Herbal Monograph
American Ginseng
Panax quinquefolius L.
Araliaceae
Cool, yin-nourishing adaptogen for blood sugar balance, immune defense, and stress recovery
Overview
Plant Description
Panax quinquefolius is a slow-growing, shade-dependent herbaceous perennial reaching 20-60 cm (8-24 inches) in height. The plant produces a single erect stem from a fleshy, aromatic, spindle-shaped to forked taproot that develops over 4-7+ years to reach commercial harvest size (typically 5-15 cm long and 1-3 cm in diameter). Mature roots are pale yellowish-tan to cream-colored externally with prominent transverse wrinkles (annulation rings) and a somewhat human-like branching form prized in traditional medicine. The root flesh is white to cream, firm, and starchy. The stem bears a whorl of 3-5 palmately compound leaves, each with 3-5 (typically 5, hence 'quinquefolius' = five-leaved) oblong-obovate, serrated leaflets, the terminal three leaflets being larger (6-15 cm long) than the two lateral ones. Leaf surfaces are glabrous above and may have sparse pubescence beneath. In its third or fourth year, the plant produces a single umbel of small, inconspicuous greenish-white flowers (5 petals, 5 stamens) on a peduncle arising from the center of the leaf whorl in late spring to early summer (June-July). Flowers are followed by bright crimson-red drupes (berries), each containing 1-3 flattened, kidney-shaped seeds, ripening in late summer to early autumn (August-September). The genus name 'Panax' derives from Greek pan (all) + akos (cure), meaning 'all-healing' or 'panacea,' reflecting the traditional reverence for ginseng as a universal remedy.
Habitat
American Ginseng is an obligate shade plant (sciophyte) of rich, mesic, deciduous hardwood forests in eastern North America. It requires 70-90% canopy shade, consistently moist but well-drained humus-rich soils with high organic matter content, and a cool, humid forest understory microclimate. The ideal habitat features north- or northeast-facing slopes with deep, loamy soils at elevations of 200-800 m (650-2600 feet). Characteristic companion species include sugar maple (Acer saccharum), tulip poplar (Liriodendron tulipifera), basswood (Tilia americana), white ash (Fraxinus americana), trillium (Trillium spp.), maidenhair fern (Adiantum pedatum), goldenseal (Hydrastis canadensis), and blue cohosh (Caulophyllum thalictroides). The plant is intolerant of full sun, waterlogged soils, and heavy clay. Wild populations have been severely depleted across much of the historical range due to over-harvesting for the lucrative export trade to East Asia.
Distribution
Native to eastern North America from southern Quebec and Ontario, Canada, south through the eastern United States to Georgia and Alabama, and west to Minnesota, Iowa, Nebraska, and Oklahoma. The center of abundance historically was the Appalachian Mountain region, particularly the states of West Virginia, Virginia, Kentucky, Tennessee, North Carolina, and Ohio. Wild populations have declined dramatically since the 18th century due to commercial harvesting. American Ginseng is now listed in CITES Appendix II (Convention on International Trade in Endangered Species), requiring export permits from the U.S. Fish and Wildlife Service. Nineteen U.S. states and several Canadian provinces currently permit regulated wild harvest with strict seasonal restrictions. Commercial cultivation occurs primarily in Wisconsin (which produces the majority of U.S. cultivated ginseng), Ontario (Canada), British Columbia, and parts of the Appalachian region. China is also a significant cultivator of P. quinquefolius (known as Xi Yang Shen) for domestic consumption and export.
Parts Used
Root (Radix Panacis Quinquefolii)
Preferred: Dried whole or sliced root; tincture (1:5, 60% ethanol); standardized extract (capsule/tablet); decoction
The dried root is the official and primary medicinal part, listed in the American Herbal Pharmacopoeia (AHP), United States Pharmacopeia (USP), and Chinese Pharmacopoeia (as Xi Yang Shen). The root accumulates ginsenosides over multiple years of growth; older and wild-harvested roots generally have higher total ginsenoside content and are more valued. Root morphology (wild/woods-cultivated vs field-cultivated) affects market value but does not necessarily indicate therapeutic superiority. The root contains the full ginsenoside profile (Rb1 > Re > Rc > Rd > Rb2 > Rg1) plus polysaccharides, polyacetylenes, and other bioactives.
Root hairs and rootlets (fine lateral roots)
Preferred: Dried rootlets for decoction or tea; tincture
The fine lateral roots and root hairs contain a higher concentration of certain ginsenosides (particularly Rb1 and Re) per unit weight than the main taproot, and are sometimes sold separately as a more affordable preparation. The rootlets are a byproduct of root processing and are used in teas, tinctures, and extracts.
Leaf (Folium Panacis Quinquefolii)
Preferred: Dried leaf for tea infusion; leaf extract
American Ginseng leaves contain ginsenosides (particularly Rb3, Rd, and Re, with a different ratio than the root) and have been used in herbal teas and some preparations. The leaf is not the official pharmacopeial part and has been studied less extensively, but limited research suggests anti-hyperglycemic and antioxidant activity. Leaf harvest does not destroy the plant, making it a more sustainable alternative to root harvest.
Berry (fruit)
Preferred: Dried berry; berry extract
The red berries contain ginsenosides (particularly Re at high concentration) and have shown anti-hyperglycemic activity in animal studies (Xie et al. 2004). Berry extracts are a relatively novel commercial product. Berries are a byproduct of ginseng cultivation and can be harvested without destroying the plant, supporting sustainable production.
Key Constituents
Ginsenosides (dammarane-type triterpenoid saponins)
Ginsenosides are the principal bioactive constituents of American Ginseng and the basis for standardization of commercial products (typically standardized to 4-7% total ginsenosides by HPLC). The characteristic high Rb1/Rg1 ratio defines the pharmacological identity of P. quinquefolius versus P. ginseng: a PPD-dominant profile associated with calming, yin-nourishing, anti-inflammatory, neuroprotective, and anti-hyperglycemic actions versus the more balanced or PPT-dominant profile of Asian Ginseng associated with stimulating, yang-tonifying effects. This ginsenoside ratio difference provides the pharmacochemical basis for the distinct TCM classifications of the two species (cool vs warm). Total ginsenoside content and the Rb1/Rg1 ratio are the most important quality markers for American Ginseng products. AHP and USP monographs specify ginsenoside content requirements.
Polysaccharides (ginsenans and pectic polysaccharides)
American Ginseng polysaccharides are a pharmacologically important constituent class distinct from the ginsenosides. The CVT-E002/COLD-fX extract has the strongest clinical evidence base, with multiple RCTs demonstrating URI prevention efficacy. Polysaccharides modulate innate immunity through enhancement of NK cell activity, macrophage activation, and cytokine production (IL-2, IFN-gamma). They also contribute to the hypoglycemic activity of whole-root preparations. Hot-water extraction is the primary method for polysaccharide recovery.
Polyacetylenes
Polyacetylenes are minor but bioactive constituents of American Ginseng root that contribute cytotoxic, anti-inflammatory, and antimicrobial activity. They are lipophilic and best extracted by ethanol or hydroalcoholic solvents. While their clinical contribution at typical oral doses is uncertain, they form part of the complex multi-constituent pharmacology of the whole root.
Flavonoids and phenolic compounds
Flavonoids and phenolic compounds contribute antioxidant capacity to American Ginseng preparations but are not considered primary therapeutic constituents. Their presence adds to the polypharmacy of the whole-root extract.
Volatile oil and miscellaneous compounds
Volatile oil, amino acids, and micronutrients contribute to the overall tonic and nutritive properties of whole-root American Ginseng preparations. The volatile oil contributes to the distinctive aroma and may have mild pharmacological activity. These constituents are secondary to the ginsenosides and polysaccharides in determining therapeutic activity.
Herbal Actions
Helps the body adapt to stress and restore homeostasis
American Ginseng is one of the most extensively documented adaptogenic herbs in Western and integrative practice. It meets the classical Brekhman-Dardymov criteria for an adaptogen: (1) produces a nonspecific stress-protective response, (2) has a normalizing influence on physiology regardless of the direction of pathological change, and (3) is innocuous and does not disturb normal body functions. The adaptogenic profile of P. quinquefolius is distinct from P. ginseng -- cooler, more calming, and less stimulating, making it particularly suited to individuals with heat signs, yin deficiency, or stress-related burnout with agitation. Clinical evidence from the Barton et al. (2013) Mayo Clinic RCT demonstrated significant reduction in cancer-related fatigue (a complex stress-depletion state), supporting the adaptogenic classification. The high Rb1 content mediates HPA axis modulation and neuroprotective stress-buffering effects.
[1, 4, 12]Modulates and balances immune function
American Ginseng demonstrates clinically significant immunomodulating activity, primarily through its polysaccharide constituents (CVT-E002/COLD-fX). Multiple large RCTs (McElhaney et al. 2004, 2006, 2011) demonstrated that the standardized polysaccharide extract enhances innate immune function (increased NK cell activity, elevated IL-2 production) and reduces the incidence and severity of upper respiratory infections in elderly and community-dwelling adults. Ginsenosides Rb1 and Rg1 also modulate immune cell function, with Rb1 promoting anti-inflammatory M2 macrophage polarization and Rg1 enhancing antigen-presenting cell activity. The overall immunomodulatory profile is balancing rather than purely stimulating, consistent with adaptogenic immune support.
[1, 9, 10, 11]Enhances cognitive function, memory, and mental performance
American Ginseng has demonstrated cognitive-enhancing effects in clinical studies. Scholey et al. (2010) conducted a double-blind, placebo-controlled crossover study showing that Cereboost (a standardized American Ginseng extract) significantly improved working memory, reaction time, and cognitive performance as measured by the Cognitive Drug Research battery. Effects were observed at 100, 200, and 400 mg doses, with optimal effects at 200 mg. Ginsenosides Rb1 and Rg1 both demonstrate neuroprotective and neurotrophic properties -- Rb1 enhances nerve growth factor (NGF) expression and protects against excitotoxicity, while Rg1 promotes long-term potentiation and hippocampal neurogenesis.
[1, 13]Soothes and protects irritated mucous membranes
American Ginseng is traditionally classified as a yin-nourishing, fluid-generating herb in TCM -- Xi Yang Shen 'generates fluids and moistens dryness.' The polysaccharide content and cooling, moistening energetics support a mild demulcent action on dry, depleted mucous membranes. This action distinguishes it from the more drying Asian Ginseng. Particularly relevant for dry cough, dry mouth, and the fluid-depleted state seen in febrile illness, chronic stress, or post-menopausal yin deficiency.
[1, 3]Reduces inflammation
Ginsenosides (particularly Rb1 and Rd) demonstrate anti-inflammatory activity through inhibition of NF-kB signaling, suppression of pro-inflammatory cytokines (TNF-alpha, IL-1beta, IL-6), and modulation of macrophage polarization toward anti-inflammatory M2 phenotype. In vivo studies show reduced inflammation in models of colitis, neuroinflammation, and metabolic inflammation. The anti-inflammatory action is moderate and contributes to the overall adaptogenic and metabolic benefits rather than serving as a primary anti-inflammatory agent.
[1, 20]Prevents or slows oxidative damage to cells
American Ginseng extracts demonstrate significant antioxidant activity through multiple mechanisms: direct free radical scavenging (DPPH, superoxide, hydroxyl radicals), enhancement of endogenous antioxidant enzymes (SOD, catalase, glutathione peroxidase), and inhibition of lipid peroxidation. Both ginsenosides and polysaccharide fractions contribute to antioxidant capacity. Rb1 specifically protects against oxidative stress-induced neuronal and cardiomyocyte damage. The antioxidant action contributes to neuroprotective, cardioprotective, and anti-aging effects.
[1, 21]Stimulates digestive secretions via bitter taste receptors
American Ginseng has a mildly bitter taste alongside its predominant sweetness. The ginsenosides (triterpenoid saponins) contribute a mild bitterness that stimulates digestive secretions via bitter taste receptor activation. The bitter quality is less pronounced than in many traditional bitter herbs. In TCM, the slight bitterness of Xi Yang Shen is associated with its ability to clear deficiency heat and direct qi downward.
[1, 3]Strengthens and tones the heart muscle
Ginsenosides (particularly Rb1, Re, and Rg1) demonstrate cardioprotective effects including: improved myocardial contractility, protection against ischemia-reperfusion injury, anti-arrhythmic activity, reduction of oxidative damage to cardiomyocytes, and modest improvement of lipid profiles. Clinical studies in type 2 diabetes populations have shown improvements in arterial stiffness markers. The cardiotonic action is mild and supportive rather than pronounced.
[1, 6]Therapeutic Indications
Endocrine System
Type 2 diabetes mellitus and postprandial hyperglycemia
American Ginseng has the strongest clinical evidence for blood sugar regulation of any ginseng species. Vuksan and colleagues at the University of Toronto conducted multiple rigorous RCTs demonstrating that American Ginseng root (3 g) taken 40 minutes before or together with a glucose challenge significantly reduces postprandial glycemia by 20-30% in both type 2 diabetic patients and healthy controls (Vuksan et al. 2000, 2001, 2008). The effect is consistent and reproducible across multiple trials. Mechanisms include delayed gastric emptying, enhanced insulin secretion, improved insulin sensitivity, and inhibition of intestinal glucose absorption. Both ginsenosides and polysaccharide fractions contribute. The AHP monograph recognizes anti-hyperglycemic activity as a primary indication.
[1, 6, 7, 8]Metabolic syndrome and insulin resistance
Beyond acute postprandial glycemia, longer-term supplementation with American Ginseng has shown improvements in fasting glucose, HbA1c, and insulin sensitivity in clinical studies. The combination of anti-hyperglycemic, anti-inflammatory, and antioxidant actions positions American Ginseng as a supportive agent for the metabolic syndrome cluster. Vuksan et al. (2008) demonstrated sustained glycemic benefits over 8 weeks of supplementation.
[6, 8]Adrenal fatigue and HPA axis dysregulation (chronic stress adaptation)
As a documented adaptogen, American Ginseng modulates the hypothalamic-pituitary-adrenal (HPA) axis and supports recovery from chronic stress-induced depletion. The cooling, yin-nourishing profile makes it specifically appropriate for the 'wired but tired' presentation -- adrenal overactivation with simultaneous depletion (a pattern often described in TCM as yin deficiency with deficiency heat). Clinical evidence from the cancer-related fatigue RCT (Barton et al. 2013) demonstrates efficacy against a complex stress-depletion state.
[1, 12]Immune System
Prevention of upper respiratory tract infections (colds and influenza)
The CVT-E002 (COLD-fX) polysaccharide extract of American Ginseng is one of the best-studied natural products for URI prevention, supported by multiple large RCTs. McElhaney et al. (2004) RCT in 198 community-dwelling elderly found that COLD-fX (400 mg/day for 4 months) reduced the relative risk of acute respiratory illness by 48% and the mean number of URIs per person. McElhaney et al. (2006) confirmed immunological enhancement with increased NK cell activity. A 2011 multi-center RCT (n=783) showed significant reduction in the number of Jackson-verified colds by 25% and in total symptom days. COLD-fX is approved as a natural health product in Canada for URI prevention.
[9, 10, 11, 19]Immune deficiency and recurrent infections
American Ginseng polysaccharides enhance innate immune surveillance through increased NK cell cytotoxicity, enhanced macrophage phagocytosis, and elevated IL-2 and IFN-gamma production. These immunomodulating effects support its traditional use as an immune tonic for individuals with recurrent infections and general immune debility. Particularly well-suited for elderly or chronically stressed individuals with depleted immune function.
[1, 9, 10]Nervous System
Cognitive impairment, poor working memory, and mental fatigue
Scholey et al. (2010) double-blind, placebo-controlled crossover study demonstrated that Cereboost (standardized American Ginseng extract) significantly improved working memory, choice reaction time accuracy, and cognitive performance at doses of 100-400 mg. Effects were observed acutely (within hours of a single dose). Mechanism involves ginsenoside-mediated enhancement of cholinergic neurotransmission, neuroprotection, and cerebral blood flow improvement. Rb1 specifically enhances NGF expression and synaptic plasticity.
[1, 13]Cancer-related fatigue
Barton et al. (2013) conducted a landmark double-blind, multicenter RCT through the Mayo Clinic and North Central Cancer Treatment Group (n=364, the largest ginseng fatigue trial to date) evaluating American Ginseng (2000 mg/day) for cancer-related fatigue. At 8 weeks, the American Ginseng group showed significantly greater improvement in the general subscale of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) compared to placebo (P=0.003). Patients receiving active cancer treatment (radiation, chemotherapy) showed the most pronounced benefit. No significant adverse effects were observed.
[12]Chronic fatigue and stress-related exhaustion
The adaptogenic action of American Ginseng addresses the fatigue-depletion pattern common in chronic stress, overwork, and convalesence. The cool energetics make it particularly appropriate for fatigue accompanied by heat signs (restlessness, irritability, night sweats, dry mouth). Clinical evidence from the Barton et al. cancer-related fatigue trial provides the strongest support, but traditional use for general fatigue and debility is extensive across both Native American and TCM traditions.
[1, 3, 12]Respiratory System
Acute upper respiratory infections (treatment and symptom reduction)
Beyond prevention, American Ginseng (CVT-E002) has demonstrated efficacy in reducing the severity and duration of URI symptoms once infection occurs. The 2011 McElhaney multi-center RCT showed reduced total symptom severity scores and shorter illness duration. The immunomodulating polysaccharides enhance innate viral defense mechanisms including NK cell activity and interferon production.
[11, 19]Chronic respiratory debility with dry cough (yin-deficient lung pattern)
In TCM, Xi Yang Shen nourishes Lung yin and generates fluids, indicated for chronic dry cough, hoarseness, dry throat, and respiratory debility following febrile illness. The demulcent, fluid-generating action moistens depleted respiratory mucosa. Particularly appropriate for dry, atrophic respiratory conditions in elderly or chronically ill patients.
[3, 15]Cardiovascular System
Cardiovascular risk reduction in type 2 diabetes
Multiple studies from the Vuksan group have demonstrated that American Ginseng improves vascular function markers in type 2 diabetic patients, including reductions in arterial stiffness and improvements in endothelial function. The combination of anti-hyperglycemic, anti-inflammatory, and antioxidant effects provides multi-targeted cardiovascular risk reduction in metabolic disease.
[6, 8]Mild hypertension (as adjunctive support)
Limited clinical data suggest modest blood pressure-lowering effects with American Ginseng supplementation. One clinical study found that American Ginseng (3 g/day) reduced systolic blood pressure in hypertensive individuals over 12 weeks. Effects are mild and supplementary to other interventions.
[1]Digestive System
Digestive weakness with poor appetite (spleen qi deficiency)
Traditional use in both TCM and Eclectic medicine for poor appetite, weak digestion, and loss of taste associated with chronic illness or debility. Xi Yang Shen tonifies Spleen qi while its cool nature prevents aggravation of digestive heat. Eclectic physicians used it for 'atonic dyspepsia with nervous debility.' The mild bitter taste supports gastric secretory function.
[3, 15]Reproductive System
Menopausal symptoms with yin deficiency (hot flashes, night sweats, insomnia)
American Ginseng's cool, yin-nourishing energetics make it traditionally indicated for menopausal yin deficiency patterns: hot flashes, night sweats, insomnia, restlessness, and vaginal dryness. It is preferred over warming Asian Ginseng in perimenopausal women, especially those with heat signs. Limited direct clinical trial data for menopausal symptoms specifically, but the TCM indication is well-established and the pharmacological profile (cooling, fluid-generating, adaptogenic) supports this use.
[3, 4]Energetics
Temperature
cool
Moisture
slightly moist
Taste
Tissue States
hot/excitation, dry/atrophy
The energetics of American Ginseng represent one of the most clinically important distinctions from Asian Ginseng (P. ginseng). In TCM, Xi Yang Shen is classified as sweet, slightly bitter, and cool (liang), entering the Heart, Lung, and Kidney meridians. Its primary action is to 'supplement qi and nourish yin, clear fire and generate fluids.' This cool, moistening energetic profile makes it specifically indicated for qi and yin deficiency with heat signs -- a pattern commonly seen in chronic stress, burnout, post-febrile debility, chronic disease depletion, and menopausal states. In Western herbal energetics, American Ginseng is considered cool in temperature and slightly moist, addressing tissue states of hot/excitation (inflammation, agitation, restless depletion) and dry/atrophy (tissue desiccation from chronic stress or aging). It is the preferred ginseng species for hot, dry constitutional types and for individuals who find Asian Ginseng too stimulating, warming, or aggravating. The sweet taste reflects its qi-tonifying and nutritive quality; the slight bitterness supports its heat-clearing and descending action. CAVEAT: Herbal energetics are interpretive frameworks within Western herbalism and TCM, not standardized across all practitioners.
Traditional Uses
Native American (Iroquois, Cherokee, and other eastern tribes)
- Used by the Iroquois (Haudenosaunee) Confederacy as a general tonic and medicine for strength and vitality
- Cherokee used the root as a treatment for headache, cramps, fever, and female complaints
- Delaware (Lenape) used it as a general health tonic and ceremonial medicine
- Meskwaki and Ojibwe used the root as a love charm, fertility aid, and strengthening tonic
- Penobscot used the root mixed with other herbs for kidney and urinary complaints
- Various tribes used the root poultice topically for sores, wounds, and swellings
- Root was chewed or decocted as a general revitalizing remedy during times of weakness, illness recovery, or heavy physical exertion
"Moerman's Ethnobotanical Database documents use of Panax quinquefolius by multiple eastern North American tribes including the Iroquois, Cherokee, Delaware, Meskwaki, Ojibwe, Penobscot, and Pawnee. The Iroquois used it as a tonic, emetic, and compound ingredient for various ailments. Cherokee used it for croup, shortness of breath, and as a general tonic. Native knowledge of ginseng habitat and properties was instrumental in the early colonial ginseng trade -- French Jesuit Father Joseph-Francois Lafitau in 1716 discovered American Ginseng near Montreal based on descriptions of Asian Ginseng by Jesuit missionaries in China, with guidance from Mohawk informants who knew the plant as 'garantogen' (legs-and-thighs, referring to the root shape)."
Traditional Chinese medicine (Xi Yang Shen, adopted post-18th century)
- Supplements qi and nourishes yin (bu qi yang yin) -- the primary TCM indication
- Clears deficiency fire and generates fluids (qing xu huo, sheng jin ye)
- Treats Lung yin deficiency: dry cough, hemoptysis, shortness of breath, wheezing from deficiency
- Treats Stomach yin deficiency: dry mouth and throat, poor appetite, thirst
- Treats Heart qi and yin deficiency: palpitations, insomnia, forgetfulness
- Used in chronic wasting illness, convalescence from febrile disease, and post-operative recovery
- Used for diabetes (xiao ke syndrome) with thirst and wasting
- Preferred over Ren Shen (P. ginseng) when qi deficiency is accompanied by heat signs
"American Ginseng entered the Chinese materia medica after large-scale export from North America began in the early 18th century. The Bencao Congxin (New Compilation of Materia Medica, 1757) by Wu Yiluo first formally documented Xi Yang Shen: 'It supplements Lung and reduces fire, generates fluids, and eliminates fatigue. Xi Yang Shen is cool in nature and supplements deficiency fire; it is used when one desires Ren Shen (Asian Ginseng) but cannot tolerate its warmth.' The Yixue Zhongzhong Canxilu (Records of Heart-felt Experiences in Medicine, 1885) by Zhang Xichun further elaborated its use for yin deficiency with heat. Today Xi Yang Shen is listed in the Chinese Pharmacopoeia (2020 edition) as an official drug."
Eclectic American medicine (19th-early 20th century)
- Used as a mild, cooling tonic for debility and convalescence
- Indicated for 'nervous dyspepsia' (indigestion associated with nervous exhaustion)
- Used for nausea, vomiting, and loss of appetite in febrile and chronic diseases
- Employed as a mild stimulant to appetite and digestion without producing heat or excitement
- Used in pulmonary complaints with dry, tickling cough
- Combined with other herbs for female complaints associated with weakness and debility
"Felter and Lloyd's King's American Dispensatory (1898) describes Panax quinquefolium as a 'mild, soothing, mucilaginous and somewhat stimulant remedy' useful for 'stomach and bowel derangements where a mild tonic is desired.' Scudder (Specific Medication, 1870s) recommended it for 'irritation of mucous membranes with debility' and as a tonic in convalescence. The Eclectic physicians generally used American Ginseng as a milder, cooling alternative to the stronger Asian Ginseng, consistent with the TCM distinction in energetics."
[15]
Colonial American and frontier medicine (18th-19th century)
- Root chewed raw or decocted as a tonic for 'general debility'
- Used as a fever remedy and restorative during and after illness
- Extensively harvested for export to China from the 1710s onward, driving a massive commercial trade
- Used in Appalachian folk medicine as a general health tonic, often prepared as a tea or chewed raw
- Carried as a personal talisman and chewed during hard labor or travel for endurance
"American Ginseng was one of the most valuable and intensively harvested wild plants in colonial and frontier America. The trade was initiated by Jesuit missionaries around 1716 and quickly became a significant economic commodity. Daniel Boone was a noted ginseng trader. John Jacob Astor built early commercial success partly on the ginseng trade to Canton, China. The root was widely used in frontier folk medicine as a general tonic, stimulant, and fever remedy."
Modern Research
American Ginseng and postprandial glycemia in type 2 diabetes (University of Toronto RCTs)
A series of rigorous randomized controlled trials led by Vladimir Vuksan at the University of Toronto establishing the anti-hyperglycemic effects of American Ginseng. These are landmark studies that form the core evidence base for the blood sugar regulation indication.
Findings: Vuksan et al. (2000) demonstrated that 3 g American Ginseng root taken 40 minutes before a 25 g oral glucose challenge significantly reduced postprandial area under the curve (AUC) for blood glucose by approximately 20% in both type 2 diabetic patients and healthy controls (P < 0.05). This finding was replicated across multiple trials. Vuksan et al. (2001) showed that timing of administration mattered: when given 40 minutes before the glucose load, significant reductions occurred, but when given simultaneously, effects were variable. Vuksan et al. (2008) extended to longer-term supplementation (3 g/day for 8 weeks), demonstrating sustained reductions in fasting blood glucose and HbA1c in type 2 diabetics. Mechanisms include slowed gastric emptying, enhanced insulin secretion, improved peripheral insulin sensitivity, and inhibition of intestinal glucose transporters.
Limitations: Most studies from a single research group (Vuksan laboratory), though results have been independently replicated. Relatively small sample sizes in individual trials (typically n=20-40). Variable ginsenoside content across different American Ginseng root batches may affect reproducibility. Most studies measured acute postprandial glycemic response rather than long-term diabetes outcomes (HbA1c, complications).
CVT-E002 (COLD-fX) for prevention of upper respiratory infections in the elderly
A pivotal RCT evaluating the proprietary American Ginseng polysaccharide extract CVT-E002 (COLD-fX) for prevention of acute respiratory illness in community-dwelling elderly (n=198), conducted over a 4-month flu season period.
Findings: McElhaney et al. (2004) randomized 198 community-dwelling elderly adults (mean age 81.5 years) to COLD-fX 200 mg twice daily or placebo for 4 months during the influenza season. The COLD-fX group had significantly fewer confirmed acute respiratory illnesses (32% vs 62%, relative risk reduction of 48%, P=0.04). Mean duration of respiratory symptoms was also reduced. The COLD-fX group showed enhanced NK cell and T-cell activity. There were no significant adverse effects. This was the first large RCT establishing American Ginseng polysaccharide extract efficacy for URI prevention.
Limitations: Single-center study in a specific elderly population (long-term care and community residents). Relatively short intervention period (4 months). A proprietary extract (COLD-fX) that may not represent all American Ginseng products. The elderly population may not generalize to younger adults. Funded by the manufacturer (Afexa Life Sciences).
[9]
CVT-E002 (COLD-fX) immunological mechanisms and confirmatory trial
Follow-up study examining the immunological mechanisms underlying the URI-preventive effects of CVT-E002, demonstrating enhancement of innate immune parameters in healthy elderly volunteers.
Findings: McElhaney et al. (2006) demonstrated that COLD-fX supplementation in elderly subjects significantly increased the proportion of T cells and NK cells producing IL-2 and IFN-gamma compared to placebo. Enhanced lymphocyte proliferation in response to mitogenic stimulation was observed. These immunological improvements preceded and correlated with the clinical reduction in respiratory infections. The findings support a mechanism of innate immune enhancement rather than direct antiviral activity.
Limitations: Immunological outcomes are surrogate markers; direct correlation with clinical protection cannot be assumed. Same single-center design and manufacturer-funded limitations as the 2004 trial.
[10]
Multi-center confirmatory RCT of COLD-fX for cold prevention in community adults
Large, multi-center, randomized, double-blind, placebo-controlled trial (n=783) evaluating COLD-fX for prevention of common colds in community-dwelling adults, representing the largest American Ginseng clinical trial.
Findings: McElhaney et al. (2011) enrolled 783 community-dwelling adults across 5 Canadian sites. Participants received COLD-fX (200 mg twice daily) or placebo for 6 months during the cold/flu season. The COLD-fX group had 25% fewer Jackson-verified colds compared to placebo (mean 0.68 vs 0.93 colds per person, P=0.038). Total symptom severity scores and total days of cold symptoms were also significantly reduced. Incidence of recurrent colds (2 or more) was significantly lower in the COLD-fX group. The trial confirmed the earlier findings in a larger, multi-center design with a broader age range.
Limitations: Self-reported symptoms (Jackson criteria) introduce potential bias. 6-month duration; long-term effects beyond one cold season not studied. Modest effect size (25% reduction in cold incidence). COLD-fX is a specific proprietary extract; results may not generalize to crude root or other preparations. Industry-funded trial.
[11]
Systematic review of North American ginseng for upper respiratory infections
Systematic review and meta-analysis evaluating the efficacy of Panax quinquefolius preparations for prevention and treatment of upper respiratory infections, synthesizing the body of COLD-fX clinical trial data.
Findings: Seida et al. (2011) systematically reviewed the clinical evidence for North American ginseng (P. quinquefolius) in URI prevention and treatment. The pooled analysis of RCTs showed significant reduction in the incidence of upper respiratory infections (relative risk 0.75, 95% CI 0.59-0.94) and reduction in symptom severity. The evidence was strongest for the CVT-E002 (COLD-fX) extract in elderly populations. The review concluded that there is moderate-quality evidence supporting American Ginseng polysaccharide extract for URI prevention.
Limitations: Most included trials used the same proprietary extract (COLD-fX), limiting generalizability. Many trials were industry-funded. Heterogeneity in study designs and populations. Limited data on crude root or non-standardized preparations.
[19]
American Ginseng for cancer-related fatigue (Mayo Clinic multicenter RCT)
Landmark double-blind, multicenter RCT conducted through the Mayo Clinic and North Central Cancer Treatment Group evaluating American Ginseng (2000 mg/day) for cancer-related fatigue -- the largest ginseng fatigue trial to date (n=364).
Findings: Barton et al. (2013) randomized 364 cancer patients (with various cancer types) experiencing fatigue to American Ginseng 2000 mg/day (standardized to 3% ginsenosides) or placebo for 8 weeks. The American Ginseng group showed significantly greater improvement in fatigue on the MFSI-SF general subscale (P=0.003) and in physical, mental, and vitality-related fatigue subscales. The most pronounced benefit was seen in patients receiving active cancer treatment (chemotherapy, radiation). The intervention was well-tolerated with no significant differences in adverse events between groups. This trial established American Ginseng as one of the few evidence-based natural products for cancer-related fatigue.
Limitations: Heterogeneous cancer population (multiple cancer types and stages). 8-week treatment period; long-term efficacy not assessed. Single standardized product (Wisconsin Ginseng Board-sourced root). Modest effect size, though clinically meaningful. Did not assess underlying mechanisms (inflammatory markers, cortisol levels, etc.).
[12]
Cognitive enhancement with standardized American Ginseng extract (Cereboost)
Double-blind, placebo-controlled, crossover study evaluating the acute cognitive effects of a standardized American Ginseng extract (Cereboost) using the Cognitive Drug Research (CDR) computerized assessment battery.
Findings: Scholey et al. (2010) tested Cereboost (standardized American Ginseng extract) at doses of 100, 200, and 400 mg in a crossover design (n=32 healthy young adults). Significant improvements were found in working memory (Corsi block tapping, P < 0.05), choice reaction time accuracy, and 'calm' and 'content' self-rated mood states compared to placebo. Cognitive benefits were dose-dependent, with 200 mg producing optimal effects. Improvements were detectable within 1-3 hours of ingestion. The ginsenoside profile and particularly the high Rb1 content were proposed as mediating the nootropic effects through cholinergic enhancement and cerebral blood flow improvement.
Limitations: Acute single-dose study; chronic cognitive effects not assessed. Small sample size (n=32). Healthy young adults only; no data on cognitively impaired populations. Single branded extract (Cereboost); may not generalize to all American Ginseng preparations. Crossover design with brief washout period.
[13]
Ginsenoside pharmacokinetics and the Rb1/Rg1 ratio as a quality differentiator
Research characterizing the distinct ginsenoside profiles of P. quinquefolius versus P. ginseng and the pharmacokinetic behavior of ginsenosides, establishing the Rb1/Rg1 ratio as the chemical basis for species differentiation.
Findings: Multiple analytical studies have confirmed that P. quinquefolius root has a significantly higher Rb1/Rg1 ginsenoside ratio (typically 3:1 to >10:1) compared to P. ginseng (typically 0.5:1 to 2:1). This ratio difference is consistent across wild, woods-cultivated, and field-cultivated American Ginseng. The PPD-dominant profile of P. quinquefolius correlates with its cooler, more calming pharmacological effects, while the more balanced PPT/PPD profile of P. ginseng correlates with its more stimulating actions. Oral ginsenosides undergo extensive gut bacterial metabolism; PPD-type ginsenosides (Rb1, Rb2, Rc, Rd) are converted to compound K as the primary absorbable metabolite, while PPT-type ginsenosides (Re, Rg1) are converted to protopanaxatriol. HPLC ginsenoside profiling is the standard method for authenticating species identity and detecting adulteration.
Limitations: Ginsenoside content varies significantly with root age, cultivation method, geographic origin, and processing. Standardization based on total ginsenoside percentage alone does not capture the therapeutically important ratio differences. Individual variation in gut microbiome composition affects ginsenoside metabolism and may contribute to inter-individual variability in clinical response.
Anti-inflammatory and neuroprotective mechanisms of American Ginseng ginsenosides
Preclinical research characterizing the anti-inflammatory and neuroprotective mechanisms of American Ginseng ginsenosides, particularly Rb1 and Rd, providing mechanistic support for the clinical findings in fatigue and cognition.
Findings: Ginsenoside Rb1 inhibits NF-kB activation and reduces pro-inflammatory cytokine production (TNF-alpha, IL-1beta, IL-6) in microglial cells and macrophages. Rb1 protects hippocampal neurons against glutamate excitotoxicity and oxidative stress by upregulating endogenous antioxidant defenses (Nrf2 pathway). Ginsenoside Rd reduces ischemic brain injury in animal stroke models by protecting mitochondrial function and reducing apoptosis. Rg1, though present in lower amounts in American Ginseng, promotes hippocampal neurogenesis and enhances long-term potentiation. These mechanisms provide a biological rationale for the observed clinical benefits in cancer-related fatigue, cognitive enhancement, and neuroprotection.
Limitations: In vitro and animal model data; direct translation to human clinical outcomes at oral supplement doses is uncertain. Concentrations used in cell culture studies often exceed achievable plasma concentrations after oral dosing. The contribution of individual ginsenosides versus the total extract remains unclear.
Preparations & Dosage
Capsule / Powder
Strength: Crude root powder: 500 mg per capsule. Standardized to >= 3-5% total ginsenosides by HPLC.
Dried American Ginseng root, finely powdered and encapsulated. Most clinical trials have used powdered root in capsule form. Product should be standardized to a minimum of 3-5% total ginsenosides by HPLC with confirmed P. quinquefolius ginsenoside profile (Rb1 > Re > Rc > Rd, Rb1/Rg1 ratio > 3:1). Choose products verified by third-party testing to confirm species identity and absence of pesticides, heavy metals, and adulteration with P. ginseng.
1-3 g dried root powder daily in divided doses. For postprandial glycemia: 3 g taken 40 minutes before a carbohydrate-containing meal (Vuksan protocol). For cancer-related fatigue: 2 g daily (Barton 2013 protocol). For general adaptogenic support: 1-2 g daily.
2-3 times daily, preferably taken before meals for glycemic effects
Clinical trials used 4 weeks to 6 months continuously. May be used long-term as a tonic. TCM tradition supports extended use. Periodic reassessment of need is recommended.
Not well-established in children. Not recommended under age 12 without practitioner guidance. Adolescents: half adult dose may be considered under professional supervision.
Capsule is the most common clinical trial preparation form and offers convenient, reproducible dosing. The Vuksan glycemia studies used ground root in capsule form (3 g per dose). The Barton fatigue study used 2000 mg/day. Product quality varies significantly in the commercial market. Key quality markers: (1) verified P. quinquefolius identity (not P. ginseng), (2) ginsenoside content >= 3%, (3) confirmed Rb1-dominant profile, (4) third-party heavy metal and pesticide testing. Products labeled simply as 'ginseng' without species specification should be avoided.
Standardized Extract
Strength: CVT-E002 (COLD-fX): 200 mg per capsule, standardized to poly-furanosyl-pyranosyl-saccharides. Cereboost: standardized ginsenoside extract. General: 5-8% total ginsenosides, DER 4:1 to 10:1.
Commercially prepared standardized extract of P. quinquefolius root. Two main types are clinically validated: (1) CVT-E002 (COLD-fX) -- a proprietary polysaccharide-enriched extract standardized to poly-furanosyl-pyranosyl-saccharides, used at 200 mg twice daily for immune support/URI prevention. (2) Cereboost -- a ginsenoside-standardized extract used at 100-400 mg for cognitive enhancement. Other standardized extracts are available from various manufacturers, typically standardized to 5-8% total ginsenosides.
CVT-E002 (COLD-fX): 200 mg twice daily for URI prevention (McElhaney protocol). Cereboost: 200 mg single dose for acute cognitive enhancement (Scholey protocol). General standardized extract: 200-400 mg, 1-2 times daily.
1-2 times daily
COLD-fX trials used 4-6 months during cold/flu season. Cereboost was studied for acute effects. Long-term safety data from traditional use supports extended use of standardized preparations.
COLD-fX has been studied in children aged 3-12 at reduced doses in one trial. General use in children not well-established.
Standardized extracts offer the most reproducible and clinically validated dosing. The distinction between polysaccharide-focused extracts (COLD-fX for immune support) and ginsenoside-focused extracts (for glycemia, cognition, adaptogenic effects) is clinically important as they target different therapeutic endpoints through different constituents. COLD-fX is approved as a natural health product in Canada and is one of the best-studied botanical products worldwide for URI prevention.
Tincture
Strength: 1:5, 55-65% ethanol (dried root). Fresh root tincture: 1:2 in 75% ethanol if available.
Use dried, finely chopped or coarsely powdered American Ginseng root. Standard maceration: 1:5 ratio in 55-65% ethanol. Macerate for 4-6 weeks with daily agitation. Press and filter through muslin. Store in amber glass bottles. The hydroalcoholic menstruum extracts both ginsenosides (alcohol-soluble saponins) and polysaccharides (water-soluble) when using mid-range alcohol concentration.
2-4 mL (40-80 drops) three times daily
Two to three times daily, taken in a small amount of water
May be used long-term as a tonic preparation
Not recommended for children due to alcohol content
Tincture is a traditional Western herbal preparation form that offers good bioavailability of both ginsenosides and some polysaccharides. The mid-range alcohol concentration (55-65%) is a compromise that extracts both the lipophilic ginsenosides and some water-soluble polysaccharides. Higher alcohol concentrations (>70%) improve ginsenoside extraction but reduce polysaccharide extraction. Tincture dosing was not used in the major clinical trials (which used crude powder or standardized extracts), so dosing is based on traditional practice rather than clinical trial data.
Decoction
Strength: 3-9 g dried root per 400-600 mL water; ratio approximately 1:50-1:70
Slice dried American Ginseng root into thin slices (3-5 mm) or use coarsely ground powder. Add 3-9 g of dried root to 400-600 mL of cold water. Bring to a gentle boil, then reduce heat and simmer for 30-45 minutes. Strain and drink warm. The root slices can be re-decocted once with fresh water for a second extraction. In TCM practice, Xi Yang Shen is often decocted separately from other herbs in a formula (dan jian -- separate decoction) and added to the strained formula afterward to preserve its delicate properties.
3-9 g dried root per day in decoction, divided into 2-3 doses (standard TCM dosage range for Xi Yang Shen)
Decoction prepared once daily and consumed in 2-3 divided portions
May be used long-term as a daily tonic. Particularly appropriate during recovery from illness, seasonal immune support, or periods of chronic stress.
Not established; generally not used in young children
Decoction is the traditional TCM preparation for Xi Yang Shen. Hot-water extraction primarily recovers polysaccharides and water-soluble constituents. Ginsenosides are partially extracted by water but less efficiently than by hydroalcoholic solvents. The decoction has a pleasant, mildly sweet-bitter taste -- less intensely bitter than reishi or many other medicinal decoctions. American Ginseng decoction is often taken as a simple, single-herb preparation (dan fang) or combined with Ophiopogon (Mai Men Dong), Schisandra (Wu Wei Zi), or lily bulb (Bai He) for yin-nourishing formulas.
Infusion (Tea)
Strength: 1-3 g dried root per 200-300 mL boiling water
Place 1-3 g of thinly sliced American Ginseng root or root hair/rootlet pieces in a cup or small teapot. Pour boiling water (200-300 mL) over the root slices. Cover and steep for 10-15 minutes. The slices can be re-steeped 2-3 times throughout the day, adding fresh boiling water each time. This is a lighter preparation than decoction, suitable for daily tonic use.
1-3 g dried root slices per cup, steeped and re-steeped 2-3 times throughout the day
1-3 cups daily (re-steeping the same root material)
May be used daily as a health tonic
Not established
Infusion (steeping in hot water) is a gentler extraction method than decoction and is popular for daily tonic consumption of American Ginseng, particularly in Chinese-American and East Asian cultural practice. Thin slices of premium roots are steeped and re-steeped in hot water throughout the day. This method extracts polysaccharides and a portion of ginsenosides. Less concentrated than decoction but more pleasant for regular daily use. Some consumers simply chew the softened root slices after steeping. American Ginseng tea bags containing root powder or cut root are widely available commercially.
Glycerite
Strength: 1:5 in 60% vegetable glycerin / 40% water
Use dried, finely chopped or powdered American Ginseng root. Place root material in a clean glass jar and cover with vegetable glycerin (60%) and water (40%) mixture at a 1:5 weight-to-volume ratio. Cap tightly and macerate for 6-8 weeks, shaking daily. Strain through muslin, press, and filter. Store in amber glass.
3-5 mL three times daily
Two to three times daily
May be used long-term
Glycerite is the preferred liquid preparation for children (alcohol-free). Children 6-12: 1-2 mL twice daily under practitioner guidance.
Glycerite provides an alcohol-free liquid preparation suitable for children, individuals avoiding alcohol, and those who prefer a sweeter taste. Glycerin extracts ginsenosides reasonably well (though less efficiently than ethanol) and some polysaccharides. The naturally sweet taste of the glycerite complements the mild sweetness of American Ginseng. Lower extraction efficiency compared to hydroalcoholic tincture means slightly higher doses may be needed.
[4]
Safety & Interactions
Class 2c
Not to be used with specific medications (AHPA Botanical Safety Handbook)
Contraindications
Although rare, allergic reactions to ginseng have been reported. Cross-reactivity between Panax species is possible. Individuals with confirmed allergy to any Panax species should avoid American Ginseng.
A documented case report (Yuan et al. 2004) described clinically significant INR reduction in a patient taking warfarin who started American Ginseng supplementation, suggesting that P. quinquefolius may reduce the anticoagulant effect of warfarin. This is a pharmacokinetic interaction likely involving CYP enzyme induction or competition. The AHPA Botanical Safety Handbook classifies P. quinquefolius as Class 2c ('not to be used during pregnancy and lactation' extended by caution regarding external use with drugs). Patients on warfarin should not use American Ginseng without informing their prescriber and having INR monitored more frequently.
In TCM, all forms of ginseng (including Xi Yang Shen) are traditionally contraindicated during the acute phase of external pathogenic invasion (shang han / wen bing initial stage). Tonifying qi during active infection may theoretically 'close the door with the thief inside.' Once the acute phase resolves and debility predominates, ginseng may be introduced for recovery support. This is a traditional contraindication without direct modern clinical evidence.
Drug Interactions
| Drug / Class | Severity | Mechanism |
|---|---|---|
| Warfarin (Coumadin) (Anticoagulants) | major | American Ginseng has been documented to reduce the anticoagulant effect of warfarin, likely through CYP2C9 induction or competition, resulting in decreased warfarin plasma levels and reduced INR. A case report (Yuan et al. 2004) documented clinically significant INR reduction when a patient on stable warfarin therapy began taking American Ginseng. This is an induction/competition interaction that REDUCES warfarin efficacy, the opposite direction from the interaction seen with some other herbs. |
| Insulin, metformin, sulfonylureas, and other oral hypoglycemic agents (Hypoglycemic agents) | moderate | American Ginseng has well-documented blood glucose-lowering effects (Vuksan et al. RCTs: ~20% reduction in postprandial glycemia at 3 g dose). The mechanism involves delayed gastric emptying, enhanced insulin secretion, and improved insulin sensitivity. Combined use with pharmacological antidiabetic agents could produce additive hypoglycemic effects. |
| MAO inhibitors (phenelzine, tranylcypromine) (Antidepressants (MAOIs)) | theoretical | A case report with Panax ginseng (not specifically P. quinquefolius) suggested a possible interaction with phenelzine (headache, tremor, mania-like symptoms). The interaction mechanism with American Ginseng specifically is unclear and may not apply given the different ginsenoside profile, but caution is warranted given the structural similarity between species. |
| Cyclosporine, tacrolimus, and other immunosuppressants (Immunosuppressants) | theoretical | American Ginseng's immunomodulating activity (enhanced NK cell activity, increased IL-2 and IFN-gamma production) could theoretically oppose pharmacological immunosuppression. Polysaccharide-mediated immune enhancement could counteract drug-induced immunosuppression needed for graft acceptance or autoimmune disease management. |
| CYP3A4 substrates (various medications) (Various (CYP3A4-metabolized drugs)) | minor | In vitro studies suggest that some ginsenosides may modulate CYP3A4 enzyme activity (both induction and inhibition have been reported depending on the specific ginsenoside and experimental model). Clinical significance at typical oral doses is uncertain, but potential exists for altered pharmacokinetics of CYP3A4-metabolized medications. |
Pregnancy & Lactation
Pregnancy
possibly unsafe
Lactation
insufficient data
American Ginseng is classified as Class 2c by the AHPA Botanical Safety Handbook, indicating it should not be used during pregnancy and lactation without specific guidance. Although no direct teratogenic effects have been demonstrated, in vitro studies have shown that ginsenoside Rb1 and total ginsenoside fractions may affect embryonic development in animal models. One study found ginsenoside Rd induced teratogenic effects in rat embryos at high concentrations. The German Commission E and most conservative Western herbal authorities recommend avoidance during pregnancy due to insufficient safety data. Traditional Chinese medicine does not specifically contraindicate Xi Yang Shen in pregnancy but generally advises caution with qi-tonifying herbs during the first trimester. There are no clinical studies evaluating American Ginseng safety during breastfeeding.
Adverse Effects
References
Monograph Sources
- [1] Upton R, Graff A, Jolliffe G, Langer R, Williamson E (eds.). American Herbal Pharmacopoeia and Therapeutic Compendium: American Ginseng Root (Panax quinquefolius). American Herbal Pharmacopoeia, Scotts Valley, CA (2012) . ISBN: 978-1-929425-30-2
- [2] Gardner Z, McGuffin M (eds.). American Herbal Products Association Botanical Safety Handbook, 2nd edition. CRC Press/Taylor & Francis, Boca Raton, FL (2013) . ISBN: 978-1-4665-1695-7
- [3] Bensky D, Clavey S, Stoger E. Chinese Herbal Medicine: Materia Medica, 3rd edition. Eastland Press, Seattle, WA (2004) . ISBN: 978-0-939616-42-8
- [4] Mills S, Bone K. Principles and Practice of Phytotherapy: Modern Herbal Medicine. Churchill Livingstone/Elsevier, Edinburgh (2000) . ISBN: 978-0-443-06016-8
- [5] Foster S, Duke JA. A Field Guide to Medicinal Plants and Herbs of Eastern and Central North America (Peterson Field Guides). Houghton Mifflin, Boston (2000) . ISBN: 978-0-395-98814-0
Clinical Studies
- [6] Vuksan V, Sievenpiper JL, Koo VYY, Francis T, Beljan-Zdravkovic U, Xu Z, Vidgen E. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med (2000) ; 160 : 1009-1013 . DOI: 10.1001/archinte.160.7.1009 . PMID: 10761967
- [7] Vuksan V, Sievenpiper JL, Wong J, Xu Z, Beljan-Zdravkovic U, Arnason JT, Assinewe V, Stavro MP, Jenkins AL, Leiter LA, Francis T. American ginseng (Panax quinquefolius L.) attenuates postprandial glycemia in a time-dependent but not dose-dependent manner in healthy individuals. Am J Clin Nutr (2001) ; 73 : 753-758 . DOI: 10.1093/ajcn/73.4.753 . PMID: 11273850
- [8] Vuksan V, Sung MK, Sievenpiper JL, Stavro PM, Jenkins AL, Di Buono M, Lee KS, Leiter LA, Nam KY, Arnason JT, Choi M, Naeem A. 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 : 46-56 . DOI: 10.1016/j.numecd.2006.04.003 . PMID: 16860976
- [9] 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 (2004) ; 10 : 367-380 . DOI: 10.1089/107555304323062329 . PMID: 15165418
- [10] McElhaney JE, Gravenstein S, Cole SK, Davidson E, O'Neill D, Petitjean S, Rumble B, Shan JJ. A placebo-controlled trial of a proprietary extract of North American ginseng (CVT-E002) to prevent acute respiratory illness in institutionalized older adults. J Am Geriatr Soc (2004) ; 52 : 13-19 . DOI: 10.1111/j.1532-5415.2004.52004.x . PMID: 14687309
- [11] McElhaney JE, Simor AE, McNeil S, Levin ML, McGeer A, Gafni A, Jain R, Gilmour B, Graves S, Guse K, Song J, Hasan MR, Andrew MK, Shan JJ. Efficacy and safety of CVT-E002, a proprietary extract of Panax quinquefolius in the prevention of respiratory infections in influenza-vaccinated community-dwelling adults: a multicenter, randomized, double-blind, and placebo-controlled trial. Influenza Other Respir Viruses (2011) ; 5 : 141-149 . DOI: 10.1111/j.1750-2659.2011.00205.x . PMID: 21306569
- [12] Barton DL, Liu H, Dakhil SR, Linquist B, Sloan JA, Nichols CR, McGinn TW, Stella PJ, Seeger GR, Sood A, Loprinzi CL. Wisconsin ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. J Natl Cancer Inst (2013) ; 105 : 1230-1238 . DOI: 10.1093/jnci/djt181 . PMID: 23853057
- [13] Scholey A, Ossoukhova A, Owen L, Ibarra A, Pipingas A, He K, Roller M, Stough C. Effects of American ginseng (Panax quinquefolius) on neurocognitive function: an acute, randomised, double-blind, placebo-controlled, crossover study. Psychopharmacology (2010) ; 212 : 345-356 . DOI: 10.1007/s00213-010-1964-y . PMID: 20676609
- [14] Yuan CS, Wei G, Dey L, Karrison T, Nahlik L, Maleckar S, Kasza K, Ang-Lee M, Moss J. Brief communication: American ginseng reduces warfarin's effect in healthy patients: a randomized, controlled trial. Ann Intern Med (2004) ; 141 : 23-27 . DOI: 10.7326/0003-4819-141-1-200407060-00011 . PMID: 15238367
Traditional Texts
- [15] Felter HW, Lloyd JU. King's American Dispensatory, 18th edition. Ohio Valley Company, Cincinnati (1898)
- [16] Moerman DE. Native American Medicinal Plants: An Ethnobotanical Dictionary. Timber Press, Portland, OR (2009) . ISBN: 978-0-88192-987-4
- [17] Taylor DA. Ginseng, the Divine Root: The Curious History of the Plant That Captivated the World. Algonquin Books, Chapel Hill, NC (2006) . ISBN: 978-1-56512-401-1
Pharmacopeias & Reviews
- [18] National Pharmacopoeia Committee of China. Pharmacopoeia of the People's Republic of China, Volume I: Xi Yang Shen (Panacis Quinquefolii Radix). China Medical Science Press, Beijing (2020)
- [19] 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) ; 2011 : 282151 . DOI: 10.1093/ecam/nep068 . PMID: 19892762
- [20] Assinewe VA, Baum BR, Gagnon D, Arnason JT. Phytochemistry of wild populations of Panax quinquefolius L. (North American ginseng). J Agric Food Chem (2003) ; 51 : 4549-4553 . DOI: 10.1021/jf030042h . PMID: 14705876
- [21] Kitts DD, Wijewickreme AN, Hu C. Antioxidant properties of a North American ginseng extract. Mol Cell Biochem (2000) ; 203 : 1-10 . DOI: 10.1023/A:1007078414639 . PMID: 10724326
Last updated: 2026-03-02 | Status: review
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