Adaptogens · Herbs & Botanicals · North American ginseng root with low-certainty evidence for colds, fatigue and blood sugar

American Ginseng

Q: Can American ginseng prevent colds?

Maybe slightly, but the evidence is weak. Several trials of one branded extract (COLD-fX) found fewer colds or shorter illness in healthy adults and older adults. But the largest trial (783 people) missed its main goal, a trial in people with early leukemia found no drop in illness days, and a review of five trials said the evidence was insufficient to conclude fewer or milder colds. Results for COLD-fX do not automatically apply to plain root or other products.

Q: Does American ginseng help with fatigue from cancer?

There is some support. In a US trial of 364 fatigued cancer survivors, those on American ginseng reported more improvement at 8 weeks than those on placebo, especially people still having cancer treatment. It missed its planned 4-week main time point, and a small trial in head and neck cancer survivors found no benefit. A 2024 guideline says it may be recommended for adults during treatment. Ask the cancer team first.

Q: Does American ginseng improve memory and focus?

Possibly a little, on lab tests. In several small trials of a branded extract (Cereboost), healthy adults did better on working memory tasks within hours. The trials were short, in healthy people, and linked to the makers. A trial in race car drivers found no significant cognitive effect, and nothing shows it helps everyday memory or protects against dementia.

Q: Does American ginseng lower blood sugar?

In small trials it lowered the blood sugar rise after a glucose drink in healthy people, but the effect depended on the batch of root. In one 24-person trial of people with type 2 diabetes, HbA1c was 0.29 points lower and fasting glucose 0.71 mmol/L lower than on placebo. That is a modest change from one small trial, so do not use it in place of diabetes treatment.

Q: Does American ginseng raise or lower blood pressure?

Not in people with high blood pressure: two trials (a single dose and 12 weeks) found no effect, and a pooled analysis of ginseng of all kinds found no significant change. In two trials of people with both diabetes and high blood pressure, systolic pressure was lower. If you take blood pressure medicine, tell your prescriber.

Q: Is it safe to take American ginseng with warfarin?

Not without telling your anticoagulant clinic. In a randomised trial of 20 healthy volunteers, American ginseng lowered the peak INR (the clotting test) and blood warfarin levels compared with placebo, so it could make warfarin less effective. It has not been tested in patients on steady warfarin doses, so the real-life size of the effect is unknown.

Q: Can I take American ginseng with diabetes medicine?

Ask your doctor or pharmacist first. American ginseng lowered blood sugar in small trials, so it might add to the effect of diabetes medicines or insulin. The trials read did not report low blood sugar problems, but they were small and not designed to find them.

Q: What are the side effects? Does it cause insomnia or liver problems?

In the American ginseng trials read, side effects were not more common than on placebo, including in a 364-person cancer trial and a 74-person diabetes safety trial that also found no change in liver tests. Insomnia is the most common side effect listed for Asian ginseng by NIH; whether it occurs with American ginseng was not reported in the abstracts. No case of liver injury from American ginseng was found, but the NIH LiverTox entry could not be read. The longest trial was 6 months.

Q: Is American ginseng safe in pregnancy or while breastfeeding?

Not enough is known, so it is best avoided unless a clinician agrees. No human study was found. A lab study of a ginseng compound (Rg3) slowed the heart rate of rat embryos. One small trial in 46 children aged 3 to 12 found no serious problems, but ask a paediatrician before giving it to a child.

Q: What is the difference between American, Asian and Siberian ginseng?

They are different plants. American ginseng is Panax quinquefolius; Asian ginseng is Panax ginseng; Siberian ginseng is Eleutherococcus, a different genus. Their chemistry differs (Rb1, pseudoginsenoside F11 and Rd are more typical of American; Rf, Rb2 and Rc of Asian). In one trial Asian ginseng raised blood sugar while American ginseng tended to lower it. Many reviews mix species, so check which one a result is about.

Panax quinquefolius L. · also called North American ginseng, Wisconsin ginseng, five-leaved ginseng, occidental ginseng, xi yang shen (Chinese), ginseng americano (Spanish), amerikanischer Ginseng (German); the COLD-fX type extract is CVT-E002

American ginseng (Panax quinquefolius) is a perennial root herb native to eastern North America. It is sold as ground root, capsules and extracts, most famously the COLD-fX extract taken for colds. It is a different species from Asian ginseng (Panax ginseng) and Siberian ginseng. Nothing about it is rated above low certainty. Cold-prevention trials lean slightly positive but the largest missed its main goal. A large US trial and a 2024 guideline support use for fatigue during cancer treatment. Small trials suggest lower blood sugar and better working memory scores. Safety points: it weakened warfarin in a trial, may add to diabetes medicines, has no pregnancy data, and products vary or are mixed with other species.

General information, not medical advice. Last substantive update October 25, 2026 · Not medically reviewed. A named clinician has not signed off on this page. How this page is made

Get your American Ginseng today. Order now from Amazon and have it delivered to your door.Shop American Ginseng on AmazonSupport our free guides: as an Amazon Associate we earn from qualifying purchases.

About American Ginseng

American ginseng (Panax quinquefolius) is a North American root herb, a different species from Asian ginseng (Panax ginseng) and Siberian ginseng. Its best-known use is a branded root extract (COLD-fX) taken to try to prevent colds: results are mixed and the largest trial missed its main goal. It has also been tested for cancer-related fatigue (a large US trial and a 2024 guideline support use during cancer treatment), for blood sugar and for working memory. Nothing is rated above low certainty. The main safety points are a trial showing it weakened warfarin, possible added effects with diabetes medicines, no data in pregnancy, and products that vary or are mixed with other species.

What it is

American ginseng (Panax quinquefolius L.) is a perennial herb of the Araliaceae family. GBIF lists it as native to eastern North America, from Ontario and Quebec down through many US states, and as introduced in China and Myanmar. The root is the part used, as ground root, extracts and capsules. Trials name Wisconsin-grown and Ontario-grown root.

It is a separate species from Asian ginseng (Panax ginseng). Siberian ginseng (Eleutherococcus) is not a Panax at all. Many ginseng reviews mix species, so each result on this page names the species and product where it matters.

^{60 61 12}

What is in it and how it works

The best-known compounds are ginsenosides (saponins). Rb1 is the main one, and pseudoginsenoside F11 and Rd are more typical of American than Asian ginseng, which has more Rf, Rb2 and Rc. Some extracts are rich in sugar chains called polysaccharides instead: the COLD-fX type extract is one. Rats given the polysaccharide extract and a ginsenoside extract showed different immune effects.

After a large dose of root powder, Rb1 appeared in human blood and gut bacteria turned it into compound K. Most mechanism work is in cells and animals and does not show how it acts in people. The mix of compounds varies from batch to batch, which matters because blood-sugar effects varied between batches.

^{12 54 7 46 14}

Traditional and current uses

We could not confirm details of historical use by Indigenous peoples or in Chinese medicine from the sources read, so those are not described here. A 2011 review says a standardised ginseng extract became the best-selling cold and flu remedy in Canada. Today it is also taken for energy and tiredness, blood sugar and thinking.

Health authorities: the ASCO and Society for Integrative Oncology guideline says it may be recommended for fatigue in adults during cancer treatment. We did not confirm an EU monograph or Health Canada wording for American ginseng.

^{43 9}

What the research shows

Colds: five trials of North American ginseng (747 people) found 25% fewer total colds in one trial and 6.2 days shorter illness in two, but the reviewers said the evidence was insufficient to conclude fewer or milder colds. The biggest trial (783 people) missed its main goal. In people with early leukemia it did not cut illness days. Cancer fatigue: a US trial of 364 survivors found more improvement at 8 weeks, but missed its 4-week main time point; a small trial in head and neck survivors was null.

Blood sugar and blood pressure: small trials from one research network show lower blood sugar after a glucose drink, and a small fall in HbA1c in type 2 diabetes. Blood pressure was unchanged in people with hypertension but lower in two trials in people with diabetes and hypertension. Thinking: several small trials of one branded extract showed better working memory test scores. Pooled reviews often mix Asian and American ginseng and do not apply to American ginseng alone.

^{43 34 23 4 21 53 36 49 42 28}

At a glance

Traditional uses history, not proof

Sold in Canada as a cold and flu remedy: a 2011 review says a standardised extract became the best-selling cold and flu remedy there
Taken for tiredness, blood sugar and thinking (current use)
Historical use by Indigenous peoples and in Chinese medicine could not be confirmed from the sources read

Studied for research

Colds and respiratory infections, low certainty; the biggest trial missed its main goal
Cancer-related fatigue, low certainty; a guideline says it may be recommended during treatment
Working memory in healthy adults, low certainty; mostly one branded extract
Blood sugar after a glucose drink and in type 2 diabetes, low certainty
Blood pressure, mixed; cholesterol, mood, immune markers and muscle damage, very low
Cancer prevention or treatment: no human evidence

Main compounds

Ginsenosides, mainly Rb1; pseudoginsenoside F11 and Rd are more typical of American than Asian ginseng
Polysaccharides (sugar chains) in the COLD-fX type extract
Compound K, made by gut bacteria from Rb1
Panaxynol (polyacetylene), reported in a paper title only

Common forms

Ground root powder and capsules
Branded extracts studied in trials: CVT-E002 / COLD-fX (polysaccharide-rich), Cereboost and HT1001 (ginsenoside-rich)
Alcohol and water extracts, which behaved differently in lab studies
Asian ginseng and Siberian ginseng are different plants

Research links: NIH NCCIH: Asian ginseng (covers Asian ginseng only) · ASCO and Society for Integrative Oncology fatigue guideline (2024) · GBIF: Panax quinquefolius · Research Library · Genes & Biomarkers Library

The plant and its history

Accepted scientific name: Panax quinquefolius L.
Naming authority: L. (Linnaeus), as shown in the GBIF backbone name. Place and year of the original description were not checked.
Synonyms: Aralia quinquefolia (L.) Decne. & Planch.; Aureliana canadensis Lafit.; Ginseng quinquefolium (L.) Alph.Wood; Panax americanus (Raf.) Raf.; Panax cuneatus Raf.; Panax obovatus Raf.; Panax quinquefolius var. americanus Raf.; Panax quinquefolius var. obovatus Raf.
Common names: American ginseng (English); North American ginseng (English (used in trial titles)); Five-leaved ginseng (English); Occidental ginseng (English); Wisconsin ginseng (English (used for the Wisconsin-grown root in the N07C2 trial title)); Sang (English (US trade term, listed in GBIF)); Redberry (English (listed in GBIF)); ginseng americano (Spanish); ginseng d'Amérique (French); amerikanischer Ginseng (German); xi yang shen (Chinese (pinyin; language field blank in GBIF)); Zhooniyaa Ojiibik (Ojibwe (code oji in GBIF))
Botanical family: Araliaceae (order Apiales). The genus Panax is the "true ginseng" group: Asian ginseng (P. ginseng), Sanchi or notoginseng (P. notoginseng) and Japanese ginseng (P. japonicus) are separate species named in the sources read. Siberian ginseng (Eleutherococcus senticosus) is in a different genus.
Classification: Plantae > Tracheophyta > Magnoliopsida > Apiales > Araliaceae > Panax > Panax quinquefolius
Native range: GBIF, drawing on ITIS, Catalogue of Life, the World Checklist of Vascular Plants and VASCAN, lists it as native to eastern North America: Canada (Ontario, Quebec) and many US states from Maine and Minnesota down to Alabama and Louisiana, including Wisconsin. It is listed as introduced in China and Myanmar.
Habitat: NOT verified from a source read. GBIF habit entry (VASCAN) says "herb". Habitat descriptions were not read.
What the plant looks like: Roots: Not described in the sources read. The root is the part used in the trials.; Stems: Not described in the sources read.; Leaves: Not described in the sources read. The species epithet "quinquefolius" and the English name "five-leaved ginseng" point to leaves made of five leaflets (GBIF names list), but this was not checked against a botanical description.; Flowers: Not described in the sources read.; Fruit: Not described in the sources read; "redberry" is listed as an English name in GBIF.
Cultivation: Trial titles name Wisconsin-grown and Ontario-grown root, so farm-grown root is used in research. The farming methods were not read.
Harvest and processing: Processing changes the product. In two studies the type of extract changed the result: an alcohol extract acted like estrogen in breast cancer cells while a water extract did not, and only a water extract reduced muscle damage in rats. Drying, age at harvest and steaming were not covered in the sources read.
Look-alikes and adulterants: Name: Asian ginseng (Panax ginseng); Note: The main look-alike and the species most often confused with it. A 2026 study found the two very hard to tell apart under the microscope; chemical fingerprints differ (Rb1, pseudoginsenoside F11 and Rd more typical of American; Rf, Rb2 and Rc more typical of Asian).; Name: Sanchi or notoginseng (Panax notoginseng); Note: Another Panax species, named in reviews as a common market substitute.; Name: Japanese ginseng (Panax japonicus); Note: Another Panax species, included in a 2026 authentication study.; Name: Siberian ginseng (Eleutherococcus senticosus); Note: A different genus sold as "ginseng"; a 25-product survey measured its marker compounds (eleutherosides) separately from Panax ginsenosides.; Name: Codonopsis pilosula and Platycodon grandiflorus; Note: Root plants named as common adulterants of Panax roots; they lack ginsenosides.
Sustainability and conservation: GBIF shows no IUCN Red List assessment ("not evaluated"). Trade controls under CITES were not verified.

Traditional use and history history, not clinical proof

Tradition or era	Documented use	Source
Use by Indigenous peoples of North America and early trade with China	NOT verified. It is widely stated that American ginseng root was used by Indigenous peoples and was exported to China from the early 1700s, but no source read for this profile confirms the details, and Wikipedia-level summaries were not accepted as evidence.	unverified
Traditional Chinese medicine (xi yang shen)	NOT verified. "Xi yang shen" is listed in GBIF as a Chinese name. How traditional Chinese practice uses it, and how it differs from Asian ginseng, was not confirmed from a source read. The 2017 review by Mancuso says Asian and American ginseng have been used in traditional Chinese medicine for a very long time, but does not separate the two.	p28698154
Canada, from the early 2000s	A 2011 review states that a standardised ginseng extract had become the best-selling cold and flu remedy in Canada. Trials of the extract (CVT-E002, sold as COLD-fX) were published from 2004.	p19592479
Regulatory status	NOT verified. No EU herbal monograph for American ginseng was confirmed. The Health Canada monograph (dated 2024-11-29 in a search snippet) was not read.	unverified

Traditional use shows how a plant was used. It does not show that a supplement works or is safe today.

What is inside, and how it may work

What the plant contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.

Main compounds

Compound	Family	Where it is concentrated	Activity studied	Level of evidence
Ginsenoside Rb1 PubChem 9898279	protopanaxadiol-type ginsenoside (saponin)	Root The main ginsenoside of American ginseng per Gray 2004; 10.65% total ginsenosides in the Cereboost extract; one low-quality batch had 1.66% total.	Best-known marker compound. Found in human blood after a 10 g dose of root powder (peak 19.9 ng/mL at 4 hours) and turned into compound K by gut bacteria. Did not bind estrogen receptors in a test-tube assay. ^{20 54 12}	Human data
Ginsenoside Rd PubChem 11679800	protopanaxadiol-type ginsenoside	Root Not quantified in the sources read.	More typical of American than Asian ginseng in 38 commercial samples; detected in human plasma after American ginseng. ^{12 54}	Human data
Ginsenoside Rg1 PubChem 441923	protopanaxatriol-type ginsenoside	Root Described as the major ginsenoside of Asian, not American, ginseng (Gray 2004); present at lower levels in American ginseng.	Did not bind estrogen receptors in the test-tube assay. ^{20 46}	Laboratory research
Ginsenoside Re PubChem 441921	protopanaxatriol-type ginsenoside	Root Not quantified in the sources read.	One of seven ginsenosides measured in the blood sugar trials; tested in the CYP test-tube work. ^{47 10}	Laboratory research
Ginsenosides Rc and Rb2 PubChem 12855889	protopanaxadiol-type ginsenosides	Root Not quantified in the sources read. (Rb2 PubChem CID 6917976.)	More typical of Asian than American ginseng in 38 commercial samples. ¹²	Laboratory research
Ginsenoside Rf PubChem 441922	protopanaxatriol-type ginsenoside	Root Not quantified in the sources read.	More typical of Asian ginseng in the 38-sample comparison. ¹²	Laboratory research
Pseudoginsenoside F11 PubChem 21633072	ocotillol-type ginsenoside	Root Not quantified in the sources read.	More typical of American than Asian ginseng in the 38-sample comparison, so it works as a chemical marker for telling them apart. ^{12 56}	Laboratory research
Ginsenoside Rg3 (20(S)-Rg3) PubChem 9918693	protopanaxadiol-type ginsenoside	Mainly formed by heat processing (steaming); wild American samples had less than cultivated ones in one comparison Not quantified in the sources read.	In a rat embryo culture the isolated compound slowed the embryonic heart rate. Added to American ginseng in one combination trial in the form of Rg3-enriched Korean red ginseng. ^{12 40 26}	Laboratory research
Compound K (ginsenoside K) PubChem 9852086	protopanaxadiol metabolite made by gut bacteria	Not in the plant; made in the gut from Rb1 Appeared in human plasma from 7 to 12 hours after a 10 g dose of American ginseng root (7.32 ng/mL at 12 hours).	Shows that gut bacteria change the plant compounds before they reach the blood. ⁵⁴	Human data
Poly-furanosyl-pyranosyl-saccharides (polysaccharides)	polysaccharides (sugar chains)	Root (concentrated in CVT-E002) The COLD-fX type extract is polysaccharide-rich; the paediatric trial product was standardised to 80% of these saccharides.	In rats, the polysaccharide-rich extract changed immune cytokines differently from a ginsenoside extract. ^{7 50}	Animal research
Panaxynol (falcarinol) PubChem 5281149	polyacetylene	Root (per a paper title) Not quantified in the sources read.	Described by a 2024 paper title as a compound from American ginseng. Only the title is verified. ¹⁷	Laboratory research

Mechanisms, receptors and pathways

Target or pathway	Gene or receptor	What was found	Level
Conversion of ginsenosides by gut bacteria	Intestinal microbiota	After 10 g of American ginseng root powder, Rb1 fell from a 4-hour peak while compound K rose from 7 to 12 hours, supporting a role of gut bacteria in changing Rb1 to compound K. ⁵⁴	Human data
Immune signalling	IL-2, interferon-gamma, T cells, gut IgA	In rats, CVT-E002 lowered spleen IL-2 and interferon-gamma output and activated T cells; a ginsenoside extract raised gut IgA-positive cells instead. In 10 men, ginseng lowered CD8+ T cells and raised ex vivo IL-2 production. ^{7 8}	Animal research
Estrogen receptor binding	Estrogen receptor alpha and beta	An alcohol extract bound both estrogen receptors and activated estrogen-responsive genes in breast cancer cells; a water extract did not. Receptor binding in root extracts was linked to zearalenone, a mould toxin, not to Rb1 or Rg1. ^{27 20}	Laboratory research
Liver enzymes that handle drugs	CYP1A1, CYP1A2, CYP1B1; CYP3A4, CYP2C9	In test tubes a North American ginseng extract inhibited CYP1 enzymes, and was 45 times stronger against CYP1A2 than an Asian ginseng extract. In rats neither species raised CYP2B1, CYP3A23 or CYP1A2 expression. In another rat study ginsenosides raised CYP3A4 and CYP2C9 activity while lowering warfarin levels (ginseng species not stated). ^{10 57 16}	Laboratory research
Blood sugar handling	Ginsenoside mix (PPD:PPT ratio)	The ratio of two ginsenoside groups predicted some of the blood sugar effect across eight ginseng types, but explained little of it; a batch with low total ginsenosides did nothing. ^{47 46}	Human data
Acetylcholine system	Choline acetyltransferase (ChAT)	In mice challenged with amyloid-beta and in nerve stem cells, Cereboost raised ChAT gene expression and acetylcholine. In people, a 2-week trial reported better scores on an acetylcholine-sensitive attention task. ^{44 5}	Animal research
Gut microbiome and short-chain fatty acids	Gut bacteria (Akkermansia, Lactobacillus)	In a lab gut simulator, Cereboost raised acetate, propionate and butyrate and increased Akkermansia and Lactobacillus. ⁵	Laboratory research
Frontal brain activity	Prefrontal cortex	A faster frontal brain signal (shorter SSVEP latency) during working-memory retrieval after a single dose, without a change in test scores. ⁵⁵	Human data
Muscle inflammation	Neutrophils, creatine kinase	In rats, a water extract reduced neutrophil infiltration and muscle damage after downhill running; in 12 men, creatine kinase and a lipid-peroxidation marker were lower after a hard run. ^{18 31}	Animal research
Oxidative balance	Glutathione, malondialdehyde, 8-OHdG	In 25 postmenopausal women, markers of oxidative damage rose and total antioxidant content fell on ginseng root powder. ¹⁵	Human data

Absorption, metabolism and elimination

Absorption: Ginsenosides are absorbed slowly and poorly. After a 10 g dose of American ginseng root powder in 6 healthy adults, Rb1 appeared in plasma with a peak of 19.90 ng/mL at 4 hours; Rd and Rg2 were also detected.
Distribution: Not described in human studies found.
Metabolism: Gut bacteria convert Rb1 to compound K, which appeared in plasma between 7 and 12 hours (7.32 ng/mL at 12 hours; its peak was not reached by the last sample). A review says most saponins have poor bioavailability and unknown metabolism.
Elimination: Not studied; sampling stopped at 12 hours.
Bioavailability: Only the plasma curves from six people are available: Rb1 area under the curve 155.0 ng.h/mL and compound K 26.4 ng.h/mL over 0 to 12 hours after 10 g of root powder. No absolute bioavailability figure was found.

^{54 56}

Isolated compounds versus whole extracts

American ginseng is not one substance. The polysaccharide-rich extract used in cold trials (CVT-E002) differs from ginsenoside-rich extracts (Cereboost, HT1001, 10% ginsenoside extracts) and from plain ground root. In rats the polysaccharide extract and a ginsenoside extract changed immune responses in different ways. Blood sugar effects varied between root batches, and extraction with alcohol or water changed estrogen-like and muscle effects. Results from one preparation should not be applied to another, or to Asian ginseng.

Nutritional composition

No nutrient data were looked up for American ginseng root. It is used as a supplement, not as a food, so nutrient content is not the reason people take it.

17benefits and uses looked at

62studies and sources checked

Low certaintybest evidence rating found

17lab markers tracked in trials

2 mixed findings5 low certainty8 very low certainty2 not enough evidence

What was looked at

The 17 benefits and uses checked for American Ginseng, each with how strong the evidence is. Tap one to open it.

Colds and respiratory infections in healthy adults (prevention)Low certainty
Respiratory illness and flu in older adults (prevention)Very low certainty
Respiratory illness in people with chronic lymphocytic leukemiaMixed findings
Colds in childrenNot enough evidence
Cancer-related fatigueLow certainty
Working memory and attention in healthy adultsLow certainty
Mood, calmness and mental tirednessVery low certainty
Working memory in schizophreniaVery low certainty
Simulated driving performanceVery low certainty
Blood sugar after a sugary drink in people without diabetesLow certainty
Blood sugar control in type 2 diabetesLow certainty
Blood pressureMixed findings
Cholesterol and blood fatsVery low certainty
Immune cell markers around exerciseVery low certainty
Muscle damage after hard exerciseVery low certainty
Antioxidant protection (oxidative stress)Very low certainty
Preventing or treating cancerNot enough evidence

Lab markers tracked in the studies

Number of colds per personDays of cold symptomsLaboratory-confirmed influenza or RSVFour-fold antibody rises against common virusesFatigue improvement score (MFSI-SF general subscale change)Working memory test performanceFrontal brain signal speed (SSVEP latency)Simulated lap timeBlood sugar after a glucose drink (area under the curve)Fasting blood glucoseHbA1cSystolic blood pressure (top number, mmHg)Arterial stiffness (augmentation index)LDL cholesterolCreatine kinase (muscle damage marker)Oxidative damage markers (malondialdehyde, 8-OHdG)CD8+ T cells and interleukin-2 production

What is American Ginseng good for?

The main proposed uses and how strong the human evidence is for each. "Low" means small or mixed studies; "very low" means one tiny study or lab markers only. Nothing is rated above low. Combination products and Asian ginseng studies are labelled.

Benefits, one by one

Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.

Colds and respiratory infections in healthy adults (prevention)

Low certainty

American ginseng root extract taken for several months through the cold season may mean slightly fewer colds and shorter colds in healthy adults. The trials mostly used one branded extract, results were not the same in every trial, and the biggest trial missed its main goal.

5 studiesCVT-E002 (sold as COLD-fX) is a proprietary, polysaccharide-rich extr…

Studies, doses and limits

What the trials found

In a 4-month trial of 323 adults prone to colds (Predy 2005), those taking the extract had fewer colds, fewer people with 2 or more colds and fewer days of symptoms than placebo. A 6-month trial of 783 vaccinated adults (McElhaney 2011) found no difference in its planned main outcome (laboratory-confirmed respiratory infections: 5.5% placebo, 5.2% at the lower dose, 4.6% at the higher dose), though colds meeting a symptom-based definition were fewer and milder in the treated groups. A systematic review of 5 trials (747 people, all of North American ginseng; Seida 2011) found a 25% reduction in total colds in one trial, a non-significant trend to fewer people catching a cold, and 6.2 fewer days of illness in two trials, and the authors concluded the evidence was insufficient to say ginseng reduces how often or how severely people get colds. A 2020 pooled analysis that mixed Asian and American ginseng found lower infection incidence (RR 0.69) but flagged high or unclear bias.

Results

Predy 2005: 0.68 vs 0.93 colds per person; 10.0% vs 22.8% had 2 or more colds; 10.8 vs 16.5 symptom days. McElhaney 2011: main outcome no difference (P = 0.89). Seida 2011: duration 6.2 days shorter in 2 trials.

Effect sizes as reported

Predy 2005: colds per person difference 0.25 (95% CI 0.04 to 0.45); 2 or more colds 12.8 percentage points fewer (95% CI 4.3 to 21.3). Seida 2011: at least one cold RR 0.70 (95% CI 0.48 to 1.02, not significant); duration 6.2 days shorter (95% CI 3.4 to 9.0). Antonelli 2020 (both species): RR 0.69 (95% CI 0.52 to 0.90).

Why this rating

Several randomised trials lean the same way on colds and duration, but the largest trial missed its main goal, the best results come from secondary or unplanned analyses, nearly all trials used one proprietary extract, and the reviewers themselves called the evidence insufficient for fewer or milder colds.

Form and dose studied

CVT-E002 (sold as COLD-fX) is a proprietary, polysaccharide-rich extract of American ginseng root. Results from it cannot be assumed for plain powder or other extracts. Trials used 2 capsules a day for 4 months, or 400 to 800 mg a day for 6 months.

Who was studied

Healthy adults aged 18 to 65 (some with frequent colds), and vaccinated community adults.

Limits

One extract in most trials; industry links are likely (proprietary product, not stated in the abstracts); symptom-based definitions of a cold; the Seida review searched only to December 2007.

Why researchers looked

Colds are very common. A Canadian extract of American ginseng root (CVT-E002, sold as COLD-fX) became a top-selling cold remedy in Canada, so it has been tested in several trials.

Traditional use

The Seida review states that standardised ginseng extract became the best-selling cold and flu remedy in Canada. No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Animal research

In rats, the polysaccharide-rich extract changed immune cytokines (IL-2, interferon-gamma) and T cells in a different way from a ginsenoside extract. This is animal data and does not show how the extract acts in people.

A proposed mechanism does not show that the effect happens in people.

No serious problems were reported in these trials. Ask a pharmacist before combining with warfarin or diabetes medicines (see safety).

^{39 34 43 1 7}

Respiratory illness and flu in older adults (prevention)

Very low certainty

Two small trials in older adults suggested American ginseng extract (COLD-fX) may cut flu and respiratory illness. The numbers of cases were small and one benefit appeared only in a late window of the season, so this is weak evidence.

2 studiesCVT-E002 (sold as COLD-fX) is a proprietary, polysaccharide-rich extr…

Studies, doses and limits

What the trials found

McElhaney 2004 pooled two small trials in nursing-home residents (average age 81 and 83.5; about 90% vaccinated). Laboratory-confirmed influenza occurred in 7 of 101 on placebo and 1 of 97 on the extract, and influenza plus RSV in 9 of 101 vs 1 of 97. In McElhaney 2006, 43 community-living adults aged 65 or older took the extract for 4 months. Illness was similar in the first 2 months, but in the last 2 months 32% on the extract and 62% on placebo reported illness, and symptoms lasted 5.6 vs 12.6 days. No flu was circulating that season.

Results

Influenza 7/101 vs 1/97 (OR 7.73, P = .033); influenza plus RSV 9/101 vs 1/97 (OR 10.50, P = .009). 2006 trial: 32% vs 62% illness in months 3-4.

Effect sizes as reported

Authors report 89% lower relative risk (2004) and 48% lower risk, 55% shorter duration (2006, last 2 months).

Why this rating

Both trials are small, the 2004 result rests on 10 cases in total, the 2006 benefit appears only in a late window, and the product is proprietary with no independent repeat found.

Form and dose studied

Who was studied

Older adults in long-term care or living at home, aged 65 and over.

Limits

Tiny case numbers; pooled seasons; flu vaccination was common so results may not apply to unvaccinated people.

Why researchers looked

Older adults in care homes are at high risk of flu and RSV, so a safe prevention aid would matter.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Animal research

Not shown in people. In rats the extract changed immune signals (animal data).

A proposed mechanism does not show that the effect happens in people.

Well tolerated in these trials; not enough people to rule out rare problems.

^{32 33}

Respiratory illness in people with chronic lymphocytic leukemia

Mixed findings

A large trial in people with early chronic lymphocytic leukemia found no reduction in days of respiratory illness. It did find less moderate-to-severe sore throat and more antibody rises on the extract.

1 studiesCVT-E002 (sold as COLD-fX) is a proprietary, polysaccharide-rich extr…

Studies, doses and limits

What the trials found

High 2012 randomised 293 people with early-stage, untreated CLL to CVT-E002 or placebo over a winter. The two main goals were not met: illness days 8.5 vs 6.8 and severe illness days 2.9 vs 2.6 (ginseng vs placebo). At least one illness occurred in 51% vs 56%. Sore throat was less often moderate to severe on the extract (P = .004), and four-fold antibody rises against 9 common viruses were more frequent (16% vs 7%).

Results

Illness days 8.5 vs 6.8; severe illness days 2.9 vs 2.6; any illness 51% vs 56%; antibody rises 16% vs 7%.

Effect sizes as reported

Any illness difference -5 points (95% CI -16 to 7); more intense illness 32% vs 39% (95% CI -18 to 4).

Why this rating

One well-run, NIH-funded randomised trial: the two planned main goals were null, but some secondary results leaned in favour.

Form and dose studied

CVT-E002 (sold as COLD-fX) is a proprietary, polysaccharide-rich extract of American ginseng root. Results from it cannot be assumed for plain powder or other extracts.

Who was studied

Adults with early, untreated CLL.

Limits

One trial; secondary findings are exploratory; antibody changes not linked to illness.

Why researchers looked

People with this blood cancer get respiratory infections often, so an immune-supporting herb was tested.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Pharmacological theory

Not shown. The authors suggest the extract may boost antibody responses; antibody rises were not tied to specific illnesses.

A proposed mechanism does not show that the effect happens in people.

Well tolerated; fewer grade 3 or worse side effects on the extract (P = .02).

²³

Colds in children

Not enough evidence

One small safety trial found no serious problems in children aged 3 to 12 who took American ginseng extract during a cold. It was not designed to show whether it helps.

1 studiesAmerican ginseng root extract standardised to 80% poly-furanosyl-pyra…

Studies, doses and limits

What the trials found

Vohra 2008 pre-recruited 75 children and randomised the 46 who developed a respiratory infection to a standard dose, a low dose or placebo (15, 16 and 15 children). There were no serious adverse events and no differences in the number, severity or link to treatment of side effects. The trial was not powered to test benefit.

Results

No serious adverse events; no group differences in side effects.

Effect sizes as reported

Safety and tolerability trial only.

Why this rating

No efficacy trial in children was found; the safety trial had 46 children.

Form and dose studied

American ginseng root extract standardised to 80% poly-furanosyl-pyranosyl-saccharides, weight-based doses.

Who was studied

Children aged 3 to 12.

Limits

Very small; short; not an efficacy trial.

Why researchers looked

Colds are the most common childhood illness, so a safe remedy would be welcome.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Pharmacological theory

Not studied.

A proposed mechanism does not show that the effect happens in people.

Use in children should be decided with a paediatrician or pharmacist; the trial does not show long-term safety.

⁵⁰

Cancer-related fatigue

Low certainty

In a large US trial, fatigued cancer survivors who took American ginseng for 8 weeks reported more improvement in fatigue than those on placebo, especially people still having cancer treatment. A cancer-care guideline says it may be recommended during treatment. A small trial in head and neck cancer survivors found no benefit.

6 studiesWisconsin-grown American ginseng root, 2000 mg a day in the large tri…

Studies, doses and limits

What the trials found

The Alliance/Mayo trial N07C2 (Barton 2013) randomised 364 fatigued cancer survivors at 40 sites to American ginseng or placebo for 8 weeks. At 4 weeks, the planned main time point, the improvement in the general fatigue score was 14.4 vs 8.2 points (P = .07, not significant). At 8 weeks it was 20 vs 10.3 points (P = .003). Benefit was larger in people receiving active cancer treatment than in those who had finished, and side effects did not differ. An earlier pilot (Barton 2010, 290 people, 750 to 2000 mg a day) showed only non-significant trends toward benefit at the higher doses. A 2020 trial in 32 head and neck cancer survivors (Guglielmo 2020) found no benefit at 8 weeks. The 2024 ASCO and Society for Integrative Oncology guideline (113 trials reviewed) says American ginseng may be recommended in adults undergoing cancer treatment, and rated the evidence for fatigue treatments overall as low to moderate certainty.

Results

N07C2: 8 weeks, 20 vs 10.3 points (P = .003); 4 weeks 14.4 vs 8.2 (P = .07). Pilot: SF-36 vitality +10.5 to +14.6 on higher doses vs +7.3 to +7.8 on placebo (not significant). Head and neck survivors: BFI 4.6 vs 3.4 (not significant).

Effect sizes as reported

Change scores with standard deviations as reported; no confidence intervals in the abstracts.

Why this rating

One large, well-run phase III trial supports benefit at 8 weeks but missed its planned 4-week main goal, and a small trial in survivors was null. The guideline rates overall fatigue evidence low to moderate.

Form and dose studied

Wisconsin-grown American ginseng root, 2000 mg a day in the large trial; 1000 mg a day in the small null trial.

Who was studied

Fatigued adults with cancer, many during treatment; head and neck survivors in the null trial.

Limits

Self-reported fatigue; subgroup finding (during treatment) is exploratory; reviews of this topic reuse the same trials; ginseng is not a cancer treatment.

Why researchers looked

Fatigue is one of the most common and distressing effects of cancer and its treatment, and few treatments help.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Pharmacological theory

Not established. Ideas include effects on stress hormones and inflammation, but none was shown in these trials.

A proposed mechanism does not show that the effect happens in people.

No differences in side effects in N07C2. People on cancer treatment should check with their oncology team first because of possible interactions (see safety).

^{4 3 21 9 41 2}

Working memory and attention in healthy adults

Low certainty

In several small, short trials, a branded American ginseng extract (Cereboost) improved working memory test scores in healthy people within hours, and some effects built up over 2 weeks. Gains are on lab tests, not proven everyday benefits, and the trials were connected to the extract makers.

6 studiesCereboost, American ginseng root extract with 10.65% ginsenosides; si…

Studies, doses and limits

What the trials found

Scholey 2010 (32 young adults, single doses of 100, 200 or 400 mg) found better working memory (Corsi block) at all doses and times, with no change in blood glucose. Ossoukhova 2015 (52 adults aged 40 to 60, 200 mg) found better working memory at 3 hours. Bell 2022 (61 young adults) found better working memory and attention within hours, amplified after 2 weeks of daily use, and better scores on an acetylcholine-sensitive attention task after 2 weeks. White 2020 found a faster frontal brain signal in middle-aged adults but no difference in test performance. A 2025 study of 58 professional race car drivers found no significant cognitive change after correction for multiple tests. A 2026 review by authors involved in these trials concluded effects at 100 to 400 mg are most notable for attention and working memory.

Results

Working memory improved at tested times; no numbers in abstracts. Race drivers: no significant cognitive effect.

Effect sizes as reported

Not reported as numbers in the abstracts (drivers study: Cohen d -1.274 for simulated lap time, a different outcome).

Why this rating

Several placebo-controlled crossover trials agree on working memory, but they are small, short, in healthy people, use one branded extract, were run by overlapping research groups with industry employees as authors, and a trial in drivers was null for cognition.

Form and dose studied

Cereboost, American ginseng root extract with 10.65% ginsenosides; single doses of 100 to 400 mg, or 200 mg a day.

Who was studied

Healthy adults aged 18 to 60.

Limits

Lab tests rather than daily function; many outcomes tested so some positives may be chance; no independent replication found; no long-term data.

Why researchers looked

American ginseng has a different ginsenoside mix from Asian ginseng, so researchers tested whether it affects thinking on its own.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Preliminary mechanism

Ideas in the literature include frontal-brain activation, acetylcholine effects and gut bacteria changes. In the lab gut simulator the extract raised short-chain fatty acids; in people a brain-recording study found a faster frontal brain signal without better test scores.

A proposed mechanism does not show that the effect happens in people.

No safety problems were reported in these short trials; blood glucose did not change.

^{42 38 5 55 19 6}

Mood, calmness and mental tiredness

Very low certainty

Some trials of the Cereboost extract found small mood benefits (more calmness at one dose, less mental fatigue and more self-assurance after 2 weeks), but others found none. Evidence is thin.

4 studiesCereboost extract, 100 to 200 mg.

Studies, doses and limits

What the trials found

Scholey 2010 found more calmness after the 100 mg dose only. Bell 2022 found less mental fatigue and more self-assurance after 2 weeks. Ossoukhova 2015 and the 2025 race-driver study found no mood effects.

Results

Mixed: calmness (100 mg only), mental fatigue and self-assurance improved in some trials; no mood change in two others.

Effect sizes as reported

Not given as numbers in the abstracts.

Why this rating

Scattered findings in a few small healthy-volunteer trials, with mood as a secondary outcome and several null results.

Form and dose studied

Cereboost extract, 100 to 200 mg.

Who was studied

Healthy adults.

Limits

Secondary outcomes; multiple testing; same research group and extract.

Why researchers looked

Researchers recorded mood alongside thinking tests in the same trials.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

No problems reported.

^{42 5 38 19}

Working memory in schizophrenia

Very low certainty

One small trial in people with stable schizophrenia found that a North American ginseng extract (HT1001) improved visual working memory and eased movement-type side effects of antipsychotic drugs over 4 weeks. It needs repeating.

1 studiesHT1001, a proprietary North American ginseng extract.

Studies, doses and limits

What the trials found

Chen 2012 randomised 64 stable adults with schizophrenia to HT1001 or placebo for 4 weeks. Visual working memory improved in the HT1001 group but not in the placebo group, and extrapyramidal symptoms (stiffness and movement side effects of medicines) fell only in the HT1001 group. The abstract does not report a verbal working memory improvement.

Results

Visual working memory improved within the ginseng group; extrapyramidal symptoms fell in the ginseng group.

Effect sizes as reported

No between-group numbers in the abstract.

Why this rating

A single 64-person, 4-week trial, reported as changes within each group, with no replication found.

Form and dose studied

HT1001, a proprietary North American ginseng extract.

Who was studied

Stable adults with schizophrenia taking medicines.

Limits

One trial; add-on to antipsychotics; interaction data are missing.

Why researchers looked

People with schizophrenia often have working memory problems that limit daily functioning, and current drugs do little for them.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

Anyone taking antipsychotics should only add a herb under a doctor's guidance.

¹¹

Simulated driving performance

Very low certainty

In 58 professional race car drivers, a 2025 study found faster simulated lap times after sustained use of Cereboost, but it had no placebo group, so the result is very uncertain.

1 studiesCereboost, 200 mg a day.

Studies, doses and limits

What the trials found

Ferguson 2025 followed 58 licensed drivers through four phases (baseline, acute, chronic, acute-on-chronic). Simulated lap time was about 3 seconds faster in the acute-on-chronic phase (adjusted P = 0.000003, Cohen d = -1.274); mood and cognitive tests showed no significant effect after correction. The abstract describes a within-person design with no placebo group.

Results

About 3 seconds faster simulated lap time in one phase.

Effect sizes as reported

Adjusted P = 0.000003; Cohen d -1.274.

Why this rating

No placebo group is described, the setting is a simulator, and two authors worked for the extract maker's parent group.

Form and dose studied

Cereboost, 200 mg a day.

Who was studied

Professional race car drivers.

Limits

No control group in the abstract; simulator only; expectations may play a role (97% reported feeling sharper).

Why researchers looked

Driving at speed needs fast decisions, so a cognitive supplement was tested in racing drivers.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

No problems reported.

¹⁹

Blood sugar after a sugary drink in people without diabetes

Low certainty

In small one-day trials, American ginseng root taken about 40 minutes before a glucose drink lowered the blood sugar rise in healthy people. But one batch of root did nothing, and two of five batches in another test did not work as expected, so the effect depends on the product.

5 studiesGround American ginseng root, 1 to 9 g, taken 40 minutes before a glu…

Studies, doses and limits

What the trials found

Vuksan 2000 (10 adults) found area under the blood sugar curve fell 26.6%, 29.3% and 38.5% after 3, 6 and 9 g of ground root. Vuksan 2001 (12 adults) found 1, 2 and 3 g lowered the curve by 14.4%, 10.6% and 9.1% only when taken 40 minutes beforehand. Dascalu 2007 (12 adults, 9 g of five Ontario-grown batches) found a mean 27.7% fall in glucose area and 23.8% fall in insulin area, but 2 of the 5 batches did not lower glucose as expected. Sievenpiper 2003 (12 adults, 6 g of one batch with low ginsenosides) found no effect. Sievenpiper 2004 compared eight ginseng types in 12 adults: American ginseng showed only a non-significant trend to lower blood sugar at 90 minutes, whereas Asian ginseng raised peak blood sugar.

Results

Glucose area under the curve down 9% to 38.5% in effective trials; no effect with a low-ginsenoside batch.

Effect sizes as reported

Vuksan 2000: -26.6%, -29.3%, -38.5%. Vuksan 2001: -14.4%, -10.6%, -9.1%. Dascalu 2007: -27.7% (mean of 5 batches; peak -1.0 mmol/L).

Why this rating

Several small crossover trials from one research group agree, but they are in healthy people, tested single doses with large amounts of root (up to 9 g), and some batches failed. No independent group repeated them in this search.

Form and dose studied

Ground American ginseng root, 1 to 9 g, taken 40 minutes before a glucose drink.

Who was studied

Healthy adults without diabetes.

Limits

Single-day tests; 10 to 12 people each; batch-dependent; one research group; not shown to help people with diabetes by this design.

Why researchers looked

American ginseng became the best-studied ginseng for post-meal blood sugar after a Canadian group tested it repeatedly in healthy volunteers.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Preliminary mechanism

Ideas include slower sugar absorption and more insulin release. In one 12-person trial the root also lowered insulin after a glucose drink. The effect was linked to the ginsenoside mix in the root, which varied by batch.

A proposed mechanism does not show that the effect happens in people.

People taking diabetes drugs or insulin should speak to their doctor or pharmacist because blood sugar could fall further.

^{51 52 14 46 47}

Blood sugar control in type 2 diabetes

Low certainty

In one small 8-week trial of 24 people with type 2 diabetes, American ginseng extract added to usual treatment lowered HbA1c by 0.29 points and fasting glucose by 0.71 mmol/L. A larger 74-person trial tested only safety. Pooled results for ginseng of all kinds show a small drop in fasting glucose.

5 studiesAmerican ginseng extract, 3 g a day (1 g with each meal) in the main …

Studies, doses and limits

What the trials found

Vuksan 2019 (24 people completed a crossover; 1 g with each meal for 8 weeks added to usual treatment) found HbA1c 0.29 points lower and fasting glucose 0.71 mmol/L lower than placebo, plus lower systolic blood pressure and LDL cholesterol; safety tests were unaffected. Mucalo 2014 (74 people, 12 weeks) was a safety trial and found no differences in kidney, liver, clotting tests or side effects. A combined Korean red ginseng plus American ginseng trial (Jovanovski 2021, 80 people) lowered HbA1c by 0.35 points but cannot be credited to American ginseng alone. A pooled analysis of 16 trials of ginseng of any Panax species (Shishtar 2014) found fasting glucose 0.31 mmol/L lower, with no overall change in HbA1c, and noted that most trials were short and in people already well controlled.

Results

HbA1c -0.29 points; fasting glucose -0.71 mmol/L in the American ginseng crossover trial.

Effect sizes as reported

Vuksan 2019: HbA1c -0.29% (p = 0.041), fasting glucose -0.71 mmol/L (p = 0.008). Shishtar 2014 (genus-wide): fasting glucose MD -0.31 mmol/L (95% CI -0.59 to -0.03).

Why this rating

One small randomised crossover trial supports a modest drop, plus a pooled analysis that mixes species. Trials are short, in people with good control, and from one research network.

Form and dose studied

American ginseng extract, 3 g a day (1 g with each meal) in the main trial.

Who was studied

Adults with type 2 diabetes on usual treatment, mean HbA1c about 7%.

Limits

Only 24 people; a 0.29 point HbA1c change is small; several authors of this network declare patents and ownership in a glycemic-testing company in related papers; mixed-species meta-analysis.

Why researchers looked

People with type 2 diabetes often look for add-ons to medicine, and American ginseng reduced blood sugar after meals in healthy volunteers.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Preliminary mechanism

Not established in people.

A proposed mechanism does not show that the effect happens in people.

Could add to the effect of diabetes medicines. See the safety tab on low blood sugar and speak to a doctor or pharmacist first.

^{53 37 35 45 26}

Blood pressure

Mixed findings

The evidence is mixed. Two trials in people with high blood pressure found American ginseng had no effect on blood pressure (a single dose, and 12 weeks). But in people who had both diabetes and high blood pressure, two other 12-week trials found lower systolic pressure. Pooled results for ginseng of all kinds show no overall change.

7 studiesAmerican ginseng root or extract, 3 g a day for 12 weeks in most tria…

Studies, doses and limits

What the trials found

Stavro 2005 (16 people with hypertension, 13 on blood pressure drugs; six batches, 3 g) found no overall effect on blood pressure over 160 minutes. Stavro 2006 (52 randomised, 37 analysed, 3 g a day for 12 weeks) found a neutral effect on 24-hour blood pressure and on a kidney marker. Mucalo 2013 (64 people with diabetes and hypertension, 12 weeks) found systolic pressure 11.7% lower and arterial stiffness (augmentation index) 5.3% lower than placebo. Vuksan 2019 (24 people with diabetes) found systolic pressure 5.6 mmHg lower. The combination trial of two species (Jovanovski 2021) lowered 24-hour systolic pressure by about 4 mmHg. A pooled analysis of 17 trials of ginseng of any species (Komishon 2016) found no significant effect and concluded ginseng should not be avoided out of fear of raising blood pressure.

Results

Neutral in people with hypertension; lower systolic pressure in two trials of people with diabetes plus hypertension.

Effect sizes as reported

Mucalo 2013: SBP -11.7% (P<0.001); AI -5.3% (P=0.041). Vuksan 2019: SBP -5.6 +/- 2.7 mmHg. Komishon 2016: no significant change (subgroup in diabetes/metabolic syndrome/obesity -2.76 mmHg, 95% CI -6.40 to 0.87).

Why this rating

Four trials in different groups point different ways; the pooled analysis of many ginseng species is neutral.

Form and dose studied

American ginseng root or extract, 3 g a day for 12 weeks in most trials.

Who was studied

Adults with hypertension, and adults with diabetes with or without hypertension.

Limits

Small trials; different populations; the pooled analysis mixes species; the benefit seen in diabetes trials comes from the same research network.

Why researchers looked

Early reports raised the worry that ginseng might raise blood pressure, so researchers tested American ginseng in people with hypertension.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Preliminary mechanism

Not established. In the 2020 combination trial, pulse wave velocity and blood vessel function did not change significantly.

A proposed mechanism does not show that the effect happens in people.

No rise in blood pressure was seen in the hypertension trials. People on blood pressure drugs should tell their prescriber because effects could add up.

^{48 49 36 53 26 25 28}

Cholesterol and blood fats

Very low certainty

Cholesterol changes were secondary results in small diabetes trials. American ginseng alone lowered LDL by about 12% in one 24-person trial. A two-species combination lowered total cholesterol and triglycerides in another. This is weak evidence.

2 studiesAmerican ginseng extract 3 g a day; or Korean red plus American ginse…

Studies, doses and limits

What the trials found

Vuksan 2019 reported LDL cholesterol 12.3% lower and LDL to HDL ratio 13.9% lower on American ginseng than placebo in 24 people with type 2 diabetes. In Jovanovski 2021 the Korean red plus American ginseng combination lowered total cholesterol by 0.50 mmol/L, non-HDL cholesterol by 0.54 mmol/L and triglycerides by 0.40 mmol/L, with LDL lower but not significant (p = 0.06).

Results

LDL -12.3% (American ginseng alone, 24 people); combination: total cholesterol -0.50 mmol/L, triglycerides -0.40 mmol/L.

Effect sizes as reported

Vuksan 2019: LDL-C -12.3 +/- 3.9%. Jovanovski 2021 (combination): total cholesterol -0.50 +/- 0.2 mmol/L (p = 0.01).

Why this rating

Secondary outcomes in two small trials from one network; one trial uses a two-species combination.

Form and dose studied

American ginseng extract 3 g a day; or Korean red plus American ginseng 2.25 g a day.

Who was studied

Adults with type 2 diabetes.

Limits

Secondary outcomes; no heart-attack or stroke outcomes.

Why researchers looked

Blood fats are measured routinely in diabetes trials, so ginseng was checked for effects on them.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Preliminary mechanism

Not established.

A proposed mechanism does not show that the effect happens in people.

No problems reported.

^{53 26}

Immune cell markers around exercise

Very low certainty

In 10 healthy men, 5 weeks of a North American ginseng extract changed only a few immune lab values (fewer CD8 T cells, more interleukin-2 made in the lab). Most immune measures and the stress hormones did not change.

2 studiesStandardised ginsenoside-containing North American ginseng extract, 1…

Studies, doses and limits

What the trials found

Biondo 2008 (10 healthy sedentary men, 1125 mg a day for 35 days in a crossover) found lower circulating CD8+ T cells and higher interleukin-2 made by stimulated T cells in the lab. Neutrophils, monocytes, other lymphocytes, white cell count, lymphocyte growth, neutrophil burst, lactate, insulin, cortisol and growth hormone did not change. The rat study (Biondo 2008b) found that CVT-E002 lowered spleen cytokine output while a ginsenoside extract raised gut IgA cells.

Results

CD8+ T cells lower; ex vivo IL-2 higher; most other measures unchanged.

Effect sizes as reported

Not given as numbers in the abstract.

Why this rating

One tiny crossover trial of lab markers; not infections or symptoms.

Form and dose studied

Standardised ginsenoside-containing North American ginseng extract, 1125 mg a day.

Who was studied

Healthy sedentary men.

Limits

Ten men; lab values only; rat data are not human evidence.

Why researchers looked

Hard exercise can briefly weaken immune defences, so a ginseng that supports immunity was tested around moderate exercise.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Animal research

Rat data suggest the polysaccharide-rich extract and a ginsenoside extract act on immune signals in different ways.

A proposed mechanism does not show that the effect happens in people.

No problems reported.

^{8 7}

Muscle damage after hard exercise

Very low certainty

In 12 active young men, 4 weeks of American ginseng lowered blood markers of muscle damage and fat-oxidation damage after a hard downhill run. It is a lab-marker result in a very small trial and is not proven to reduce soreness.

2 studiesAmerican ginseng extract, 1.6 g a day for 28 days.

Studies, doses and limits

What the trials found

Lin 2021 (12 active men, 1.6 g a day for 28 days then a downhill run, crossover) found the rise in creatine kinase after running was absent at 48 and 72 hours on ginseng, and the oxidative stress marker 8-iso-PGF2 alpha was lower right after, 2 hours and 24 hours after the run. Interleukin-4 differed between ginseng and placebo. The abstract does not report a difference in the pain rating. Estaki 2015 found a protective effect in rats.

Results

Creatine kinase rise eliminated at 48 and 72 hours; lower 8-iso-PGF2 alpha.

Effect sizes as reported

8-iso-PGF2 alpha p = 0.01 (0 and 2 h), p = 0.028 (24 h).

Why this rating

One 12-person trial of blood markers plus rat data.

Form and dose studied

American ginseng extract, 1.6 g a day for 28 days.

Who was studied

Physically active young men.

Limits

Marker changes are not performance or comfort outcomes; very small.

Why researchers looked

Hard downhill running causes muscle damage and inflammation, so ginseng's anti-inflammatory reputation was tested.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Animal research

In rats, an American ginseng water extract reduced muscle damage and neutrophil infiltration after downhill running; an alcohol extract lowered creatine kinase only. This is animal data.

A proposed mechanism does not show that the effect happens in people.

No problems reported.

^{31 18}

Antioxidant protection (oxidative stress)

Very low certainty

A small trial in postmenopausal women found the opposite of an antioxidant benefit: after 4 months of American ginseng root powder, blood and urine markers of oxidative damage were higher. The meaning for health is unclear, but there is no human evidence that American ginseng acts as an antioxidant.

1 studiesAmerican ginseng whole-root powder, 1 g a day.

Studies, doses and limits

What the trials found

Dickman 2009 randomised 25 postmenopausal women (12 ginseng, 13 placebo) to 1 g a day of whole-root powder for 4 months. Heart rate, blood pressure, glucose and lactate were unchanged, but resting oxidised glutathione, malondialdehyde and urine 8-hydroxydeoxyguanosine were higher, the glutathione ratio and total antioxidant content were lower, and red-cell antioxidant enzymes were higher. The authors concluded this dose caused oxidative stress.

Results

Higher oxidative damage markers on ginseng; no clinical outcome.

Effect sizes as reported

Not given as numbers in the abstract.

Why this rating

One small trial of lab markers; direction was against an antioxidant benefit.

Form and dose studied

American ginseng whole-root powder, 1 g a day.

Who was studied

Postmenopausal women 55 to 75.

Limits

25 women; markers only; not repeated.

Why researchers looked

Ginsenosides are called antioxidants in many lab studies, so researchers checked in people.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Preliminary mechanism

Cell and animal papers describe antioxidant effects; the one human trial found pro-oxidant markers.

A proposed mechanism does not show that the effect happens in people.

Not clear whether the changes matter for health.

¹⁵

Preventing or treating cancer

Not enough evidence

There is no evidence from human trials that American ginseng prevents or treats cancer. Cell experiments show mixed effects, including an estrogen-like growth effect of an alcohol extract at low concentrations. Its only studied cancer use is easing fatigue.

2 studiesNot applicable.

Studies, doses and limits

What the trials found

No randomised trial of American ginseng for cancer prevention or tumour outcomes was found in PubMed. The 2024 cancer-fatigue guideline recommends it only for fatigue during treatment. King 2006 tested extracts on breast cancer cells in dishes only.

Results

No human outcome data.

Why this rating

No human trial; cell data point both ways.

Who was studied

People with cancer.

Limits

Test-tube findings cannot be applied to people.

Why researchers looked

Lab studies of ginsenosides on cancer cells attract interest, and people with cancer often ask about ginseng.

Traditional use

No traditional use for this purpose was verified from a source read for this profile.

Proposed mechanism Laboratory research

In breast cancer cells, an alcohol extract of American ginseng promoted growth of estrogen-receptor-positive cells at low concentrations and slowed growth at high concentrations; a water extract did not promote growth.

A proposed mechanism does not show that the effect happens in people.

Ask the cancer care team before taking it, particularly with hormone-sensitive tumours.

^{27 9}

Connections to the rest of health

How American Ginseng connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.

Explore every connection: goals, body systems, organs, symptoms, genes

Kind of connection Connected to Search

A. Wellness goals

Connected to	Kind of connection	Evidence status	Context	Studies
Immune Support	Potential benefit	Low certainty	Colds and respiratory infections in healthy adults (prevention): American ginseng root extract taken for several months through the cold season may mean slightly fewer colds and shorter colds in healthy adults. The trials mostly used one branded extract, results were not the same in every trial, and the biggest trial missed its main goal. Respiratory illness and flu in older adults (prevention): Two small trials in older adults suggested American ginseng extract (COLD-fX) may cut flu and respiratory illness. The numbers of cases were small and one benefit appeared only in a late window of the season, so this is weak evidence.	^{39 34 43 1 7 32 33 23 50}
Reduce Fatigue	Demonstrated clinical effect	Low certainty	Cancer-related fatigue: In a large US trial, fatigued cancer survivors who took American ginseng for 8 weeks reported more improvement in fatigue than those on placebo, especially people still having cancer treatment. A cancer-care guideline says it may be recommended during treatment. A small trial in head and neck cancer survivors found no benefit.	^{4 3 21 9 41 2}
Energy Boost	Demonstrated clinical effect	Low certainty	Cancer-related fatigue: In a large US trial, fatigued cancer survivors who took American ginseng for 8 weeks reported more improvement in fatigue than those on placebo, especially people still having cancer treatment. A cancer-care guideline says it may be recommended during treatment. A small trial in head and neck cancer survivors found no benefit.	^{4 3 21 9 41 2}
Memory Support	Potential benefit	Low certainty	Working memory and attention in healthy adults: In several small, short trials, a branded American ginseng extract (Cereboost) improved working memory test scores in healthy people within hours, and some effects built up over 2 weeks. Gains are on lab tests, not proven everyday benefits, and the trials were connected to the extract makers. Working memory in schizophrenia: One small trial in people with stable schizophrenia found that a North American ginseng extract (HT1001) improved visual working memory and eased movement-type side effects of antipsychotic drugs over 4 weeks. It needs repeating.	^{42 38 5 55 19 6 11}
Cognitive Performance	Potential benefit	Low certainty	Working memory and attention in healthy adults: In several small, short trials, a branded American ginseng extract (Cereboost) improved working memory test scores in healthy people within hours, and some effects built up over 2 weeks. Gains are on lab tests, not proven everyday benefits, and the trials were connected to the extract makers.	^{42 38 5 55 19 6}
Better Focus	Potential benefit	Low certainty	Working memory and attention in healthy adults: In several small, short trials, a branded American ginseng extract (Cereboost) improved working memory test scores in healthy people within hours, and some effects built up over 2 weeks. Gains are on lab tests, not proven everyday benefits, and the trials were connected to the extract makers.	^{42 38 5 55 19 6}
Mental Clarity	Potential benefit	Very low certainty	Mood, calmness and mental tiredness: Some trials of the Cereboost extract found small mood benefits (more calmness at one dose, less mental fatigue and more self-assurance after 2 weeks), but others found none. Evidence is thin.	^{42 5 38 19}
Calm Relaxation	Potential benefit	Very low certainty	Mood, calmness and mental tiredness: Some trials of the Cereboost extract found small mood benefits (more calmness at one dose, less mental fatigue and more self-assurance after 2 weeks), but others found none. Evidence is thin.	^{42 5 38 19}
Brain Health	Potential benefit	Very low certainty	Working memory in schizophrenia: One small trial in people with stable schizophrenia found that a North American ginseng extract (HT1001) improved visual working memory and eased movement-type side effects of antipsychotic drugs over 4 weeks. It needs repeating.	¹¹
Peak Performance	Potential benefit	Very low certainty	Simulated driving performance: In 58 professional race car drivers, a 2025 study found faster simulated lap times after sustained use of Cereboost, but it had no placebo group, so the result is very uncertain.	¹⁹
Blood Sugar Balance	Demonstrated clinical effect	Low certainty	Blood sugar after a sugary drink in people without diabetes: In small one-day trials, American ginseng root taken about 40 minutes before a glucose drink lowered the blood sugar rise in healthy people. But one batch of root did nothing, and two of five batches in another test did not work as expected, so the effect depends on the product.	^{51 52 14 46 47}
Metabolic Health	Demonstrated clinical effect	Low certainty	Blood sugar after a sugary drink in people without diabetes: In small one-day trials, American ginseng root taken about 40 minutes before a glucose drink lowered the blood sugar rise in healthy people. But one batch of root did nothing, and two of five batches in another test did not work as expected, so the effect depends on the product.	^{51 52 14 46 47}
Blood Sugar Balance	Potential benefit	Low certainty	Blood sugar control in type 2 diabetes: In one small 8-week trial of 24 people with type 2 diabetes, American ginseng extract added to usual treatment lowered HbA1c by 0.29 points and fasting glucose by 0.71 mmol/L. A larger 74-person trial tested only safety. Pooled results for ginseng of all kinds show a small drop in fasting glucose.	^{53 37 35 45 26}
Metabolic Health	Potential benefit	Low certainty	Blood sugar control in type 2 diabetes: In one small 8-week trial of 24 people with type 2 diabetes, American ginseng extract added to usual treatment lowered HbA1c by 0.29 points and fasting glucose by 0.71 mmol/L. A larger 74-person trial tested only safety. Pooled results for ginseng of all kinds show a small drop in fasting glucose.	^{53 37 35 45 26}
Blood Pressure Support	Potential benefit	Mixed findings	Blood pressure: The evidence is mixed. Two trials in people with high blood pressure found American ginseng had no effect on blood pressure (a single dose, and 12 weeks). But in people who had both diabetes and high blood pressure, two other 12-week trials found lower systolic pressure. Pooled results for ginseng of all kinds show no overall change.	^{48 49 36 53 26 25 28}
Heart Health	Potential benefit	Mixed findings	Blood pressure: The evidence is mixed. Two trials in people with high blood pressure found American ginseng had no effect on blood pressure (a single dose, and 12 weeks). But in people who had both diabetes and high blood pressure, two other 12-week trials found lower systolic pressure. Pooled results for ginseng of all kinds show no overall change. Cholesterol and blood fats: Cholesterol changes were secondary results in small diabetes trials. American ginseng alone lowered LDL by about 12% in one 24-person trial. A two-species combination lowered total cholesterol and triglycerides in another. This is weak evidence.	^{48 49 36 53 26 25 28}
Cholesterol Balance	Potential benefit	Very low certainty	Cholesterol and blood fats: Cholesterol changes were secondary results in small diabetes trials. American ginseng alone lowered LDL by about 12% in one 24-person trial. A two-species combination lowered total cholesterol and triglycerides in another. This is weak evidence.	^{53 26}
Immune Support	Biological association	Very low certainty	Immune cell markers around exercise: In 10 healthy men, 5 weeks of a North American ginseng extract changed only a few immune lab values (fewer CD8 T cells, more interleukin-2 made in the lab). Most immune measures and the stress hormones did not change.	^{8 7}
Muscle Recovery	Biological association	Very low certainty	Muscle damage after hard exercise: In 12 active young men, 4 weeks of American ginseng lowered blood markers of muscle damage and fat-oxidation damage after a hard downhill run. It is a lab-marker result in a very small trial and is not proven to reduce soreness.	^{31 18}
Physical Stamina	Biological association	Very low certainty	Muscle damage after hard exercise: In 12 active young men, 4 weeks of American ginseng lowered blood markers of muscle damage and fat-oxidation damage after a hard downhill run. It is a lab-marker result in a very small trial and is not proven to reduce soreness.	^{31 18}
Healthy Aging	Biological association	Very low certainty	Antioxidant protection (oxidative stress): A small trial in postmenopausal women found the opposite of an antioxidant benefit: after 4 months of American ginseng root powder, blood and urine markers of oxidative damage were higher. The meaning for health is unclear, but there is no human evidence that American ginseng acts as an antioxidant.	¹⁵
Immune Support	Preliminary mechanism	Not enough evidence	Preventing or treating cancer: There is no evidence from human trials that American ginseng prevents or treats cancer. Cell experiments show mixed effects, including an estrogen-like growth effect of an alcohol extract at low concentrations. Its only studied cancer use is easing fatigue.	^{27 9}

B. Body systems

Connected to	Kind of connection	Evidence status	Context	Studies
Cardiovascular system	Drug or supplement interaction	Mixed findings	Possible added effect with blood pressure medicines; neutral in hypertension trials. Weakened warfarin in healthy volunteers (INR lower); blood pressure effect mixed. Preparation or compound: American ginseng root and extract	^{49 36 58}
Blood clotting (INR)	Drug or supplement interaction	Low certainty	Lowered warfarin effect in healthy volunteers. Preparation or compound: American ginseng root	⁵⁸
Liver	Biological association	Not enough evidence	Liver tests unchanged in two diabetes trials; no cases found. Preparation or compound: American ginseng extract	^{37 53}
Reproductive system and pregnancy	Contraindication	Not enough evidence	Lab data in rat embryos; no human data. No human data; rat embryo heart rate slowed in a lab study. Preparation or compound: Ginsenoside Rg3 (isolated)	⁴⁰
Hormone-sensitive tissue	Biological association	Not enough evidence	Estrogen-like activity in cell experiments. Preparation or compound: Alcohol extract of American ginseng root	^{27 20}
Immune system	Biological association	Not enough evidence	Changes in immune markers; theory for autoimmune conditions. Studied for: Colds and respiratory infections in healthy adults (prevention) Preparation or compound: Polysaccharide-rich extract (CVT-E002)	^{8 7 39 34 43 1 32 33 23 50 27 9}
Immune system	Potential benefit	Low certainty	Fewer or shorter colds in some trials; the largest trial missed its main goal. Preparation or compound: CVT-E002 (COLD-fX) root extract	^{39 34 43}
Hepatic system	Biological association	Not enough evidence	Liver tests unchanged in two diabetes trials; no liver injury case found. Safety relationship, not a benefit. Preparation or compound: American ginseng extract	^{37 53}
Nervous system	Potential benefit	Low certainty	Better working memory test scores in small, short trials. Preparation or compound: Cereboost root extract	^{42 38 5}
Respiratory System	Biological association	Low certainty	Studied for: Colds and respiratory infections in healthy adults (prevention) Studied for: Respiratory illness and flu in older adults (prevention)	^{39 34 43 1 7 32 33 23 50}
Nervous System	Biological association	Low certainty	Studied for: Cancer-related fatigue Studied for: Working memory and attention in healthy adults	^{4 3 21 9 41 2 42 38 5 55 19 6 11}
Stress Mood	Biological association	Very low certainty	Studied for: Mood, calmness and mental tiredness	^{42 5 38 19}
Metabolism Weight	Biological association	Low certainty	Studied for: Blood sugar after a sugary drink in people without diabetes Studied for: Blood sugar control in type 2 diabetes	^{51 52 14 46 47 53 37 35 45 26 15}
Endocrine System	Biological association	Low certainty	Studied for: Blood sugar after a sugary drink in people without diabetes Studied for: Blood sugar control in type 2 diabetes	^{51 52 14 46 47 53 37 35 45 26}
Cardiovascular System	Biological association	Mixed findings	Studied for: Blood pressure Studied for: Cholesterol and blood fats	^{48 49 36 53 26 25 28}
Musculoskeletal System	Biological association	Very low certainty	Studied for: Muscle damage after hard exercise	^{31 18}

F. Functional actions

Connected to	Kind of connection	Evidence status	Context	Studies
Blood sugar regulation	Drug or supplement interaction	Low certainty	Could add to diabetes medicines. Preparation or compound: American ginseng root and extract	^{51 53}
Blood sugar regulation	Potential benefit	Low certainty	Lower post-meal glucose in healthy people; modest HbA1c fall in one diabetes trial. Could add to diabetes drugs. Preparation or compound: American ginseng root and extract	^{51 53}

I. Biomarkers

Connected to	Kind of connection	Evidence status	Context	Studies
Number of colds per person	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{39 43}
Days of cold symptoms	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{39 43 33}
Laboratory-confirmed influenza or RSV	Biological association	Very low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{32 34}
Four-fold antibody rises against common viruses	Biological association	Very low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	²³
Fatigue improvement score (MFSI-SF general subscale change)	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	^{4 21}
Working memory test performance	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	^{42 38 19}
Frontal brain signal speed (SSVEP latency)	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	⁵⁵
Simulated lap time	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	¹⁹
Blood sugar after a glucose drink (area under the curve)	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{51 52 14 46}
Fasting blood glucose	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{53 45}
HbA1c	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{53 26 45}
Systolic blood pressure (top number, mmHg)	Biological association	Mixed findings	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{48 49 36 53 28}
Arterial stiffness (augmentation index)	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{36 25}
LDL cholesterol	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{53 26}
Creatine kinase (muscle damage marker)	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{31 18}
Oxidative damage markers (malondialdehyde, 8-OHdG)	Biological association	Very low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	^{15 31}
CD8+ T cells and interleukin-2 production	Biological association	Very low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	⁸

J. Genes, receptors and enzymes

Connected to	Kind of connection	Evidence status	Context	Studies
CYP1A2	Preliminary mechanism	In vitro	Strongly inhibited in test tubes by a North American ginseng extract; not raised in rat liver.	^{10 57}
CYP3A4 and CYP2C9	Preliminary mechanism	Animal	Activity raised and warfarin levels lowered in rats given ginsenosides (ginseng species not stated).	¹⁶
ESR1 and ESR2 (estrogen receptors alpha and beta)	Preliminary mechanism	In vitro	Alcohol extract bound both receptors in test tubes and in cells; zearalenone in extracts also bound them.	^{27 20}
CHAT (choline acetyltransferase)	Preliminary mechanism	Animal	Raised by Cereboost in nerve stem cells and mouse brain.	⁴⁴

K. Biological pathways

Connected to	Kind of connection	Evidence status	Context	Studies
Cytokine signalling (IL-2, interferon-gamma)	Preliminary mechanism	Animal	Changed by CVT-E002 in rats and in T cells from men on a North American ginseng extract.	^{7 8}
Gut microbiome short-chain fatty acid production	Preliminary mechanism	In vitro	Raised in a lab gut simulator with Cereboost.	⁵
Glutathione and oxidative balance	Preliminary mechanism	Human	Oxidative damage markers rose in a small human trial.	¹⁵

L. Active compounds

Connected to	Kind of connection	Evidence status	Context	Studies
Ginsenoside Rb1	Biological association	Human	Best-known marker compound. Found in human blood after a 10 g dose of root powder (peak 19.9 ng/mL at 4 hours) and turned into compound K by gut bacteria. Did not bind estrogen receptors in a test-tube assay. Preparation or compound: Root	^{20 54 12}
Ginsenoside Rd	Biological association	Human	More typical of American than Asian ginseng in 38 commercial samples; detected in human plasma after American ginseng. Preparation or compound: Root	^{12 54}
Ginsenoside Rg1	Biological association	In vitro	Did not bind estrogen receptors in the test-tube assay. Preparation or compound: Root	^{20 46}
Ginsenoside Re	Biological association	In vitro	One of seven ginsenosides measured in the blood sugar trials; tested in the CYP test-tube work. Preparation or compound: Root	^{47 10}
Ginsenosides Rc and Rb2	Biological association	In vitro	More typical of Asian than American ginseng in 38 commercial samples. Preparation or compound: Root	¹²
Ginsenoside Rf	Biological association	In vitro	More typical of Asian ginseng in the 38-sample comparison. Preparation or compound: Root	¹²
Pseudoginsenoside F11	Biological association	In vitro	More typical of American than Asian ginseng in the 38-sample comparison, so it works as a chemical marker for telling them apart. Preparation or compound: Root	^{12 56}
Ginsenoside Rg3 (20(S)-Rg3)	Biological association	In vitro	In a rat embryo culture the isolated compound slowed the embryonic heart rate. Added to American ginseng in one combination trial in the form of Rg3-enriched Korean red ginseng. Preparation or compound: Mainly formed by heat processing (steaming); wild American samples had less than cultivated ones in one comparison	^{12 40 26}
Compound K (ginsenoside K)	Biological association	Human	Shows that gut bacteria change the plant compounds before they reach the blood. Preparation or compound: Not in the plant; made in the gut from Rb1	⁵⁴
Poly-furanosyl-pyranosyl-saccharides (polysaccharides)	Biological association	Animal	In rats, the polysaccharide-rich extract changed immune cytokines differently from a ginsenoside extract. Preparation or compound: Root (concentrated in CVT-E002)	^{7 50}
Panaxynol (falcarinol)	Biological association	In vitro	Described by a 2024 paper title as a compound from American ginseng. Only the title is verified. Preparation or compound: Root (per a paper title)	¹⁷

Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).

Evidence at a glance: what changed in 17 lab markers

Tap a number to show only those markers. Counts are markers, not people.

Metabolic3 Other743

The evidence

The research centre for American Ginseng. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.

Evidence by outcome

Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).

How we rate evidence

High certainty

Several well-run trials or reviews agree; further research is unlikely to change the picture much.

Moderate certainty

Good trials point the same way, but some doubt remains.

Low certainty

Small, short or inconsistent trials. The finding could change with better research.

Very low certainty

Very little or very weak human data. Treat as a possibility only.

Mixed findings

Trials or reviews disagree with each other.

Not enough evidence

Not enough human research to say either way.

Evidence against

Good research found no benefit, or found harm.

We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We searched PubMed for American ginseng, Panax quinquefolius, COLD-fX, CVT-E002 and Cereboost across colds, cancer fatigue, blood sugar, blood pressure, thinking, interactions and quality, read the abstracts, checked plant names in GBIF and NCBI and compounds in PubChem, and read the NIH NCCIH page on Asian ginseng. Only abstracts were read for nearly all studies. Not verified: the NIH LiverTox and LactMed entries could not be opened, the Health Canada monograph could not be read, EMA, FDA, WHO and Commission E statements were not confirmed, and history of traditional use could not be confirmed. Certainty ratings are the compiler's own reading, not formal grades. No study is cited that we could not verify in PubMed.

Study library: every study we checked 62

Design Research type Plant part Year from Search

Study	Design	People	Product, dose, length	Result
Antonelli 2020 Ginseng integrative supplementation for seasonal acute upper respiratory infections: A systematic review and meta-analysis. Complement Ther Med · PMID 32951718 · DOI	Meta-analysis	Adults in 9 articles (10 trials) of Asian or American ginseng for seasonal upper respiratory infections	Panax ginseng or Panax quinquefolius preparations pooled together root Various Various · vs placebo or standard care	Pooled incidence was lower and, in healthy people only, duration was shorter. The authors say bias risk was high or unclear in most trials and publication bias could not be excluded. Incidence RR 0.69; duration MD -3.11 days (healthy people only). (Incidence 95% CI 0.52 to 0.90; duration 95% CI -5.81 to -0.40 days) Methods, limits and funding Outcomes: Incidence and duration of seasonal acute upper respiratory infections Limitations: Mixes two species, so it cannot be read as American ginseng alone. High-to-unclear risk of bias. Funding and conflicts: Not funded; authors report no conflicts. Read: abstract
Arring 2018 Ginseng as a Treatment for Fatigue: A Systematic Review. J Altern Complement Med · PMID 29624410 · DOI	Systematic review	People with fatigue in 10 studies of Asian or American ginseng	Panax ginseng and Panax quinquefolius, not separated in the abstract root Various Various · vs Various	Ten studies were included. The reviewers described a low risk of adverse events and modest evidence for effect, and called ginseng a promising treatment for fatigue while asking for stronger research. Narrative summary. Methods, limits and funding Outcomes: Self-reported fatigue Limitations: Mixes two species and many conditions. Only the abstract was read. Funding and conflicts: Funding and conflicts of interest were not stated in the abstract and the full text was not read. Read: abstract
Barton 2010 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 · PMID 19415341 · DOI	Controlled trial	290 Adults with cancer-related fatigue	American ginseng (Panax quinquefolius) root root 750, 1000 or 2000 mg a day (twice-daily dosing) 8 weeks · vs placebo	No result reached statistical significance, but trends favoured the 1000 and 2000 mg doses. SF-36 vitality rose 10.5 to 14.6 points on those doses vs 7.3 to 7.8 on placebo and 750 mg. More than twice as many on ginseng felt a benefit. No difference in side effects. Nonsignificant trends only. Methods, limits and funding Outcomes: Brief Fatigue Inventory; SF-36 vitality; Global Impression of Benefit Limitations: A pilot dose-finding trial, not designed to prove benefit. Only the abstract was read. Funding and conflicts: Funded by the US National Cancer Institute (extramural support listed). Conflicts not stated in the abstract. Read: abstract
Barton 2013 Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. J Natl Cancer Inst · PMID 23853057 · DOI	Controlled trial	364 Fatigued cancer survivors at 40 institutions; many were still on cancer treatment	Wisconsin-grown American ginseng root root 2000 mg a day 8 weeks · vs placebo	At 4 weeks the improvement was 14.4 (SD 27.1) on ginseng vs 8.2 (SD 24.8) on placebo, not significant (P = .07). At 8 weeks it was 20 (SD 27) vs 10.3 (SD 26.1), significant (P = .003). Benefit was greater in people having active cancer treatment than in those who had finished. Side effects did not differ. 8 weeks: 20 vs 10.3 points (P = .003); 4 weeks: P = .07. Methods, limits and funding Outcomes: General subscale of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF), main goal at 4 weeks Limitations: The pre-planned 4-week main goal was not met; the 8-week result was a later time point. Self-reported fatigue; the subgroup finding (during treatment) was exploratory. Only the abstract was read. Funding and conflicts: Funded by the US National Cancer Institute (extramural support listed); Mayo Clinic and Alliance cooperative group. Authors conflicts not stated in the abstract. Read: abstract
Bell 2022 A randomized, placebo-controlled trial investigating the acute and chronic benefits of American Ginseng (Cereboost®) on mood and cognition in healthy young adults, including in vitro investigation of gut microbiota changes as a possible mechanism of action. Eur J Nutr · PMID 34396468 · DOI	Controlled trial	61 Healthy young adults	Cereboost American ginseng root extract root Dose not given in the abstract Single dose, then 2 weeks daily, then a further acute dose · vs placebo	Working memory and attention improved in the hours after a dose, more so after two weeks of daily use. Chronic use improved an attention task, mental fatigue and self-assurance. A separate lab gut-model study showed more short-chain fatty acids. Significant improvements; no numbers in the abstract. Methods, limits and funding Outcomes: Working memory, attention, mood; also a laboratory gut-model study Limitations: Healthy young adults only. The gut-microbiome link is from a lab simulator, not people. Funding and conflicts: Three authors are employees of Naturex SA, who took part in design and write-up but not in data collection or analysis (stated in the paper). Pre-registered, NCT03579095. Registration: NCT03579095 Read: abstract
Bell 2026 Effects of American ginseng (Panax quinquefolius) extract on human neurocognitive function: a review. Nutr Neurosci · PMID 41017752 · DOI	Narrative review	Double-blind randomised trials of American ginseng extracts on cognition, mood or fatigue	American ginseng extracts root 2000 mg (cancer fatigue) and 100 to 400 mg (cognition) Various · vs Various	The reviewers say trials point to better attention and working memory in healthy adults and in people with schizophrenia at 100 to 400 mg, and limited fatigue benefit in cancer at 2000 mg. They also describe possible links to frontal brain activity, gut bacteria and acetylcholine. Narrative; no pooled numbers. Methods, limits and funding Outcomes: Cognition, mood, fatigue Limitations: A narrative review by authors who also ran several of the Cereboost trials. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Biondo 2008 Effect of CVT-E002 (COLD-fX) versus a ginsenoside extract on systemic and gut-associated immune function. Int Immunopharmacol · PMID 18550018 · DOI	Animal research animal	Young male rats	CVT-E002 compared with a ginsenoside extract of North American ginseng root 450 or 900 mg per kg (CVT-E002); 450 mg per kg (ginsenoside extract) 7 days · vs control diet	CVT-E002 lowered spleen IL-2 and interferon-gamma output after stimulation and lowered activated T cells; the ginsenoside extract instead raised IgA-positive gut cells. The authors concluded the polysaccharide-rich extract affects immunity in a different way from a ginsenoside extract. Animal data Methods, limits and funding Outcomes: Immune cell proportions and cytokines in spleen, lymph nodes and gut Limitations: Rats, 7 days. Funding and conflicts: Not stated in the abstract. Read: abstract
Biondo 2008 A randomized controlled crossover trial of the effect of ginseng consumption on the immune response to moderate exercise in healthy sedentary men. Appl Physiol Nutr Metab · PMID 18923572 · DOI	Controlled trial	10 Ten healthy sedentary men	Standardised ginsenoside-containing North American ginseng extract root 1125 mg a day 35 days, then a 3-month washout and crossover · vs placebo	Ginseng lowered circulating CD8+ T cells and raised ex vivo interleukin-2 production by stimulated T cells. It did not change white cell counts, neutrophils, monocytes, other lymphocytes, lymphocyte growth or neutrophil burst. Lactate, insulin, cortisol and growth hormone responses to exercise were unchanged. Limited effects on a few immune measures Methods, limits and funding Outcomes: Immune cell counts and function before, during and after moderate exercise; hormones Limitations: Only 10 men; lab immune markers are not infections or symptoms. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Bower 2024 Management of Fatigue in Adult Survivors of Cancer: ASCO-Society for Integrative Oncology Guideline Update. J Clin Oncol · PMID 38754041 · DOI	Guideline	Adults with cancer-related fatigue (113 randomised trials reviewed, 2013 to 2023)	American ginseng among many interventions root Not given in the abstract Not given in the abstract · vs Various	The guideline says American ginseng showed benefit during cancer treatment and that it may be recommended in adults undergoing treatment. Certainty of evidence for fatigue interventions overall was low to moderate. Other supplements did not help. Recommendation level: may be recommended during treatment. Methods, limits and funding Outcomes: Cancer-related fatigue Limitations: Only the abstract was read. The abstract does not give the ginseng-specific certainty rating or the studies behind it. Funding and conflicts: Guideline by ASCO and the Society for Integrative Oncology; author disclosures are in the full article (not read). Read: abstract
Chang 2002 In vitro effect of standardized ginseng extracts and individual ginsenosides on the catalytic activity of human CYP1A1, CYP1A2, and CYP1B1. Drug Metab Dispos · PMID 11901090 · DOI	Laboratory research in-vitro	Human recombinant enzymes and human liver microsomes	Standardised North American ginseng extract (NAGE) compared with Asian ginseng extract G115 and individual ginsenosides root Test-tube concentrations	Both extracts reduced CYP1 enzyme activity in the test tube. The North American extract was 45 times more potent than the Asian extract at inhibiting CYP1A2. The main ginsenosides tested did not explain it. In-vitro inhibition Methods, limits and funding Outcomes: Activity of CYP1A1, CYP1A2 and CYP1B1 enzymes Limitations: Test-tube only; no information on whether this happens at normal doses in people. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Chen 2012 HT1001, a proprietary North American ginseng extract, improves working memory in schizophrenia: a double-blind, placebo-controlled study. Phytother Res · PMID 22213250 · DOI	Controlled trial	64 Stable adults with schizophrenia (DSM-IV)	HT1001, a proprietary North American ginseng extract with known ginsenoside levels root Dose not given in the abstract 4 weeks · vs placebo	Visual working memory improved in the HT1001 group but not in the placebo group. Movement-type medication side effects (extrapyramidal symptoms) fell on HT1001 only. The abstract does not report an improvement in verbal working memory. Within-group improvement; no between-group numbers in the abstract. Methods, limits and funding Outcomes: Verbal and visual working memory; symptoms; medication side effects Limitations: 64 people, 4 weeks. The abstract describes changes within each group rather than a direct comparison. Add-on to antipsychotics. Funding and conflicts: Funding and conflicts of interest were not stated in the abstract and the full text was not read. Read: abstract
Chen 2015 Chemical differentiation and quality evaluation of commercial Asian and American ginsengs based on a UHPLC-QTOF/MS/MS metabolomics approach. Phytochem Anal · PMID 25448530 · DOI	Analytical study n/a	38 17 Asian and 21 American ginseng commercial samples	Commercial Panax ginseng and Panax quinquefolius root	Ginsenoside Rb1, pseudoginsenoside F11 and ginsenoside Rd were more likely in American ginseng; ginsenosides Rf, Rb2 and Rc were more likely in Asian ginseng. This gives chemical markers to tell the two apart. Method study Methods, limits and funding Outcomes: UHPLC-QTOF chemical fingerprints Limitations: 38 samples only. Funding and conflicts: Not stated in the abstract. Read: abstract
Choi 2017 A systematic review of the pharmacokinetic and pharmacodynamic interactions of herbal medicine with warfarin. PLoS One · PMID 28797065 · DOI	Systematic review	9 randomised trials of herbs with warfarin (various herbs)	Herbs including American ginseng, Korean red ginseng, ginger, garlic and others various Various Various · vs Various	American ginseng altered the pharmacodynamic parameters of warfarin; the other ginseng trial found no significant effect. Study quality and reporting were low, and the authors said firm conclusions were not possible. No major adverse events were reported in any trial. Qualitative Methods, limits and funding Outcomes: Pharmacokinetic and pharmacodynamic effects on warfarin Limitations: Low-quality trials, mostly small healthy-volunteer studies. Funding and conflicts: Authors report no competing interests. Read: abstract
Dascalu 2007 Five batches representative of Ontario-grown American ginseng root produce comparable reductions of postprandial glycemia in healthy individuals. Can J Physiol Pharmacol · PMID 18066131 · DOI	Controlled trial	12 Twelve healthy adults (mean age 26.5)	Five batches of Ontario-grown American ginseng root root 9 g taken 40 minutes before a 75 g glucose test Single doses on 6 visits · vs water (control)	Averaged over the five batches, peak blood sugar fell by 1.0 mmol/L, glucose area under the curve fell 27.7% and insulin area fell 23.8%. But two of the five batches (40%) did not lower blood sugar as expected, whatever their saponin content. Glucose AUC -27.7% (173 vs 240 mmol.min/L); peak -1.0 mmol/L; insulin AUC -23.8% Methods, limits and funding Outcomes: Blood sugar and insulin after a 75 g glucose test Limitations: Only 12 healthy people, a water control rather than a matching placebo, and a very large 9 g dose. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Dickman 2009 American ginseng supplementation induces an oxidative stress in postmenopausal women. J Am Coll Nutr · PMID 19828907 · DOI	Controlled trial	25 Postmenopausal women aged 55 to 75 (12 on ginseng, 13 on placebo)	American ginseng whole-root powder root Two 500 mg capsules a day (1 g a day) 4 months · vs placebo	Ginseng did not change heart rate, blood pressure, glucose or lactate. But markers of oxidative stress were worse: higher resting oxidised glutathione, lower glutathione ratio, lower total antioxidant content, and higher malondialdehyde and urine 8-hydroxydeoxyguanosine. Red-cell antioxidant enzymes rose. The authors concluded the dose caused oxidative stress. Higher oxidative damage markers on ginseng; no hard clinical outcome Methods, limits and funding Outcomes: Blood and urine markers of oxidative stress before and after a 30-minute walk Limitations: Small (25 women) and lab markers only; the meaning of the changes for health is uncertain. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Dong 2017 Global deregulation of ginseng products may be a safety hazard to warfarin takers: solid evidence of ginseng-warfarin interaction. Sci Rep · PMID 28725042 · DOI	Animal research animal	Rats	Ginsenosides extracted from ginseng (species not stated in the abstract) root Not given in the abstract Warfarin 1 week, then 3 weeks of warfarin with ginsenosides · vs warfarin alone	Ginsenosides weakened warfarin's effect in a dose- and time-dependent way. Warfarin blood levels fell and 7-hydroxywarfarin rose. Activities of CYP3A4 and CYP2C9, which break warfarin down, rose. Animal data Methods, limits and funding Outcomes: INR, thrombosis, warfarin levels, clotting factors, liver enzyme activity Limitations: Rats; species of ginseng not given in the abstract. Cannot be read as proof for people. Funding and conflicts: The authors declared no competing interests. Read: abstract
Edens 2024 Exploring the use of panaxynol from American ginseng to combat intestinal inflammation and colon cancer. Am J Physiol Gastrointest Liver Physiol · PMID 38915278 · DOI	Commentary n/a	n/a	Panaxynol root	PubMed record has no abstract; only the title is verified (it describes panaxynol as a compound from American ginseng). n/a Methods, limits and funding Outcomes: n/a Limitations: Title only. Nothing beyond the title is used. Read: title-only
Estaki 2015 North American ginseng protects against muscle damage and reduces neutrophil infiltration after an acute bout of downhill running in rats. Appl Physiol Nutr Metab · PMID 25531801 · DOI	Animal research animal	Male Wistar rats before a single downhill run	North American ginseng alcohol or water extract root 300 mg per kg a day 14 days · vs water placebo	Both extracts lowered creatine kinase. Only the water extract also reduced signs of muscle damage and neutrophil infiltration. Animal data Methods, limits and funding Outcomes: Plasma creatine kinase, muscle damage and neutrophils in soleus muscle Limitations: Rats, not people. Funding and conflicts: Not stated in the abstract. Read: abstract
Ferguson 2025 The influence of cereboost on mood, cognitive function, and simulated driving in professional race car drivers. Front Sports Act Living · PMID 41048625 · DOI	Non randomised	58 Licensed professional race car drivers	Cereboost American ginseng extract root 200 mg a day Four phases: baseline, acute, chronic and acute-on-chronic · vs Within-person comparison across phases (no separate placebo group described)	No significant effect on mood or cognitive tests after correcting for multiple tests. Simulated lap time improved by about 3 seconds in the acute-on-chronic phase (adjusted P = 0.000003, Cohen d = -1.274). 97% said they felt mentally sharper. Lap time about 3 seconds faster; mood and cognition null. (Adjusted P = 0.000003) Methods, limits and funding Outcomes: Mood questionnaires, spatial memory, split attention, simulated lap time Limitations: The abstract describes a within-subject design with no placebo group, so practice and expectation effects cannot be excluded. Simulator, not a track. Funding and conflicts: Two authors were employed by Givaudan (the extract maker group). Stated in the paper. Read: abstract
Gray 2004 Mycotoxins in root extracts of American and Asian ginseng bind estrogen receptors alpha and beta. Exp Biol Med (Maywood) · PMID 15169976 · DOI	Laboratory research in-vitro	Cell-free receptor binding assays	American and Asian ginseng root extracts root Test-tube extracts	Root extracts contained substances that bound both estrogen receptors, more strongly alpha, and more in methanol than hot-water extracts. The binding was linked to zearalenone, an estrogen-like mould toxin from Fusarium fungi. The main ginsenosides Rb1 and Rg1 did not bind. In-vitro binding Methods, limits and funding Outcomes: Binding to estrogen receptors alpha and beta Limitations: Test-tube only. Suggests contamination, not the plant's own compounds, explained the estrogen-like signal. Funding and conflicts: Not stated in the abstract. Read: abstract
Guglielmo 2020 A randomized, double-blind, placebo controlled, phase II study to evaluate the efficacy of ginseng in reducing fatigue in patients treated for head and neck cancer. J Cancer Res Clin Oncol · PMID 32617701 · DOI	Controlled trial	32 Head and neck cancer survivors, at least 1 year after treatment, with fatigue score above 4	American ginseng unspecified 1000 mg a day 8 weeks · vs placebo	Average fatigue score at 8 weeks was 4.6 on ginseng and 3.4 on placebo (not significant). The activity-interference item leaned towards placebo (P = 0.06). The authors concluded the evidence is insufficient to recommend American ginseng after treatment for head and neck cancer. No significant difference. Methods, limits and funding Outcomes: Brief Fatigue Inventory Limitations: Only 32 people; a lower dose (1000 mg) than the 2000 mg trial; survivors, not people in active treatment. Funding and conflicts: Two authors reported personal fees and grants from drug companies "outside the submitted work". Read: abstract
Harkey 2001 Variability in commercial ginseng products: an analysis of 25 preparations. Am J Clin Nutr · PMID 11382666 · DOI	Analytical study n/a	25 commercial ginseng products bought in a US health food store (Panax and Eleutherococcus)	Ginseng products measured for 7 ginsenosides and 2 eleutherosides root · vs Label claims	All products were the right genus (Panax or Eleutherococcus). Marker amounts differed greatly from labels and between products: ginsenosides varied 15-fold between capsules and 36-fold between liquids. Up to 36-fold variation Methods, limits and funding Outcomes: Marker compound amounts versus label Limitations: Products from 2001, a single store, not specific to American ginseng; no systematic search for adulterants. Funding and conflicts: Not stated in the abstract. Read: abstract
High 2012 A randomized, controlled trial of Panax quinquefolius extract (CVT-E002) to reduce respiratory infection in patients with chronic lymphocytic leukemia. J Support Oncol · PMID 22266154 · DOI	Controlled trial	293 Adults with early-stage, untreated chronic lymphocytic leukemia	CVT-E002, American ginseng root extract root Dose not given in the abstract About 3 months of winter season (January to March 2009) · vs placebo	The two main goals were not met: illness days 8.5 vs 6.8 and severe illness days 2.9 vs 2.6 (ginseng vs placebo). At least one illness: 51% vs 56%. Less moderate-to-severe sore throat on ginseng. Four-fold antibody rises against 9 common viruses: 16% vs 7%. Any illness difference -5 percentage points; more intense illness 32% vs 39%. (Any illness 95% CI -16% to 7%; more intense illness 95% CI -18% to 4%) Methods, limits and funding Outcomes: Days with acute respiratory illness; severe illness days; antibody rises Limitations: Both planned main outcomes were null; sore throat and antibody findings were secondary. Antibody changes were not tied to specific illnesses. Funding and conflicts: Funded by the US National Institutes of Health (extramural support listed in the PubMed record). Conflicts not stated in the abstract. Read: abstract
Ichim 2020 A Review of Authenticity and Authentication of Commercial Ginseng Herbal Medicines and Food Supplements. Front Pharmacol · PMID 33505315 · DOI	Systematic review n/a	507 507 ginseng-containing commercial products from 12 countries	Panax ginseng, Panax quinquefolius and Panax notoginseng products various · vs Label claims	76% were authentic and 24% adulterated. Most adulteration was other Panax species substituted for the labelled one; substituting leaves, stems or flowers for the root was also reported. By region: North America 23%, Europe 35%, Asia 21%; in the USA 12%. 24% of products adulterated Methods, limits and funding Outcomes: Authenticity of botanical and chemical identity Limitations: Combines results of many studies with different methods; not American ginseng alone. Funding and conflicts: The authors declared no conflicts. Read: abstract
Jovanovski 2020 Vascular effects of combined enriched Korean Red ginseng (Panax Ginseng) and American ginseng (Panax Quinquefolius) administration in individuals with hypertension and type 2 diabetes: A randomized controlled trial. Complement Ther Med · PMID 32147072 · DOI	Controlled trial	80 Adults with type 2 diabetes and hypertension	A combination of Rg3-enriched Korean red ginseng (Panax ginseng) plus American ginseng root 2.25 g three times a day (as the abstract states; the companion report gives 2.25 g a day, so no dose is relied on) 12 weeks · vs control	Central systolic blood pressure fell by 4.69 mmHg versus control. Pulse wave velocity and the reactive hyperemia index (blood vessel function tests) did not change significantly. Central systolic BP -4.69 +/- 2.24 mmHg (p=0.04); PWV -0.40 +/- 0.28% (p=0.17) Methods, limits and funding Outcomes: Central blood pressure, pulse wave velocity, endothelial function Limitations: Same trial population as the cardiometabolic paper, and a two-species combination. Funding and conflicts: A senior author holds patents and was part-owner of a glycemic-testing company (stated in the paper). Read: abstract
Jovanovski 2021 Effect of coadministration of enriched Korean Red Ginseng (Panax ginseng) and American ginseng (Panax quinquefolius L) on cardiometabolic outcomes in type-2 diabetes: A randomized controlled trial. J Ginseng Res · PMID 34803424 · DOI	Controlled trial	80 Adults with type 2 diabetes (HbA1c 6.5 to 8%) and hypertension	A combination of ginsenoside Rg3-enriched Korean red ginseng (Panax ginseng) plus American ginseng root 2.25 g a day combined 12 weeks · vs wheat bran	Combined ginseng lowered 24-hour systolic blood pressure by about 4 mmHg, HbA1c by 0.35 percentage points, and total cholesterol, non-HDL cholesterol and triglycerides. LDL fell but not significantly (p=0.06). No adverse safety outcomes. 24-h systolic BP -3.98 +/- 2.0 mmHg (p=0.04); HbA1c -0.35 +/- 0.1% (p=0.02); total cholesterol -0.50 mmol/L; triglycerides -0.40 mmol/L Methods, limits and funding Outcomes: 24-hour systolic blood pressure (main goal), HbA1c, lipids, safety Limitations: It is a combination of two species, so effects cannot be given to American ginseng alone. 80 people, 12 weeks. Funding and conflicts: A senior author holds patents and was part-owner of a glycemic-testing company (stated in the paper). Registered NCT01578837. Registration: NCT01578837 Read: abstract
King 2006 Extraction-dependent effects of American ginseng (Panax quinquefolium) on human breast cancer cell proliferation and estrogen receptor activation. Integr Cancer Ther · PMID 16880429 · DOI	Laboratory research in-vitro	Human breast cancer cell lines (MCF-7 and MDA-MB-231)	American ginseng root extracted with methanol or with water root Test-tube concentrations (5 to 100 micrograms/mL low range) 6 days · vs untreated cells	The alcohol extract, but not the water extract, increased growth of estrogen-receptor-positive cells at low concentrations, and this was blocked by estrogen blockers; it also bound the estrogen receptors and switched on estrogen-responsive genes. At higher concentrations both extracts slowed growth of the cells. In-vitro estrogen-like effect with alcohol extract Methods, limits and funding Outcomes: Cell growth, estrogen receptor binding, estrogen-responsive gene activity Limitations: Cell culture only. Extraction method changed the result. Funding and conflicts: Not stated in the abstract. Read: abstract
Komishon 2016 The effect of ginseng (genus Panax) on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials. J Hum Hypertens · PMID 27074879 · DOI	Meta-analysis	1381 Adults in 17 randomised trials of at least 4 weeks of ginseng (genus Panax)	Ginseng (genus Panax); species not separated in the abstract root Various At least 4 weeks · vs placebo or control	No significant effect on blood pressure was found. In people with diabetes, metabolic syndrome or obesity, systolic pressure was about 2.8 mmHg lower, but this was not statistically significant. The authors concluded ginseng seems to have a neutral effect and should not be discouraged for fear of raising blood pressure. No significant change; subgroup systolic MD -2.76 mmHg (95% CI -6.40 to 0.87 (P=0.14)) Methods, limits and funding Outcomes: Systolic, diastolic and mean arterial pressure Limitations: Mixes species and preparations; heterogeneity noted by the authors. Funding and conflicts: Conflict statement not read. Read: abstract
Külkamp 2026 Microscopy Combined with LC-UV Analysis as a Tool for Authentication of Ginseng Species Used in Traditional Medicine and Detection of Their Adulterants. J Diet Suppl · PMID 42262747 · DOI	Analytical study n/a	Four Panax species and two common adulterants	Panax ginseng, P. quinquefolius, P. japonicus, P. notoginseng, plus Codonopsis pilosula and Platycodon grandiflorus root	Panax roots share secretory ducts and starch grains and contain ginsenosides, while the two adulterants lack ginsenosides. Asian and American ginseng looked very alike under the microscope and remained hard to tell apart that way. Method study Methods, limits and funding Outcomes: Microscopy and HPLC fingerprints Limitations: Lab method study, not a market survey. Funding and conflicts: Not stated in the abstract. Read: abstract
Li 2023 Ginseng and health outcomes: an umbrella review. Front Pharmacol · PMID 37465522 · DOI	Umbrella review	19 meta-analyses of ginseng (mostly not species-specific)	Ginseng root	Reports benefit for fatigue, physical function, sexual function, menopausal symptoms, metabolic indicators, inflammatory markers, unstable angina and respiratory diseases, but graded the underlying reviews as low or critically low quality (14 of 19 critically low). Adverse events were stomach and gut symptoms and possible bleeding; none serious. Umbrella review Methods, limits and funding Outcomes: Many health outcomes Limitations: Mixes ginseng types; critically low methodological quality for most of the reviews. Funding and conflicts: The authors declared no conflicts. Read: abstract
Lin 2021 American Ginseng Attenuates Eccentric Exercise-Induced Muscle Damage via the Modulation of Lipid Peroxidation and Inflammatory Adaptation in Males. Nutrients · PMID 35010953 · DOI	Controlled trial	12 Twelve physically active young men	American ginseng extract root 1.6 g a day 28 days before a downhill running test · vs placebo (crossover)	Rises in creatine kinase after downhill running were absent at 48 and 72 hours on ginseng. A marker of fat oxidation damage (8-iso-prostaglandin F2 alpha) was lower after running, and interleukin-4 differed between ginseng and placebo. CK rise eliminated at 48 and 72 h; 8-iso-PGF2a lower (p=0.01 at 0 and 2 h, p=0.028 at 24 h) Methods, limits and funding Outcomes: Muscle damage and inflammation markers after downhill running; pain rating Limitations: Twelve young men, lab markers rather than performance or soreness benefit; the abstract does not report a pain-rating difference. Only the abstract was read. Funding and conflicts: The authors declared no conflict of interest. Read: abstract
McElhaney 2004 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 · PMID 14687309 · DOI	Controlled trial	198 Residents of nursing homes and assisted living, average age 81 and 83.5 years; about 90% had flu shots	CVT-E002 (sold as COLD-fX), a proprietary, polysaccharide-rich extract of American ginseng root root 200 mg twice a day 8 weeks (2000 season) and 12 weeks (2000-2001 season) · vs placebo	Two small trials were pooled. Laboratory-confirmed influenza: 7 of 101 on placebo vs 1 of 97 on CVT-E002. Influenza plus RSV: 9 of 101 vs 1 of 97. Influenza: odds ratio 7.73 (P=.033). Influenza plus RSV: odds ratio 10.50 (P=.009); 89% relative risk reduction reported by the authors. Methods, limits and funding Outcomes: Acute respiratory illness; laboratory-confirmed influenza and RSV Limitations: Two seasons pooled; very few cases (10 cases of influenza or RSV in total across both groups); only about 90% vaccinated so results may not carry to unvaccinated people. Funding and conflicts of interest were not stated in the abstract and the full text was not read. Funding and conflicts: Not stated in the abstract. The extract is a proprietary commercial product. Read: abstract
McElhaney 2006 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 · PMID 16566675 · DOI	Controlled trial	43 Community-living adults aged 65 and over	COLD-fX (CVT-E002), American ginseng root extract root 2 capsules a day, 200 mg each 4 months (flu vaccine given after month 1) · vs placebo	No difference in the first 2 months. In the last 2 months fewer people on COLD-fX reported illness (32% vs 62%) and symptoms were shorter (5.6 vs 12.6 days). Authors report 48% lower relative risk and 55% shorter duration in the last 2 months. Methods, limits and funding Outcomes: Incidence and duration of acute respiratory illness reported by participants Limitations: Only 43 people. The benefit appeared only in an unplanned-looking late window (the last 2 months). No influenza was circulating in the community that season. Funding and conflicts of interest were not stated in the abstract and the full text was not read. Funding and conflicts: Not stated in the abstract. The extract is a proprietary commercial product. Read: abstract
McElhaney 2011 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 · PMID 23074661 · DOI	Controlled trial	783 Community-living adults who had received an influenza vaccine	CVT-E002, American ginseng root extract root 400 mg or 800 mg a day 6 months · vs placebo	The main outcome did not differ: 5.5% (placebo), 5.2% (400 mg), 4.6% (800 mg). Jackson-confirmed infections were lower in the treated groups, and severity and duration were reduced. Primary outcome P = 0.89 (no difference). Jackson-confirmed infections P < 0.04. Methods, limits and funding Outcomes: Primary: laboratory-confirmed clinical respiratory infections. Secondary: Jackson-confirmed infections, severity and duration Limitations: The planned main outcome was null; the positive findings come from a secondary analysis in study completers. Numbers behind the secondary results are not in the abstract. Funding and conflicts of interest were not stated in the abstract and the full text was not read. Funding and conflicts: Not stated in the abstract. The extract is a proprietary commercial product. Read: abstract
Mucalo 2012 Effect of American ginseng (Panax quinquefolius L.) on glycemic control in type 2 diabetes. Coll Antropol · PMID 23390846	Narrative review	Narrative review of American ginseng in type 2 diabetes	American ginseng root Not given Not given · vs Not given	The review says American ginseng is the best-studied herb for post-meal blood sugar and that ginsenoside levels vary widely between products, so over-the-counter products may vary just as much in effect. Narrative Methods, limits and funding Outcomes: Glycemic control, efficacy and safety Limitations: No new data; the abstract gives no numbers. Funding and conflicts: Not stated in the abstract. Read: abstract
Mucalo 2013 Effect of American ginseng (Panax quinquefolius L.) on arterial stiffness in subjects with type-2 diabetes and concomitant hypertension. J Ethnopharmacol · PMID 23973636 · DOI	Controlled trial	64 Adults with well-controlled hypertension and type 2 diabetes (mean age 63)	American ginseng extract root 3 g a day, added to usual treatment 12 weeks · vs placebo	Compared with placebo, American ginseng lowered radial augmentation index by 5.3% and systolic blood pressure by 11.7%. Diastolic pressure did not change. Augmentation index -5.3% (P=0.041); systolic BP -11.7% (P<0.001) Methods, limits and funding Outcomes: Augmentation index (arterial stiffness) and blood pressure Limitations: 64 people, 12 weeks, in a group with both diabetes and hypertension. The authors say it needs more study before use as an add-on. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Mucalo 2014 American Ginseng Extract (Panax quinquefolius L.) Is Safe in Long-Term Use in Type 2 Diabetic Patients. Evid Based Complement Alternat Med · PMID 24891873 · DOI	Controlled trial	74 Adults with well-controlled type 2 diabetes (mean age 63, BMI 32); 74 completed	American ginseng extract with 10% ginsenosides root 500 mg with each meal (3 g a day) 12 weeks · vs placebo	No change in kidney, liver or clotting tests versus placebo, and no difference in the number or severity of adverse events. No difference in safety measures Methods, limits and funding Outcomes: Safety: kidney (urates, creatinine), liver (AST, ALT) and clotting (PV, INR) tests, adverse events Limitations: A safety trial in people with diabetes who were in good control, 12 weeks. The abstract does not say whether anyone took warfarin. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Ossoukhova 2015 Improved working memory performance following administration of a single dose of American ginseng (Panax quinquefolius L.) to healthy middle-age adults. Hum Psychopharmacol · PMID 25778987 · DOI	Controlled trial	52 Healthy adults aged 40 to 60 (mean 51.6)	Cereboost American ginseng root extract root 200 mg, single dose Single dose, tested at 1, 3 and 6 hours · vs placebo (crossover)	At 3 hours the Working Memory factor was better than placebo, driven by spatial working memory. Mood and blood glucose did not change. Significant working-memory factor at 3 hours; no numbers in the abstract. Methods, limits and funding Outcomes: Cognitive Drug Research battery; mood; blood glucose Limitations: One dose, one day, and gains were seen at one of three time points. Healthy people, so not a treatment trial. Funding and conflicts: Not stated in the abstract; branded extract. Read: abstract
Predy 2005 Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ · PMID 16247099 · DOI	Controlled trial	323 Healthy adults aged 18-65 in Edmonton with at least 2 colds in the previous year	Poly-furanosyl-pyranosyl-saccharide-rich American ginseng root extract (the COLD-fX type) root 2 capsules a day (capsule strength not given in the abstract) 4 months · vs placebo	Among the 279 people analysed (130 ginseng, 149 placebo), mean colds per person were 0.68 vs 0.93. 10.0% vs 22.8% had 2 or more colds. Total symptom days 10.8 vs 16.5. Difference in colds per person 0.25; people with 2 or more colds 12.8 percentage points fewer. (Colds per person 95% CI 0.04 to 0.45; 2 or more colds difference 95% CI 4.3 to 21.3) Methods, limits and funding Outcomes: Number of Jackson-verified colds; symptom score; days of symptoms Limitations: 44 people who did not start treatment were left out of the analysis (23 ginseng, 21 placebo), so it was not a full intention-to-treat analysis. Only people prone to colds were enrolled. Funding and conflicts of interest were not stated in the abstract and the full text was not read. Funding and conflicts: Not stated in the abstract. The extract is a proprietary commercial product. Read: abstract
Ritchie 2026 The Effect of Some Complementary Medicine Active Components on Rat Embryonic Heart Rate In Vitro. Birth Defects Res · PMID 41634959 · DOI	Laboratory research in-vitro	Rat embryos grown in the lab (day 13 of pregnancy)	Ginsenoside Rg3 (a compound found in ginseng, mostly after steaming), alongside allicin, EGCG and berberine isolated compound Lab concentrations Embryo culture	All four compounds slowed the embryonic heart rate. The authors calculated the margin of safety for ginsenoside Rg3 as acceptable. In-vitro; no human pregnancy data Methods, limits and funding Outcomes: Embryonic heart rate Limitations: Isolated compound, not an American ginseng product; Rg3 is a minor component of unsteamed American ginseng root (not verified in these sources). Funding and conflicts: Not stated in the abstract. Read: abstract
Sadeghian 2021 Ginseng and Cancer-Related Fatigue: A Systematic Review of Clinical Trials. Nutr Cancer · PMID 32691627 · DOI	Systematic review	Cancer patients in 7 trials and 1 retrospective study (3 on American ginseng, 3 on Asian, 2 on Korean)	American, Asian and Korean ginseng reviewed separately root American ginseng 2000 mg a day Up to 8 weeks · vs placebo or none	Reviewers reported that American ginseng with more than 5% ginsenosides at 2000 mg a day for up to 8 weeks reduced fatigue. Study quality varied greatly. They said there are not enough high-quality studies to make ginseng a standard treatment. Narrative summary; no pooled number in the abstract. Methods, limits and funding Outcomes: Cancer-related fatigue Limitations: Includes the N07C2 trial, so it is not independent evidence. Quality varied. Funding and conflicts: Funding and conflicts of interest were not stated in the abstract and the full text was not read. Read: abstract
Scholey 2010 Effects of American ginseng (Panax quinquefolius) on neurocognitive function: an acute, randomised, double-blind, placebo-controlled, crossover study. Psychopharmacology (Berl) · PMID 20676609 · DOI	Controlled trial	32 Healthy young adults	Cereboost, American ginseng root extract standardised to 10.65% ginsenosides root 100, 200 or 400 mg, single doses Single dose, tested 1, 3 and 6 hours later · vs placebo (crossover)	Working memory (Corsi block) was better after every dose at every time point. Choice reaction accuracy and calmness improved with 100 mg only. Other working-memory tasks varied by dose. Blood glucose did not change. Significant working-memory improvement; no numbers in the abstract. Methods, limits and funding Outcomes: Working memory, reaction time, mood, blood glucose Limitations: 32 young adults, one-day effects only, many tests so some positive results may be by chance. Called a preliminary study by its authors. Funding and conflicts: Not stated in the abstract; the extract is a branded product (Cereboost). Read: abstract
Seida 2011 North American (Panax quinquefolius) and Asian Ginseng (Panax ginseng) Preparations for Prevention of the Common Cold in Healthy Adults: A Systematic Review. Evid Based Complement Alternat Med · PMID 19592479 · DOI	Systematic review	747 Healthy adults in 5 trials, all of North American ginseng	North American ginseng root preparations (Asian ginseng was eligible but no trial of it was found) root Various 8 to 16 weeks · vs placebo or no treatment	Total colds were 25% lower in one trial. Risk of at least one cold or infection was RR 0.70 but not statistically significant. Duration was 6.2 days shorter in two trials. Total colds -25% (one trial); at least one cold RR 0.70; duration -6.2 days (two trials). (Total colds 95% CI 5 to 45%; at least one cold RR 95% CI 0.48 to 1.02; duration 95% CI 3.4 to 9.0 days) Methods, limits and funding Outcomes: Number, severity and duration of colds and acute respiratory infections Limitations: Study quality varied widely. Searches ended in December 2007. Several of the trials used the same proprietary extract. The authors concluded evidence was insufficient for fewer or milder colds. Funding and conflicts: Funding and conflicts of interest were not stated in the abstract and the full text was not read. Read: abstract
Shin 2016 Cereboost™, an American ginseng extract, improves cognitive function via up-regulation of choline acetyltransferase expression and neuroprotection. Regul Toxicol Pharmacol · PMID 27112419 · DOI	Animal research animal	Mice given amyloid-beta peptide in the brain; nerve stem cells in culture	Cereboost American ginseng root extract (high in ginsenoside Rb1) root Not given in the abstract Not given in the abstract · vs untreated model animals	Cereboost protected the cultured nerve cells, raised the gene for choline acetyltransferase (the enzyme that makes acetylcholine), and restored memory performance and acetylcholine levels in the mice. Animal and cell data Methods, limits and funding Outcomes: Learning and memory, choline acetyltransferase gene expression, acetylcholine Limitations: Mouse model of Alzheimer disease; does not show an effect in people. Funding and conflicts: Not stated in the abstract. Read: abstract
Shishtar 2014 The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials. PLoS One · PMID 25265315 · DOI	Meta-analysis	People with and without diabetes in 16 trials of at least 30 days of ginseng (genus Panax)	Ginseng (genus Panax); species not separated in the abstract root Various At least 30 days; 67% of trials shorter than 12 weeks · vs placebo or control	Fasting blood glucose was modestly lower on ginseng (about 0.31 mmol/L). Fasting insulin, HbA1c and insulin resistance did not change overall. HbA1c fell in parallel-group trials only. Fasting glucose MD -0.31 mmol/L (95% CI -0.59 to -0.03) Methods, limits and funding Outcomes: Fasting glucose, insulin, HbA1c, insulin resistance Limitations: Mixes species; most trials were short and in people already in good control. The authors call for larger and longer trials with standardised preparations. Funding and conflicts: A senior author holds patents and had a stake in a glycemic-testing company, per the paper's own statement (abstract-level reading). Read: abstract
Sievenpiper 2003 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 · PMID 12571655 · DOI	Controlled trial	12 Twelve adults with normal glucose tolerance	One batch of American ginseng root with low ginsenoside levels (1.66% total ginsenosides) root 6 g, 40 minutes before a 75 g glucose test Single dose · vs placebo (single-blind)	This batch had no significant effect on blood sugar, insulin or insulin sensitivity indices. The authors suggested the low ginsenoside content and altered ginsenoside ratios might explain the difference from earlier batches. No significant effect Methods, limits and funding Outcomes: Blood sugar and insulin after a 75 g glucose test Limitations: Single-blind, 12 people; it is a null result that shows batch-to-batch variation. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Sievenpiper 2004 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 · PMID 15190050 · DOI	Controlled trial	12 Twelve healthy adults	Eight types of ginseng, including American, American-wild, Asian, Asian-red, Vietnamese-wild, Siberian, Japanese and Sanchi root 3 g, 40 minutes before a 75 g glucose test Ten single-dose test days · vs two placebos (crossover)	Effects differed by type. American ginseng tended to lower blood sugar at 90 minutes (P<0.06, not significant). Asian ginseng raised peak blood sugar, wild American ginseng raised blood sugar at 120 minutes, and Siberian ginseng raised blood sugar at several times. The ratio of two ginsenoside groups predicted some of the effects, but explained little. American ginseng: trend only (P<0.06) in this trial. Methods, limits and funding Outcomes: Blood sugar and insulin after a 75 g glucose test Limitations: Twelve people. Only the abstract was read. Shows that "ginseng" is not one thing. Funding and conflicts: Not stated in the abstract. Read: abstract
Stavro 2005 North American ginseng exerts a neutral effect on blood pressure in individuals with hypertension. Hypertension · PMID 15998708 · DOI	Controlled trial	16 Sixteen adults with hypertension (mean age 61; 13 on blood pressure medicine)	Six batches of North American ginseng root powder root 3 g single doses (6 batches, 2 placebo days) Eight test mornings, blood pressure checked for 160 minutes · vs placebo	None of the batches differed from placebo in the overall blood pressure change over 160 minutes. At a few single time points the average of the ginseng batches was slightly higher or lower, so the authors called the effect neutral. Neutral on average Methods, limits and funding Outcomes: Ambulatory blood pressure after a single dose Limitations: Sixteen people and single doses, so it says nothing about long-term use. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Stavro 2006 Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension · PMID 16520410 · DOI	Controlled trial	52 Adults with hypertension; 52 randomised, 37 analysed	North American ginseng root 3 g a day 12 weeks, with an 8-week washout and crossover · vs placebo	Ginseng had a neutral effect on all 24-hour blood pressure measures and on cystatin C compared with placebo; the intention-to-treat analysis agreed. Neutral Methods, limits and funding Outcomes: 24-hour ambulatory blood pressure; kidney marker cystatin C Limitations: Many dropouts (40 completed, 37 analysed). Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Vohra 2008 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 · PMID 18676527 · DOI	Controlled trial	46 Children aged 3 to 12 with an upper respiratory infection (75 recruited; 46 became ill and were randomised)	American ginseng root extract standardised to 80% poly-furanosyl-pyranosyl-saccharides root Two weight-based dose levels (standard and low) During one winter (November 2005 to March 2006) · vs placebo	No serious adverse events. The number, severity and link to treatment of adverse events did not differ between the three groups. Not an efficacy trial. Methods, limits and funding Outcomes: Safety and tolerability; Canadian Acute Respiratory Infection Flu Scale Limitations: Phase II safety trial with 15, 16 and 15 children in the arms. It was not designed to show whether the extract works. Funding and conflicts of interest were not stated in the abstract and the full text was not read. Funding and conflicts: Not stated in the abstract. Read: abstract
Vuksan 2000 American ginseng improves glycemia in individuals with normal glucose tolerance: effect of dose and time escalation. J Am Coll Nutr · PMID 11194526 · DOI	Controlled trial	10 Ten adults without diabetes (mean age 41)	American ginseng ground root root 0, 3, 6 or 9 g, given 40, 80 or 120 minutes before a 25 g glucose drink Single doses on 12 separate days · vs placebo (crossover)	All three doses lowered the rise in blood sugar at 30, 45 and 60 minutes. Area under the curve fell 26.6% (3 g), 29.3% (6 g) and 38.5% (9 g). Timing (40, 80 or 120 min before) made no extra difference. AUC -26.6%, -29.3%, -38.5% (P<0.05) Methods, limits and funding Outcomes: Blood sugar after a 25 g glucose drink Limitations: Ten people, single-day tests, capillary blood glucose; people without diabetes. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Vuksan 2001 American ginseng (Panax quinquefolius L.) attenuates postprandial glycemia in a time-dependent but not dose-dependent manner in healthy individuals. Am J Clin Nutr · PMID 11273850 · DOI	Controlled trial	12 Twelve healthy adults (mean age 42)	American ginseng root root 1, 2 or 3 g, given 40, 20, 10 or 0 minutes before a 25 g glucose drink 16 single-dose test days · vs placebo (crossover)	Blood sugar was lower over the last 45 minutes after 1, 2 or 3 g than after placebo, with no difference between doses. Area under the curve fell 14.4%, 10.6% and 9.1%. The effect only appeared when taken 40 minutes beforehand, not 20, 10 or 0. AUC -14.4%, -10.6%, -9.1% (P<0.05) Methods, limits and funding Outcomes: Blood sugar after a 25 g glucose drink Limitations: Twelve healthy people, one day per test, no long-term data. Only the abstract was read. Funding and conflicts: Not stated in the abstract. Read: abstract
Vuksan 2019 Efficacy and safety of American ginseng (Panax quinquefolius L.) extract on glycemic control and cardiovascular risk factors in individuals with type 2 diabetes: a double-blind, randomized, cross-over clinical trial. Eur J Nutr · PMID 29478187 · DOI	Controlled trial	24 Adults with type 2 diabetes controlled by usual treatment (mean age 64, mean HbA1c 7.1%)	American ginseng extract root 1 g with each meal (3 g a day), added to usual treatment 8 weeks, with a 4-week or longer washout and crossover · vs placebo	Compared with placebo, American ginseng lowered HbA1c by 0.29 percentage points and fasting blood glucose by 0.71 mmol/L, lowered systolic blood pressure by 5.6 mmHg, and LDL cholesterol by 12.3%. Safety measures were unaffected. HbA1c -0.29% (p=0.041); fasting glucose -0.71 mmol/L (p=0.008); systolic BP -5.6 +/- 2.7 mmHg; LDL-C -12.3 +/- 3.9% Methods, limits and funding Outcomes: HbA1c (main goal); fasting glucose; blood pressure; lipids; safety (liver, kidney) Limitations: Only 24 people completed it, two 8-week periods, and lipid and blood-pressure results were secondary. The authors say larger trials with standardised preparations are needed. Only the abstract was read. Funding and conflicts: Funding and conflict statement not read. Registered NCT02923453. Several authors of this group declare patents and ownership in a glycemic-testing company in their other papers (see the 2021 trial). Registration: NCT02923453 Read: abstract
Wang 2011 Ultra-performance liquid chromatography and time-of-flight mass spectrometry analysis of ginsenoside metabolites in human plasma. Am J Chin Med · PMID 22083988 · DOI	Pharmacokinetic study	6 Six healthy adults	American ginseng root powder root 10 g single dose Blood samples over 12 hours	Ginsenosides Rb1, Rd, Rg2 and compound K were found in plasma. Rb1 peaked at 19.90 +/- 5.43 ng/mL at 4 hours; compound K appeared from 7 to 12 hours (7.32 +/- 1.35 ng/mL at 12 hours, peak not reached). Area under the curve 0-12 h: Rb1 155.0 +/- 19.5, compound K 26.4 +/- 6.4 ng.h/mL. Rb1 peak 19.90 ng/mL at 4 h; compound K from 7 h Methods, limits and funding Outcomes: Plasma ginsenosides and gut-bacteria metabolites Limitations: Six people, one big dose, 12-hour sampling. Funding and conflicts: Not stated in the abstract. Read: abstract
White 2020 Effects of Panax quinquefolius (American ginseng) on the steady state visually evoked potential during cognitive performance. Hum Psychopharmacol · PMID 32896022 · DOI	Controlled trial	Healthy adults aged 40 to 60	American ginseng (Panax quinquefolius) root 200 mg, single dose Single dose, tested 6 hours later · vs placebo (crossover)	Brain-signal latency in the front of the brain was shorter on ginseng during working-memory retrieval. There were no treatment effects on the behavioural scores of either task. Brain-signal change only; no change in test performance. Methods, limits and funding Outcomes: Steady-state visually evoked potentials (brain recording) during working memory and attention tasks Limitations: A brain-recording study with no performance benefit. Sample size not stated in the abstract. Funding and conflicts: The authors declared no conflict of interest. Read: abstract
Yang 2022 A review for discovering bioactive minor saponins and biotransformative metabolites in Panax quinquefolius L. Front Pharmacol · PMID 35979234 · DOI	Narrative review n/a	Review of minor saponins in P. quinquefolius	Ginsenosides: protopanaxadiol-, protopanaxatriol-, oleanane- and ocotillol-type root	Classifies the ginsenosides by their skeleton and notes poor bioavailability and little known metabolism for most saponins. Narrative Methods, limits and funding Outcomes: Structures and metabolism of minor ginsenosides Limitations: Mostly chemistry and preclinical pharmacology. Funding and conflicts: The authors declared no conflicts. Read: abstract
Yu 2005 Lack of evidence for induction of CYP2B1, CYP3A23, and CYP1A2 gene expression by Panax ginseng and Panax quinquefolius extracts in adult rats and primary cultures of rat hepatocytes. Drug Metab Dispos · PMID 15466162 · DOI	Animal research animal	Adult male rats and rat liver cells	Panax ginseng and Panax quinquefolius extracts (10% ginsenosides for American ginseng) root 100 or 400 mg per kg a day for American ginseng 21 days · vs vehicle	Neither extract raised these liver enzyme genes or their activity, while positive-control drugs did. No induction in rats Methods, limits and funding Outcomes: Liver gene expression and activity of CYP2B1, CYP3A23 and CYP1A2 (liver drug-handling enzymes) Limitations: Rats and rat cells; human liver enzymes can behave differently. Funding and conflicts: Not stated in the abstract. Read: abstract
Yuan 2004 Brief communication: American ginseng reduces warfarin's effect in healthy patients: a randomized, controlled Trial. Ann Intern Med · PMID 15238367 · DOI	Controlled trial	20 Twenty healthy volunteers (young, in a research unit)	American ginseng (product details not given in the abstract) root Dose not given in the abstract 4-week study: warfarin for 3 days in week 1 and again in week 4; ginseng or placebo started in week 2 · vs placebo	After 2 weeks of ginseng, peak INR was lower than with placebo, and the INR area under the curve, peak warfarin level and warfarin area under the curve were also lower. Peak INR and peak warfarin level moved together. Peak INR difference -0.19 (P = 0.0012) (95% CI -0.36 to -0.07) Methods, limits and funding Outcomes: INR (blood clotting test) and blood warfarin levels Limitations: Young healthy volunteers given short warfarin courses, not patients taking steady warfarin doses (the authors say so). Only the abstract was read. Funding and conflicts: Funded by US public health research grants (listed in the PubMed record). Read: abstract
Zhai 2026 Rapid identification of adulteration in American ginseng powder using near-infrared spectroscopy combined with machine learning. Spectrochim Acta A Mol Biomol Spectrosc · PMID 41481954 · DOI	Analytical study n/a	1680 Laboratory-prepared American ginseng powder mixed with 6 adulterants at 20 to 80%	American ginseng powder with Angelica dahurica, Astragalus membranaceus, Panax notoginseng and wheat flour powder	The authors say American ginseng powder is frequently adulterated with low-cost substitutes. The best model identified the adulterated samples with 95.6% accuracy in the lab. Method study (accuracy 0.956) Methods, limits and funding Outcomes: Near-infrared spectroscopy with machine learning Limitations: Samples were mixed in the laboratory, not bought from shops; the "frequently adulterated" statement is the authors' background claim. Funding and conflicts: The authors declared no competing interests. Read: abstract
s-gbif-panax-quinquefolius GBIF Backbone Taxonomy: Panax quinquefolius L. (usageKey 5372246) · Source	Reference database n/a			Methods, limits and funding Read: full-text
s-ncbi-taxon-44588 NCBI Taxonomy: Panax quinquefolius (taxid 44588) · Source	Reference database n/a			Methods, limits and funding Read: full-text
s-nccih-asian-ginseng NCCIH: Asian Ginseng (page updated February 2025) · Source	Authoritative guidance n/a			Methods, limits and funding Read: full-text

What we do not know yet

What the evidence supports: possible small effects on colds, cancer-related fatigue, post-meal blood sugar and working memory, all low certainty. Nothing about American ginseng is rated above low.
What is uncertain: nearly all cold and thinking trials used one branded extract each (COLD-fX; Cereboost) with industry links, and blood sugar results varied between root batches, so one product's result does not carry to another.
Not tested: no American-ginseng-only trial for anxiety, depression, sleep, stress hormones, menopause or sexual function; no long trials beyond 6 months; no pregnancy or breastfeeding data; warfarin never tested in patients.
Missing sources: the NIH LiverTox and LactMed entries, the Health Canada monograph and any EU or FDA statements on American ginseng could not be read.
Pooled reviews of ginseng often mix Asian and American ginseng and cannot be applied to American ginseng alone.
Human drug-enzyme (CYP) effects have not been measured; only test-tube and rat data exist.

How new research is added

New studies are found by a saved PubMed search and are placed in a review queue. A person reads each one before it changes any evidence rating or safety wording. New publications never change ratings automatically.

Lab markers

What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".

Metabolic 3

▼

Fasting blood glucose

Lowered in trials

Blood sugar after not eating overnight.

Low certainty

Results and what it means

Why it was measured

Basic diabetes control measure.

Statistical vs. clinical meaning

Small drop in one American ginseng trial; pooled analysis mixes species.

Safety implication

A 0.3 to 0.7 mmol/L change is modest.

Study	Result	People	Product
⁵³	-0.71 mmol/L vs placebo (p = 0.008)	24 adults with type 2 diabetes	American ginseng extract 3 g a day, 8 weeks
⁴⁵	Genus-wide pooled MD -0.31 mmol/L (95% CI -0.59 to -0.03)	16 trials, people with and without diabetes	Ginseng of any Panax species

^{53 45}

▼

HbA1c

Lowered in trials

A blood test that reflects average blood sugar over about 3 months.

Low certainty

Results and what it means

Why it was measured

Main outcome of diabetes trials.

Statistical vs. clinical meaning

Small changes; trials short; only one trial of American ginseng alone.

Safety implication

A 0.29 point drop is small compared with diabetes drugs; not shown to prevent complications.

Study	Result	People	Product
⁵³	-0.29 percentage points vs placebo (p = 0.041)	24 adults with type 2 diabetes	American ginseng extract 3 g a day, 8 weeks
²⁶	-0.35 +/- 0.1% vs control (p = 0.02); combination of two species	80 adults with type 2 diabetes and hypertension	Korean red + American ginseng 2.25 g a day, 12 weeks
⁴⁵	No significant overall change in the genus-wide pooled analysis	9 comparisons, mixed ginseng	Ginseng of any Panax species

^{53 26 45}

▼

LDL cholesterol

Lowered in trials

The cholesterol carried in low-density lipoprotein, a risk marker for heart disease.

Very low certainty

Results and what it means

Why it was measured

Secondary outcome in diabetes trials.

Statistical vs. clinical meaning

Secondary outcome in tiny trials.

Safety implication

Not shown to prevent heart disease.

Study	Result	People	Product
⁵³	-12.3 +/- 3.9% vs placebo	24 adults with type 2 diabetes	American ginseng extract 3 g a day
²⁶	-0.35 mmol/L, p = 0.06 (not significant)	80 adults with diabetes and hypertension	Korean red + American ginseng combination

^{53 26}

Other 14

▼

Number of colds per person

Lowered in trials

How many colds a person gets over the study period, counted by symptoms (Jackson criteria).

Low certainty

Results and what it means

Why it was measured

Main outcome of the cold-prevention trials.

Statistical vs. clinical meaning

A modest difference in a symptom-based count; the review called the evidence insufficient for fewer colds.

Safety implication

None expected from the measurement itself.

Study	Result	People	Product
³⁹	0.68 vs 0.93 colds per person; 10.0% vs 22.8% with 2 or more colds	Healthy adults with 2 or more colds in the prior year	American ginseng extract vs placebo, 4 months
⁴³	Total colds 25% lower in one trial; at least one cold RR 0.70 (95% CI 0.48 to 1.02)	Healthy adults, 5 trials	North American ginseng root preparations

^{39 43}

▼

Days of cold symptoms

Lowered in trials

Total days a person reports cold or respiratory symptoms.

Low certainty

Results and what it means

Why it was measured

Shows whether illness is shorter, not just rarer.

Statistical vs. clinical meaning

Consistent in direction but self-reported and from few trials; the 2006 result was in a late window.

Safety implication

None.

Study	Result	People	Product
³⁹	10.8 vs 16.5 symptom days	Healthy adults	American ginseng extract vs placebo, 4 months
⁴³	6.2 days shorter in two trials (95% CI 3.4 to 9.0)	Healthy adults	North American ginseng root preparations
³³	5.6 vs 12.6 days in the last 2 months	Community-living adults 65+	COLD-fX vs placebo

^{39 43 33}

↕

Laboratory-confirmed influenza or RSV

Mixed results in trials

Respiratory illness confirmed by a lab test (culture or antibody rise) rather than by symptoms alone.

Very low certainty

Results and what it means

Why it was measured

A stricter outcome than symptom counts.

Statistical vs. clinical meaning

One small trial with few cases favoured the extract; one large trial showed no difference.

Safety implication

None.

Study	Result	People	Product
³²	Influenza 7/101 vs 1/97; influenza plus RSV 9/101 vs 1/97	Nursing-home residents	CVT-E002 vs placebo
³⁴	5.5% placebo, 5.2% at the lower dose, 4.6% at the higher dose (P = 0.89)	Vaccinated community adults	CVT-E002 vs placebo, 6 months

^{32 34}

▲

Four-fold antibody rises against common viruses

Raised in trials

A blood test showing the body made more antibodies against viruses over the study.

Very low certainty

Results and what it means

Why it was measured

A possible sign the extract boosts immune responses.

Statistical vs. clinical meaning

One secondary result in one trial; not tied to specific illnesses.

Safety implication

No benefit shown for infection days.

Study	Result	People	Product
²³	16% on the extract vs 7% on placebo (P = .04)	Adults with early CLL	CVT-E002 vs placebo

²³

▲

Fatigue improvement score (MFSI-SF general subscale change)

Raised in trials

A questionnaire score; a larger change means more improvement in fatigue.

Low certainty

Results and what it means

Why it was measured

Main outcome of the large cancer fatigue trial.

Statistical vs. clinical meaning

Self-reported scores; the planned 4-week result was not significant.

Safety implication

None beyond usual precautions.

Study	Result	People	Product
⁴	4 weeks: 14.4 vs 8.2 (P = .07); 8 weeks: 20 vs 10.3 (P = .003)	Fatigued cancer survivors	American ginseng vs placebo
²¹	Brief Fatigue Inventory at 8 weeks 4.6 vs 3.4, not significant	Head and neck cancer survivors	American ginseng vs placebo

^{4 21}

▲

Working memory test performance

Raised in trials

Scores on computer tests of how well people hold and use information for a few seconds.

Low certainty

Results and what it means

Why it was measured

Main outcome of the Cereboost trials.

Statistical vs. clinical meaning

Positive in three placebo-controlled trials, null in a fourth; lab tests only.

Safety implication

None.

Study	Result	People	Product
⁴²	Corsi block improved at all doses and times	Healthy young adults	Cereboost 100/200/400 mg
³⁸	Working Memory factor better at 3 hours	Healthy adults 40-60	Cereboost 200 mg
¹⁹	No significant cognitive effect after correction	Professional drivers	Cereboost 200 mg a day

^{42 38 19}

▼

Frontal brain signal speed (SSVEP latency)

Lowered in trials

How quickly a brain-wave response recorded from the scalp appears while a person does a task.

Very low certainty

Results and what it means

Why it was measured

Looks for a brain correlate of the working memory effect.

Statistical vs. clinical meaning

One small study; a faster signal is not shown to mean better thinking.

Safety implication

None.

Study	Result	People	Product
⁵⁵	Shorter frontal latency during working-memory retrieval; no change in test performance	Healthy adults 40-60	American ginseng 200 mg

⁵⁵

▼

Simulated lap time

Lowered in trials

Time to complete a lap in a racing simulator.

Very low certainty

Results and what it means

Why it was measured

Practical outcome in the drivers study.

Statistical vs. clinical meaning

No placebo group described.

Safety implication

None.

Study	Result	People	Product
¹⁹	About 3 seconds faster in the acute-on-chronic phase (adjusted P = 0.000003)	Professional drivers	Cereboost 200 mg a day

¹⁹

▼

Blood sugar after a glucose drink (area under the curve)

Lowered in trials

The total rise in blood sugar over the 1 to 2 hours after drinking a measured amount of glucose.

Low certainty

Results and what it means

Why it was measured

Main outcome of the short healthy-volunteer trials.

Statistical vs. clinical meaning

Statistically significant in several small trials but batch-dependent.

Safety implication

A rise in blood sugar after a drink is not a disease outcome.

Study	Result	People	Product
⁵¹	Area under curve -26.6%, -29.3% and -38.5% at 3, 6 and 9 g	10 adults without diabetes	Ground American ginseng root vs placebo
⁵²	Area under curve -14.4%, -10.6%, -9.1% at 1, 2, 3 g; only when taken 40 min before	12 healthy adults	Ground American ginseng root
¹⁴	-27.7% mean of 5 batches; 2 of 5 batches did not lower glucose as expected	12 healthy adults	9 g of Ontario-grown root
⁴⁶	No significant effect from one low-ginsenoside batch	12 adults	6 g root

^{51 52 14 46}

↕

Systolic blood pressure (top number, mmHg)

Mixed results in trials

Pressure in the arteries when the heart beats.

Mixed findings

Results and what it means

Why it was measured

Main outcome of blood pressure trials.

Statistical vs. clinical meaning

Different trials give different answers depending on the population.

Safety implication

Office or 24-hour blood pressure is a risk marker, not a heart outcome.

Study	Result	People	Product
⁴⁸	No overall change over 160 minutes after a single dose	16 adults with hypertension	North American ginseng 3 g
⁴⁹	No change in 24-hour pressure after 12 weeks	37 adults with hypertension analysed	North American ginseng 3 g a day
³⁶	-11.7% vs placebo (P<0.001)	64 adults with diabetes and hypertension	American ginseng extract 3 g a day, 12 weeks
⁵³	-5.6 +/- 2.7 mmHg vs placebo (p<0.001)	24 adults with type 2 diabetes	American ginseng extract 3 g a day, 8 weeks
²⁸	No significant effect, 17 trials	1381 adults	Ginseng of any Panax species

^{48 49 36 53 28}

▼

Arterial stiffness (augmentation index)

Lowered in trials

A measure from pulse waves of how stiff the arteries are.

Very low certainty

Results and what it means

Why it was measured

Checks whether blood vessel stiffness changes with ginseng.

Statistical vs. clinical meaning

One positive trial; the combination trial found no change in other stiffness tests.

Safety implication

Not a clinical outcome.

Study	Result	People	Product
³⁶	Radial augmentation index -5.3% vs placebo (P=0.041)	64 adults with diabetes and hypertension	American ginseng extract 3 g a day
²⁵	Pulse wave velocity -0.40 +/- 0.28% (p = 0.17, not significant); reactive hyperemia index unchanged	80 adults with diabetes and hypertension	Korean red + American ginseng combination

^{36 25}

▼

Creatine kinase (muscle damage marker)

Lowered in trials

An enzyme that leaks from damaged muscle into the blood.

Very low certainty

Results and what it means

Why it was measured

Marker of muscle damage after hard exercise.

Statistical vs. clinical meaning

One human trial of 12 men.

Safety implication

Lower marker does not prove better recovery.

Study	Result	People	Product
³¹	Rise after downhill running eliminated at 48 and 72 hours	12 active men	American ginseng extract 1.6 g a day for 28 days
¹⁸	Lowered in rats given alcohol or water extract	Rats	North American ginseng 300 mg per kg a day

^{31 18}

▲

Oxidative damage markers (malondialdehyde, 8-OHdG)

Raised in trials

Blood and urine chemicals that rise when cells are damaged by oxidation.

Very low certainty

Results and what it means

Why it was measured

Check whether ginseng acts as an antioxidant.

Statistical vs. clinical meaning

The two small trials point in opposite directions.

Safety implication

Unclear meaning.

Study	Result	People	Product
¹⁵	Higher plasma malondialdehyde and urine 8-OHdG on ginseng	25 postmenopausal women	American ginseng root powder 1 g a day, 4 months
³¹	Lower 8-iso-PGF2 alpha after a hard run	12 active men	American ginseng extract 1.6 g a day

^{15 31}

↕

CD8+ T cells and interleukin-2 production

Mixed results in trials

White cell counts and a cell signal measured in blood samples.

Very low certainty

Results and what it means

Why it was measured

Immune lab markers.

Statistical vs. clinical meaning

One tiny trial.

Safety implication

Immune lab changes are not infection outcomes.

Study	Result	People	Product
⁸	CD8+ T cells lower; ex vivo IL-2 higher; other immune measures unchanged	10 healthy men	North American ginseng extract 1125 mg a day, 35 days

⁸

Safety

What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.

Main points to know 6

If you take warfarin, tell the doctor who manages it before using American ginseng. In a randomised trial of 20 healthy volunteers, two weeks of American ginseng lowered the effect of warfarin: the peak INR (the clotting test) was lower than with placebo and blood warfarin levels were lower. A systematic review of herb and warfarin trials also found American ginseng changed warfarin's effect. Warfarin works in a narrow range, so a weaker effect could raise clot risk. Do not start, stop or change ginseng without telling the clinic that checks your INR. Controlled trial ^{58 13}
If you take diabetes medicines or insulin, ask your doctor or pharmacist first. American ginseng lowered blood sugar after a glucose drink in healthy volunteers and lowered HbA1c and fasting glucose in a small trial of people with type 2 diabetes. It may add to the effect of diabetes medicines. The diabetes trials did not report low blood sugar problems, but they were small. Check blood sugar as your doctor advises. Controlled trial ^{51 53 37}
If you take blood pressure medicine, tell your prescriber. Trials in people with high blood pressure found no change in blood pressure, but two trials in people with diabetes and high blood pressure found lower systolic pressure. The effects might add to blood pressure medicines in some people. Controlled trial ^{49 36 28}
Pregnancy, breastfeeding and children: not enough safety data. No human study of American ginseng in pregnancy or breastfeeding was found. A lab study of a ginseng compound (Rg3) in rat embryos slowed the embryonic heart rate. One small safety trial in 46 children aged 3 to 12 reported no serious problems. Do not use in pregnancy or breastfeeding unless a clinician agrees, and ask a paediatrician before giving to a child. Laboratory research ^{40 50}
"Ginseng" is not one plant. American, Asian and Siberian ginseng are different. American ginseng (Panax quinquefolius) has a different mix of ginsenosides from Asian ginseng (Panax ginseng), and Siberian ginseng (Eleutherococcus) is a different genus. In one trial, Asian ginseng raised blood sugar while American ginseng tended to lower it. Safety and drug-interaction statements about one do not automatically apply to another. Products can be mislabelled or mixed with other species. Controlled trial ^{47 12 24}
If you have a hormone-sensitive cancer or are on cancer treatment, ask your cancer team. An alcohol extract of American ginseng acted like estrogen in breast cancer cells in a dish, but a water extract did not. This is lab data only. A cancer-care guideline says American ginseng may be recommended for fatigue during treatment. Interactions with chemotherapy have not been studied in people in the papers read here. Laboratory research ^{27 9}

Side effects 5

Effect	How often	Severity and recovery	Evidence
No more side effects than placebo in American ginseng trials In the 364-person cancer fatigue trial, side effects by self-report and clinician grading did not differ from placebo. In the 74-person diabetes safety trial, the number and severity of adverse events did not differ. In 46 children and in 293 people with leukemia, no excess was reported. The longest American ginseng trial was 6 months, so long-term safety is not shown.	Not established	none reported Not applicable	Controlled trial ^{4 37 50 23}
Stomach and gut symptoms; possible bleeding (ginseng in general) An umbrella review of 19 meta-analyses of ginseng (mostly not species-specific, rated low or critically low quality) listed stomach and gut symptoms and potential bleeding as adverse events and found no serious adverse events. It does not separate American ginseng.	Not established	mild to unclear Not stated	Systematic review ³⁰
Trouble sleeping or nervousness NCCIH lists insomnia as the most common side effect of Asian ginseng. None of the American ginseng trial abstracts read here reported insomnia or nervousness as a finding, and the abstracts do not say whether it was looked for. Not established either way for American ginseng.	Not established	unknown for American ginseng Not stated	Authoritative guidance ⁶²
Higher markers of oxidative damage in blood and urine In 25 postmenopausal women, 4 months of 1 g a day of whole-root powder raised malondialdehyde and urine 8-hydroxydeoxyguanosine and lowered total antioxidant content. The authors interpret this as oxidative stress. One small trial; clinical meaning unknown.	Not established	unclear Not stated	Controlled trial ¹⁵
Low blood sugar (possible) American ginseng lowers blood sugar in some trials, so low blood sugar is possible in people on glucose-lowering drugs. The trials read here did not report it, but they were small and are not designed to detect it.	Not established	unknown Not stated	Pharmacological theory ⁵³

Liver

No case of liver injury attributed to American ginseng was found in the PubMed search done for this profile (the search was not exhaustive). The NIH LiverTox entry for ginseng could not be opened and was not read. NCCIH lists liver damage as a less common effect reported for Asian ginseng. In two trials in people with type 2 diabetes (74 people for 12 weeks, 24 people for 8 weeks) liver tests did not change. ^{37 53 62}

How often. No frequency of liver injury could be found. Absence of reports is not proof of safety, and products vary in content.

Monitoring. No monitoring advice from an agency was read. Stop and seek care for yellow skin or eyes, dark urine, pale stools, severe tiredness or upper-right belly pain.

This is a safety connection. It is not evidence that American Ginseng supports liver health.

Medicines and supplements 8

With	Why it matters	Importance	Evidence	What to do
Warfarin prescription	American ginseng lowered both the clotting effect (INR) and blood warfarin levels in healthy volunteers. In rats, ginsenosides also lowered warfarin levels and raised activity of warfarin-clearing liver enzymes (species of ginseng not stated).	Randomised trial in 20 healthy volunteers: peak INR lower than placebo (difference -0.19, 95% CI -0.36 to -0.07). Not tested in patients on steady warfarin doses, and a review rated the warfarin-herb trials as low quality.	Controlled trial Low certainty ^{58 13 16}	Tell the clinic that manages your warfarin before starting or stopping American ginseng, and ask whether to check INR more often.
Diabetes medicines and insulin prescription	American ginseng lowered blood sugar after glucose and HbA1c in small trials.	The effect could add to medicines. No trial in the abstracts read reported dangerous low blood sugar.	Controlled trial Low certainty ^{51 53}	Ask a doctor or pharmacist first; follow the blood sugar checks advised for your medicines.
Blood pressure medicines prescription	Systolic pressure was lower in two trials of people with diabetes and high blood pressure, and unchanged in two trials of people with high blood pressure.	Unclear; the pooled ginseng analysis found no significant effect.	Controlled trial Mixed findings ^{49 36 28}	Tell your prescriber and keep checking blood pressure as advised.
Drugs cleared by the liver enzyme CYP1A2 (ask a pharmacist for your medicines) prescription	In test-tube work an extract of North American ginseng reduced CYP1A2 activity 45 times more strongly than an Asian ginseng extract. In rats, neither species raised CYP2B1, CYP3A23 or CYP1A2 gene expression. No study of American ginseng with a drug was found in this search apart from warfarin.	Unknown in people. The test-tube concentrations may not be reached after normal use.	Laboratory research Not enough evidence ^{10 57}	A pharmacist can check whether any of your medicines are cleared mainly by CYP1A2.
Blood thinners other than warfarin, aspirin and similar medicines prescription	An umbrella review of ginseng lists possible bleeding as an adverse event; the mechanism for American ginseng is not established.	No American ginseng study with these drugs was found.	Systematic review Not enough evidence ³⁰	Tell your prescriber before combining.
Chemotherapy and other cancer treatments prescription	No human interaction study was found. The ASCO guideline says American ginseng may be recommended for fatigue in adults undergoing cancer treatment.	Unknown. Lab data on estrogen-like effects apply to alcohol extracts and cells.	Authoritative guidance Not enough evidence ^{9 27}	Ask the oncology team before using it during treatment.
Hormone therapies and anti-estrogen drugs prescription	An alcohol extract of American ginseng bound estrogen receptors and promoted growth of estrogen-receptor-positive breast cancer cells at low concentrations in a dish; zearalenone, an estrogen-like mould toxin, was found in root extracts and could explain the binding.	Lab only; no human evidence either way.	Laboratory research Not enough evidence ^{27 20}	Ask your clinician if you have a hormone-sensitive condition or take hormone drugs.
Immune-suppressing medicines and autoimmune conditions prescription	The extract changed immune markers in rats and in a small human trial (CD8+ T cells, interleukin-2). NCCIH says Asian ginseng may worsen autoimmune disorders.	Theory; no American ginseng study in these groups.	Pharmacological theory Not enough evidence ^{8 62}	Ask your specialist before using it.

Who should check first 7

Situation	Advice	Evidence
Pregnancy	Do not use unless a clinician says so. No human safety data; a lab study of a ginseng compound slowed rat embryo heart rate.	Laboratory research ⁴⁰
Breastfeeding	No data on American ginseng in breast milk were read (LactMed could not be opened). Avoid unless a clinician agrees.	Pharmacological theory
Taking warfarin without INR monitoring	Do not combine without telling the clinic that manages warfarin.	Controlled trial ⁵⁸
Allergy to ginseng or related products	Do not use if you have had a reaction to ginseng. NCCIH lists severe allergic reactions as an uncommon effect of Asian ginseng.	Authoritative guidance ⁶²
Hormone-sensitive cancers or conditions	Ask your clinician. Lab data show an estrogen-like action of an alcohol extract.	Laboratory research ²⁷
Children	Only one 46-child safety trial exists; ask a paediatrician.	Controlled trial ⁵⁰
Planned surgery	No American ginseng surgery study was found. Because of possible effects on blood sugar and clotting, tell the surgical team you use it.	Pharmacological theory ^{58 53}

Overdose, product quality and regulators

Summary. No studies found in this search show serious toxicity of American ginseng root at the amounts studied in trials. The longest trial found was 6 months. Rare effects could be missed.

Animal. In rats given an extract of American ginseng (10% ginsenosides) at 100 or 400 mg per kg a day for 21 days, body weight gain and liver weight did not change.

Human doses studied. Trials in this profile ran up to 6 months (a branded extract in older adults), 2000 mg a day for 8 weeks (cancer fatigue), 3 g a day for 12 weeks (diabetes and blood pressure), and single doses of up to 9 g in blood sugar tests.

High dose or long term signals. One 4-month trial of 1 g a day of root powder in postmenopausal women raised oxidative damage markers. No long-term (multi-year) human data on American ginseng were found.

Overdose response. No case report of American ginseng overdose was found in the search.

Genotoxicity. Genotoxicity and cancer-causing studies were not found or read.

Toxic plant parts. The root is the part studied in the trials. Leaves, stems and berries are used in some other products; no toxicity source was read for them, so no statement is made.

Two kinds of quality problem are documented for ginseng products: wide differences in ginsenoside content and mix, and substitution with other Panax species or cheaper plants. An estrogen-like mould toxin (zearalenone) has been found in ginseng root extracts.

Mould toxin in root extracts. Gray 2004 found that American and Asian ginseng root extracts bound estrogen receptors, and analysis pointed to zearalenone (a Fusarium mould toxin), not to the main ginsenosides Rb1 and Rg1. Prevalence in products was not measured. ²⁰

Species substitution and adulteration. A review of 507 ginseng products from 12 countries found 24% adulterated, most often by swapping in another Panax species; swapping root for leaves, stems or flowers was also reported. In the USA 12% were adulterated (small number of products). A 2026 paper says American ginseng powder is frequently adulterated with cheap substitutes and shows a lab method that detects powders spiked with Angelica dahurica, Astragalus, Panax notoginseng or wheat flour at 95.6% accuracy. Under the microscope Asian and American ginseng stay hard to tell apart. ^{24 59 29}

Content varies between products and batches. In 25 US ginseng products, ginsenoside amounts differed greatly from labels, up to 15-fold between capsules and 36-fold between liquids; the products had the right genus. In trials, blood-sugar effects of American ginseng depended on the batch: one low-ginsenoside batch had no effect and 2 of 5 Ontario batches did not work as expected. ^{22 46 14}

Chemical markers that distinguish American from Asian ginseng. Rb1, pseudoginsenoside F11 and Rd were more typical of American ginseng; Rf, Rb2 and Rc of Asian ginseng in 38 commercial samples. ¹²

Body	Action	Date
NCCIH (US National Institutes of Health) (United States)	Fact sheet on Asian ginseng (Panax ginseng) only: side effects (insomnia most common), possible effects on clotting and blood sugar, advice against use in pregnancy and breastfeeding for some experts. source	2025-02
ASCO and Society for Integrative Oncology (United States)	2024 guideline update: "Psychoeducation and American ginseng may be recommended in adults undergoing cancer treatment" for cancer-related fatigue. source	2024-07-10

When to get medical help

Swelling of the face, lips or throat, trouble breathing or a widespread rash (allergic reaction): get emergency care.
Signs of bleeding or clotting problems if you take warfarin: unusual bruising, black stools, blood in urine, or a new swollen painful leg, chest pain or sudden shortness of breath.
Shaking, sweating, confusion, fast heartbeat or fainting if you take diabetes medicine (possible low blood sugar).
Yellow skin or eyes, dark urine or severe upper belly pain.
Vaginal bleeding after menopause or breast changes while taking any ginseng product: see a clinician (reported in older ginseng literature; not shown for American ginseng).

Stop the supplement and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.

General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.

Frequently asked questions

Can American ginseng prevent colds?

Maybe slightly, but the evidence is weak. Several trials of one branded extract (COLD-fX) found fewer colds or shorter illness in healthy adults and older adults. But the largest trial (783 people) missed its main goal, a trial in people with early leukemia found no drop in illness days, and a review of five trials said the evidence was insufficient to conclude fewer or milder colds. Results for COLD-fX do not automatically apply to plain root or other products.

^{39 34 23 43}

Does American ginseng help with fatigue from cancer?

There is some support. In a US trial of 364 fatigued cancer survivors, those on American ginseng reported more improvement at 8 weeks than those on placebo, especially people still having cancer treatment. It missed its planned 4-week main time point, and a small trial in head and neck cancer survivors found no benefit. A 2024 guideline says it may be recommended for adults during treatment. Ask the cancer team first.

^{4 21 9}

Does American ginseng improve memory and focus?

Possibly a little, on lab tests. In several small trials of a branded extract (Cereboost), healthy adults did better on working memory tasks within hours. The trials were short, in healthy people, and linked to the makers. A trial in race car drivers found no significant cognitive effect, and nothing shows it helps everyday memory or protects against dementia.

^{42 38 5 19}

Does American ginseng lower blood sugar?

In small trials it lowered the blood sugar rise after a glucose drink in healthy people, but the effect depended on the batch of root. In one 24-person trial of people with type 2 diabetes, HbA1c was 0.29 points lower and fasting glucose 0.71 mmol/L lower than on placebo. That is a modest change from one small trial, so do not use it in place of diabetes treatment.

^{51 14 46 53}

Does American ginseng raise or lower blood pressure?

Not in people with high blood pressure: two trials (a single dose and 12 weeks) found no effect, and a pooled analysis of ginseng of all kinds found no significant change. In two trials of people with both diabetes and high blood pressure, systolic pressure was lower. If you take blood pressure medicine, tell your prescriber.

^{48 49 36 28}

Is it safe to take American ginseng with warfarin?

Not without telling your anticoagulant clinic. In a randomised trial of 20 healthy volunteers, American ginseng lowered the peak INR (the clotting test) and blood warfarin levels compared with placebo, so it could make warfarin less effective. It has not been tested in patients on steady warfarin doses, so the real-life size of the effect is unknown.

^{58 13}

Can I take American ginseng with diabetes medicine?

Ask your doctor or pharmacist first. American ginseng lowered blood sugar in small trials, so it might add to the effect of diabetes medicines or insulin. The trials read did not report low blood sugar problems, but they were small and not designed to find them.

^{53 37}

What are the side effects? Does it cause insomnia or liver problems?

In the American ginseng trials read, side effects were not more common than on placebo, including in a 364-person cancer trial and a 74-person diabetes safety trial that also found no change in liver tests. Insomnia is the most common side effect listed for Asian ginseng by NIH; whether it occurs with American ginseng was not reported in the abstracts. No case of liver injury from American ginseng was found, but the NIH LiverTox entry could not be read. The longest trial was 6 months.

^{4 37 23 53}

Is American ginseng safe in pregnancy or while breastfeeding?

Not enough is known, so it is best avoided unless a clinician agrees. No human study was found. A lab study of a ginseng compound (Rg3) slowed the heart rate of rat embryos. One small trial in 46 children aged 3 to 12 found no serious problems, but ask a paediatrician before giving it to a child.

^{40 50}

What is the difference between American, Asian and Siberian ginseng?

They are different plants. American ginseng is Panax quinquefolius; Asian ginseng is Panax ginseng; Siberian ginseng is Eleutherococcus, a different genus. Their chemistry differs (Rb1, pseudoginsenoside F11 and Rd are more typical of American; Rf, Rb2 and Rc of Asian). In one trial Asian ginseng raised blood sugar while American ginseng tended to lower it. Many reviews mix species, so check which one a result is about.

^{12 47 22}

Does American ginseng act like estrogen? Is it safe with cancer?

The evidence is lab-only. An alcohol extract acted like estrogen in breast cancer cells in a dish at low concentrations, but a water extract did not. An estrogen-like mould toxin (zearalenone) found in ginseng extracts could explain the binding. No human study shows a hormone effect or a cancer risk. Ask your cancer team or clinician if you have a hormone-sensitive condition or take hormone drugs.

^{27 20 9}

How can I tell if a ginseng product is real American ginseng?

You cannot tell by looking: Asian and American ginseng look very alike under the microscope. A review of 507 products found 24% adulterated, mostly with other Panax species, and in 25 US products the ginsenoside content varied up to 36-fold from the label. Look for products that name Panax quinquefolius and the plant part, and ask a pharmacist about quality seals and about amounts.

^{24 22 29}

Explore by health goal

Immune Support Memory Support Blood Sugar Balance Metabolic Health Heart Health Reduce Fatigue Energy Boost Cognitive Performance Better Focus Mental Clarity Calm Relaxation Brain Health Peak Performance Blood Pressure Support Cholesterol Balance Muscle Recovery Physical Stamina Healthy Aging

Editorial transparency

Written by: AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records.
Medical review: None. This page has not been reviewed by a physician or pharmacist.
First published: 2026-10-25
Last substantive update: 2026-10-25
How we research: We searched PubMed for American ginseng, Panax quinquefolius, COLD-fX, CVT-E002 and Cereboost across colds, cancer fatigue, blood sugar, blood pressure, thinking, interactions and quality, read the abstracts, checked plant names in GBIF and NCBI and compounds in PubChem, and read the NIH NCCIH page on Asian ginseng. Only abstracts were read for nearly all studies. Not verified: the NIH LiverTox and LactMed entries could not be opened, the Health Canada monograph could not be read, EMA, FDA, WHO and Commission E statements were not confirmed, and history of traditional use could not be confirmed. Certainty ratings are the compiler's own reading, not formal grades. No study is cited that we could not verify in PubMed.
How we rate evidence: See "How we rate evidence" in the Evidence tab.
Independence: No product is promoted on this page. No affiliate links are shown. If one is added later it will be labelled and kept apart from the evidence.

Sources 62

Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.

Antonelli M, Donelli D, Firenzuoli F. Ginseng integrative supplementation for seasonal acute upper respiratory infections: A systematic review and meta-analysis.. Complement Ther Med. 2020. PMID 32951718. DOI 10.1016/j.ctim.2020.102457. (abstract)
Arring NM, Millstine D, Marks LA, et al.. Ginseng as a Treatment for Fatigue: A Systematic Review.. J Altern Complement Med. 2018. PMID 29624410. DOI 10.1089/acm.2017.0361. (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. PMID 19415341. DOI 10.1007/s00520-009-0642-2. (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. PMID 23853057. DOI 10.1093/jnci/djt181. (abstract)
Bell L, Whyte A, Duysburgh C, et al.. A randomized, placebo-controlled trial investigating the acute and chronic benefits of American Ginseng (Cereboost®) on mood and cognition in healthy young adults, including in vitro investigation of gut microbiota changes as a possible mechanism of action.. Eur J Nutr. 2022. PMID 34396468. DOI 10.1007/s00394-021-02654-5. (abstract)
Bell L, Fança-Berthon P, Cozannet RL, et al.. Effects of American ginseng (Panax quinquefolius) extract on human neurocognitive function: a review.. Nutr Neurosci. 2026. PMID 41017752. DOI 10.1080/1028415X.2025.2555921. (abstract)
Biondo PD, Goruk S, Ruth MR, et al.. Effect of CVT-E002 (COLD-fX) versus a ginsenoside extract on systemic and gut-associated immune function.. Int Immunopharmacol. 2008. PMID 18550018. DOI 10.1016/j.intimp.2008.04.003. (abstract)
Biondo PD, Robbins SJ, Walsh JD, et al.. A randomized controlled crossover trial of the effect of ginseng consumption on the immune response to moderate exercise in healthy sedentary men.. Appl Physiol Nutr Metab. 2008. PMID 18923572. DOI 10.1139/H08-080. (abstract)
Bower JE, Lacchetti C, Alici Y, et al.. Management of Fatigue in Adult Survivors of Cancer: ASCO-Society for Integrative Oncology Guideline Update.. J Clin Oncol. 2024. PMID 38754041. DOI 10.1200/JCO.24.00541. (abstract)
Chang TK, Chen J, Benetton SA. In vitro effect of standardized ginseng extracts and individual ginsenosides on the catalytic activity of human CYP1A1, CYP1A2, and CYP1B1.. Drug Metab Dispos. 2002. PMID 11901090. DOI 10.1124/dmd.30.4.378. (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. PMID 22213250. DOI 10.1002/ptr.3700. (abstract)
Chen Y, Zhao Z, Chen H, et al.. Chemical differentiation and quality evaluation of commercial Asian and American ginsengs based on a UHPLC-QTOF/MS/MS metabolomics approach.. Phytochem Anal. 2015. PMID 25448530. DOI 10.1002/pca.2546. (abstract)
Choi S, Oh DS, Jerng UM. A systematic review of the pharmacokinetic and pharmacodynamic interactions of herbal medicine with warfarin.. PLoS One. 2017. PMID 28797065. DOI 10.1371/journal.pone.0182794. (abstract)
Dascalu A, Sievenpiper JL, Jenkins AL, et al.. Five batches representative of Ontario-grown American ginseng root produce comparable reductions of postprandial glycemia in healthy individuals.. Can J Physiol Pharmacol. 2007. PMID 18066131. DOI 10.1139/Y07-030. (abstract)
Dickman JR, Koenig RT, Ji LL. American ginseng supplementation induces an oxidative stress in postmenopausal women.. J Am Coll Nutr. 2009. PMID 19828907. DOI 10.1080/07315724.2009.10719773. (abstract)
Dong H, Ma J, Li T, et al.. Global deregulation of ginseng products may be a safety hazard to warfarin takers: solid evidence of ginseng-warfarin interaction.. Sci Rep. 2017. PMID 28725042. DOI 10.1038/s41598-017-05825-9. (abstract)
Edens R, Gutierrez A, Engevik MA. Exploring the use of panaxynol from American ginseng to combat intestinal inflammation and colon cancer.. Am J Physiol Gastrointest Liver Physiol. 2024. PMID 38915278. DOI 10.1152/ajpgi.00135.2024. (title-only)
Estaki M, Noble EG. North American ginseng protects against muscle damage and reduces neutrophil infiltration after an acute bout of downhill running in rats.. Appl Physiol Nutr Metab. 2015. PMID 25531801. DOI 10.1139/apnm-2014-0331. (abstract)
Ferguson DP, Franca-Berthon P, Williams C, et al.. The influence of cereboost on mood, cognitive function, and simulated driving in professional race car drivers.. Front Sports Act Living. 2025. PMID 41048625. DOI 10.3389/fspor.2025.1658468. (abstract)
Gray SL, Lackey BR, Tate PL, et al.. Mycotoxins in root extracts of American and Asian ginseng bind estrogen receptors alpha and beta.. Exp Biol Med (Maywood). 2004. PMID 15169976. DOI 10.1177/153537020422900615. (abstract)
Guglielmo M, Di Pede P, Alfieri S, et al.. A randomized, double-blind, placebo controlled, phase II study to evaluate the efficacy of ginseng in reducing fatigue in patients treated for head and neck cancer.. J Cancer Res Clin Oncol. 2020. PMID 32617701. DOI 10.1007/s00432-020-03300-z. (abstract)
Harkey MR, Henderson GL, Gershwin ME, et al.. Variability in commercial ginseng products: an analysis of 25 preparations.. Am J Clin Nutr. 2001. PMID 11382666. DOI 10.1093/ajcn/73.6.1101. (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. PMID 22266154. DOI 10.1016/j.suponc.2011.10.005. (abstract)
Ichim MC, de Boer HJ. A Review of Authenticity and Authentication of Commercial Ginseng Herbal Medicines and Food Supplements.. Front Pharmacol. 2020. PMID 33505315. DOI 10.3389/fphar.2020.612071. (abstract)
Jovanovski E, Lea-Duvnjak-Smircic, Komishon A, et al.. Vascular effects of combined enriched Korean Red ginseng (Panax Ginseng) and American ginseng (Panax Quinquefolius) administration in individuals with hypertension and type 2 diabetes: A randomized controlled trial.. Complement Ther Med. 2020. PMID 32147072. DOI 10.1016/j.ctim.2020.102338. (abstract)
Jovanovski E, Smircic-Duvnjak L, Komishon A, et al.. Effect of coadministration of enriched Korean Red Ginseng (Panax ginseng) and American ginseng (Panax quinquefolius L) on cardiometabolic outcomes in type-2 diabetes: A randomized controlled trial.. J Ginseng Res. 2021. PMID 34803424. DOI 10.1016/j.jgr.2019.11.005. (abstract)
King ML, Adler SR, Murphy LL. Extraction-dependent effects of American ginseng (Panax quinquefolium) on human breast cancer cell proliferation and estrogen receptor activation.. Integr Cancer Ther. 2006. PMID 16880429. DOI 10.1177/1534735406291341. (abstract)
Komishon AM, Shishtar E, Ha V, et al.. The effect of ginseng (genus Panax) on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials.. J Hum Hypertens. 2016. PMID 27074879. DOI 10.1038/jhh.2016.18. (abstract)
Külkamp J, Osman AG, Katragunta K, et al.. Microscopy Combined with LC-UV Analysis as a Tool for Authentication of Ginseng Species Used in Traditional Medicine and Detection of Their Adulterants.. J Diet Suppl. 2026. PMID 42262747. DOI 10.1080/19390211.2026.2680314. (abstract)
Li Z, Wang Y, Xu Q, et al.. Ginseng and health outcomes: an umbrella review.. Front Pharmacol. 2023. PMID 37465522. DOI 10.3389/fphar.2023.1069268. (abstract)
Lin CH, Lin YA, Chen SL, et al.. American Ginseng Attenuates Eccentric Exercise-Induced Muscle Damage via the Modulation of Lipid Peroxidation and Inflammatory Adaptation in Males.. Nutrients. 2021. PMID 35010953. DOI 10.3390/nu14010078. (abstract)
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. PMID 14687309. DOI 10.1111/j.1532-5415.2004.52004.x. (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. PMID 16566675. DOI 10.1089/acm.2006.12.153. (abstract)
McElhaney JE, Simor AE, McNeil S, et al.. 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. PMID 23074661. DOI 10.1155/2011/759051. (abstract)
Mucalo I, Rahelić D, Jovanovski E, et al.. Effect of American ginseng (Panax quinquefolius L.) on glycemic control in type 2 diabetes.. Coll Antropol. 2012. PMID 23390846. (abstract)
Mucalo I, Jovanovski E, Rahelić 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. PMID 23973636. DOI 10.1016/j.jep.2013.08.015. (abstract)
Mucalo I, Jovanovski E, Vuksan V, et al.. American Ginseng Extract (Panax quinquefolius L.) Is Safe in Long-Term Use in Type 2 Diabetic Patients.. Evid Based Complement Alternat Med. 2014. PMID 24891873. DOI 10.1155/2014/969168. (abstract)
Ossoukhova A, Owen L, Savage K, et al.. Improved working memory performance following administration of a single dose of American ginseng (Panax quinquefolius L.) to healthy middle-age adults.. Hum Psychopharmacol. 2015. PMID 25778987. DOI 10.1002/hup.2463. (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. PMID 16247099. DOI 10.1503/cmaj.1041470. (abstract)
Ritchie HE, Xia A, Polson JW. The Effect of Some Complementary Medicine Active Components on Rat Embryonic Heart Rate In Vitro.. Birth Defects Res. 2026. PMID 41634959. DOI 10.1002/bdr2.70016. (abstract)
Sadeghian M, Rahmani S, Zendehdel M, et al.. Ginseng and Cancer-Related Fatigue: A Systematic Review of Clinical Trials.. Nutr Cancer. 2021. PMID 32691627. DOI 10.1080/01635581.2020.1795691. (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. PMID 20676609. DOI 10.1007/s00213-010-1964-y. (abstract)
Seida JK, Durec T, Kuhle S. North American (Panax quinquefolius) and Asian Ginseng (Panax ginseng) Preparations for Prevention of the Common Cold in Healthy Adults: A Systematic Review.. Evid Based Complement Alternat Med. 2011. PMID 19592479. DOI 10.1093/ecam/nep068. (abstract)
Shin K, Guo H, Cha Y, et al.. Cereboost™, an American ginseng extract, improves cognitive function via up-regulation of choline acetyltransferase expression and neuroprotection.. Regul Toxicol Pharmacol. 2016. PMID 27112419. DOI 10.1016/j.yrtph.2016.04.006. (abstract)
Shishtar E, Sievenpiper JL, Djedovic V, et al.. The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.. PLoS One. 2014. PMID 25265315. DOI 10.1371/journal.pone.0107391. (abstract)
Sievenpiper JL, Arnason JT, Leiter LA, et al.. 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. PMID 12571655. DOI 10.1038/sj.ejcn.1601550. (abstract)
Sievenpiper JL, Arnason JT, Leiter LA, et al.. 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. PMID 15190050. DOI 10.1080/07315724.2004.10719368. (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. PMID 15998708. DOI 10.1161/01.HYP.0000173424.77483.1e. (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. PMID 16520410. DOI 10.1161/01.HYP.0000205150.43169.2c. (abstract)
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. PMID 18676527. DOI 10.1542/peds.2007-2186. (abstract)
Vuksan V, Stavro MP, Sievenpiper JL, et al.. American ginseng improves glycemia in individuals with normal glucose tolerance: effect of dose and time escalation.. J Am Coll Nutr. 2000. PMID 11194526. DOI 10.1080/07315724.2000.10718073. (abstract)
Vuksan V, Sievenpiper JL, Wong J, et al.. American ginseng (Panax quinquefolius L.) attenuates postprandial glycemia in a time-dependent but not dose-dependent manner in healthy individuals.. Am J Clin Nutr. 2001. PMID 11273850. DOI 10.1093/ajcn/73.4.753. (abstract)
Vuksan V, Xu ZZ, Jovanovski E, et al.. Efficacy and safety of American ginseng (Panax quinquefolius L.) extract on glycemic control and cardiovascular risk factors in individuals with type 2 diabetes: a double-blind, randomized, cross-over clinical trial.. Eur J Nutr. 2019. PMID 29478187. DOI 10.1007/s00394-018-1642-0. (abstract)
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. PMID 22083988. DOI 10.1142/S0192415X11009470. (abstract)
White DJ, Camfield DA, Ossoukhova A, et al.. Effects of Panax quinquefolius (American ginseng) on the steady state visually evoked potential during cognitive performance.. Hum Psychopharmacol. 2020. PMID 32896022. DOI 10.1002/hup.2756. (abstract)
Yang Z, Deng J, Liu M, et al.. A review for discovering bioactive minor saponins and biotransformative metabolites in Panax quinquefolius L.. Front Pharmacol. 2022. PMID 35979234. DOI 10.3389/fphar.2022.972813. (abstract)
Yu CT, Chen J, Teng XW, et al.. Lack of evidence for induction of CYP2B1, CYP3A23, and CYP1A2 gene expression by Panax ginseng and Panax quinquefolius extracts in adult rats and primary cultures of rat hepatocytes.. Drug Metab Dispos. 2005. PMID 15466162. DOI 10.1124/dmd.104.001917. (abstract)
Yuan CS, Wei G, Dey L, et al.. Brief communication: American ginseng reduces warfarin's effect in healthy patients: a randomized, controlled Trial.. Ann Intern Med. 2004. PMID 15238367. DOI 10.7326/0003-4819-141-1-200407060-00011. (abstract)
Zhai D, Zhou J, Ma J, et al.. Rapid identification of adulteration in American ginseng powder using near-infrared spectroscopy combined with machine learning.. Spectrochim Acta A Mol Biomol Spectrosc. 2026. PMID 41481954. DOI 10.1016/j.saa.2025.127409. (abstract)
. GBIF Backbone Taxonomy: Panax quinquefolius L. (usageKey 5372246). . . (full-text)
. NCBI Taxonomy: Panax quinquefolius (taxid 44588). . . (full-text)
. NCCIH: Asian Ginseng (page updated February 2025). . . (full-text)

Where to buy

Check the label first. Whatever you buy, look for these:

The plant part and extract type
A third-party testing mark (USP, NSF or ConsumerLab)
Other ingredients and fillers
Interactions: ask a pharmacist if you take medicines, are pregnant or have a thyroid condition

Talk to a pharmacist or doctor before you start any supplement, especially if you take medicines. See the Safety tab for interactions.

Browse American Ginseng on Amazon

Amazon · Several brands to compare

Shop American Ginseng on Amazon

Support our free guides: as an Amazon Associate we earn from qualifying purchases. Full disclosure.

Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.