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Scientific Name(s): Panax ginseng C.A. Meyer., Panax quinquefolius L.
Common Name(s): American ginseng, Asian ginseng, Canadian ginseng, Chinese ginseng, Korean ginseng, Oriental ginseng, Radix ginseng

Medically reviewed by Last updated on Nov 30, 2022.

Clinical Overview


Ginseng root is widely used for its adaptogenic, immunomodulatory, antineoplastic, cardiovascular, CNS, endocrine, and ergogenic effects, but these uses have not been confirmed by clinical trials.


According to the Complete German Commission E Monographs, crude preparations of dried root powder 1 to 2 g can be taken daily for up to 3 months. In numerous clinical trials, the dosage of crude root has ranged from 0.5 to 3 g/day and the dose of extracts has generally ranged from 100 to 800 mg.


Contraindications have not been established aside from known hypersensitivity.


Information regarding safety and efficacy in pregnancy and lactation is lacking.


Limited evidence exists for any established interactions, with most data derived from laboratory studies and healthy volunteers.

Adverse Reactions

It is estimated that more than 6 million people regularly ingest ginseng in the United States. There have been few reports of severe reactions and a very low incidence of adverse events has been reported in clinical trials. Hypersensitivity and anaphylaxis have been reported. Inappropriate use of P. ginseng or ginseng abuse syndrome includes symptoms such as hypertension, diarrhea, sleeplessness, mastalgia, skin rash, confusion, and depression. Two cases of new onset acute manic episodes subsequent to high doses have also been reported.


None known.

Scientific Family

  • Araliaceae (ginseng)


Ginseng commonly refers to P. quinquefolius L. or P. ginseng C.A. Meyer, 2 members of the family Araliaceae. Several other species are less commonly used in Asia. The ginsengs were classified as members of the genus Aralia in older texts. In the eastern and central United States and Canada, P. quinquefolius is found in rich, cool woods; a large crop is grown commercially in Wisconsin. The Asian species P. ginseng is cultivated in Korea and China. The short plant grows 3 to 7 compound leaves that drop in the fall and bears a cluster of red or yellowish fruits from June to July. The shape of the root can vary depending on the species and has been used to distinguish types of ginseng. Medicinally, the root is considered the most valuable part of the plant in providing the pharmacologically active ginsenosides. Ginsenoside content varies with the age of the root, season of harvest, and method of preservation. While at least 4 ginsenosides are detectable in most young roots, this number more than doubles after 6 years of growth. High-quality ginseng is generally collected in the fall after 5 to 6 years of growth.1, 2

P. ginseng should not be confused with Siberian ginseng (Eleutherococcus senticosus), a related species with different chemistry.1


Ginseng is perhaps the most widely recognized plant used in traditional medicine and now plays a major role in the herbal health care market. It is classified into 3 types according to processing; fresh, white (dried after peeling), and red (steamed and dried). For more than 2,000 years, various forms have been used medicinally. The name Panax derives from the Greek word for "all healing," and its properties have been so touted. Ginseng root's man-shaped figure (shen-seng means "man-root") led proponents of the doctrine of signatures, an ancient European herbalists philosophy, to believe that the root could strengthen any part of the body. Through the ages, the root has been used in the treatment of asthenia, atherosclerosis, blood and bleeding disorders, erectile dysfunction, hypertension, liver dysfunction, and colitis, as well as to relieve the effects of aging, cancer, postmenopausal disorder, and senility.3, 4, 86

Evidence of the root's general strengthening effect has been examined for its ability to raise mental and physical capacity, as well as its protectant effect against diabetes, neurosis, radiation sickness, and some cancers. Today, its popularity is widely due to the adaptogenic or stress-protective effect of the saponins.3, 4


Major compounds in ginseng include triterpene saponins, polyacetylenes, sequiterpenes, polysaccharides, peptidoglycans, nitrogen-containing compounds, and other compounds, including fatty acids, carbohydrates, and phenolic compounds.2, 5, 6 The triterpene saponins are considered the most active compounds, and some estimates report up to 150 different ginsenosides, grouped into either dammarane or oleanane groups.6 Ginsenosides Rb1, Rb, Rc, Rd, Re, Rf, and Rg1 are the most common components of commercial ginseng products.86 Many analytical methods have been described and standards published. The European Pharmacopoeia requires a minimum of 0.4% combined Rg1 and Rb1 ginsenosides, while the Chinese Pharmacopoeia requires ginseng radix (dry root) to have not less than 0.3% Rg1 and Re combined ginsenosides and not less than 0.2% Rb1.5

Most traditional ginseng herbal preparations contain ginsenosides. However, a commercially available product, known as CVT-E002, a patented aqueous extract of approximately 80% to 90% poly-furanosyl-pyranosyl-saccharides from the roots of North American ginseng (P. quinquefolius), does not contain ginsenosides.7 Adulterants are commonly found in ginseng preparations due to the high cost of authentic ginseng roots, and the presence of natural methylxanthines may also contribute to some reported physiological effects.6, 7, 8

Variances in cultivation and processing methods, as well as the individual genetics of each plant source, result in varying chemical compositions among commercial products. This may contribute to the lack of consensus among studies on the pharmacology and efficacy of ginseng and should be considered when conducting and interpreting research.2, 9 A second factor that may have produced erratic results is the discovery that ginsenosides (specifically Rb1, Rb2, Rc, and Rd) are metabolized extensively by the human gut microflora and that some of the resulting metabolites are pharmacologically active, such as compound K. Colonic bacteria can remove the 3 sugars from ginsenoside Rb1 in stepwise fashion, and the deglycosylated compounds are then esterified in the liver with the fatty acids stearic, palmitic, and oleic acid. These esters persist in the liver for as long as 24 hours.10, 86 Thus, differences in an individual's gut flora may lead to differing pharmacological responses to ginseng preparations. Additionally, ginsenoside bioavailability as well as the content of ginsenoside metabolites (ie, compound K, Rh1, Rg3, protopanaxatriol, protopanaxadiol) of red ginseng were found to be increased with the fermented product.86

Uses and Pharmacology

Reviews of the effects of ginseng have been published. Most studies have used whole-root preparations, with considerable variations due to uncertain species identification, age of the roots, and curing process used. Variations in saponins between the species also may contribute to the lack of consensus among researchers on ginseng's pharmacology.(2, 6, 11)


Animal data

Both ginsenosides and polyacetylenes have demonstrated anticarcinogenic effects in vitro, including direct cytotoxic and growth inhibitory effects, induction of differentiation, and inhibition of metastasis. High concentrations of M1, an active metabolite of Rb1, Rb2, and Rc, induced cell death of mouse melanoma cells by regulating proteins involved in apoptosis. Ginsenosides Rh2 and Rh3 induced differentiation of promyelocytic leukemia cells into granulocytes; Rg3 inhibited adhesion and invasion of melanoma cells and decreased pulmonary metastasis.(6, 12, 13)

Clinical data

Epidemiological data support a protective effect of ginseng on nonspecific organ cancers.(6, 14) A long-term study of ginseng 1 g taken weekly for 3 years among adults with long-term atrophic gastritis showed no effect on the overall relative risk of cancer. In the male subgroup analysis, there was a reduction in the risk of non–organ-specific cancers.(14)

Trials evaluating the effect of ginseng (both P. quinquefolius and P. ginseng) on cancer-related fatigue at doses of 800 mg to 2 g/day over 4 to 12 weeks have shown effects for some, but not all, aspects of mental and physical functioning.(15, 16, 75, 91) Ginseng may improve some of the adverse effects of chemotherapy-related transcatheter arterial chemoembolization.(17)

A systematic review of herbal medicines as adjuvants to the FOLFOX4 regimen used for treating colorectal cancer was conducted to identify evidence of safety and efficacy as well as management of chemotherapy side effects. A total of 13 Chinese randomized clinical trials involving 940 patients were included, which compared herbal medicines plus FOLFOX4 combination to the FOLFOX4 regimen alone in patients with advanced (stage IV) colorectal cancer. Although 58 different herbs and/or extracts were used, Panax ginseng was one of the 6 most common herbs found in treatment preparations (n = 5 in studies). Tumor response rate, overall survival at 1 year, time to progression, quality of life, body weight, nausea/vomiting, and neutropenia improved significantly (P values ranged from P < 0.00001 to P = 0.01) with herbal adjuvants. Ginseng was included in each of the studies contributing to these results.(82)

The American Society of Clinical Oncology clinical practice guideline adaptation for the screening, assessment, and management of fatigue in adult survivors of cancer (2014) notes that results from small pilot studies on the effectiveness of supplements, such as ginseng, for managing cancer-related fatigue are equivocal.(81)

Cardiovascular effects

Ginseng saponins have been reported to act as selective calcium antagonists and enhance the release of nitric oxide from endothelial and neuronal cells. In vitro studies have shown that total ginseng saponins extracted from Panax notoginseng and P. quinquefolius inhibited calcium entry through receptor-operated calcium channels without affecting calcium entry through voltage channels or intracellular calcium release.(6, 18)

Animal data

In studies involving rabbits and dogs, ginsenosides Ro and Rb from P. ginseng offered a protective effect in myocardial ischemia and reperfusion injuries. This effect may be partly mediated by increased release of prostacyclin and by activation of nitric oxide synthase and subsequent release of nitric oxide. An inhibitory effect on platelet aggregation and on the conversion of fibrinogen to fibrin has been demonstrated, and the prevention of atheroma in rabbits fed a high-cholesterol diet has been observed.(6, 19)

Clinical data

Clinical trials evaluating the effect of ginseng on the cardiovascular system are limited. Hypotensive and hypertensive effects have been postulated. In a short-term study in healthy adults, ginseng 3 g had no effect on blood pressure but lowered the arterial augmentation index(20) while a 12-week study among hypertensive adults found no effect of ginseng on 24-hour blood pressure or on renal function.(21) Shenfu injection, a mixture of ginseng and monkshood, has been used to prevent reperfusion injury following mitral valve replacement.(22) Sanchi (P. notoginseng) is widely used in traditional Chinese medicine in acute ischemic stroke. The saponins in sanchi are similar to those found in P. ginseng and are classified as dammarane saponins (Rb1 and Rg1 primarily). A review of clinical trials found limited evidence of effect of sanchi on short-term effects of ischemic stroke, but noted that the trials were of limited methodological quality.(23)

In a double-blind controlled trial, 64 adults with well-controlled type 2 diabetes and hypertension received 3 g of American ginseng or placebo for 12 weeks. Ginseng significantly improved arterial stiffness by 5.3% (P = 0.041) and systolic blood pressure by 11.7% (P < 0.001); no effect was noted on diastolic blood pressure.(79)

CNS effects

Rb1 and Rg1 appear to play a major role in CNS stimulatory and inhibitory effects and may modulate neurotransmitters. Cholinergic activity, implicated in mediating learning and memory processes, is affected by certain ginsenosides. Antioxidant, anti-inflammatory, antiapoptotic, and immune stimulatory effects are suggested to contribute to a protective effect in neurodegenerative disorders.(24)

Animal data

Animal studies show that Rb1, Rg1, and Re prevent scopolamine-induced memory deficits, and that Rb1 and Rg1 appear to increase central choline uptake and facilitate the release of acetylcholine from hippocampal tissues. Results from a study in aged rats suggest that daily oral administration of P. ginseng extract 8 g/kg/day for 12 days improved learning performance. In animal tissues, ginseng extract inhibited gamma-aminobutyric acid (GABA), glutamine, dopamine, noradrenalin, and serotonin uptake in a concentration-dependent manner.(6, 24, 25, 26)

Clinical data

Limited high-quality clinical trials have been conducted, and systematic reviews include data from very few studies.(11, 27) An anxiolytic effect via GABA modulation was suggested to be responsible for an observed improvement in sleep disorders for fermented ginseng.(28) Among healthy adults, short-term effects of P. ginseng and P. quinquefolius include increased mental performance, increased calmness, and decreased mental fatigue.(29, 30, 31) A review of the effect of ginseng on cognitive function in Alzheimer disease found an effect in favor of ginseng for the mini-mental status examination and Alzheimer Disease Assessment Scale for the 2 included studies.(27, 32) A 2010 Cochrane systematic evidence review examining ginseng’s effect on cognition found it difficult to pool the available data due to heterogeneity of studies. The reviewers stated that there was some evidence to suggest benefit of ginseng in healthy people for improvement in cognitive function, behavior, and quality of life. There was a lack of high-quality evidence to support ginseng’s use in patients with dementia.(76)

The American Psychiatric Association (APA) guideline watch for the treatment of patients with Alzheimer disease and other dementias (2014) did not find enough definitive new evidence to change the 2007 guideline recommendations for alternative agents, including ginseng.(90)


Animal data

Widespread usage of ginseng and the availability of limited clinical trial data make animal studies largely redundant.

Evidence appears to support the modulation of insulin sensitization and secretion based on cholinergic, dopaminergic, adrenergic, and nitric oxide actions found with ginsenosides. These have been noted to affect glucose metabolism in animal studies.(24, 33, 34)

Clinical data

Limited quality clinical trials have been conducted among adults with diabetes, with the majority of studies evaluating ginseng in healthy volunteers. Improvements in blood glucose measures and glycemic control have been reported in some(33, 34, 35, 36, 37) but not all(31, 38, 39) studies.

Ergogenic effects

Animal data

Widespread usage of ginseng and the availability of limited clinical trial data make animal studies largely redundant.

Clinical data

Evidence supporting the efficacy of ginseng in improving physical performance is conflicting. Physical performance in young, active volunteers did not improve in 4 studies; however, other studies reported a decrease in heart rate and an increase in maximal oxygen uptake.(11, 40) One comprehensive literature search evaluated P. ginseng preparations in data from human studies. Properly controlled studies using higher doses (standardized to 2 g/day of dried root) administered for at least 8 weeks and in larger subject numbers more often exhibited improvement in physical or psychomotor performance. Benefit of ginseng may be greater in untrained subjects or in those older than 40 years.(41)

The Society for Integrative Oncology's updated guideline on the evidence-based use of integrative therapies during and after breast cancer treatment (2017) recommends ginseng be considered for improving fatigue during treatment (grade C).(88)

Fatigue, cancer-related

Clinical data

Patients diagnosed with cancer within the past 2 years who presented with cancer-related fatigue and who were undergoing or had undergone curative intent treatment were randomized to 2,000 mg/day of Wisconsin/American ginseng (P. quinquefolius) or placebo for 8 weeks. In this double-blind, multicenter trial of 364 patients, a significant improvement in fatigue scores was documented after 8 weeks in the ginseng group compared to controls (P=0.003). Significance was retained in the subgroup of patients currently undergoing cancer therapy (P=0.01) but was similar to placebo for those who had previously undergone cancer therapy. Ginseng was well tolerated with no significant differences in the incidence of side effects between groups.(104) Similar benefit was observed with 2,000 mg/day of Korean red ginseng (P. ginseng) in a multicenter, randomized, double-blind, phase 3 trial that enrolled 471 colorectal cancer patients with cancer-related fatigue who were undergoing adjuvant or palliative mFOLFOX-6 chemotherapy regimen. Of the 330 per-protocol patients who completed the 16-week study, those in the ginseng group experienced significant reductions in global fatigue scores compared with placebo (P=0.019) as well as "fatigue right now" (P=0.045), "mood" (P=0.006), "relations with others" (P=0.003), and "enjoyment of life" (P=0.036) subscores. Although perceived stress was improved in the ginseng group (P=0.024), fatigue-related quality-of-life scores remained similar between groups at week 16. Significant benefit for fatigue was retained for patients at least 60 years of age (P=0.000), at least 80% compliance (P=0.013), and in females (P=0.023). The incidence of adverse events was similar between groups with grade 1 or 2 neutropenia (6% vs 3%), headache (7% vs 2%), and URTI (6% vs 2%) occurring at least twice as often with ginseng than with placebo.(105)

Fatigue, chronic

Clinical data

A double-blind, placebo-controlled, randomized clinical trial investigated antifatgue effects of P. ginseng (20% ethanol extract) in 90 adults with idiopathic chronic fatigue. Fatigue severity measured by numerical self-rating scores was significantly improved by 1 and 2 g daily doses; additionally, the 2 g/day doses significantly reduced visual analogue scores. Serum levels of antioxidants and biomarkers associated with oxidative stress (ie, reactive oxygen species, malondialdehyde) were also decreased significantly by both ginseng doses compared with placebo.(73)

Fatigue, multiple sclerosis-associated

Clinical data

Fatigue is a common and frequently bothersome problem in patients with multiple sclerosis (MS), and a randomized, double-blind, placebo-controlled crossover pilot study (n = 47) was conducted. Patients received 6-week courses of ginseng or placebo, with a 2-week washout between crossover therapies. Patients were instructed to titrate therapy upward beginning with 1 capsule/day for 1 week, 2 capsules/day in week 2, and 4 capusles/day for the next 4 weeks. Capsules contained 100 mg of ginseng extract or placebo. No significant difference in benefit for MS-related fatigue reduction was seen for ginseng versus. placebo.(78)


Clinical data

P. ginseng (100 mg/day root extract, 27% ginsenosides) was compared with amitriptyline 25 mg/day and placebo in a double-blind randomized clinical trial for the treatment of fibromyalgia in adult women. Over the 12-week study period, statistically significant reductions from baseline were documented for pain, fatigue, and sleep in all 3 treatment groups (n = 38); however, no differences between groups occurred.(74)

Immunomodulatory and adaptogenic effects

Animal data

Animal studies have shown that ginseng extracts can prolong swimming time, prevent stress-induced ulcers, stimulate the proliferation of hepatic ribosomes, increase natural killer-cell activity, and possibly enhance the production of interferons.(42) Increased spleen B lymphocyte proliferation and serum immunoglobulin production have been documented in animal models. Increased peritoneal exudate macrophage production of the cytokines IL-1, tumor necrosis factor–alpha, and IL-6, and the production of nitric oxide has also been reported.(43, 44)

Clinical data

Studies in healthy volunteers measuring T-lymphocyte immunomodulation yield equivocal results.(11, 26) Studies in healthy sedentary men and healthy physically active men have found no effect of ginseng on immune markers.(40, 45) Modulation of CD8+ T cells and interleukin production was reported in sedentary men beginning to exercise.(45) A possible effect of ginseng on the CD4+ T cell count in HIV-positive men was reported.(46)

Clinical trials supported by the manufacturers of a patented P. quinquefolius preparation suggest a lowered incidence of influenza with the use of ginseng as a prophylactic, especially among elderly patients.(47, 48, 49, 50, 51, 77) Dosage studies have taken place to evaluate the effect of ginseng in children with upper respiratory tract infections.(52) Experimental and placebo groups experienced significant improvements from baseline in symptoms of allergic rhinitis over a 4-week double-blind, randomized, controlled trial. Symptom duration for nasal congestion was significantly shorter for fermented red ginseng (1.5 g/day as 750 mg twice daily) starting from week 1 compared to symptom duration for placebo in week 4. (Jung 2011)

Compared to baseline and placebo, administration of 6 g/day of the acidic polysaccharide Y-75 (Ginsan) from P. ginseng for 14 weeks resulted in significantly enhanced natural killer cell cytotoxic activity in 72 healthy volunteers. Red blood cell phagocytic activity was also significantly increased at 14 weeks compared with placebo.(83)

Other uses

Hepatoprotective effects

Limited data in animals suggest some hepatoprotective effects of ginseng show better results than seen with vitamin E against cyclophosphamide-induced liver injury.(100)

Sexual dysfunction

Studies in postmenopausal women suggest ginseng 1 g daily (as Korean red ginseng) may increase sexual arousal possibly via a relaxing effect on the clitoral cavernosal muscle and vaginal smooth muscle.(53)

In men, an improvement in erectile function has been shown in a meta-analysis of clinical studies.(54, 55) The American Urological Association guidelines on the management of erectile dysfunction (2005) states that herbal therapies are not recommended for the treatment of erectile dysfunction based on insufficient data. They note that evidence from a small randomized controlled trial has suggested that Korean red ginseng may be an effective treatment, but this needs to be validated by larger trials.(72)

Menopausal symptoms

The Society of Obstetricians and Gynaecologists of Canada revised clinical practice guidelines on managing menopausal vasomotor symptoms (2021) do not recommend ginseng based on a lack of evidence to support clinical benefit.(106) Likewise, the Endocrine Society clinical practice guidelines for the treatment of symptoms of the menopause (2015) recommend counseling patients on the lack of consistent evidence for benefit of complementary medicine therapies, including ginseng, as an alternative nonhormonal therapy for vasomotor symptoms (weak recommendation; low quality evidence).(89) The North American Menopause Society position statement for nonhormonal management of menopause-associated vasomotor symptoms (2015) states that ginseng does not appear to be effective for vasomotor symptoms (Level I).(98)


Ginseng root is standardized according to ginsenosides content, and can be chewed or taken as a powder, liquid extract, decoction, or infusion.

According to the Complete German Commission E Monographs, crude preparations of dried root powder 1 to 2 g can be taken daily for up to 3 months.8 In numerous clinical trials, the dosage of crude root has ranged from 0.5 to 3 g/day and the dose of extracts has generally ranged from 100 to 400 mg.2, 11, 13 Other trials have used higher dosages.38, 91

Pregnancy / Lactation

Avoid use during pregnancy and lactation due to insufficient safety evidence.2, 56 Concerns regarding estrogenic effects of ginseng have not been established, while in vitro teratogenicity in rats has been reported at artificially high doses of ginsenosides. 2, 56

An association of ginseng with androgenization in a case report is considered doubtful and more likely due to an adulterant in the preparation.56, 57 Ginseng is widely used in Asian countries among pregnant women and evidence from a cohort study and a review of clinical trials conducted in Singapore found no association between adverse events and the consumption of ginseng products in pregnant women.56


Agents with antiplatelet properties: Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of agents with antiplatelet properties. Bleeding may occur. Consider therapy modification.(58, 59, 60, 61)

Anticoagulants: Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of anticoagulants. Bleeding may occur. Consider therapy modification.(58, 59, 60, 61)

Antihypertensive agents: Herbs (hypertensive properties) may diminish the antihypertensive effect of antihypertensive agents. Monitor therapy.(92)

Atorvastatin: Drug-induced liver injury was reported within 1 week of starting a ginseng/silymarin supplement in a patient with hepatitis on stable atorvastatin doses for the previous 5 years. The drug-induced atorvastatin interaction was scored as "probable" and precipitated by ginseng.(99)

Digoxin: Ginseng (Siberian) may increase the serum concentration of digoxin. No action needed.(94)

Fexofenadine: Ginseng (Panax) may increase the serum concentration of fexofenadine. No action needed.(96, 101, 102)

Herbs (anticoagulant/antiplatelet properties): May enhance the adverse/toxic effect of other herbs (anticoagulant/antiplatelet properties). Bleeding may occur. Consider therapy modification.(58)

Hypoglycemia agents: Herbs (hypoglycemic properties) may enhance the hypoglycemic effect of hypoglycemia-associated agents. Monitor therapy.(93)

Imatinib: Ginseng (Panax) may enhance the hepatotoxic effect of imatinib.No action needed.(62, 63, 64, 65, 66, 67, 68)

Nonsteroidal anti-Inflammatory agents: Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of nonsteroidal anti-inflammatory agents. Bleeding may occur. Consider therapy modification.(58)

Phenelzine: Ginseng products may enhance the adverse/toxic effect of phenelzine. No action needed.(103)

Salicylates: Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of salicylates. Bleeding may occur. Consider therapy modification.(58, 59, 60, 61)

Thrombolytic agents: Herbs (anticoagulant/antiplatelet properties) may enhance the adverse/toxic effect of thrombolytic agents. Bleeding may occur. Consider therapy modification.(58, 59, 60, 61)

Adverse Reactions

It is estimated that more than 6 million people regularly ingest ginseng in the United States. There have been few reports of severe reactions, and a very low incidence of adverse events has been reported in clinical trials.56 Hypersensitivity and anaphylaxis have been reported69 and the QTc interval may be increased.70

Inappropriate use of P. ginseng has been described causing symptoms such as hypertension, diarrhea, sleeplessness, mastalgia, vaginal bleeding, skin rash, confusion, and depression. A "ginseng abuse syndrome" was described based on an uncontrolled study in which participants used up to 15 g ginseng daily. When the dosage was reduced to 1.7 g/day, adverse reactions resolved.2, 56

Estrogenic effects have been reported in both pre- and postmenopausal women. However, studies with standardized extracts have shown no effect on estrogenic receptors (rats) or progesterone receptors (humans).2, 56 A case of orobuccolingual dyskinesia was reported in a 46-year-old menopausal woman after using a product containing black cohosh and ginseng for over a year.80 Two cases of new onset acute manic psychosis associated with high-dose, long-term ginseng use were reported in a 23 year-old Caucasian man and 79 year-old African American man after consuming an estimated 7 and 10 times, respectively, the daily recommended traditional Chinese medicinal dose. Neither patient had a psychiatric history. Approximately 15 g/day for 1 month and 20 g/day for 2 months, respectively, were consumed prior to emergency evaluation of bizarre or inappropriate behavior and psychomotor activity, restlessness, irritability, and anxiousness. All symptoms remitted in both patients with administration of supportive care and a short course of antipsychotic medication.84

In the 2016 Scientific Statement by the American Heart Association regarding drugs that may cause or exacerbate heart failure, ginseng has been recognized as a product with possibly harmful cardiovascular effects, such as hypo- or hypertension or decreased diuretic responsiveness, and may be harmful in patients with heart failure. The guidance noted that naturoceuticals are not recommended for the management of heart failure symptoms or for the secondary prevention of cardiovascular events, and that nutritional supplements are not recommended for the treatment of heart failure [Low-quality; Limited].85

Data collected between 2004 and 2013 from 8 US centers in the Drug-induced Liver Injury Network revealed that 15.5% (130) of hepatotoxicity cases were caused by herbals and dietary supplements, whereas 85% (709) of cases were related to prescription medications. Of the 130 cases of liver injury related to supplements, 65% were from non-bodybuilding supplements and occurred most often in Hispanics/Latinos compared with non-Hispanic whites and non-Hispanic blacks. Liver transplant was also more frequent with toxicity from non-bodybuilding supplements (13%) than with conventional medications (3%) (P<0.001). Overall, the proportion of severe liver injury cases was significantly higher for supplements than for conventional medications (P=0.02). Of the 217 supplement products implicated in liver injury, 175 had identifiable ingredients, of which ginseng was among the 32 (18%) single-ingredient products.87


Embryotoxicity due to ginsenosides Rb1, Rc, Re, and Rg1 has been demonstrated in rat embryos.56 In vitro studies found no carcinogenicity, mutagenicity, or teratogenicity for Radix ginseng.2

A doping-control urinalysis was conducted under International Olympic Committee (IOC) doping control guidelines for CVT-E002 200 and found no IOC-banned substances that might induce a positive doping-control urinalysis result.71



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Frequently asked questions

1. Panax ginseng. USDA, NRCS. 2001. The PLANTS Database (, 7 February 2011). National Plant Data Team, Greensboro, NC 27401-4901 USA.
2. Radix ginseng. In: WHO Monographs on Selected Medicinal Plants. Vol 1. Geneva, Switzerland: World Health Organization; 1999.
3. Ginseng root (Asian). In: Blumenthal M. Popular Herbs in the U.S. Market. Austin, TX: American Botanical Council; 1997:37-38.
4. 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(22):2924-2942.19689273
5. Angelova N, Kong HW, van der Heijden R, et al. Recent methodology in the phytochemical analysis of ginseng. Phytochem Anal. 2008;19(1):2-16.18058794
6. Christensen LP. Ginsenosides chemistry, biosynthesis, analysis, and potential health effects. Adv Food Nutr Res. 2009;55:1-99.18772102
7. Chuang WC, Wu HK, Sheu SJ, Chiou SH, Chang HC, Chen YP. A comparative study on commercial samples of ginseng radix. Planta Med. 1995;61(5):459-465.17238100
8. Blumenthal M, Gruenwald J, Hall T, Riggins CW, Rister R, eds. Klein, Rister R, trans eds. The Complete German Commission E Monographs: Therapeutic Monographs on Medicinal Plants for Human Use. Austin, TX: American Botanical Council; 1997.
9. Chen CF, Chiou WF, Zhang JT. Comparison of the pharmacological effects of Panax ginseng and Panax quinquefolium. Acta Pharmacol Sin. 2008;29(9):1103-1108.18718179
10. Hasegawa H. Proof of the mysterious efficacy of ginseng: basic and clinical trials: metabolic activation of ginsenoside: deglycosylation by intestinal bacteria and esterification with fatty acid. J Pharmacol Sci. 2004;95(2):153-157.15215638
11. Vogler BK, Pittler MH, Ernst E. The efficacy of ginseng. A systematic review of randomised clinical trials. Eur J Clin Pharmacol. 1999;55(8):567-575.10541774
12. Qi LW, Wang CZ, Yuan CS. American ginseng: potential structure-function relationship in cancer chemoprevention. Biochem Pharmacol. 2010;80(7):947-954.20599804
13. Ng TB. Pharmacological activity of sanchi ginseng (Panax notoginseng). J Pharm Pharmacol. 2006;58(8):1007-1019.16872547
14. 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. 2010;13(3):489-494.20521975
15. Barton DL, Soori GS, Bauer BA, 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(2):179-187.19415341
16. Kim JH, Park CY, Lee SJ. Effects of sun ginseng on subjective quality of life in cancer patients: a double-blind, placebo-controlled pilot trial. J Clin Pharm Ther. 2006;31(4):331-334.16882101
17. Yinglu F, Changquan L, Xiaofeng Z, Bai L, Dezeng Z, Zhe C. A new way: alleviating postembolization syndrome following transcatheter arterial chemoembolization. J Altern Complement Med. 2009;15(2):175-181.19216654
18. Kwan CY. Vascular effects of selected antihypertensive drugs derived from traditional medicinal herbs. Clin Exp Pharmacol Physiol Suppl. 1995;22(1):S297-S299.9072399
19. Chen X. Cardiovascular protection by ginsenosides and their nitric oxide releasing action. Clin Exp Pharmacol Physiol. 1996;23(8):728-732.8886498
20. Jovanovski E, Jenkins A, Dias AG, et al. Effects of Korean red ginseng (Panax ginseng C.A. Mayer) and its isolated ginsenosides and polysaccharides on arterial stiffness in healthy individuals. Am J Hypertens. 2010;23(5):469-472.20134405
21. Stavro PM, Woo M, Leiter LA, Heim TF, Sievenpiper JL, Vuksan V. Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension. 2006;47(4):791-796.16520410
22. Zheng CD, Min S. Cardioprotection of Shenfu Injection against myocardial ischemia/reperfusion injury in open heart surgery. Chin J Integr Med. 2008;14(1):10-16.18568324
23. Chen X, Zhou M, Li Q, et al. Sanchi for acute ischaemic stroke. Cochrane Database Syst Rev. 2008;(4):CD006305.18843711
24. Radad K, Gille G, Liu L, Rausch WD. Use of ginseng in medicine with emphasis on neurodegenerative disorders. J Pharmacol Sci. 2006;100(3):175-186.16518078
25. Bahrke MS, Morgan WR. Evaluation of the ergogenic properties of ginseng: an update. Sports Med. 2000;29(2):113-133.10701714
26. Attele AS, Wu JA, Yuan CS. Ginseng pharmacology, multiple constituents and multiple actions. Biochem Pharmacol. 1999;58(11):1685-1693.10571242
27. Lee MS, Yang EJ, Kim JI, Ernst E. Ginseng for cognitive function in Alzheimer's disease: a systematic review. J Alzheimers Dis. 2009;18(2):339-344.19584437
28. Kitaoka K, Uchida K, Okamoto N, et al. Fermented ginseng improves the first-night effect in humans. Sleep. 2009;32(3):413-421.19294962
29. Reay JL, Kennedy DO, Scholey AB. Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained "mentally demanding" tasks. J Psychopharmacol. 2006;20(6):771-781.16401645
30. Scholey A, Ossoukhova A, Owen L, et al. Effects of American ginseng ( Panax quinquefolius) on neurocognitive function: an acute, randomised, double-blind, placebo-controlled, crossover study. Psychopharmacology (Berl). 2010;212(3):345-356.20676609
31. Reay JL, Scholey AB, Kennedy DO. Panax ginseng (G115) improves aspects of working memory performance and subjective ratings of calmness in healthy young adults. Hum Psychopharmacol. 2010;25(6):462-471.20737519
32. Heo JH, Lee ST, Chu K, et al. An open-label trial of Korean red ginseng as an adjuvant treatment for cognitive impairment in patients with Alzheimer's disease. Eur J Neurol. 2008;15(8):865-868.18684311
33. Vuksan V, Sievenpiper JL, Koo VY, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med. 2000;160(7):1009-1013.10761967
34. Vuksan V, Stavro MP, Sievenpiper JL, et al. Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes. Diabetes Care. 2000;23(9):1221-1226.10977009
35. Sievenpiper JL, Sung MK, Di Buono M, et al. Korean red ginseng rootlets decrease acute postprandial glycemia: results from sequential preparation- and dose-finding studies. J Am Coll Nutr. 2006;25(2):100-107.16582025
36. Reay JL, Scholey AB, Milne A, Fenwick J, Kennedy DO. Panax ginseng has no effect on indices of glucose regulation following acute or chronic ingestion in healthy volunteers. Br J Nutr. 2009;101(11):1673-1678.19017419
37. Reay JL, Kennedy DO, Scholey AB. The glycaemic effects of single doses of Panax ginseng in young healthy volunteers. Br J Nutr. 2006;96(4):639-642.17010221
38. Vuksan V, Sung MK, Sievenpiper JL, et al. Korean red ginseng (Panax ginseng) improves glucose and insulin regulation in well-controlled, type 2 diabetes: results of a randomized, double-blind, placebo-controlled study of efficacy and safety. Nutr Metab Cardiovasc Dis. 2008;18(1):46-56.16860976
39. de Andrade E, de Mesquita AA, Claro Jde A, et al. Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction. Asian J Androl. 2007;9(2):241-244.16855773
40. Kulaputana O, Thanakomsirichot S, Anomasiri W. Ginseng supplementation does not change lactate threshold and physical performances in physically active Thai men. J Med Assoc Thai. 2007;90(6):1172-1179.17624213
41. Bucci LR. Selected herbals and human exercise performance. Am J Clin Nutr. 2000;72(2)(suppl):624S-636S.10919969
42. Singh VK, Agarwal SS, Gupta BM. Immunomodulatory activity of Panax ginseng extract. Planta Med. 1984;50(6):462-465.6531406
43. Wang M, Guilbert LJ, Ling L, et al. Immunomodulating activity of CVT-E002, a proprietary extract from North American ginseng (Panax quinquefolium). J Pharm Pharmacol. 2001;53(11):1515-1523.11732754
44. Haddad PS, Azar GA, Groom S, Boivin M. Natural health products, modulation of immune function and prevention of chronic diseases. Evid Based Complement Alternat Med. 2005;2(4):513-520.16322809
45. Biondo PD, Robbins SJ, Walsh JD, McCargar LJ, Harber VJ, Field CJ. A randomized controlled crossover trial of the effect of ginseng consumption on the immune response to moderate exercise in healthy sedentary men. Appl Physiol Nutr Metab. 2008;33(5):966-975.18923572
46. Panax ginseng. Monograph. Altern Med Rev. 2009;14(2):172-176.
47. McElhaney JE, Gravenstein S, Cole SK, et al. A placebo-controlled trial of a proprietary extract of North American ginseng (CVT-E002) to prevent acute respiratory illness in institutionalized older adults [published correction appears in J Am Geriatr Soc. 2004;52(5):following 856]. J Am Geriatr Soc. 2004;52(1):13-19.14687309
48. Predy GN, Goel V, Lovlin R, Donner A, Stitt L, Basu TK. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ. 2005;173(9):1043-1048.16247099
49. Predy GN, Goel V, Lovlin R, Shan J, Basu TK. Efficacy of Cold-fX, a natural health product in the prevention of recurrent upper respiratory infections in a susceptible population: a randomized, double-blind, placebo controlled trial. J Complement Integrat Med. 2005;2(1):28.
50. Predy GN, Goel V, Lovlin RE, Basu TK. Immune modulating effects of daily supplementation of Cold-fX (a proprietary extract of North American ginseng) in healthy adults. J Clin Biochem Nutr. 2006;39(3):162-167.
51. McElhaney JE, Goel V, Toane B, Hooten J, Shan JJ. Efficacy of Cold-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo-controlled trial. J Altern Complement Med. 2006;12(2):153-157.16566675
52. Vohra S, Johnston BC, Laycock KL, et al. Safety and tolerability of North American ginseng extract in the treatment of pediatric upper respiratory tract infection: a phase II randomized, controlled trial of 2 dosing schedules. Pediatrics. 2008;122(2):e402-e410.18676527
53. Oh KJ, Chae MJ, Lee HS, Hong HD, Park K. Effects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical study. J Sex Med. 2010;7(4, pt 1):1469-1477.20141583
54. 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(4):444-450.18754850
55. Kim TH, Jeon SH, Hahn EJ, et al. Effects of tissue-cultured mountain ginseng (Panax ginseng CA Meyer) extract on male patients with erectile dysfunction. Asian J Androl. 2009;11(3):356-361.19234482
56. 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(1):e87-e94.18204104
57. Ernst E. Herbal medicinal products during pregnancy: are they safe? BJOG. 2002;109(3):227–235.11950176
58. Mousa SA. Antithrombotic effects of naturally derived products on coagulation and platelet function. Methods Mol Biol. 2010;663:229-240.20617421
59. Stanger MJ, Thompson LA, Young AJ, et al. Anticoagulant activity of select dietary supplements. Nutr Rev. 2012;70(2):107-117.22300597
60. Spolarich AE, Andrews L. An examination of the bleeding complications associated with herbal supplements, antiplatelet and anticoagulant medications. J Dent Hyg. 2007;81(3):67.17908423
61. Ulbricht C, Chao W, Costa D, et al. Clinical evidence of herb-drug interactions: a systematic review by the Natural Standard Research Collaboration. Curr Drug Metab. 2008;9(10):1063-1120.19075623
62. Bilgi N, Bell K, Ananthakrishnan AN, Atallah E. Imatinib and Panax ginseng: a potential interaction resulting in liver toxicity. Ann Pharmacother. 2010;44(5)926-928.2033233410.1345/aph.1M715
63. Etheridge AS, Black SR, Patel PR, So J, Mathews JM. An in vitro evaluation of cytochrome P450 inhibition and P-glycoprotein interaction with goldenseal, Ginkgo biloba, grape seed, milk thistle, and ginseng extracts and their constituents. Planta Med. 2007;73(8):731-741.17611934
64. Liu Y, Zhang JW, Li W, et al. Ginsenoside metabolites, rather than naturally occurring ginsenosides, lead to inhibition of human cytochrome P450 enzymes. Toxicol Sci. 2006;91(2):356-364.16547074
65. Liu Y, Ma H, Zhang JW, Deng MC, Yang L. Influence of ginsenoside Rh1 and F1 on human cytochrome p450 enzymes. Planta Med. 2006;72(2):126-131.16491447
66. He N, Edeki T. The inhibitory effects of herbal components on CYP2C9 and CYP3A4 catalytic activities in human liver microsomes. Am J Ther. 2004;11(3):206-212.15133536
67. Wanwimolruk S, Wong K, Wanwimolruk P. Variable inhibitory effect of different brands of commercial herbal supplements on human cytochrome P-450 CYP3A4. Drug Metabol Drug Interact. 2009;24(1):17-35.19353999
68. Gurley BJ, Gardner SF, Hubbard MA, et al. Clinical assessment of effects of botanical supplementation on cytochrome P450 phenotypes in the elderly: St John's wort, garlic oil, Panax ginseng and Ginkgo biloba. Drugs Aging. 2005;22(6):525-539.15974642
69. Barrett B, Brown DJ. Proprietary Phytomedicinal Product Therapeutic Monograph: CVT-E002 (Cold-fX). Austin, TX: American Botanical Council; 2007.
70. Caron MF, Hotsko AL, Robertson S, Mandybur L, Kluger J, White CM. Electrocardiographic and hemodynamic effects of Panax ginseng. Ann Pharmacother. 2002;36(5):758-76311978148
71. Goel DP, Geiger JD, Shan JJ, Kriellaars D, Pierce GN. Doping-control urinalysis of a ginseng extract, Cold-fX, in athletes. Int J Sport Nutr Exerc Metab. 2004;14(4):473-480.15467104
72. Erectile Dysfunction Guideline Update Panel. Erectile dysfunction. American Urological Association (2005).
73. Kim HG, Cho JH, Yoo SR, et al. Antifatigue effects of Panax ginseng C.A. Meyer: A randomised, double-blind, placebo-controlled trial. PLoS One 2013;8(4):e61271.23613825
74. Braz AS, Morais LC, Paula AP, Diniz MF, Almeida RN. Effects of Panax ginseng extract in patients with fibromyalgia: a 12-week, randomized, double-blind, placebo-controlled trial. Rev Bras Psiquiatr. 2013;35(1):21-28.23567596
75. Barton DL, Liu H, Dakhil SR, et al. Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. J Natl Cancer Inst. 2013;105(16):1230-123819415341
76. Geng J, Dong J, Ni H, et al. Ginseng for cognition. Cochrane Database Syst Rev. 2010;12:CD007769.2115438310.1002/14651858.CD007769.pub2
77. Lee CS, Lee JH, Oh M, et al. Preventive effect of Korean red ginseng for acute respiratory illness: a randomized and double-blind clinical trial. J Korean Med Sci. 2012;27(12):1472-1428.23255845
78. Kim E, Cameron M, Lovera J, Schaben L, Bourdette D, Whitham R. American ginseng does not improve fatigue in multiple sclerosis: a single center randomized double-blind placebo-controlled crossover pilot study. Mult Scler. 2011;17(12):1523-1526.21803872
79. Mucalo I, Jovanovski E, Rahelic D, Bozikov V, Romic Z, Vuksan V. Effect of American ginseng (Panax quinquefolius L.) on arterial stiffness in subjects with type-2 diabetes and concomitant hypertension. J Ethnopharmacol. 2013;150:148-153.23973636
80. Sen A. Orobuccolingual dyskinesia after long-term use of black cohosh and ginseng. J Neuropsychiatry Clin Neurosci. 2013;25(4):E50.24247891
81. Bower JE, Bak K, Berger A, et al. Screening, Assessment, and Management of Fatigue in Adult Survivors of Cancer: An American Society of Clinical Oncology Clinical Practice Guideline Adaptation. J Clin Oncol. 2014 Apr 21 [epub ahead of print].24733803
82. Chen M, May BH, Zhou IW, Xue CC, Zhang AL. FOLFOX 4 combined with herbal medicine for advanced colorectal cancer: a systematic review. Phytother Res. 2014;28(7):976-991.24343974
83. Cho YJ, Son HJ, Kim KS. A 14-week randomized, placebo-controlled, double-blind clinical trial to evaluate the efficacy and safety of ginsent polysaccharide (Y-75). J Transl Med. 2014;12:283.25297058
84. Norelli LJ, Xu C. Manic psychosis associated with ginseng: a report of two cases and discussion of the literature. J Diet Suppl. 2015;12(2):119-125.24689505
85. Page RL 2nd, O'Bryant CL, Cheng D, et al; American Heart Association Clinical Pharmacology and Heart Failure and Transplantation Committees of the Council on Clinical Cardiology; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular and Stroke Nursing; and Council on Quality of Care and Outcomes Research. Drugs That May Cause or Exacerbate Heart Failure: A Scientific Statement From the American Heart Association. Circulation. 2016;134(6):e32-69.27400984
86. Kim MG, Kim Y, Jeon JY, Kim DS. Effect of fermented red ginseng on cytochrome P450 and P-glycoprotein activity in healthy subjects, as evaluated using the cocktail approach. Br J Clin Pharmacol. 2016;82:1580-1590.27495955
87. Navarro VJ, Barnhart H, Bonkovsky HL, et al. Liver injury from herbals and dietary supplements in the U.S. drug-induced liver injury network. Hepatology. 2014;60(4):1399-1408.25043597
88. Greenlee H, DuPont-Reyes MJ, Balneaves LG, et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin. 2017;67(3):194-232. doi:10.3322/caac.2139728436999
89. Stuenkel CA, Davis SR, Gompel A, et al. Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015;100(11):3975-4011.26444994
90. Rabins PV, Rovner BW, Rummans T, Schneider LS, Tariot PN. Guideline watch (October 2014): practice guideline for the treatment of patients with Alzheimer's disease and other dementias. Accessed July 22, 2017.
91. Yennurajalingam S, Tannir NM, Williams JL, et al. A double-bind, randomized, placebo-controlled trial of Panax ginseng for cancer-related fatigue in patients with advanced cancer. J Natl Compr Canc Netw. 2017;15(9):1111-1120.28874596
92. Jalili J, Askeroglu U, Alleyne B, Guyuron B. Herbal products that may contribute to hypertension. Plast Reconstr Surg. 2013;131(1):168-173.23271526
93. Hui H, Tang G, Go VL. Hypoglycemic herbs and their action mechanisms. Chin Med. 2009;4:11.19523223
94. McRae S. Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng. CMAJ. 1996;155(3):293-295.8705908
95. Jiang X, Williams KM, Liauw WS, et al. Effect of St John's wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol. 2004;57(5):592-599.15089812
96. Kim D-S, Kim Y, Jeon J-Y, Kim M-G. Effect of red ginseng on cytochrome P450 and P-glycoprotein activities in healthy volunteers. J Ginseng Res. 2016;40(4):375-381.27746690
97. Jung JW, Kang HR, Ji GE, Park MS, Song WJ, Kim MH, Kwon JW, Kim TW, Park HW, Cho SH, min KU. Therapeutic effects of fermented red ginseng in allergic rhinitis: a randomized, double-blind, placebo-controlled study. Allergy Asthma Immunol Res. 2011;3(2):103-110.21461249
98. Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause. 2015;22(11):1155-1172.26382310
99. Laube R, Liu K. An unwanted complement: rare case of potential liver injury induced by an interaction between ginseng and atorvastatin. Br J Clin Pharmacol. 2019;85(7):1612-1613.30980549
100. Abdelfattah-Hassan A, Shalaby SI, Khater SI, El-Shetry ES, Abd El Fadil H, Elsayed SA. Panax ginseng is superior to vitamin E as a hepatoprotector against cyclophosphamide-induced liver damage. Complement Ther Med. 2019;46:95-102.31519295
101. Kim M-G, Kim Y, Jeon J-Y, Kim D-S. Effect of fermented red ginseng on cytochrome P450 and P-glycoprotein activity in healthy subjects, as evaluated using the cocktail approach. Br J Clin Pharmacol. 2016;82(6):1580-1590.27495955
102. Malati CY, Robertson SM, Hunt JD, Chairez C, Alfaro RM, Kovacs JA, Penzak SR. Influence of panax ginseng on cytochrome P450 (CYP)3A and P-glycoprotein (P-gp) activity in healthy participants. J Clin Pharmacol. 2012;52(6):932-939.21646440
103. Jones BD, Runikis AM. Interaction of ginseng with phenelzine. J Clin Psychopharmacol. 1987;7(3):201-202.3597812
104. Barton DL, Liu H, Dakhil SR, et al. Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. J Natl Cancer Inst. 2013;105(16):1230-1238. doi:10.1093/jnci/djt18123853057
105. Kim JW, Han SW, Cho JY, et al. Korean red ginseng for cancer-related fatigue in colorectal cancer patients with chemotherapy: A randomised phase III trial. Eur J Cancer. 2020;130:51-62. doi:10.1016/j.ejca.2020.02.01832172198
106. Yuksel N, Evaniuk D, Huang L, et al. Guideline No. 422a: Menopause: Vasomotor symptoms, prescription therapeutic agents, complementary and alternative medicine, nutrition, and lifestyle [published correction appears in J Obstet Gynaecol Can. 2022;44(2):227]. J Obstet Gynaecol Can. 2021;43(10):1188-1204.e1. doi:10.1016/j.jogc.2021.08.00334390867

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