Supplements

Ginseng

Updated · 30 sources · Editorial policy

“Ginseng” is a name used for several different herbal roots. True ginseng comes from plants of the genus Panax. The two most studied are Asian ginseng (Panax ginseng, also sold as Korean, Chinese, red or white ginseng) and American ginseng (Panax quinquefolius). “Siberian ginseng” is a different plant, Eleutherococcus senticosus (eleuthero), with different active compounds. In the US, only Panax products may legally be labeled “ginseng.”

Ginseng is sold as a dietary supplement for energy, fatigue, stamina, sexual function, blood sugar and immunity. The single most important fact is that the evidence is modest and depends on the species. Some effects on fatigue, colds and blood glucose are small but measurable. Controlled trials have not consistently shown that any of these plants improves strength, endurance or anabolic hormones.

This page summarizes what clinical trials, systematic reviews and NIH sources report. It is for education only and is not medical advice.

Property Detail
Type Herbal dietary supplement (root extract); not an FDA-approved drug
Species called “ginseng” Asian ginseng (Panax ginseng), American ginseng (Panax quinquefolius); “Siberian ginseng” is Eleutherococcus senticosus
Main active compounds Ginsenosides in Panax species; eleutherosides in Eleutherococcus
Route Oral (capsules, extracts, teas)
Doses used in cited trials 400–800 mg/day standardized Panax extracts; 2,000–3,000 mg American ginseng; 120–1,200 mg/day eleuthero extract
Half-life No single value. Ginsenoside Rb1 ≈ 35–58 h; its gut metabolite compound K ≈ 8–10 h (human PK studies of red ginseng extract)
US labeling rule “Ginseng” may only be used for plants of the genus Panax (21 U.S.C. 343(u))
WADA status Not named on the 2026 Prohibited List

What it is

Ginseng supplements are made mainly from the root. Asian ginseng is native to Korea, northeastern China and far-eastern Siberia, and has been used in traditional Chinese medicine and as an “adaptogen,” a herb thought to help the body resist stress (NCCIH). “Red” and “white” ginseng are the same species, Panax ginseng, prepared in two different ways.

The three plants sold as ginseng differ in ways that matter for the evidence:

Plant Botanical name Marker compounds Examples of trials cited on this page
Asian ginseng (Korean, red, white) Panax ginseng Ginsenosides Pharmacokinetics of red ginseng, cancer-related fatigue, warfarin interaction
American ginseng Panax quinquefolius Ginsenosides (one cold-prevention extract was polysaccharide-rich) Colds, cancer-related fatigue, post-meal blood glucose, warfarin interaction
“Siberian ginseng” (eleuthero, ciwujia) Eleutherococcus senticosus Eleutherosides, not ginsenosides Endurance exercise, stress-related fatigue

A 2001 analysis of 25 US products measured ginsenosides as markers for the Panax species and eleutherosides as markers for Eleutherococcus (Harkey et al., Am J Clin Nutr 2001). Because eleuthero lacks ginsenosides, results from Panax trials do not transfer to it, and the reverse is also true.

US law treats a food or supplement as misbranded “if it purports to be or is represented as ginseng” unless it is derived from a plant in the genus Panax (21 U.S.C. 343(u)). This means eleuthero cannot legally be represented as ginseng in the US.

Other herbs marketed as adaptogens have their own pages, including Ashwagandha and Rhodiola Rosea. Many reviews below pool several ginseng species, so species-specific results are named where trials report them.

How it works in the body

Most ginsenosides are large sugar-bound molecules that are poorly absorbed. Gut bacteria strip sugars from them, turning ginsenosides such as Rb1 into smaller metabolites such as compound K. This step varies a lot from person to person, which is one reason blood levels differ widely between people taking the same product (Choi et al., J Ginseng Res 2020).

Two human studies of Korean red ginseng extract (Panax ginseng) measured these compounds:

Study Design Compound Peak time Half-life
Kim, J Ginseng Res 2013 10 healthy men, single 9 g dose of extract Ginsenoside Rb1 8.7 h 58.5 h
Kim 2013 Same Compound K 12.2 h 7.8 h
Choi et al., J Ginseng Res 2020 15 healthy adults, single dose and 15 days of dosing Ginsenoside Rb1 3.5 h (single dose) 35.1 h single; 51.0 h after 15 days
Choi 2020 Same Compound K 7.9 h (single dose) 9.95 h single; 7.6 h after 15 days

With daily dosing, exposure (AUC) to Rb1, Rb2 and Rc rose 4.5- to 6.7-fold over 15 days, while compound K did not accumulate. Repeated high-dose red ginseng was well tolerated and did not change blood pressure or body temperature (Choi et al., J Ginseng Res 2020). Comparable human pharmacokinetic data for American ginseng and eleuthero were not found for this page.

Regulatory status

  • United States: ginseng and eleuthero are sold as dietary supplements. Supplements are not approved by the FDA before sale, and manufacturers are responsible for their safety and labeling (NCCIH).
  • Labeling: the word “ginseng” is legally reserved for Panax products (21 U.S.C. 343(u)).
  • Sport: ginseng and eleuthero are not named on the WADA 2026 Prohibited List. Like any supplement, a product can still be contaminated with prohibited substances.

What the research shows

NCCIH notes that most Asian ginseng trials have been small (under 200 participants) and shorter than 3 months (NCCIH). Products, doses and species also vary between trials, which makes pooling difficult.

Exercise performance, strength and hormones

This is the outcome most relevant to athletes, and the evidence is largely negative for all three plants.

Source Plant Design Result
Bach et al., J Korean Med Sci 2016 Ginseng (mixed) Meta-analysis, 8 RCTs on physical performance SMD −0.01 (95% CI −0.29 to 0.27), no effect
Khan et al., J Sports Sci 2022 Ginseng (mixed) Meta-analysis, 14 studies in athletes and active people No effect on VO2 max, peak power, heart rate, perceived exertion or creatine kinase; only vertical jump improved, short-term, at over 300 mg/day
Youl Kang et al., J Strength Cond Res 2002 Ginseng root extract, 20 g Randomized, 8 men, after resistance exercise No difference in growth hormone, testosterone, cortisol or IGF-1 over 2 h
Dowling et al., Med Sci Sports Exerc 1996 Eleuthero, 6 weeks Double-blind, 20 trained distance runners No effect on oxygen uptake, heart rate, lactate or time to exhaustion
Eschbach et al., Int J Sport Nutr Exerc Metab 2000 Eleuthero, 1,200 mg/day for 7 days Double-blind crossover, 9 trained cyclists No change in fat use; 10-km time trial 18.10 vs 17.83 min (not significant)
Kuo et al., Chin J Physiol 2010 Eleuthero, 800 mg/day for 8 weeks Double-blind crossover, 9 recreationally trained men Authors reported endurance time +23% and VO2 peak +12% after 8 weeks of eleuthero

A review of the eleuthero endurance literature found that the 3 positive studies available at the time had severe methodological flaws, while 5 rigorous studies (up to 1,000–1,200 mg/day for 1–6 weeks) showed no benefit (Goulet and Dionne, Int J Sport Nutr Exerc Metab 2005). The later positive trial by Kuo had only 9 participants. NCCIH summarizes that most research shows Asian ginseng does not improve athletic performance (NCCIH).

Fatigue

Pooled results are mixed and effects are small:

  • A 2016 meta-analysis found a small reduction in fatigue in 4 RCTs (SMD 0.34, 95% CI 0.16–0.52) but called the evidence insufficient because the trials were few and small (Bach et al., J Korean Med Sci 2016).
  • A 2023 meta-analysis of 19 RCTs found no significant overall effect (SMD −0.36, 95% CI −0.82 to 0.11). Ginseng did reduce general, non-disease-specific fatigue (SMD −0.48, 95% CI −0.71 to −0.25), and adverse events were not increased (Li et al., J Integr Complement Med 2023).

Two large trials in cancer-related fatigue reached different results by species and setting:

Trial Plant and dose n Result
Barton et al., JNCI 2013 American ginseng, 2,000 mg/day for 8 weeks 364 Fatigue score improved 20 vs 10.3 points at 8 weeks (p = 0.003); not significant at the 4-week primary time point (p = 0.07)
Yennurajalingam et al., JNCCN 2017 Asian ginseng extract, 400 mg twice daily for 28 days 127 (112 evaluable) Both groups improved; 7.5 vs 6.5 points, no difference (p = 0.67)

Eleuthero has also been tested for stress-related fatigue. In 144 adults, adding 120 mg/day of eleuthero extract to stress management training for 8 weeks gave negligible extra benefit (Schaffler et al., Pharmacopsychiatry 2013).

Erectile dysfunction

A 2021 Cochrane review included 9 placebo-controlled trials with 587 men with mild to moderate erectile dysfunction, all with follow-up of 12 weeks or less (Lee et al., Cochrane 2021):

Outcome Effect vs placebo Certainty
Erectile function (IIEF-15 domain, 1–30 scale) +3.52 points (95% CI 1.79–5.25); below the 4-point minimal important difference Low
Erectile function (IIEF-5, 1–25 scale) +2.39 points (95% CI 0.89–3.88); below the 5-point minimal important difference Moderate
Self-reported ability to have intercourse RR 2.55 (95% CI 1.76–3.69) Low
Adverse events RR 1.45 (95% CI 0.69–3.03), no clear difference Low

The reviewers concluded ginseng may have only trivial effects on validated erectile function scores. No trial compared it with PDE5 inhibitors such as sildenafil.

Colds and respiratory infections

The cold data come almost entirely from American ginseng. A systematic review of 5 trials (747 participants), all using North American ginseng, found (Seida et al., Evid Based Complement Alternat Med 2011):

  • a non-significant trend toward fewer people getting at least one cold (RR 0.70, 95% CI 0.48–1.02);
  • shorter colds, by 6.2 days (95% CI 3.4–9.0; 2 trials);
  • insufficient evidence overall that ginseng reduces how often colds occur or how severe they are.

The largest single trial gave 323 adults two 200 mg capsules a day of a polysaccharide-rich American ginseng extract, or placebo, for 4 months. Among the 279 who started treatment, the ginseng group had fewer colds per person (0.68 vs 0.93) and fewer had 2 or more colds (10.0% vs 22.8%) (Predy et al., CMAJ 2005).

Blood sugar

A meta-analysis of 16 RCTs lasting at least 30 days found that ginseng (genus Panax) lowered fasting blood glucose by 0.31 mmol/L (≈5.6 mg/dL; 95% CI 0.03–0.59 mmol/L). It did not significantly change HbA1c, fasting insulin or insulin resistance (Shishtar et al., PLoS One 2014).

In a short crossover study, 3 g of American ginseng reduced the rise in blood glucose after a glucose drink by 18–22% in 10 people without diabetes and 9 with type 2 diabetes. In people without diabetes, the effect appeared only when ginseng was taken 40 minutes before the glucose (Vuksan et al., Arch Intern Med 2000). NCCIH describes the overall diabetes evidence as inconclusive and conflicting (NCCIH).

Cognition

A Cochrane review found 9 randomized trials, only 5 with usable data, too varied to pool. It concluded there is a lack of convincing evidence that Panax ginseng improves cognition in healthy people, and no high-quality evidence in dementia (Geng et al., Cochrane 2010).

Side effects and risks

General tolerability

Clinical trials suggest that adverse events with single-ingredient Panax ginseng products occur at rates similar to placebo. The most common are headache, sleep problems and gastrointestinal upset. Serious events appear mainly in isolated case reports and with multi-ingredient products, where causation is hard to assign (Coon and Ernst, Drug Saf 2002).

NCCIH lists insomnia as the most common side effect of Asian ginseng. It considers short-term use (up to 6 months) likely safe for most people, but notes rare reports of severe rash, liver damage and severe allergic reactions, and that it may worsen autoimmune disorders and interfere with blood clotting (NCCIH). LiverTox states that ginseng has not been implicated in causing liver injury, but that it may cause herb-drug interactions that can lead to liver injury (LiverTox).

Blood pressure

Despite older concerns, a meta-analysis of 17 trials (n = 1,381) lasting at least 4 weeks found no significant effect of ginseng (genus Panax) on systolic, diastolic or mean blood pressure (Komishon et al., J Hum Hypertens 2016).

Interactions

  • Warfarin (American ginseng): in a randomized, double-blind trial in 20 healthy volunteers, 2 weeks of American ginseng lowered peak INR (a measure of clotting time) compared with placebo (difference −0.19, 95% CI −0.36 to −0.07) and reduced warfarin blood levels (Yuan et al., Ann Intern Med 2004). A weaker anticoagulant effect raises clot risk for people who rely on warfarin.
  • Warfarin (Asian ginseng): in 12 healthy men, 7 days of Panax ginseng pretreatment did not change warfarin levels or INR (Jiang et al., Br J Clin Pharmacol 2004). The two species may therefore behave differently.
  • Diabetes medicines: ginseng may lower blood sugar, so NCCIH advises people with diabetes to consult a clinician before use (NCCIH).
  • Digoxin tests: a 74-year-old man on stable digoxin had repeatedly high digoxin levels while taking Siberian ginseng, which normalized when he stopped (McRae, CMAJ 1996). Lab studies found that some Asian and Siberian ginseng products cause falsely high or low readings on certain digoxin immunoassays (Dasgupta et al., Am J Clin Pathol 2003).
  • Possible interactions with phenelzine (an MAO-inhibitor antidepressant) and alcohol have also been reported (Coon and Ernst, Drug Saf 2002).

Who should be cautious

  • Pregnancy: some studies suggest Asian ginseng may be unsafe in pregnancy, and one of its compounds caused birth defects in animals. Safety in breastfeeding is unknown (NCCIH).
  • Children and infants: some experts recommend against use (NCCIH).
  • People on anticoagulants, diabetes medicines or digoxin, for the reasons above.

Quality and contamination

Ginseng products vary widely in strength. In the 2001 analysis of 25 US products, every product contained the labeled plant genus, but marker compound levels often differed from label claims. Ginsenoside content varied 15-fold among capsules and 36-fold among liquids; eleutheroside content varied 43-fold and 200-fold (Harkey et al., Am J Clin Nutr 2001). Batch-to-batch differences of this size may help explain inconsistent trial results.

Key takeaways

  • “Ginseng” means different plants. Asian and American ginseng are Panax species containing ginsenosides; “Siberian ginseng” (eleuthero) is a different plant, and US law bars calling it ginseng.
  • No anabolic or performance effect shown. Meta-analyses found no effect on physical performance or VO2 max, and a trial found no change in testosterone or growth hormone after exercise; rigorous eleuthero trials were also negative.
  • Small benefits in some areas. Effects include a small reduction in general fatigue, shorter colds with American ginseng, and a fasting glucose drop of about 0.31 mmol/L.
  • Trivial effect on erectile function. Cochrane found score changes below the minimal important difference, with low-certainty evidence.
  • Generally well tolerated, with interactions. Insomnia and headache are the main side effects; American ginseng weakened warfarin’s effect, and ginseng can distort some digoxin tests.
  • Products are inconsistent. Active-marker content varied up to 200-fold between products in one US analysis.

Sources

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