Ginseng is a plant, and its root is widely used in dietary supplements, teas, and energy drinks. Many types of ginseng exist, but the two most popular are Panax ginseng (Korean ginseng) and Panax quinquefolius (American ginseng). Both contain ginsenosides, considered to be the active constituents of ginseng, but they differ mostly in where they are grown. Panax quinquefolius is grown mostly in North America, while Panax  ginseng is grown in Korea and northeast China. Both are similarly marketed as dietary supplements to promote brain health and enhance cognitive performance.

Panax ginseng and Panax quinquefolius seem to have similar short-term effects and might help Military Service Members boost brain health when used in small amounts. The effects of long-term use are questionable for both.

What do we know about Panax ginseng (Korean ginseng)?

Some of the latest research has shown improvements in brain health, specifically as related to performance on attention and memory-related tasks up to 6 hours after a single use of 200-400 mg of Panax ginseng. No such effects have been reported with amounts greater than 400 mg.

The research into any long-term benefit for healthy adults taking Panax ginseng to boost brain health and performance is minimal. Small studies have shown improvements in a few attention-related tasks for those who consume 200 mg Panax ginseng daily, up to 12 weeks. No studies have been conducted for longer than 12 weeks.  

What do we know about Panax quinquefolius (American ginseng)?

Less research has been done on Panax quinquefolius. However, the latest research has shown effects similar to those of Panax ginseng after a single use of 100–400 mg Panax guinquefolius. There have been no long-term studies on the effects of Panax quinquefolius on brain health.

Can either type help boost brain health?

Some research shows that Panax ginseng and Panax quinquefolius might help boost brain health over the short-term when taken in small amounts. However, larger studies are needed to confirm the benefits of taking either type to help boost brain health and optimize cognitive performance in healthy individuals.

How is ginseng listed on product labels of dietary supplements, teas, and energy drinks?

Panax ginseng and Panax quinquefolius are the two most common types of ginseng in dietary supplement products marketed for brain health. They should not be confused with other types, such as Siberian ginseng (from the root of Eleutherococcus senticosus), which does not contain ginsenosides. However, the way ginseng is listed on product labels can be confusing. A standardized extract of Panax ginseng is often labeled “G115,” which means certain processes were carried out to enure the quality of the ingredient (including the presence of 4% ginsenosides). Panax quinquefolius is often shown on labels as “American ginseng.” Teas and energy drinks also commonly contain ginseng listed as “American ginseng” or Panax ginseng, but other times you will just see “ginseng” or “ginseng root” or “ginseng extract.” In this case you can’t tell what the ingredient is. In dietary supplements, ginseng is sometimes combined with other ingredients in a proprietary blend, in which case you also can’t tell how much is included.

Are these types of ginseng safe for a Military Service Member?

Panax ginseng and Panax quinquefolius are likely safe for adults when used short term and in small amounts (less than 400 mg per day). Common minor side effects with both types include insomnia, headache, and stomach upset. Long-term use (continuous use past 6 months) could be unsafe. Severe effects reported seem to be more common with combination products where it is challenging to know which of the ingredients could be responsible for the effects. Both types of ginseng might be unsafe for women who are pregnant or breast-feeding, as well as for infants and children.

If you can’t tell what type of ginseng, or how much ginseng, is in a product, then you don’t know if it’s safe or not!

The U.S. Food and Drug Administration (FDA) has issued warning letters to some manufacturers of “ginseng” dietary supplements for making false health claims. In addition, testing of some products with ginseng has shown that these products do not always contain what’s on the product label, which means that ginseng dietary supplements might be misbranded or adulterated. Ginseng could intensify the effects of stimulants such as caffeine and could be dangerous when combined with certain medications. It’s important to consult a pharmacist or doctor before you take any ginseng products.

Can ginseng produce a positive result on a military drug-screening test?

The dietary supplement ingredient ginseng, of any type, is not prohibited for use by Military Service Members and should not register on a routine military drug-screening test.

The evidence presented in this article is only for healthy individuals using Panax ginseng or Panax quinquefolius to boost brain health and cognitive performance. It does not represent the evidence for ginseng combined with other ingredients, or for those experiencing cognitive decline.

References

Al-kuraisy, H., & Al-Gareeb, A. (2017). Eustress and malondialdehyde (MDA): Role of Panax ginseng: Randomized, placebo controlled study. Iranian Journal of Psychiatry, 12(3), 194–200.

Baek, J. H., Heo, J.-Y., Fava, M., Mischoulon, D., Choi, K. W., Na, E. J., . . . Jeon, H. J. (2019). Effect of Korean red ginseng in individuals exposed to high stress levels: A 6-week, double-blind, randomized, placebo-controlled trial. Journal of Ginseng Research, 43(3), 402–407. doi:10.1016/j.jgr.2018.03.001

Bilia, A. R., & Bergonzi, M. C. (2020). The G115 standardized ginseng extract: An example for safety, efficacy, and quality of an herbal medicine. Journal of Ginseng Research, 44(2), 179–193. doi:10.1016/j.jgr.2019.06.003

Carlile, P. V. (2015). Unexplained alveolar hemorrhage associated with ginkgo and ginseng use. Journal of Bronchology & Interventional Pulmonology, 22(2), 170–172. doi:10.1097/lbr.0000000000000150

Chen, S. X., & Cohen, P. R. (2018). The ginseng pimple: An inflammatory papule following ginseng consumption. Dermatology Online Journal, 24(9), Article 17.  Retrieved from https://escholarship.org/uc/item/7s87z6cc

Cho, J., Park, W., Lee, S., Ahn, W., & Lee, Y. (2004). Ginsenoside-Rb1 from Panax ginseng C.A. Meyer activates estrogen receptor-α and -β, independent of ligand binding. The Journal of Clinical Endocrinology & Metabolism, 89(7), 3510–3515. doi:10.1210/jc.2003-031823

Coon, J. T., & Ernst, E. (2002). Panax ginseng. Drug Safety, 25(5), 323–344. doi:10.2165/00002018-200225050-00003

Cui, S., Wu, J., Wang, J., & Wang, X. (2017). Discrimination of American ginseng and Asian ginseng using electronic nose and gas chromatography–mass spectrometry coupled with chemometrics. Journal of Ginseng Research, 41(1), 85–95. doi:10.1016/j.jgr.2016.01.002

D'Angelo, L., Grimaldi, R., Caravaggi, M., Marcoli, M., Perucca, E., Lecchini, S., . . . Crema, A. (1986). A double-blind, placebo-controlled clinical study on the effect of a standardized ginseng extract on psychomotor performance in healthy volunteers. Journal of Ethnopharmacology, 16(1), 15–22. doi:10.1016/0378-8741(86)90063-2

Fukumoto, Y., Ong Lai Teik, D., Lee, X. S., Lim, C. J., Low, C. M., Muslima, M., & Aquili, L. (2016). Ginseng and Ginkgo biloba effects on cognition as modulated by cardiovascular reactivity: A randomised trial. Plos One, 11(3), Article e0150447. doi:10.1371/journal.pone.0150447

Ichim, M. C., & de Boer, H. J. (2021). A review of authenticity and authentication of commercial ginseng herbal medicines and food supplements. Frontiers in Pharmacology, 11, Article 612071. doi:10.3389/fphar.2020.612071

Kennedy, D. O., Haskell, C. F., Wesnes, K. A., & Scholey, A. B. (2004). Improved cognitive performance in human volunteers following administration of guarana (Paullinia cupana) extract: Comparison and interaction with Panax ginseng. Pharmacology Biochemistry and Behavior, 79(3), 401–411. doi:10.1016/j.pbb.2004.07.014

Kennedy, D. O., Reay, J. I., & Scholey, A. B. (2007). Effects of 8 weeks administration of Korean Panax ginseng extract on the mood and cognitive performance of healthy individuals. Journal of Ginseng Research, 31(1), 34–43. doi:10.5142/jgr.2007.31.1.034

Kennedy, D. O., Scholey, A. B., & Wesnes, K. A. (2002). Modulation of cognition and mood following administration of single doses of Ginkgo biloba, ginseng, and a ginkgo/ginseng combination to healthy young adults. Physiology & Behavior, 75(5), 739–751. doi:10.1016/s0031-9384(02)00665-0

Kim, D.-H. (2012). Chemical Diversity of Panax ginseng, Panax quinquifolium, and Panax notoginseng. Journal of Ginseng Research, 36(1), 1–15. doi:10.5142/jgr.2012.36.1.1

LaSala, G. S., McKeever, R. G., Patel, U., Okaneku, J., Vearrier, D., & Greenberg, M. I. (2015). Effect of single-dose Ginkgo biloba and Panax ginseng on driving performance. Clinical Toxicology, 53(2), 108–112. doi:10.3109/15563650.2014.999159

Norelli, L. J., & Xu, C. (2014). Manic psychosis associated with ginseng: A report of two cases and discussion of the literature. Journal of Dietary Supplements, 12(2), 119–125. doi:10.3109/19390211.2014.902001

Ossoukhova, A., Owen, L., Savage, K., Meyer, M., Ibarra, A., Roller, M., . . . Scholey, A. (2015). Improved working memory performance following administration of a single dose of American ginseng (Panax quinquefolius L.) to healthy middle-age adults. Human Psychopharmacology: Clinical and Experimental, 30(2), 108–122. doi:10.1002/hup.2463

Reay, J. L., Kennedy, D. O., & Scholey, A. B. (2006). Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained ‘mentally demanding’ tasks. Journal of Psychopharmacology, 20(6), 771–781. doi:10.1177/0269881106061516

Reay, J. L., Kennedy, D. O., & Scholey, A. B. (2016). Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity. Journal of Psychopharmacology, 19(4), 357–365. doi:10.1177/0269881105053286

Reay, J. L., Scholey, A. B., & Kennedy, D. O. (2010). Panax ginseng (G115) improves aspects of working memory performance and subjective ratings of calmness in healthy young adults. Human Psychopharmacology: Clinical and Experimental, 25(6), 462–471. doi:10.1002/hup.1138

Scholey, A., Ossoukhova, A., Owen, L., Ibarra, A., Pipingas, A., He, K., . . . Stough, C. (2010). Effects of American ginseng (Panax quinquefolius) on neurocognitive function: An acute, randomised, double-blind, placebo-controlled, crossover study. Psychopharmacology, 212(3), 345–356. doi:10.1007/s00213-010-1964-y

Scholey, A. B., & Kennedy, D. O. (2002). Acute, dose-dependent cognitive effects of Ginkgo biloba, Panax ginseng and their combination in healthy young volunteers: Differential interactions with cognitive demand. Human Psychopharmacology: Clinical and Experimental, 17(1), 35–44. doi:10.1002/hup.352

Sünram-Lea, S. I., Birchall, R. J., Wesnes, K. A., & Petrini, O. (2005). The effect of acute administration of 400mg of Panax ginseng on cognitive performance and mood in healthy young volunteers. Current Topics in Nutraceutical Research, 3(1), 65–74.

U.S. Food & Drug Administration. (2016). Warning Letter: Hus’s Ginseng Enterprises, Inc.   Retrieved 4 February 2021 from https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/hsus-ginseng-enterprises-inc-495527-07222016

U.S. Food & Drug Administration. (2017). Warning Letter: C K Solutions, Inc.   Retrieved 4 February 2021 from https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/c-k-solutions-inc-528543-08102017

U.S. Food & Drug Administration. (2019). Warning Letter: Uustar Corporation dba Daily Vita, LLC.   Retrieved 4 February 2021 from https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/uustar-corporation-dba-daily-vita-llc-570337-03122019

Viviano, A., Steele, D., Edsell, M., & Jahangiri, M. (2017). Over-the-counter natural products in cardiac surgery: A case of ginseng-related massive perioperative bleeding. BMJ Case Reports, 2017, Article bcr-2016-218068. doi:10.1136/bcr-2016-218068

Yeo, H.-B., Yoon, H.-K., Lee, H.-J., Kang, S.-G., Jung, K.-Y., & Kim, L. (2012). Effects of Korean red ginseng on cognitive and motor function: A double-blind, randomized, placebo-controlled trial. Journal of Ginseng Research, 36(2), 190–197. doi:10.5142/jgr.2012.36.2.190