What is it?
People take American ginseng by mouth for stress, to boost the immune system, and as a stimulant.
American ginseng is often used to fight infections such as colds and flu. There is some evidence that it might help prevent colds and flu and make symptoms milder when infections do occur.
American ginseng is used for other infections including HIV/AIDS, infections of the intestine (dysentery), and particular infections (Pseudomonas infections) that are common in people with cystic fibrosis.
Some people use American ginseng to improve digestion and for loss of appetite, as well as for vomiting, inflammation of the colon (colitis), and inflammation of the lining of the stomach (gastritis).
American ginseng is also used for low iron in the blood (anemia), diabetes, insulin resistance related to HIV treatments, cancer-related fatigue, high blood pressure, trouble sleeping (insomnia), nerve pain, erectile dysfunction (ED), fever, hangover symptoms, attention deficit-hyperactivity disorder (ADHD), blood and bleeding disorders, breast cancer, dizziness, headaches, convulsions, fibromyalgia, "hardening of the arteries" (atherosclerosis), memory loss, rheumatoid arthritis, schizophrenia, improving athletic performance, improving mental performance, as an anti-aging aid, menopausal symptoms, complications during pregnancy or childbirth, and for nervous exhaustion (neurasthenia).
You may also see American ginseng listed as an ingredient in some soft drinks. Oils and extracts made from American ginseng are used in soaps and cosmetics.
Don't confuse American ginseng with Siberian ginseng (Eleutherococcus senticosus) or Asian ginseng (Panax ginseng). They have different medicinal effects.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for AMERICAN GINSENG are as follows:
Possibly effective for...
- Diabetes. Taking 3 grams of American ginseng by mouth, up to two hours before a meal, can lower blood sugar after a meal in patients with type 2 diabetes. However, larger doses do not seem to have a greater effect. Taking 100-200 mg of American ginseng by mouth for 8 weeks might also help lower pre-meal blood sugar levels in patients with type 2 diabetes. Different American ginseng products may have different effects. Researchers think that is because they contain different amounts of the active chemicals called ginsenosides.
- Respiratory tract infections. Some research suggests that taking a specific American ginseng extract called CVT-E002 (Cold-FX, Afexa Life Sciences, Canada) 200-400 mg twice daily for 3-6 months during flu season might prevent cold or flu symptoms in adults between the ages of 18 and 65. People older than 65 seem to need a flu shot at month 2 along with this treatment in order to decrease their risk of getting the flu or colds. This extract also seems to help make symptoms milder and last a shorter length of time when infections do occur. Some evidence suggests that the extract might not reduce the chance of getting the first cold of a season, but it seems to reduce the risk of getting repeat colds in a season. However, it might not help prevent cold or flu-like symptoms in patients with weakened immune systems.
Possibly ineffective for...
- Athletic performance. Taking 1600 mg of American ginseng by mouth for 4 weeks does not seem to improve athletic performance. But it might decrease muscle damage during exercise.
Insufficient evidence to rate effectiveness for...
- Insulin resistance caused by HIV treatment. Early research shows that taking capsules containing 1 gram of American ginseng root three times daily for 14 days while receiving the drug indinavir, which is a type of HIV therapy, does not reduce insulin resistance caused by indinavir in healthy people.
- Attention deficit-hyperactivity disorder (ADHD). There is early evidence that a specific product (AD-fX, Afexa Life Sciences, Canada) containing American ginseng extract in combination with ginkgo leaf extract might help improve ADHD symptoms such as anxiety, hyperactivity, and impulsiveness in children aged 3-17 years.
- Breast cancer. Some studies conducted in China suggest that breast cancer patients treated with any form of ginseng (American or Panax) do better and feel better. However, this may not be a result of taking the ginseng, because the patients in the study were also more likely to be treated with the prescription cancer drug tamoxifen. It is difficult to know how much of the benefit to attribute to ginseng.
- Cancer-related fatigue. Research on the effects of American ginseng in people with fatigue related to cancer is not consistent. One study shows that taking 700-2000 mg of American ginseng daily for 8 weeks does not reduce fatigue in people with cancer. However, other research shows that taking 2000 mg of American ginseng in two doses daily for 8 weeks reduces fatigue by 51%. The conflicting results might be due to the different methods used to measure fatigue in the studies.
- Mental performance. Some research suggests that taking one 100-400 mg dose of American ginseng (Cereboost, Naturex) 1-6 hours before mental tests improves short-term memory and reaction time in healthy people.
- High blood pressure. Evidence on the effects of American ginseng in people with high blood pressure is not consistent. Some research shows that taking 1500 mg of American ginseng twice daily for 12 weeks does not reduce blood pressure. But other research shows that taking 1000 mg of American ginseng extract three times daily for 12 weeks lowers blood pressure in people with diabetes and high blood pressure. The differences in the research might be related to the amount of ginsenosides, the active chemical in American ginseng, that is contained in the products used.
- Menopausal symptoms. Early research suggests that taking a product containing American ginseng, black cohosh, dong quai, milk thistle, red clover, and vitex agnus-castus (Phyto-Female Complex, SupHerb, Netanya, Israel) twice daily for 3 months reduces menopausal symptoms, including hot flashes, night sweats, and sleep quality. However, it is not clear if these effects are caused by American ginseng or the other ingredients in the product.
- Schizophrenia. Early research shows that American ginseng might improve some mental symptoms associated with schizophrenia. Taking 100 mg of a specific American ginseng extract called HT1001 (Afexa Life Sciences, Canada) twice daily for 4 weeks improves the patient's ability to hold visual information in the mind short-term. This treatment might also reduce some physical side effects of antipsychotic drugs. However, it does not improve other mental symptoms.
- Bleeding disorders.
- Digestive disorders.
- Hangover symptoms.
- Memory loss.
- Nerve pain.
- Pregnancy and childbirth complications.
- Rheumatoid arthritis.
- Swine flu.
- Other conditions.
How does it work?
Are there safety concerns?
When taken by mouth, American ginseng can cause some side effects including diarrhea, itching, trouble sleeping (insomnia), headache, and nervousness. In some people, American ginseng might also cause rapid heartbeat, increased blood pressure or decreased blood pressure, breast tenderness, vaginal bleeding in women, and other side effects. Uncommon side effects that have been reported include a severe rash called Stevens-Johnson syndrome, liver damage, and severe allergic reaction.
Special precautions & warnings:Children: American ginseng is POSSIBLY SAFE for children when taken by mouth appropriately, short-term. A specific American ginseng extract called CVT-E002 (Cold-FX, Afexa Life Sciences, Canada) has been used in doses of 4.5-26 mg/kg daily for 3 days in children 3-12 years-old.
Pregnancy and breast-feeding: American ginseng is POSSIBLY UNSAFE in pregnancy. One of the chemicals in Panax ginseng, a plant related to American ginseng, has been linked to possible birth defects. Do not take American ginseng if you are pregnant.
There is not enough reliable information about the safety of taking American ginseng if you are breast feeding. Stay on the safe side and avoid use.
Diabetes: American ginseng might lower blood sugar. In people with diabetes who are taking medications to lower blood sugar, adding American ginseng might lower it too much. Monitor your blood sugar closely if you have diabetes and use American ginseng.
Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: American ginseng preparations that contain chemicals called ginsenosides might act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don't use American ginseng that contains ginsenosides. However, some American ginseng extracts have had the ginsenosides removed (Cold-FX, Afexa Life Sciences, Canada). American ginseng extracts such as these that contain no ginsenosides or contain only a low concentration of ginsenosides do not appear to act like estrogen.
Trouble sleeping (insomnia): High doses of American ginseng have been linked with insomnia. If you have trouble sleeping, use American ginseng with caution.
Schizophrenia (a mental disorder): High doses of American ginseng have been linked with sleep problems and agitation in people with schizophrenia . Be careful when using American ginseng if you have schizophrenia.
Surgery: American ginseng might affect blood sugar levels and might interfere with blood sugar control during and after surgery. Stop taking American ginseng at least 2 weeks before a scheduled surgery.
Are there interactions with medications?
- Warfarin (Coumadin)
- Warfarin (Coumadin) is used to slow blood clotting. American ginseng has been reported to decrease the effectiveness of warfarin (Coumadin). Decreasing the effectiveness of warfarin (Coumadin) might increase the risk of clotting. It is unclear why this interaction might occur. To avoid this interaction, do not take American ginseng if you take warfarin (Coumadin).
- Medications for depression (MAOIs)
- American ginseng might stimulate the body. Some medications used for depression can also stimulate the body. Taking American ginseng along with these medications used for depression might cause side effects such as anxiousness, headache, restlessness, and insomnia.
Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.
- Medications for diabetes (Antidiabetes drugs)
- American ginseng might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking American ginseng along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
- Medications that decrease the immune system (Immunosuppressants)
- American ginseng can increase the immune system. Taking American ginseng along with some medications that decrease the immune system might decrease the effectiveness of these medications.
Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), and other corticosteroids (glucocorticoids).
Are there interactions with herbs and supplements?
- Herbs and supplements that can lower blood sugar
- American ginseng might lower blood sugar. If it is taken along with other herbs and supplements that might lower blood sugar, blood sugar might get too low in some people. Some herbs and supplements that might lower blood sugar include devil's claw, fenugreek, ginger, guar gum, Panax ginseng, and Siberian ginseng.
Are there interactions with foods?
- There are no known interactions with foods.
What dose is used?
- For reducing blood sugar in people with type 2 diabetes: 3 grams up to 2 hours before a meal. American ginseng should be taken within 2 hours of a meal. If it is taken too long before eating, the blood sugar might become too low.100-200 mg of American ginseng have been taken daily for up to 8 weeks.
- For preventing upper respiratory tract infections such as the common cold or flu: a specific American ginseng extract called CVT-E002 (Cold-FX, Afexa Life Sciences, Canada) 200-400 mg twice daily for 3-6 months has been used.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.
- McElhaney JE, Simor AE, McNeil S, Predy GN. Efficacy and safety of CVT-E002, a proprietary extract of panax quinquefolius in the prevention of respiratory infections in influenza-vaccinated community-dwelling adults: a multicenter, randomized, double-blind, and placebo-controlled trial. Influenza Res Treat 2011;2011:759051. View abstract.
- Carlson AW. Ginseng: America's botanical drug connection to the orient. Economic Botany. 1986;40:233-249.
- Wang CZ, Kim KE, Du GJ, et al. Ultra-Performance Liquid Chromatography and Time-of-Flight Mass Spectrometry Analysis of Ginsenoside Metabolites in Human Plasma. Am J Chin Med. 2011; 39: 1161-1171. View abstract.
- Charron D, Gagnon D. The demography of northern populations of Panax quinquefolium (American ginseng). J Ecology. 1991;79:431-445.
- Martínez-Mir I, Rubio E, Morales-Olivas FJ, Palop-Larrea V. Transient ischemic attack secondary to hypertensive crisis related to Panax ginseng. Ann Pharmacother 2004;38:1970. View abstract.
- Andrade ASA, Hendrix C, Parsons TL, et al. Pharmacokinetic and metabolic effects of American ginseng (Panax quinquefolius) in healthy volunteers receiving the HIV protease inhibitor indinavir. BMC Complement Alt Med. 2008;8:50. View abstract.
- Mucalo I, Jovanovski E, Rahelic D, et al. Effect of American ginseng (Panax quinquefolius L.) on arterial stiffness in subjects with type-2 diabetes and concomitant hypertension. J Ethnopharmacol. 2013;150:148-53. View abstract.
- High KP, Case D, Hurd D, et al. A randomized, controlled trial of Panax quinquefolius extract (CVT-E002) to reduce respiratory infection in patients with chronic lymphocytic leukemia. J Support Oncol. 2012;10:195-201. View abstract.
- Chen EY, Hui CL. HT1001, a proprietary North American ginseng extract, improves working memory in schizophrenia: a double-blind, placebo-controlled study. Phytother Res. 2012;26:1166-72. View abstract.
- Barton DL, Liu H, Dakhil SR, et al. Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. J Natl Cancer Inst. 2013;105:1230-8. View abstract.
- Lee, S. T., Chu, K., Sim, J. Y., Heo, J. H., and Kim, M. Panax ginseng enhances cognitive performance in Alzheimer disease. Alzheimer Dis.Assoc.Disord. 2008;22:222-226. View abstract.
- Barton DL, Soori GS, Bauer BA, et al. Pilot study of Panax quinquefolius (American ginseng) to improve cancer-related fatigue: a randomized, double-blind, dose-finding evaluation: NCCTG trial N03CA. Support Care Cancer 2010;18:179-87. View abstract.
- Stavro PM, Woo M, Leiter LA, et al. Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 2006;47:791-6. View abstract.
- Stavro PM, Woo M, Heim TF, et al. North American ginseng exerts a neutral effect on blood pressure in individuals with hypertension. Hypertension 2005;46:406-11. View abstract.
- Scholey A, Ossoukhova A, Owen L, et al. Effects of American ginseng (Panax quinquefolius) on neurocognitive function: an acute, randomised, double-blind, placebo-controlled, crossover study. Psychopharmacology (Berl) 2010;212:345-56. View abstract.
- Predy GN, Goel V, Lovlin RE, et al. Immune modulating effects of daily supplementation of COLD-fX (a proprietary extract of North American ginseng) in healthy adults. J Clin Biochem Nutr 2006;39:162-167.
- Vohra S, Johnston BC, Laycock KL, et al. Safety and tolerability of North American ginseng extract in the treatment of pediatric upper respiratory tract infection: a phase II randomized, controlled trial of 2 dosing schedules. Pediatrics 2008;122:e402-10. View abstract.
- Rotem C, Kaplan B. Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study. Gynecol Endocrinol 2007;23:117-22. View abstract.
- King ML, Adler SR, Murphy LL. Extraction-dependent effects of American ginseng (Panax quinquefolium) on human breast cancer cell proliferation and estrogen receptor activity. Integr Cancer Ther 2006;5:236-43. View abstract.
- Hsu CC, Ho MC, Lin LC, et al. American ginseng supplementation attenuates creatine kinase level induced by submaximal exercise in human beings. World J Gastroenterol 2005;11:5327-31. View abstract.
- Sengupta S, Toh SA, Sellers LA, et al. Modulating angiogenesis: the yin and the yang in ginseng. Circulation 2004;110:1219-25. View abstract.
- Cui Y, Shu XO, Gao YT, et al. Association of ginseng use with survival and quality of life among breast cancer patients. Am J Epidemiol 2006;163:645-53. View abstract.
- McElhaney JE, Goel V, Toane B, et al. Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo controlled trial. J Altern Complement Med 2006;12:153-7. View abstract.
- Lim W, Mudge KW, Vermeylen F. Effects of population, age, and cultivation methods on ginsenoside content of wild American ginseng (Panax quinquefolium). J Agric Food Chem 2005;53:8498-505. View abstract.
- Eccles R. Understanding the symptoms of the common cold and influenza. Lancet Infect Dis 2005;5:718-25. View abstract.
- Turner RB. Studies of "natural" remedies for the common cold: pitfalls and pratfalls. CMAJ 2005;173:1051-2. View abstract.
- Wang M, Guilbert LJ, Ling L, et al. Immunomodulating activity of CVT-E002, a proprietary extract from North American ginseng (Panax quinquefolium). J Pharm Pharmacol 2001;53:1515-23. View abstract.
- Wang M, Guilbert LJ, Li J, et al. A proprietary extract from North American ginseng (Panax quinquefolium) enhances IL-2 and IFN-gamma productions in murine spleen cells induced by Con-A. Int Immunopharmacol 2004;4:311-5. View abstract.
- Chen IS, Wu SJ, Tsai IL. Chemical and bioactive constituents from Zanthoxylum simulans. J Nat Prod 1994;57:1206-11. View abstract.
- Predy GN, Goel V, Lovlin R, et al. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ 2005;173:1043-8.. View abstract.
- Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. Decreasing, null and increasing effects of eight popular types of ginseng on acute postprandial glycemic indices in healthy humans: the role of ginsenosides. J Am Coll Nutr 2004;23:248-58. View abstract.
- Yuan CS, Wei G, Dey L, et al. American ginseng reduces warfarin's effect in healthy patients: a randomized, controlled trial. Ann Intern Med 2004;141:23-7. View abstract.
- Wiwanikit V, Taungjarwinai W. A case report of suspected ginseng allergy. Medscape General Medicine 6 , 2004. Available at: www.medscape.com/viewarticle/482833 (Accessed 17 September 2004).
- 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;52:13-9. View abstract.
- Murphy LL, Lee TJ. Ginseng, sex behavior, and nitric oxide. Ann N Y Acad Sci 2002;962:372-7. View abstract.
- Lee YJ, Jin YR, Lim WC, et al. Ginsenoside-Rb1 acts as a weak phytoestrogen in MCF-7 human breast cancer cells. Arch Pharm Res 2003;26:58-63.. View abstract.
- Chan LY, Chiu PY, Lau TK. An in-vitro study of ginsenoside Rb-induced teratogenicity using a whole rat embryo culture model. Hum Reprod 2003;18:2166-8.. View abstract.
- Benishin CG, Lee R, Wang LC, Liu HJ. Effects of ginsenoside Rb1 on central cholinergic metabolism. Pharmacology 1991;42:223-9.. View abstract.
- Wang X, Sakuma T, Asafu-Adjaye E, Shiu GK. Determination of ginsenosides in plant extracts from Panax ginseng and Panax quinquefolius L. by LC/MS/MS. Anal Chem 1999;71:1579-84.. View abstract.
- Yuan CS, Attele AS, Wu JA, et al. Panax quinquefolium L. inhibits thrombin-induced endothelin release in vitro. Am J Chin Med 1999;27:331-8. View abstract.
- Li J, Huang M, Teoh H, Man RY. Panax quinquefolium saponins protects low density lipoproteins from oxidation. Life Sci 1999;64:53-62.. View abstract.
- Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. Variable effects of American ginseng: a batch of American ginseng (Panax quinquefolius L.) with a depressed ginsenoside profile does not affect postprandial glycemia. Eur J Clin Nutr 2003;57:243-8. View abstract.
- Lyon MR, Cline JC, Totosy de Zepetnek J, et al. Effect of the herbal extract combination Panax quinquefolium and Ginkgo biloba on attention-deficit hyperactivity disorder: a pilot study. J Psychiatry Neurosci 2001;26:221-8. View abstract.
- Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause 2002;9:145-50. View abstract.
- Luo P, Wang L. Peripheral blood mononuclear cell production of TNF-alpha in response to North American ginseng stimulation [abstract]. Alt Ther 2001;7:S21.
- Vuksan V, Stavro MP, Sievenpiper JL, et al. Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes. Diabetes Care 2000;23:1221-6. View abstract.
- Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.
- Morris AC, Jacobs I, McLellan TM, et al. No ergogenic effect of ginseng ingestion. Int J Sport Nutr 1996;6:263-71. View abstract.
- Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care 1995;18:1373-5. View abstract.
- Siegel RK. Ginseng Abuse Syndrome. JAMA 1979;241:1614-5.
- Park HJ, Lee JH, Song YB, Park KH. Effects of dietary supplementation of lipophilic fraction from Panax ginseng on cGMP and cAMP in rat platelets and on blood coagulation. Biol Pharm Bull 1996;19:1434-9. View abstract.
- Vuksan V, Sievenpiper JL, Koo VY, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med 2000;160:1009-13. View abstract.
- Janetzky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm 1997;54:692-3. View abstract.
- Jones BD, Runikis AM. Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987;7:201-2. View abstract.
- Shader RI, Greenblatt DJ. Phenelzine and the dream machine-ramblings and reflections. J Clin Psychopharmacol 1985;5:65. View abstract.
- Hamid S, Rojter S, Vierling J. Protracted cholestatic hepatitis after the use of Prostata. Ann Intern Med 1997;127:169-70. View abstract.
- Brown R. Potential interactions of herbal medicines with antipsychotics, antidepressants and hypnotics. Eur J Herbal Med 1997;3:25-8.
- Dega H, Laporte JL, Frances C, et al. Ginseng as a cause of Stevens-Johnson syndrome. Lancet 1996;347:1344. View abstract.
- Ryu S, Chien Y. Ginseng-associated cerebral arteritis. Neurology 1995;45:829-30. View abstract.
- Gonzalez-Seijo JC, Ramos YM, Lastra I. Manic episode and ginseng: Report of a possible case. J Clin Psychopharmacol 1995;15:447-8. View abstract.
- Greenspan EM. Ginseng and vaginal bleeding [letter]. JAMA 1983;249:2018. View abstract.
- Hopkins MP, Androff L, Benninghoff AS. Ginseng face cream and unexplained vaginal bleeding. Am J Obstet Gynecol 1988;159:1121-2. View abstract.
- Palmer BV, Montgomery AC, Monteiro JC, et al. Gin Seng and mastalgia [letter]. BMJ 1978;1:1284. View abstract.
- Scaglione F, Cattaneo G, Alessandria M, Cogo R. Efficacy and safety of the standardized Ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold. Drugs Exp Clin Res 1996;22:65-72. View abstract.
- Foster S, Tyler VE. Tyler's Honest Herbal, 4th ed., Binghamton, NY: Haworth Herbal Press, 1999.
- Duda RB, Zhong Y, Navas V, et al. American ginseng and breast cancer therapeutic agents synergistically inhibit MCF-7 breast cancer cell growth. J Surg Oncol 1999;72:230-9. View abstract.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.