, including MAO inhibitors, are also uncertain. Consultation is advisable with autoimmune disease or immunosuppressants as well.

Look-alikes

Botany

Family

Araliaceae

Native regions

Korea, Northeast China, Russian Far East, cultivated

Harvest window

Roots after four to six years of growth

Habitat

Native to the cool, shaded understorey of deciduous forests in Korea, northeast China (especially the Changbai mountains), and the Russian Far East. Prefers rich, well-drained forest soils with significant leaf litter, and a north-facing aspect that keeps direct sunlight off the plant. Wild-grown Panax ginseng is now rare and protected in much of its native range; the great majority of commercial ginseng is cultivated, often under shade cloth, with roots harvested at four to six years of growth.

Identification & foraging

Slow-growing perennial reaching about sixty centimetres at maturity. The palmately compound leaves usually have five oval leaflets, with a small umbel of greenish-white flowers at the stem tip and bright red fruits later. Other Panax species share these features, so they alone do not establish species identity. The fleshy root can branch into a humanlike shape, reflected in the Chinese name Renshen, or man-root.

Similar plants and look-alikes

American Ginseng (Panax quinquefolius)

American ginseng is a different species in the same genus Panax, native to North American deciduous forests. It also contains ginsenosides, with a composition that differs from Asian ginseng. Traditional uses differ as well. A product labelled Panax quinquefolius is therefore not automatically interchangeable with Panax ginseng.

Siberian Ginseng (Eleutherococcus senticosus)

Siberian ginseng (Eleutherococcus senticosus) belongs to a completely different genus and, despite the English common name, is not a true ginseng. It does not contain ginsenosides; its bioactives are a different group called eleutherosides. Its tradition and modern use do not map onto Panax ginseng. Read the label carefully when buying; products labelled Siberian ginseng or eleuthero are not the same thing as Panax ginseng products.

Read the entry: Eleutherococcus (Siberian Ginseng)

FAQs

What is the difference between Panax ginseng and Siberian ginseng?

Panax ginseng (Asian ginseng) and Panax quinquefolius (American ginseng) are two species in the genus Panax and belong to the Araliaceae family. Siberian ginseng (Eleutherococcus senticosus) belongs to a completely different genus; despite the common name, it is not a true ginseng, it does not contain ginsenosides, and it has a different bioactive profile (eleutherosides). The two plants are used differently in both tradition and modern practice; a product labelled Siberian ginseng or eleuthero is not the same thing as a Panax ginseng product.

What is the difference between red and white ginseng?

White ginseng is the fresh root (peeled or unpeeled) that is then air-dried. Red ginseng is made by steaming the fresh root first and then drying it; this treatment changes the ginsenoside profile (some ginsenosides are transformed into other forms) and gives the root its red colour. In Traditional Chinese Medicine red ginseng is regarded as more warming and tonifying and is used in cases of greater depletion; white ginseng is regarded as milder. Both come from the same plant (Panax ginseng), and the choice is more a matter of tradition and processing than a clean clinical distinction.

Can I take ginseng with high blood pressure?

If you have hypertension or take blood-pressure medicines, discuss ginseng with your doctor or pharmacist first. A consistent rise in blood pressure from usual doses of Panax ginseng has not been established; older reports are difficult to interpret because of unclear products, high doses and concurrent caffeine use. Interactions with blood-pressure medicines are also uncertain. Ginseng does not replace hypertension treatment.

What time of day should I take ginseng?

Follow the leaflet for your product. Ginseng can cause insomnia; taking it earlier may help if you are sensitive to this effect. EMA specifies up to three months of use for the covered medicines. Seek medical advice if symptoms persist for more than two weeks or worsen.

References

6 sources.

Geng J, Dong J, Ni H, Lee MS, Wu T, Jiang K, Wang G, Zhou AL, Malouf R. Ginseng for cognition. 2010. doi:10.1002/14651858.CD007769.pub2
Reay JL, Scholey AB, Kennedy DO. Panax ginseng (G115) improves aspects of working memory performance and subjective ratings of calmness in healthy young adults. 2010. doi:10.1002/hup.1138
Lee YH, Lee BK, Choi YJ, Yoon IK, Chang BC, Gwak HS. Interaction between warfarin and Korean red ginseng in patients with cardiac valve replacement. 2010. doi:10.1016/j.ijcard.2009.09.553
European Medicines Agency, HMPC. European Union herbal monograph on Panax ginseng C.A.Mey., radix, Final Revision 1. 2024. Source
European Medicines Agency, HMPC. Assessment report on Panax ginseng C.A.Mey., radix, Revision 1. 2024. Source
National Center for Complementary and Integrative Health. Asian Ginseng. 2025. Source

Legal notice: The depiction of historical significance and traditional use is context within our encyclopedia and not a health claim for any product, not a treatment promise, and not a substitute for medical advice. What may be stated on product labels, product pages, or in advertising is governed by the applicable legal requirements.