Korean Red Ginseng: Traditional Processing, Research and Safety

What red ginseng is

Korean red ginseng is Asian ginseng (Panax ginseng), which is native to the Far East, including Korea, northeastern China and far-eastern Siberia. [1] "Red" and "white" ginseng are the same plant prepared in two ways. [1] A review describes dried white ginseng and processed (steamed) red ginseng as the products of the two most common traditional post-harvest processes. [2] Red ginseng is described in one source as unskinned ginseng that is steamed or otherwise heated and then dried. [3]

We do not describe how to process, prepare or dose it. This site's page on adaptogens covers where ginseng sits among herbs promoted for stress.

Traditional use

Ginseng is used in Korean, Chinese and Japanese traditions, and the Korea Ginseng Corporation authors of a monograph describe it as traditionally used as a nourishing and tonifying agent and for a variety of diseases. [4] Those authors are employed by a ginseng company, which is a source of potential bias. This is traditional use only; it does not show a benefit. Many of the ideas behind it (tonifying, balancing) are traditional frameworks. See Traditional Korean Medicine.

Is red ginseng different from white?

Chemically, yes: the reviewers say the different chemical compositions of white and red ginseng could result in different interactions with signaling pathways. [2] That is a laboratory-level statement. A 2018 monograph notes that international ginseng monographs, including WHO's, have been based on white ginseng data and mention red ginseng only partly. [4] NCCIH does not separate the two types when it describes trials, and notes that most were small (fewer than 200 participants) and shorter than 3 months. [1]

What research shows

Evidence is judged by use. Most trials are small and short. [1]

1. Erectile dysfunction

   Mixed; benefit small and uncertain

   A 2008 review of seven small, low-quality trials of red ginseng gave suggestive results but called for more rigorous studies. [3] A 2021 Cochrane review of nine placebo-controlled studies (587 men) concluded ginseng may have only trivial effects on erectile function, mostly on low-certainty evidence, with follow-up up to 12 weeks. [5]

2. Fatigue

   Promising but limited

   A 2023 review of 19 trials found no significant reduction in fatigue overall, but a reduction for general fatigue and for ginseng herbal formulas; effect sizes were small. [6]

3. Athletic performance

   No good evidence of benefit

   NCCIH: most research shows no improvement. [1]

4. Thinking, flu, blood sugar

   Insufficient evidence

   NCCIH describes small or preliminary or conflicting research. [1]

5. Aging, asthma, anxiety

   Insufficient evidence

   Not enough reliable information to say. [1]

The Cochrane review's authors include researchers at the Korea Institute of Oriental Medicine, and one is listed as an editorial board member of the Journal of Ginseng Research. [5] Placebo effects matter in subjective outcomes such as fatigue and sexual function.

Safety

Short-term oral use (up to 6 months) in recommended amounts appears safe for most people, but long-term safety has been questioned. [1] Insomnia is the most common side effect; uncommon reports include severe rash, liver damage and severe allergic reactions. [1] Ginseng may worsen autoimmune disorders and interfere with blood clotting, and might lower blood sugar, so people with diabetes should talk with a provider first. [1]

Pregnancy, breastfeeding and children. Some experts recommend against use in infants, children, and pregnant or breastfeeding women. [1] Some studies suggest it may be unsafe by mouth during pregnancy. [1] See pregnancy and breastfeeding.

Medicines. NCCIH says ginseng might interact with certain medicines. [1] For warfarin, small trials found no significant change in INR in 25 patients with Korean red ginseng, whose authors advised close monitoring, and in 25 stroke patients given Panax ginseng. [7][8] Those are small studies; a blood thinner needs your prescriber's input. [9]

Product quality

Products vary. In an older US analysis (2004), total ginsenosides in ginseng supplements ranged from 5.3 to 18.2 mg per serving between brands, and ginseng was among the most variable products. [10] Labels may not tell you what you are getting. See product quality and contamination. We recommend no brands.

Who should check first

Ask a clinician or pharmacist before use if you take medicines (especially blood thinners or diabetes medicines), have diabetes or an autoimmune disorder, are pregnant or breastfeeding, or have liver disease. Do not use ginseng in place of medical care for a health problem such as erectile dysfunction; raise it with a clinician. See talking with a health professional.