Panax ginseng: what the evidence says about fatigue, focus and blood sugar

"Ginseng" on a label can mean different plants, and the research on one does not transfer to the others.

• Panax ginseng (Asian, Chinese or Korean ginseng) is the subject of this page. It is native to Korea, northeastern China and far-eastern Siberia. "Red" and "white" ginseng are the same root prepared in two different ways NCCIH.
• American ginseng (Panax quinquefolius) is a related species from North America. It has its own trials, including the warfarin study described below Yuan 2004.
• "Siberian ginseng" (eleuthero, Eleutherococcus senticosus) is a different plant from a different genus. It is not a Panax ginseng, and nothing on this page applies to it.

The compounds thought to matter most in Panax ginseng are ginsenosides NCCIH. Products vary a great deal in how much they contain.

A 2023 systematic review and meta-analysis included 19 randomized trials of ginseng and ginseng herbal formulas for fatigue. Pooled together, ginseng did not significantly reduce fatigue severity. In subgroups, ginseng reduced general (non-disease-specific) fatigue compared with controls, and multi-ingredient ginseng formulas helped chronic fatigue. The effect sizes were small, and ginseng did not cause more side effects than the comparison groups Li 2023.

NCCIH adds that most ginseng trials have been small, with fewer than 200 people, and shorter than 3 months, and that not all research agrees on a fatigue benefit NCCIH. The European Medicines Agency accepts Panax ginseng only as a traditional herbal medicine for symptoms of fatigue and weakness, based on long-standing use, for up to 3 months in adults EMA.

Tiredness that lasts for weeks has many medical causes, from anemia and thyroid problems to sleep apnea and depression. See a clinician before reaching for a supplement, and see our energy page for what the evidence says about food and tiredness.

A Cochrane review found nine randomized, double-blind, placebo-controlled trials, eight in healthy people. Only five had usable data, and they could not be pooled because they measured different things at different doses for different lengths of time. Some aspects of thinking, behavior and quality of life improved, but the reviewers concluded there was a lack of convincing evidence that Panax ginseng enhances cognition in healthy people, and no high-quality evidence in dementia Geng 2010.

NCCIH notes a small amount of research suggesting better abstract thinking, attention and reaction time in middle-aged adults but not young ones, and that any memory benefit appeared to depend on adding ginkgoNCCIH.

A 2022 meta-analysis of 20 randomized trials in people with prediabetes or type 2 diabetes found that ginseng lowered fasting blood glucose, total cholesterol and a measure of insulin resistance (HOMA-IR)Naseri 2022. NCCIH, looking across the wider research, calls the evidence on blood sugar control in diabetes inconclusive and conflicting NCCIH.

The clearest human data on a warfarin interaction comes from American ginseng: in a randomized, placebo-controlled trial in 20 healthy volunteers, 2 weeks of American ginseng lowered the peak INR and blood warfarin levels, meaning warfarin worked less well Yuan 2004. For Panax ginseng the picture is mixed. A small randomized trial in 25 stroke patients starting warfarin found no difference in INR between those given Panax ginseng and those who were not Lee 2008, while NCCIH notes that Asian ginseng may interfere with blood clotting NCCIH.

In practice: if you take warfarin or another blood thinner, do not start or stop any kind of ginseng without telling your prescriber, who may want to check your INR.

The EU monograph lists a herbal tea of 1 to 2 g of cut dried white ginseng root simmered in 150 ml of water, 2 to 3 times a day, alongside many extract doses, and limits use to 3 months EMA. Check the species on the label says Panax ginseng. If you want a dried root or tea rather than a capsule, iHerb lists Panax ginseng roots, teas and extracts.