What is Panax ginseng? A plain-English guide

Panax ginseng is a plant native to Korea, northeastern China and far-eastern Siberia [9]. The root is the part most often used for health [9]. Its common names include Asian, Chinese, Korean, red and white ginseng [9].

Traditionally, it has been used as an adaptogen, a herb thought to help the body resist stress [9].

Not every product called "ginseng" comes from this plant [8]. American ginseng is a different Panax plant, and Siberian ginseng is not a Panax plant at all [8]. This guide covers Panax ginseng only.

The main active parts are thought to be ginsenosides [9], a family of about thirty natural compounds [8].

Researchers have studied Panax ginseng for memory and thinking [1][2], for tiredness [3] and for exercise [4].

NCCIH, part of the US National Institutes of Health, notes that most of these trials had fewer than 200 people [9]. Most also lasted less than 3 months [9].

Does Panax ginseng help memory?

Evidence grade for memory: C, limited. Why this grade

A 2010 Cochrane review, which searched studies up to 2009, found 9 randomized controlled trials [1]. In this kind of study, people are split by chance into groups, and one group gets a dummy pill called a placebo. Eight of the 9 trials were in healthy people [1].

The trials were too different to combine, and the review found no convincing evidence that ginseng improves thinking in healthy people [1].

A 2024 meta-analysis pooled 15 trials with 671 people [2]. A meta-analysis is a study that combines the results of many trials. It found a small memory benefit, but no effect on overall thinking, attention or higher-level skills such as planning [2].

That review mixed healthy people with people who had memory problems, schizophrenia or Alzheimer's disease, or who were in hospital [2]. So its memory result may not apply to healthy adults.

Does Panax ginseng help with tiredness?

Evidence grade for mental fatigue: C, limited. Why this grade

A 2023 meta-analysis pooled 19 randomized trials in people with tiredness [3]. The review also included herbal formulas that contain ginseng [3]. Compared with control groups, ginseng did not clearly lower tiredness overall [3].

In one part of that review, ginseng did reduce general tiredness that was not linked to a disease [3]. The authors noted that the effects were small [3]. NCCIH says Asian ginseng alone may have a small benefit for general tiredness [9]. Some people in these trials were tired because of an illness [3], so results may not apply to healthy adults.

One small double-blind trial tested 30 healthy young adults [5]. On separate days, each person took 200 mg of a branded extract called G115, 400 mg, or a placebo [5]. After 200 mg, people rated themselves as less mentally tired during long mental tasks at most test points [5].

Does Panax ginseng help exercise performance?

Evidence grade for endurance performance: N, no benefit shown. Why this grade

A 2016 meta-analysis combined 8 trials that compared ginseng with a placebo, and found no improvement in physical performance [4]. NCCIH also says most research shows no gain in athletic performance [9].

To see what each grade means, read how we grade evidence.

Table: Doses used in studies (not a recommendation)

These are research amounts, not advice for anyone. Health Canada's guide for licensed products sets 200 to 600 mg of a standardized extract a day, for adults 18 and older [10]. Talk to a clinician before trying any supplement.

A 2002 safety review gathered side effect reports from trials and elsewhere [6]. In its trial data, side effects were about as common with ginseng alone as with a placebo [6]. The most common were headache, sleep problems and stomach upset [6]. The Cochrane review found no serious side effects linked to ginseng [1].

NCCIH reports that short-term use by mouth, up to 6 months, in recommended amounts appears to be safe for most people [9]. It says trouble sleeping is the most common side effect [9]. Rarer reports include severe rash, liver damage and severe allergic reactions [9].

A 2017 review notes trouble sleeping and other nervous system effects in people taking more than 2.5 g a day [8]. Products that mix ginseng with other ingredients have been linked to serious side effects and even deaths [6]. The safety review notes that the other ingredients may have caused these problems [6].

Some evidence suggests ginseng might lower blood sugar [9]. In the G115 trial, both doses lowered blood sugar [5].

Ginseng may also change how some medicines work [9]. In 12 healthy people, 28 days of ginseng lowered blood levels of a test medicine, midazolam [7]. The authors wrote that ginseng appeared to speed up a liver enzyme, a protein that helps break down some medicines [7]. They advised close checks for people taking medicines handled by this enzyme where a small change in blood level matters [7].

A 2017 narrative review advises people on blood thinners, such as warfarin, to avoid ginseng supplements because of bleeding risk [8]. It gives the same advice for antiplatelet medicines [8]. The safety review found interactions were rare [6]. Possible ones were reported with a blood thinner (warfarin), an antidepressant (phenelzine) and alcohol [6].

If you take any of these medicines, talk to your doctor or pharmacist before combining them with Panax ginseng.

• Pregnancy and breastfeeding: Health Canada requires product labels to say to ask a health care practitioner before use [10]. NCCIH notes that some studies suggest ginseng may be unsafe in pregnancy [9]. Some experts advise against its use during pregnancy or breastfeeding [9].
• Children: Health Canada's rules cover adults 18 and older [10]. Some experts advise against use in infants and children [9].
• People with diabetes: Health Canada requires the same label advice [10].
• People taking antidepressants, blood thinners or digoxin: Health Canada requires the same label advice [10]. A review also urges caution with digoxin and corticosteroids [8].
• People with autoimmune conditions: a review advises caution [8], and NCCIH notes that ginseng may worsen autoimmune disorders [9].