Ginseng () is the root of plants in the genus '' Panax'', such as Korean ginseng ('' P. ginseng''), South China ginseng ('' P. notoginseng''), and American ginseng ('' P. quinquefolius''), typically characterized by the presence of ginsenosides and gintonin. Ginseng is most commonly used in the cuisines and medicines of

China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's List of countries and dependencies by population, most populous country, with a Population of China, population exceeding 1.4 billion, slig ...

and

Korea Korea ( ko, 한국, or , ) is a peninsular region in East Asia. Since 1945, it has been divided at or near the 38th parallel, with North Korea (Democratic People's Republic of Korea) comprising its northern half and South Korea (Republic ...

. Although ginseng has been used in

traditional medicine Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...

over centuries, modern

clinical research Clinical research is a branch of healthcare science that determines the safety and effectiveness ( efficacy) of medications, devices, diagnostic products and treatment regimens intended for human use. These may be used for prevention, treat ...

is inconclusive about its medical effectiveness. There is no substantial evidence that ginseng is effective for treating any medical condition, and in the United States, for example, its use has not been approved by the US

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...

(FDA) as a

prescription drug A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The r ...

. Although ginseng is commonly sold as a

dietary supplement A dietary supplement is a manufactured product intended to supplement one's diet by taking a pill, capsule, tablet, powder, or liquid. A supplement can provide nutrients either extracted from food sources or that are synthetic in order ...

, inconsistent manufacturing practices for supplements have led to analyses showing that ginseng products may be contaminated with toxic metals or unrelated filler compounds, and its excessive use may have

adverse effect An adverse effect is an undesired harmful effect resulting from a medication or other intervention, such as surgery. An adverse effect may be termed a " side effect", when judged to be secondary to a main or therapeutic effect. The term compl ...

s or untoward interactions with

History

One of the first written texts covering the use of ginseng as a medicinal herb was the '' Shen Nong Pharmacopoeia'', written in China in 196 AD. In his ''

Compendium of Materia Medica The ''Bencao gangmu'', known in English as the ''Compendium of Materia Medica'' or ''Great Pharmacopoeia'', is an encyclopedic gathering of medicine, natural history, and Chinese herbology compiled and edited by Li Shizhen and published in the ...

'' herbal of 1596,

Li Shizhen Li Shizhen (July 3, 1518 – 1593), courtesy name Dongbi, was a Chinese acupuncturist, herbalist, naturalist, pharmacologist, physician, and writer of the Ming dynasty. He is the author of a 27-year work, found in the ''Compendium o ...

described ginseng as a "superior tonic". However, the herb was not used as a "cure-all" medicine, but more specifically as a tonic for patients with chronic illnesses and those who were convalescing. Control over ginseng fields in China and Korea became an issue in the 16th century.

Ginseng species

Ginseng plants belong only to the genus '' Panax''. Cultivated species include '' Panax ginseng'' (Korean ginseng), '' Panax notoginseng'' (South China ginseng), and '' Panax quinquefolius'' (American ginseng). Ginseng is found in cooler climates – Korean Peninsula, Northeast China,

Russian Far East The Russian Far East (russian: Дальний Восток России, r=Dal'niy Vostok Rossii, p=ˈdalʲnʲɪj vɐˈstok rɐˈsʲiɪ) is a region in Northeast Asia. It is the easternmost part of Russia and the Asian continent; and is admin ...

, Canada and the United States, although some species grow in warm regions – South China ginseng being native to

Southwest China Southwest China () is a region in the south of the People's Republic of China. Geography Southwest China is a rugged and mountainous region, transitioning between the Tibetan Plateau to the west and the Chinese coastal hills (东南丘陵) and ...

and Vietnam. '' Panax vietnamensis'' (Vietnamese ginseng) is the southernmost ''Panax'' species known.

Wild and cultivated ginseng

Wild ginseng

Wild ginseng () grows naturally in mountains and is hand-picked by gatherers known as ''simmani'' (). The wild ginseng plant is now almost extinct in China and endangered globally. This is due to high demand for the product in recent years, leading to the harvesting of wild plants faster than they can grow and reproduce (a wild ginseng plant can take years to reach maturity). Wild ginseng can be processed to be red or white ginseng. Wild American ginseng has long been used by Native Americans for medicine. Since the mid-1700s, it has been harvested for international trade. Today wild American ginseng can be harvested in 19 states but has restrictions for exporting. File:Wild ginseng.jpg, Wild Korean ginseng (''P. ginseng'') File:American Ginseng 3.jpg, Wild American ginseng (''P. quinquefolius'')

Cultivated ginseng

Cultivated ginseng () is less expensive compared to rarely available wild ginseng. Wild cultivated ginseng () is planted on mountains by humans and is allowed to grow like wild ginseng. File:인삼사진.jpg, Cultivated Korean ginseng (''P. ginseng'') File:Americanginseng.jpg, Cultivated American ginseng (''P. quinquefolius'')

Ginseng processing

Ginseng seed normally does not germinate until the second spring following the harvest of berries in the Autumn. They must first be subjected to a long period of storage in a moist medium with a warm/cold treatment, a process known as stratification.

Fresh ginseng

Fresh ginseng (), also called "green ginseng", is non-dried raw product. Its use is limited by availability. File:Punggi-insam.jpg, Fresh ginseng ('' P. ginseng'')

White ginseng

White ginseng () is peeled and dried ginseng. White ginseng is fresh ginseng which has been dried without being heated. It is peeled and dried to reduce the water content to 12% or less. White ginseng air-dried in the sun may contain less of the therapeutic constituents. Enzymes contained in the root may break down these constituents in the process of drying. Drying in the sun bleaches the root to a yellowish-white color.

Red ginseng

Red ginseng () is steamed and dried ginseng, which has reddish color. Red ginseng is less vulnerable to decay than white ginseng. It is ginseng that has been peeled, heated through steaming at standard boiling temperatures of , and then dried or sun-dried. It is frequently marinated in an herbal brew which results in the root becoming extremely brittle. File:Korean red ginseng.jpg, Red ginseng ('' P. ginseng'')

Production

Commercial ginseng is sold in over 35 countries, with China as the largest consumer. In 2013, global sales of ginseng exceeded $2 billion, of which half was produced by South Korea. In the early 21st century, 99% of the world's 80,000 tons of ginseng was produced in just four countries: China (44,749 tons), South Korea (27,480 tons), Canada (6,486 tons), and the United States (1,054 tons). All ginseng produced in

South Korea South Korea, officially the Republic of Korea (ROK), is a country in East Asia, constituting the southern part of the Korea, Korean Peninsula and sharing a Korean Demilitarized Zone, land border with North Korea. Its western border is formed ...

is Korean ginseng (''P. ginseng''), while ginseng produced in China includes ''P. ginseng'' and South China ginseng (''P. notoginseng''). Ginseng produced in Canada and the United States is mostly American ginseng (''P. quinquefolius''). *

Uses

Ginseng may be included in energy drinks or herbal teas in small amounts or sold as a

Food or beverage

The root is most often available in dried form, either whole or sliced. Ginseng leaf, although not as highly prized, is sometimes also used. In

Korean cuisine Korean cuisine has evolved through centuries of social and political change. Originating from ancient agricultural and nomadic traditions in Korea and southern Manchuria, Korean cuisine reflects a complex interaction of the natural envi ...

, ginseng is used in various ''

banchan ''Banchan'' (, from Korean: ) or bansang are small side dishes served along with cooked rice in Korean cuisine. As the Korean language does not distinguish between singular and plural grammatically, the word is used for both one such dish o ...

'' (side dishes) and '' guk'' (soups), as well as tea and

alcoholic beverages An alcoholic beverage (also called an alcoholic drink, adult beverage, or a drink) is a drink that contains ethanol, a type of alcohol that acts as a drug and is produced by fermentation of grains, fruits, or other sources of sugar. The cons ...

. Ginseng-infused tea and

liquor Liquor (or a spirit) is an alcoholic drink produced by distillation of grains, fruits, vegetables, or sugar, that have already gone through alcoholic fermentation. Other terms for liquor include: spirit drink, distilled beverage or h ...

, known as '' insam cha'' (literally "ginseng tea") and ''

insam-ju ''Insam-ju'' (), also called ginseng liquor or ginseng wine, is an alcoholic beverage made of ginseng. As ginseng itself, the liquor is one of the specialities of both North North is one of the four compass points or cardinal directions. It ...

'' ("ginseng liquor") is consumed. File:Insam-twigim.jpg, ''Insam- twigim'' (ginseng fritters) File:Korean soup-Samgyetang-11.jpg, ''

Samgye-tang ''Samgye-tang'' () or ginseng chicken soup, * meaning ginseng ( Kor. ''sam'') - chicken (Kor. ''gye'') - soup (Kor. ''tang'') in Korean, consists primarily of a whole young chicken ( ''poussin'') filled with garlic, rice, jujube, and ginsen ...

'' (ginseng chicken soup) File:Insam-cha and yugwa.jpg, '' Insam-cha'' (ginseng tea) and '' yugwa'' (rice puffs) File:Insamju (ginseng liquor).jpg, ''

Insam-ju ''Insam-ju'' (), also called ginseng liquor or ginseng wine, is an alcoholic beverage made of ginseng. As ginseng itself, the liquor is one of the specialities of both North North is one of the four compass points or cardinal directions. It ...

'' (ginseng liquor) File:Korea-Sokcho-Sansamju-Wild ginseng wine-02.jpg, '' Sansam-ju'' (wild ginseng liquor)

Dietary supplement

Although ginseng is commonly sold as a

, concerns have been raised about manufactured ginseng products containing toxic metals or filler materials, such as rice or wheat.

Traditional medicine and phytochemicals

Although ginseng has been used in

for centuries, modern research is inconclusive about its biological effects. Preliminary

indicates possible effects on memory, fatigue,

menopause Menopause, also known as the climacteric, is the time in women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause usually occurs between the age of 47 and 54. Medical professionals often d ...

symptoms, and insulin response in people with mild

diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...

. Out of 44 studies examined between 2005–2015, 29 showed positive, limited evidence, and 15 showed no effects. , there is insufficient evidence to indicate that ginseng has any health effects. A 2021 review indicated that ginseng had "only trivial effects on erectile function or satisfaction with intercourse compared to placebo". Although the roots are used in

traditional Chinese medicine Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of acti ...

, the leaves and stems contain larger quantities of the

phytochemical Phytochemicals are chemical compounds produced by plants, generally to help them resist fungi, bacteria and plant virus infections, and also consumption by insects and other animals. The name comes . Some phytochemicals have been used as poison ...

s than the roots, and are easier to harvest. The constituents include

steroid A steroid is a biologically active organic compound with four rings arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter membrane fluidity; and ...

saponin Saponins (Latin "sapon", soap + "-in", one of), also selectively referred to as triterpene glycosides, are bitter-tasting usually toxic plant-derived organic chemicals that have a foamy quality when agitated in water. They are widely distributed ...

s known as ginsenosides, but the effects of these ginseng compounds have not been studied with high-quality

as of 2021, and therefore remain unknown.

FDA warning letters

As of 2019, the United States FDA and

Federal Trade Commission The Federal Trade Commission (FTC) is an independent agency of the United States government whose principal mission is the enforcement of civil (non-criminal) antitrust law and the promotion of consumer protection. The FTC shares jurisdiction o ...

have issued numerous warning letters to manufacturers of ginseng dietary supplements for making false claims of health or anti-disease benefits, stating that the "products are not generally recognized as safe and effective for the referenced uses" and are illegal as unauthorized "new drugs" under federal law.

Safety and side effects

Ginseng generally has a good safety profile and the incidence of adverse effects is minor when used over the short term. Concerns exist when ginseng is used chronically, potentially causing side effects such as

headache Headache is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches. Headaches can occur as a result ...

insomnia Insomnia, also known as sleeplessness, is a sleep disorder in which people have trouble sleeping. They may have difficulty falling asleep, or staying asleep as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, ...

, and digestive problems. The risk of interactions between ginseng and prescription medications is believed to be low, but ginseng may have adverse effects when used with the blood thinner

warfarin Warfarin, sold under the brand name Coumadin among others, is a medication that is used as an anticoagulant (blood thinner). It is commonly used to prevent blood clots such as deep vein thrombosis and pulmonary embolism, and to prevent st ...

. Ginseng also has adverse drug reactions with phenelzine, and a potential interaction has been reported with

imatinib Imatinib, sold under the brand names Gleevec and Glivec (both marketed worldwide by Novartis) among others, is an oral chemotherapy medication used to treat cancer. Imatinib is a small molecule inhibitor targeting multiple receptor tyrosine kin ...

, resulting in hepatotoxicity, and with

lamotrigine Lamotrigine, sold under the brand name Lamictal among others, is a medication used to treat epilepsy and stabilize mood in bipolar disorder. For epilepsy, this includes focal seizures, tonic-clonic seizures, and seizures in Lennox-Gastaut sy ...

. Other side effects may include anxiety,

, fluctuations in blood pressure, breast pain, vaginal bleeding,

nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of th ...

, or

diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin w ...

. If taken with other herbal supplements, ginseng may interact with them or with prescribed medicines or foods.

Overdose

The common ginsengs (''P. ginseng'' and ''P. quinquefolia'') are generally considered to be relatively safe even in large amounts. One of the most common and characteristic symptoms of an acute overdose of ''P. ginseng'' is bleeding. Symptoms of mild overdose may include dry mouth and lips, excitation, fidgeting, irritability, tremor, palpitations, blurred vision, headache, insomnia, increased body temperature, increased blood pressure, edema, decreased appetite, dizziness, itching, eczema, early morning diarrhea, bleeding, and fatigue.Chinese Medical Herbology and Pharmacology, by John K. Chen, Tina T. Chen Symptoms of severe overdose with ''P. ginseng'' may include

, vomiting,

irritability Irritability (also called as crankiness) is the excitatory ability that living organisms have to respond to changes in their environment. The term is used for both the physiological reaction to stimuli and for the pathological, abnormal or excessi ...

, restlessness, urinary and bowel incontinence, fever, increased blood pressure, increased respiration, decreased sensitivity and reaction to light, decreased heart rate, cyanotic (blue) facial complexion, red facial complexion, seizures, convulsions, and

delirium Delirium (also known as acute confusional state) is an organically caused decline from a previous baseline of mental function that develops over a short period of time, typically hours to days. Delirium is a syndrome encompassing disturbances ...

Terminology and etymology

The English word "ginseng" comes from the

Hokkien The Hokkien () variety of Chinese is a Southern Min language native to and originating from the Minnan region, where it is widely spoken in the south-eastern part of Fujian in southeastern mainland China. It is one of the national languages ...

Chinese (; where this transliteration is in

Pe̍h-ōe-jī (; ; ), also sometimes known as the Church Romanization, is an orthography used to write variants of Southern Min Chinese, particularly Taiwanese and Amoy Hokkien. Developed by Western missionaries working among the Chinese diaspora in Sout ...

). The first

character Character or Characters may refer to: Arts, entertainment, and media Literature * ''Character'' (novel), a 1936 Dutch novel by Ferdinand Bordewijk * ''Characters'' (Theophrastus), a classical Greek set of character sketches attributed to The ...

(

pinyin Hanyu Pinyin (), often shortened to just pinyin, is the official romanization system for Standard Mandarin Chinese in China, and to some extent, in Singapore and Malaysia. It is often used to teach Mandarin, normally written in Chinese fo ...

''rén''; or ) means "person" and the second character (; ) means "plant root" in a forked shape.The word 參 ''shēn'' "plant root" itself, from

Old Chinese Old Chinese, also called Archaic Chinese in older works, is the oldest attested stage of Chinese, and the ancestor of all modern varieties of Chinese. The earliest examples of Chinese are divinatory inscriptions on oracle bones from around 12 ...

*''srəm'', has been compared to words meaning 'root' in other languages of the

Sino-Tibetan Sino-Tibetan, also cited as Trans-Himalayan in a few sources, is a family of more than 400 languages, second only to Indo-European in number of native speakers. The vast majority of these are the 1.3 billion native speakers of Chinese languages. ...

family such as Japhug ''tɤ-zrɤm'' "root", see The Korean loanword ''insam'' comes from the cultivated ginseng (), which is less expensive than wild ginseng. The botanical genus name ''Panax'', meaning "all-healing" in Greek, shares the same origin as "

panacea In Greek mythology, Panacea (Greek ''Πανάκεια'', Panakeia), a goddess of universal remedy, was the daughter of Asclepius and Epione. Panacea and her four sisters each performed a facet of Apollo's art: * Panacea (the goddess of univers ...

" and was applied to this genus because

Carl Linnaeus Carl Linnaeus (; 23 May 1707 – 10 January 1778), also known after his ennoblement in 1761 as Carl von Linné Blunt (2004), p. 171. (), was a Swedish botanist, zoologist, taxonomist, and physician who formalised binomial nomenclature, ...

was aware of its wide use in

Chinese medicine Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of action ...

as a

muscle relaxant A muscle relaxant is a drug that affects skeletal muscle function and decreases the muscle tone. It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia. The term "muscle relaxant" is used to refer to two major therap ...

Other plants sometimes called ginseng

True ginseng plants belong only to the genus ''Panax''. Several other plants are sometimes referred to as ginseng, but they are from a different

genus Genus ( plural genera ) is a taxonomic rank used in the biological classification of living and fossil organisms as well as viruses. In the hierarchy of biological classification, genus comes above species and below family. In binomial nom ...

or even

family Family (from la, familia) is a group of people related either by consanguinity (by recognized birth) or affinity (by marriage or other relationship). The purpose of the family is to maintain the well-being of its members and of society. Idea ...

. Siberian ginseng is in the same family, but not genus, as true ginseng. The active compounds in Siberian ginseng are eleutherosides, not ginsenosides. Instead of a fleshy root, Siberian ginseng has a woody root. * ''

Angelica sinensis ''Angelica sinensis'', commonly known as ''dong quai'' () or female ginseng, is a herb belonging to the family Apiaceae, indigenous to China. ''Angelica sinensis'' grows in cool high altitude mountains in East Asia. The yellowish brown root of th ...

'' (female ginseng, ''dong quai'') * '' Codonopsis pilosula'' (poor man's ginseng) * ''

Eleutherococcus senticosus ''Eleutherococcus senticosus'' is a species of small, woody shrub in the family Araliaceae native to Northeastern Asia. It may be colloquially called devil's bush, Siberian ginseng, eleuthero, ''ciwujia'', ''Devil's shrub'', ''shigoka'', ''tou ...

'' (Siberian ginseng) * '' Gynostemma pentaphyllum'' (five-leaf ginseng, ''jiaogulan'') * '' Lepidium meyenii'' (Peruvian ginseng, ''maca'') * ''

Oplopanax horridus Devil's club or devil's walking stick (''Oplopanax horridus'', Araliaceae; syn. ''Echinopanax horridus'', ''Fatsia horrida'') is a large understory shrub native to the rainforests of the Pacific Northwest, but also disjunct on islands in Lake S ...

'' (Alaskan ginseng) * '' Pfaffia paniculata'' (Brazilian ginseng, ''suma'') * '' Pseudostellaria heterophylla'' (Prince ginseng) * '' Schisandra chinensis'' (five-flavoured berry) * '' Withania somnifera'' (Indian ginseng, ''ashwagandha'') * ''

Eurycoma longifolia ''Eurycoma longifolia'' (commonly called ''tongkat ali'', ''pasak bumi'', or ''longjack'') is a flowering plant in the family Simaroubaceae. It is native to Indochina (Cambodia, Laos, Malaysia, Myanmar, Thailand and Vietnam) and Indonesia (the ...

'' (Malaysian ginseng, ''tongkat ali'')