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Ginseng is said to enhance physical (including sexual) and mental performance and to have adaptogenic effects (ie, to increase energy and resistance to the harmful effects of stress and aging). Other claims include reduction in plasma glucose levels; increases in high-density lipoprotein (HDL), hemoglobin, and protein levels; stimulation of the immune system; and anticancer, cardiotonic, endocrine, central nervous system, and estrogenic effects. Another claim is possible beneficial effects on immune function.

Studies of ginseng have shown varying effects and limitations and include the following:

• Enhancement of immune function via modulation of inflammatory cytokines (1)

• Anticarcinogenic effects (2)

• Decreases in blood glucose (3)

• Improvement of cognitive function (4)

• Fatigue (5)

A systematic review of 5 studies (747 subjects) found no evidence that ginseng decreased the incidence or severity of colds, but ginseng did shorten cold duration (6).

A 2010 Cochrane review of 9 randomized, double-blind, placebo-controlled trials evaluated the efficacy and adverse effects of ginseng supplementation taken to improve cognitive function in healthy participants (8 trials) and those with age-associated memory impairment (1 trial) (4). The analysis found no serious adverse events with ginseng supplementation, but there was no convincing evidence for enhanced cognitive function in healthy participants or people with diagnosed dementia. A longitudinal Korean study found that ginseng intake > 5 years may benefit cognition in community-dwelling older adults (7).

A 2021 Cochrane systematic review of ginseng for improving erectile function included 9 studies (587 participants) that compared the effects of ginseng to a placebo. The review found that, compared to placebo, ginseng may have a trivial effect on erectile function (8).

Larger trials are needed to evaluate the effectiveness of ginseng. Also, further evaluation of the compounds found in the supplements is necessary to determine the components responsible for the observed beneficial effects. There may be varying effects, depending on whether the supplement used is American ginseng or Panax ginseng, and sometimes ginseng combinations are used in clinical studies. There is no evidence supporting other health claims for ginseng.

Nervousness and excitability may occur but decrease after the first few days. Ability to concentrate may decrease, and plasma glucose may become abnormally low (causing hypoglycemia). Because ginseng has an estrogen-like effect, women who are pregnant or breastfeeding should not take it, nor should children. Occasionally, there are reports of more serious effects, such as asthma attacks, increased blood pressure, palpitations, and, in postmenopausal women, uterine bleeding. To many people, ginseng tastes unpleasant.

Ginseng can interact with antihyperglycemic drugs, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, digoxin, estrogens, monoamine oxidase inhibitors, and warfarin.

Ginseng may also increase serum concentrations of certain drugs. For instance, ginseng can increase levels of imatinib and raltegravir, causing liver toxicity. If ginseng is combined with certain antiarrhythmic drugs, such as amiodarone or thioridazine, arrhythmias may occur.

(See also table Some Possible Dietary Supplement–Drug Interactions.)

1. 1. Kim JH, Yi Y-S, Kim M-Y, et al: Role of ginsenosides, the main active components of Panax ginseng, in inflammatory responses and diseases. J Ginseng Res41(4):435-443, 2016. doi: 10.1016/j.jgr.2016.08.004

2. 2. Yun TK, Zheng S, Choi SY, et al: Non-organ-specific preventive effect of long-term administration of Korean red ginseng extract on incidence of human cancers. J Med Food 13(3):489-494, 2010. doi: 10.1089/jmf.2009.1275

3. 3. 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 9(9):e107391, 2014. doi: 10.1371/journal.pone.0107391

4. 4. Geng J, Dong J, Ni H, et al: Ginseng for cognition. Cochrane Database Syst Rev (12):CD007769, 2010. doi: 10.1002/14651858.CD007769.pub2

5. 5. Arring NM, Millstine D, Marks LA, et al: Ginseng as a treatment for fatigue: a systematic review. J Altern Complement Med 24(7):624-633, 2018. doi: 10.1089/acm.2017.0361

6. 6. 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 2011:282151, 2011. doi: 10.1093/ecam/nep068

7. 7. Lho SK, Kim TH, Kwak KP, et al: Effects of lifetime cumulative ginseng intake on cognitive function in late life. Alzheimers Res Ther 10(1):50, 2018. doi: 10.1186/s13195-018-0380-0

8. 8. Lee HW, Lee MS, Kim TH, et al: Ginseng for erectile dysfunction. Cochrane Database Syst Rev 4(4):CD012654, 2021. Published 2021 Apr 19. doi:10.1002/14651858.CD012654.pub2

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

1. National Institutes of Health (NIH), National Center for Complementary and Integrative Health: General information on the use of Asian ginseng as a dietary supplement