Panax ginseng: An Overview of the Clinical Evidence

  • Ernst, Edzard (Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth)
  • Received : 2010.07.16
  • Accepted : 2010.12.10
  • Published : 2010.12.29


This overview is focused on Panax ginseng, one of the most commonly used herbal remedies. The currently available data regarding its clinical efficacy is somewhat confusing, despite the fact that many clinical trials and systematic reviews have been published. The risks of Panax ginseng seem to be only minor. Numerous mechanisms of action have been described. Future studies of this fascinating herbal remedy seem warranted but they should overcome the methodological limitations of the previous research.


  1. Lu JM, Yao Q, Chen C. Ginseng compounds: an update on their molecular mechanisms and medical applications. Curr Vasc Pharmacol 2009;7:293-302.
  2. Jia L, Zhao Y. Current evaluation of the millennium phytomedicine--ginseng (I): etymology, pharmacognosy, phytochemistry, market and regulations. Curr Med Chem 2009;16:2475-2484.
  3. Xiang YZ, Shang HC, Gao XM, Zhang BL. A comparison of the ancient use of ginseng in traditional Chinese medicine with modern pharmacological experiments and clinical trials. Phytother Res 2008;22:851-858.
  4. Ernst E. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John’s wort, ginseng, Echinacea, saw palmetto, and kava. Ann Intern Med 2002;136:42-53.
  5. Heavey S. Herbs, supplements often sold deceptively: U.S. report. Available from: http://
  6. Chen CF, Chiou WF, Zhang JT. Comparison of the pharmacological effects of Panax ginseng and Panax quinquefolium. Acta Pharmacol Sin 2008;29:1103-1108.
  7. Choi KT. Botanical characteristics, pharmacological effects and medicinal components of Korean Panax ginseng C. A. Meyer. Acta Pharmacol Sin 2008;29:1109-1118.
  8. Product review: ginseng supplements. Available from:
  9. Sievenpiper JL, Arnason JT, Vidgen E, Leiter LA, Vuksan V. A systematic quantitative analysis of the literature of the high variability in ginseng (Panax spp.): should ginseng be trusted in diabetes? Diabetes Care 2004;27:839-840.
  10. Vogler BK, Pittler MH, Ernst E. The effi cacy of ginseng. A systematic review of randomised clinical trials. Eur J Clin Pharmacol 1999;55:567-575.
  11. Coleman CI, Hebert JH, Reddy P. The effects of Panax ginseng on quality of life. J Clin Pharm Ther 2003;28:5-15.
  12. Buettner C, Yeh GY, Phillips RS, Mittleman MA, Kaptchuk TJ. Systematic review of the effects of ginseng on cardiovascular risk factors. Ann Pharmacother 2006;40:83-95.
  13. Jang DJ, Lee MS, Shin BC, Lee YC, Ernst E. Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol 2008;66:444-450.
  14. Lee MS, Yang EJ, Kim JI, Ernst E. Ginseng for cognitive function in Alzheimer’s disease: a systematic review. J Alzheimers Dis 2009;18:339-344.
  15. 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 2009; Epub ahead of print.
  16. Bahrke MS, Morgan WP, Stegner A. Is ginseng an ergogenic aid? Int J Sport Nutr Exerc Metab 2009;19:298-322.
  17. Kim S, Lee MS, Shin BC, Sim H, Ernst E. Red ginseng for treating type 2 diabetes mellitus: a systematic review and meta-analysis. submitted.
  18. Huh MH, Lee MS, Kim C, Ernst E. Ginseng for the treatment of hypertension: a systematic review. J Ginseng Res 2010;34:342-347.
  19. Helms S. Cancer prevention and therapeutics: Panax ginseng. Altern Med Rev 2004;9:259-274.
  20. Barton DL, Soori GS, Bauer BA, Sloan JA, Johnson PA, Figueras C, Duane S, Mattar B, Liu H, Atherton PJ, 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;18:179-187.
  21. Huntley AL, Ernst E. A systematic review of herbal medicinal products for the treatment of menopausal symptoms. Menopause 2003;10:465-476.
  22. Liu JP, Yang M, Du XM. Herbal medicines for viral myocarditis. Cochrane Database Syst Rev 2004;(3):CD003711.
  23. Coon JT, Ernst E. Panax ginseng: a systematic review of adverse effects and drug interactions. Drug Saf 2002;25:323-344.
  24. Seely D, Dugoua JJ, Perri D, Mills E, Koren G. Safety and efficacy of Panax ginseng during pregnancy and lactation. Can J Clin Pharmacol 2008;15:e87-e94.
  25. Chen C, Xiao YP, Song YQ. Investigation and analysis of organochlorine pesticide residues in traditional Chinese medicinal. J Shaanxi Norm Univ. Natural sciences edition 2006; 34:264-271.
  26. Li LL, Yuan WJ, Zhang SL. Analysis of organochlorine pesticide residues in the imported American ginseng and Senna. Zhong Cao Yao 2003;34:610.
  27. Xia PH, Zhang MS, Chen WS, Wu Q. Pyrethroid pesticide residues in medicianl plants in Guizhou GAP bases. Lishizhen Med & Materia Med Res 2008;19:3010-3012.
  28. Zhang MS, Zhang ZK, Xia PH. Investigation on the organochlorine pesticides residues in Chinese herbal materials from Guizhou GAP bases. Shenyang Yao Ke Da Xue Xue Bao 2009;26:473-476.
  29. Christensen LP. Ginsenosides chemistry, biosynthesis, analysis, and potential health effects. Adv Food Nutr Res 2009;55:1-99.
  30. Kiefer D, Pantuso T. Panax ginseng. Am Fam Physician 2003;68:1539-1542.
  31. Zhou W, Chai H, Lin PH, Lumsden AB, Yao Q, Chen CJ. Molecular mechanisms and clinical applications of ginseng root for cardiovascular disease. Med Sci Monit 2004;10:RA187-RA192.
  32. Sengupta S, Toh SA, Sellers LA, Skepper JN, Koolwijk P, Leung HW, Yeung HW, Wong RN, Sasisekharan R, Fan TP. Modulating angiogenesis: the yin and the yang in ginseng. Circulation 2004;110:1219-1225.
  33. Cabral de Oliveira AC, Perez AC, Prieto JG, Duarte ID, Alvarez AI. Protection of Panax ginseng in injured muscles after eccentric exercise. J Ethnopharmacol 2005;97:211-214.
  34. Jia L, Zhao Y, Liang XJ. Current evaluation of the millennium phytomedicine-ginseng (II): collected chemical entities, modern pharmacology, and clinical applications emanated from traditional Chinese medicine. Curr Med Chem 2009;16:2924-2942.
  35. Rausch WD, Liu S, Gille G, Radad K. Neuroprotective effects of ginsenosides. Acta Neurobiol Exp (Wars) 2006;66:369-375.
  36. Lee TK, Johnke RM, Allison RR, O’Brien KF, Dobbs LJ Jr. Radioprotective potential of ginseng. Mutagenesis 2005;20:237-243.
  37. Cheng Y, Shen LH, Zhang JT. Anti-amnestic and antiaging effects of ginsenoside Rg1 and Rb1 and its mechanism of action. Acta Pharmacol Sin 2005;26:143-149.
  38. Radad K, Gille G, Liu L, Rausch WD. Use of ginseng in medicine with emphasis on neurodegenerative disorders. J Pharmacol Sci 2006;100:175-186.

Cited by

  1. JB115 on Mouse Splenocytes vol.16, pp.4, 2012,
  2. Ginsenoside-Rp1 inhibits platelet activation and thrombus formation via impaired glycoprotein VI signalling pathway, tyrosine phosphorylation and MAPK activation vol.167, pp.1, 2012,
  3. Pharmacological Effects of Ginseng on Liver Functions and Diseases: A Minireview vol.2012, pp.1741-4288, 2012,
  4. Consumer Behavior and Perception of Ginseng Products by Different Age Groups vol.27, pp.3, 2012,
  5. Effects of Sun Ginseng on Memory Enhancement and Hippocampal Neurogenesis vol.27, pp.9, 2012,
  6. Protective Effect of Ginseng Polysaccharides on Influenza Viral Infection vol.7, pp.3, 2012,
  7. Traditional Korean East Asian Medicines and Herbal Formulations for Cognitive Impairment vol.18, pp.12, 2013,
  8. Gene in 10 Long-Term Slow Progressors over 20 Years: High Frequency of Deletions and G-to-A Hypermutation vol.2013, pp.1741-4288, 2013,
  9. Ginseng for Health Care: A Systematic Review of Randomized Controlled Trials in Korean Literature vol.8, pp.4, 2013,
  10. Cytotoxic metabolites from the cultures of endophytic fungi from Panax ginseng vol.97, pp.17, 2013,
  11. Red Ginseng Extract Ameliorates Autoimmune Arthritis via Regulation of STAT3 Pathway, Th17/Treg Balance, and Osteoclastogenesis in Mice and Human vol.2014, pp.1466-1861, 2014,
  12. Ginseng and Anticancer Drug Combination to Improve Cancer Chemotherapy: A Critical Review vol.2014, pp.1741-4288, 2014,
  13. Inhibition of TNF-α-Mediated NF-κB Transcriptional Activity by Dammarane-Type Ginsenosides from Steamed Flower Buds of Panax ginseng in HepG2 and SK-Hep1 Cells vol.22, pp.1, 2014,
  14. vol.49, pp.3, 2014,
  15. Manic Psychosis Associated With Ginseng: A Report of Two Cases and Discussion of the Literature vol.12, pp.2, 2015,
  16. RI and Dephosphorylation of ERK in Human Platelets vol.2015, pp.1741-4288, 2015,
  17. Effect of Dietary Supplementation of Red Ginseng By-product on Laying Performance, Blood Biochemistry, Serum Immunoglobulin and Microbial Population in Laying Hens vol.29, pp.10, 2015,
  18. Bacterial Diversity and Community Structure in Korean Ginseng Field Soil Are Shifted by Cultivation Time vol.11, pp.5, 2016,
  19. White ginseng extract induces immunomodulatory effects via the MKK4-JNK pathway vol.25, pp.6, 2016,
  20. Red ginseng and vitamin C increase immune cell activity and decrease lung inflammation induced by influenza A virus/H1N1 infection vol.68, pp.3, 2016,
  21. Ginsenoside Rk1 bioactivity: a systematic review vol.5, pp.2167-8359, 2017,
  22. Protective Effect of Korean Red Ginseng Extract on the Infections by H1N1 and H3N2 Influenza Viruses in Mice vol.15, pp.10, 2012,
  23. Optimized conditions to produce water-in-oil-in-water nanoemulsion and spray-dried nanocapsule of red ginseng extract vol.38, pp.3, 2018,
  24. : Phytochemistry and Pharmacological Diversity and Structure-Activity Relationship on Anticancer Effects vol.2018, pp.1741-4288, 2018,
  25. impaired glycoprotein VI signaling pp.1369-1635, 2018,
  26. Systematic Reviews/Meta-Analyses of Integrative Medicine in Chinese Need Regulation and Monitoring Urgently and Some Suggestions for Its Solutions vol.24, pp.2, 2018,
  27. Toward Evidence-Based Chinese Medicine: Status Quo, Opportunities and Challenges vol.24, pp.3, 2018,
  28. Effects of Korean red ginseng (Panax Ginseng Meyer) on bisphenol A exposure and gynecologic complaints: single blind, randomized clinical trial of efficacy and safety vol.14, pp.1, 2014,