Editing Ginseng

{{Short description|Root of a plant used in herbal preparations}}
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{{About|the root of plants in the genus Panax|the town|Ginseng, Kentucky}}{{Use mdy dates|date=February 2024}}
[[Image:Insam (ginseng).jpg|thumb|right|330px|A root of cultivated [[Korean ginseng]] ''(Panax ginseng)'']]

'''Ginseng''' ({{IPAc-en|ˈ|dʒ|ɪ|n|s|ɛ|ŋ}})<ref>{{cite encyclopedia | encyclopedia = Cambridge Dictionaries Online | title = Ginseng | url = http://dictionary.cambridge.org/dictionary/british/ginseng?topic=common-plants | access-date = June 4, 2011}}</ref> is the root{{efn|Traditionally the rhizome is harvested with the root, but discarded during processing. This practice is not called for in the oldest ''Shennong Ben Cao Jing'' text, but ''Huashi Zhong Cangjing'' (allegedly Han Dynasty, actually Song Dynasty) claims that the rhizome causes vomiting and destroys ''qi'', hence it should be removed. Modern Chinese clinical trials have not found such an effect, and the "vomiting" aspect is now believed to be a misrepresentation of an alleged [[expectorant]] activity of the rhizome. The rhizome also contains higher phytochemical conentrations. The ''[[Pharmacopoeia of the People's Republic of China]]'' includes the rhizome as "ginseng" since its 2005 edition.<ref>{{cite journal |author=王春来 |title=对人参芦头入药原因的探讨 |trans-title=On the reasons for using ginseng rhizome for medicine |url=https://www.doc88.com/p-3106798851011.html |journal=光明中医 |date=2013 |volume=28 |issue=7 |pages=2 |doi=10.3969/j.issn.1003-8914.2013.07.113}}</ref>}} of plants in the genus ''[[Panax]]'', such as South China ginseng (''[[Panax notoginseng|P.&nbsp;notoginseng]]''), Korean ginseng (''[[Panax ginseng|P.&nbsp;ginseng]]''), and American ginseng (''[[American ginseng|P.&nbsp;quinquefolius]]''), characterized by the presence of [[ginsenoside]]s and [[gintonin]]. Ginseng is common in the cuisines and medicines of China and [[Korea]].

Ginseng has been used in [[traditional medicine]] over centuries, though modern [[clinical research]] is inconclusive about its medical effectiveness.<ref name="drugs">{{cite web |title=Ginseng |url=https://www.drugs.com/npp/ginseng.html |publisher=Drugs.com |access-date=21 February 2024|date=30 November 2022}}</ref><ref name="nccih2">{{cite web|url=https://nccih.nih.gov/health/asianginseng/ataglance.htm|title=Asian ginseng|date=August 2020|publisher=National Center for Complementary and Integrative Health, US National Institutes of Health|location=Bethesda, MD}}</ref> There is no substantial evidence that ginseng is effective for treating any medical condition and it has not been approved by the US [[Food and Drug Administration]] (FDA) to treat or prevent a disease or to provide a health benefit.<ref name=drugs/><ref name=nccih2/><ref>{{Cite web |last=Research |first=Center for Drug Evaluation and |date=2023-07-18 |title=Development & Approval Process {{!}} Drugs |url=https://www.fda.gov/drugs/development-approval-process-drugs |archive-url=https://web.archive.org/web/20190504035841/https://www.fda.gov/drugs/development-approval-process-drugs |url-status=dead |archive-date=May 4, 2019 |access-date=2025-05-11 |website=FDA |language=en}}</ref> Although ginseng is sold as a [[dietary supplement]], inconsistent manufacturing practices for supplements have led to analyses of some ginseng products contaminated with unrelated [[filler (materials)|filler compounds]], and its excessive use may have [[adverse effect]]s or untoward interactions with [[prescription drug]]s.<ref name=drugs/><ref name=":3">{{Cite web |date=2015-02-03 |title=Herbal supplements filled with fake ingredients, New York Attorney General Eric Schneiderman finds - CBS News |url=https://www.cbsnews.com/news/herbal-supplements-targeted-by-new-york-attorney-general/ |access-date=2025-05-11 |website=www.cbsnews.com |language=en-US}}</ref>

== History ==
One of the first written texts covering the use of ginseng as a medicinal herb was the ''[[Shennong Ben Cao Jing|Shen Nong Pharmacopoeia]]'', written in China in 196 AD. In his ''[[Compendium of Materia Medica]]'' herbal of 1596, [[Li Shizhen]] described ginseng as a "superior tonic". However, the herb was not used as a "cure-all" medicine, but more specifically as a tonic for patients with [[chronic illnesses]] and those who were convalescing.<ref name=Mahady>{{cite book|author1=Mahady, Gail B. |author2=Fong, Harry H.S. |author3=Farnsworth, N.R. |title=Botanical Dietary Supplements |url=https://books.google.com/books?id=TiU-Dz2wxyAC&pg=PA207 |year=2001 |publisher=CRC Press |isbn=978-90-265-1855-3 |pages=207–215}}</ref> Control over ginseng fields in China and Korea became an issue in the 16th century.<ref>{{cite journal | last1 = Kim | first1 = Seonmin | year = 2007 | title = Ginseng and Border Trespassing Between Qing China and Choson Korea | journal = Late Imperial China | volume = 28 | issue = 1| pages = 33–61 | doi=10.1353/late.2007.0009| s2cid = 143779357 }}</ref>

==In folk belief==
In Chinese folk tales from the northeastern regions, ginseng is said to transform into children, often depicted with skyward-reaching braids, sometimes tied with red ribbons, and occasionally dressed in bellybands. In these stories, a ginseng child will typically enter a house to play with another child. However, if the adults tie a red ribbon around the child's feet, the child vanishes. When they follow the ribbon, they find it tied to a blade of grass, and upon digging, they uncover a ginseng root.<ref>{{cite book |url=https://books.google.com/books?id=kMEFvgEACAAJ |title=人参娃娃 |date=2016 |publisher=外语教学与研究出版社 |isbn=978-7-5135-8200-1 |page=5 |language=zh |trans-title=Ginseng Doll}}</ref>

== Ginseng species ==
Ginseng plants belong only to the genus ''[[Panax]]''.<ref name="CMHP" /> Cultivated species include ''[[Panax ginseng]]'' (Korean ginseng), ''[[Panax japonicus]]'' (Japanese ginseng), ''[[Panax notoginseng]]'' (South China ginseng), ''[[American ginseng|Panax quinquefolius]]'' (American ginseng).<ref name="baeg" /> Ginseng is found in cooler climates – Korean Peninsula, Northeast China, [[Russian Far East]], Canada and the United States, although some species grow in warm regions – South China ginseng being native to Southwest China and Vietnam. ''[[Panax vietnamensis]]'' (Vietnamese ginseng) is the southernmost ''Panax'' species known.{{cn|date=October 2023}}

== Wild and cultivated ginseng ==
=== Wild ginseng ===

Wild ginseng ({{Korean|hangul=산삼|hanja=山蔘|rr=sansam|lit=mountain ginseng}}) grows naturally in mountains and is hand-picked by gatherers known as ''simmani'' ({{Korean|hangul=심마니|labels=no}}).<ref name=":4">{{Cite web |date=2012-07-26 |title=All about wild ginseng - The Korea Times |url=https://www.koreatimes.co.kr/lifestyle/travel-food/20120726/all-about-wild-ginseng |access-date=2025-05-11 |website=www.koreatimes.co.kr |language=en}}</ref> The wild ginseng plant is almost extinct in China and endangered globally.<ref>{{Cite web|title=Ginseng Varieties and Glossary - NYS Dept. of Environmental Conservation|url=https://www.dec.ny.gov/animals/7474.html|access-date=July 29, 2020|website=www.dec.ny.gov|archive-date=October 13, 2020|archive-url=https://web.archive.org/web/20201013194355/https://www.dec.ny.gov/animals/7474.html}}</ref> This is due to high demand for the product in recent years, leading to the harvesting of wild plants faster than they can grow and reproduce (a wild ginseng plant can take years to reach maturity<ref>{{Cite web|date=October 5, 2015|title=Getting Started Right for Successful Ginseng Production|url=https://smallfarms.cornell.edu/2015/10/ginseng-production/|access-date=July 29, 2020|website=Cornell Small Farms|language=en-US}}</ref>). Wild ginseng can be processed to be red or white ginseng.<ref>{{Cite web|title=Red ginseng - White ginseng: What is the difference?|url=https://www.florafarm.de/red-ginseng-white-ginseng_1|access-date=July 29, 2020|website=www.florafarm.de|archive-date=September 16, 2020|archive-url=https://web.archive.org/web/20200916072003/https://www.florafarm.de/red-ginseng-white-ginseng_1}}</ref> Wild American ginseng has long been used by [[Indigenous peoples of the Americas|Native American]]s for medicine.<ref name=":1">{{Cite web|title=American Ginseng|url=https://www.fws.gov/international/plants/american-ginseng.html|access-date=July 29, 2020|website=www.fws.gov}}</ref><ref>{{Cite web|last1=Farmer|first1=Sarah|last2=Communications|first2=SRS Science|title=American Ginseng, in the Forest and in the Marketplace|url=https://www.srs.fs.usda.gov/compass/2020/05/07/american-ginseng-in-the-forest-and-in-the-marketplace/|access-date=July 29, 2020|website=CompassLive|language=en-US}}</ref><ref>{{Cite web |last=Taylor |first=David A. |title=Getting to the Root of Ginseng |url=https://www.smithsonianmag.com/science-nature/getting-to-the-root-of-ginseng-65654374/ |access-date=2025-05-11 |website=Smithsonian Magazine |language=en}}</ref> Since the mid-1700s, it has been harvested for international trade.<ref name=":1" /> Wild American ginseng can be harvested in 19 states and the [[Appalachian Mountains]] but has restrictions for exporting.<ref name=":1" /><ref>{{Cite web|title=Wild American Ginseng Information for Dealers and Exporters|url=https://www.fws.gov/international/pdf/factsheet-american-ginseng-harvesters-dealers-exporters.pdf|access-date=July 29, 2020|website=U.S. Fish & Wildlife Service}}</ref><ref>{{Cite web|title=Ginseng|url=https://www.dcnr.pa.gov:443/Conservation/WildPlants/Ginseng/Pages/default.aspx|access-date=July 29, 2020|website=Pennsylvania Department of Conservation & Natural Resources|language=en-US}}</ref>

<gallery>
File:Wild ginseng.jpg|Wild [[Panax ginseng|Korean ginseng]] (''P. ginseng'')
File:American Ginseng 3.jpg|Wild [[Panax quinquefolius|American ginseng]] (''P. quinquefolius'')
</gallery>

=== Cultivated ginseng ===

Cultivated ginseng ({{Korean|hangul=인삼|hanja=人蔘|rr=insam|lit=human ginseng}}) is less expensive than the rarely available wild ginseng.<ref name=":4" />

Cultivated ginseng ({{Korean|hangul=장뇌삼|hanja=長腦蔘|rr=jangnoesam}}) is planted on mountains by humans and is allowed to grow like wild ginseng.<ref name=":4" />

<gallery>
File:인삼사진.jpg|Cultivated [[Panax ginseng|Korean ginseng]] (''P. ginseng'')
File:Americanginseng.jpg|Cultivated [[Panax quinquefolius|American ginseng]] (''P. quinquefolius'')
</gallery>

== Ginseng processing ==
[[File:Preserved ginseng.png|thumb|254x254px|Cultivated ginseng]]
Ginseng seed normally does not germinate until the second spring following the harvest of berries in autumn. They must first be subjected to a long period of storage in a moist medium with a warm/cold treatment, a process known as [[Stratification (botany)|stratification]].<ref>{{cite web|url=https://content.ces.ncsu.edu/care-and-planting-of-ginseng-seed-and-roots|title=Care and Planting of Ginseng Seed and Roots|date=March 31, 2010|publisher=North Carolina State University|access-date=June 20, 2017|archive-date=September 24, 2019|archive-url=https://web.archive.org/web/20190924223435/https://content.ces.ncsu.edu/care-and-planting-of-ginseng-seed-and-roots}}</ref>

=== Fresh ginseng ===
Fresh ginseng ({{Korean|hangul=수삼|hanja=水蔘|rr=susam|lit=water ginseng}}), also called "green ginseng", is non-dried raw product.<ref name="PK">{{Cite news|url=https://books.google.com/books?id=AL1m1NDch4MC|title=Teas Made from Ginseng, Jujubes and Omija|date=June 2000|work=[[Pictorial Korea]]|access-date=January 2, 2018|agency=[[Korean Overseas Culture and Information Service]]|location=Seoul, Korea|page=31}}</ref> Its use is limited by availability.{{cn|date=February 2024}}

<gallery>
File:Punggi-insam.jpg|Fresh ginseng (''[[Panax ginseng|P. ginseng]]'')
</gallery>

=== White ginseng ===

White ginseng ({{Korean|hangul=백삼|hanja=白蔘|rr=baeksam|lit=white ginseng}}) is peeled and dried&nbsp;ginseng.<ref name="PK" /> White ginseng is fresh ginseng which has been dried without being heated. It is peeled and dried to reduce the water content to 12% or less.<ref name="PK" /> Drying in the sun bleaches the root to a yellowish-white color.{{cn|date=February 2024}}

=== Red ginseng ===
Red&nbsp;ginseng ({{CJKV|t=紅蔘|s=红参|p=hóngshēn|k=홍삼|rr=hongsam|l=red ginseng}}) is steamed and dried ginseng, which has reddish color.<ref name="PK" /> Red ginseng is less vulnerable to decay than white ginseng.<ref name="Fulder">{{Cite book|url=https://books.google.com/books?id=GkDW9hdYJIcC&pg=PA300|title=The book of ginseng|last=Fulder|first=Stephen|publisher=[[Healing Arts Press]]|year=1993|isbn=0-89281-491-8|edition=2nd|location=Rochester, VT|page=300|access-date=January 2, 2018}}</ref> It is ginseng that has been peeled, heated through steaming at standard boiling temperatures of {{convert|100|°C|0|abbr=on}}, and then dried or sun-dried. It is frequently marinated in an herbal brew which results in the root becoming extremely brittle.{{cn|date=February 2024}}
<gallery>
File:Korean red ginseng.jpg|Red ginseng (''[[Panax ginseng|P. ginseng]]'')
</gallery>

== Production ==
Commercial ginseng is sold in over 35 countries, with China as the largest consumer. In 2013, global sales of ginseng exceeded $2 billion, of which half was produced by South Korea.<ref name="baeg">{{cite journal|last1=Baeg|first1=In-Ho|last2=So|first2=Seung-Ho|year=2013|title=The world ginseng market and the ginseng|journal=Journal of Ginseng Research|volume=37|issue=1|pages=1–7|doi=10.5142/jgr.2013.37.1|pmc=3659626|pmid=23717152}}</ref> In the early 21st century, 99% of the world's 80,000 tons of ginseng was produced in just four countries: China (44,749 tons), South Korea (27,480 tons), Canada (6,486 tons), and the United States (1,054 tons).<ref name=baeg/> All ginseng produced in [[South Korea]] is [[Korean ginseng]] (''P. ginseng''), while ginseng produced in China includes ''P. ginseng'', [[South China ginseng]] (''P. notoginseng''),<ref name="baeg" /> and the recently introduced [[American ginseng]] (''P. quinquefolius'').<ref name="FoC:200015253">{{eFloras |2 |200015253 |Panax quinquefolius |family=Araliaceae |first1=Qibai |last1=Xiang |first2=Porter P. |last2=Lowry |access-date=25 December 2023}}</ref> Ginseng produced in Canada and the United States is mostly ''P. quinquefolius''.<ref name="baeg" /><ref name="MAFRA">{{cite web|url=http://www.mafra.go.kr/bbs/mafra/71/219856/download.do|title=2016-nyeon insam tonggye-jaryo-jip|date=May 2017|website=[[Ministry of Agriculture, Food and Rural Affairs (South Korea)|Ministry of Agriculture, Food and Rural Affairs]]|pages=2–4|language=ko|trans-title=Source book of ginseng statistics 2016 (in Korean)|format=PDF|access-date=February 24, 2018}}
* {{cite web |script-title=ko:정책분야별 자료 |url=http://www.mafra.go.kr/mafra/366/subview.do?enc=Zm5jdDF8QEB8JTJGYmJzJTJGbWFmcmElMkY3MSUyRjMwNTM3MyUyRmFydGNsVmlldy5kbyUzRg%3D%3D |date=June 7, 2017 |website=Ministry of Agriculture, Food and Rural Affairs |language=ko | title=K2WebWizard }}</ref>

As of 2020, global ''P. ginseng'' and ''P. quinquefolius'' production each sum to an approximate 7,000&nbsp;tons on a dry-weight basis. On a dry-weight basis, 70% of ''P. ginseng'' and 30% of ''P. quinquefolius'' is produced in China; 60% of ''P. quinquefolius'' is produced in Canada; and 10% of ''P. quinquefolius'' is produced in the US. ''P. ginseng'' is also cultivated in Japan.<ref>{{cite journal |author1=张绍国 |author2=李得运 |author3=于志斌 |title=全球视角下的参类贸易格局及产业发展建议 |trans-title=Ginseng [P. ginseng & P. quinquefolius] trade pattern and industrial development suggestions from a global perspective|journal=中国现代中药 |date=2022 |volume=24 |issue=8 |pages=1568–1573 |url=https://www.fx361.cc/page/2022/0907/11918061.shtml |language=zh-CN}}</ref>

== Uses ==
Ginseng may be included in [[energy drinks]] or [[herbal tea]]s in small amounts or sold as a [[dietary supplement]].<ref name=drugs/><ref name="nccih2"/><ref name=":3" /><ref name="liu">{{cite web |author1=Lindsy Liu |date=2019 |title=Side effects of ginseng supplements |url=https://www.poison.org/articles/side-effects-of-ginseng-supplements-191 |access-date=April 1, 2019 |publisher=US National Capital Poison Center}}</ref>

=== Food or beverage ===
The root is most often available in dried form, either whole or sliced. In [[Korean cuisine]], ginseng is used in various ''[[banchan]]'' (side dishes) and ''[[guk]]'' (soups), as well as [[Korean tea|tea]] and [[Korean alcoholic beverages|alcoholic beverages]].<ref name=":2">{{Cite journal|last1=Oktay|first1=Serdar|last2=Ekinci|first2=Erhun Kemal|date=July 17, 2019|title=Medicinal food understanding in Korean gastronomic culture|journal=Journal of Ethnic Foods|volume=6|issue=1|page=4|doi=10.1186/s42779-019-0003-9|issn=2352-6181|doi-access=free}}</ref> Ginseng-infused tea and [[liquor]], known as ''[[Ginseng tea|insam-cha]]'' ({{literal|ginseng tea}}) and ''[[insam-ju]]'' ('ginseng liquor') is consumed.<ref name=":2"/> Ginseng leaves are also used to prepare foods and beverages. Leaves are used to prepare Asian soups, steamed with chicken or combined with ginger, dates, and pork, or are eaten fresh.<ref>{{Cite web |last=Features |first=Mary H. Dyer last updated in |date=2019-07-17 |title=Is Ginseng Edible – Information On Edible Ginseng Plant Parts |url=https://www.gardeningknowhow.com/edible/herbs/ginseng/is-ginseng-edible.htm |access-date=2025-05-11 |website=Gardening Know How |language=en}}</ref><ref>{{Cite journal|last1=Wang|first1=Hongwei|last2=Peng|first2=Dacheng|last3=Xie|first3=Jingtian|date=October 22, 2009|title=Ginseng leaf-stem: bioactive constituents and pharmacological functions|journal=Chinese Medicine|volume=4|page=20|doi=10.1186/1749-8546-4-20|issn=1749-8546|pmc=2770043|pmid=19849852 |doi-access=free }}</ref>

<gallery>
File:Insam-twigim.jpg|''Insam-[[twigim]]'' (ginseng fritters)
File:Korean soup-Samgyetang-11.jpg|''[[Samgye-tang]]'' (ginseng chicken soup)
File:Insam-cha and yugwa.jpg|''[[Insam-cha]]'' (ginseng tea) and ''[[yugwa]]'' (rice puffs)
File:Insamju (ginseng liquor).jpg|''[[Insam-ju]]'' (ginseng liquor)
File:Korea-Sokcho-Sansamju-Wild ginseng wine-02.jpg|''[[Sansam-ju]]'' (wild ginseng liquor)
</gallery>

===Traditional medicine and phytochemicals===
Although ginseng has been used in [[traditional medicine]] for centuries, there is no good evidence it causes any improvement of health or lowers the risk of any disease.<ref name=":0">{{Cite journal|last1=Lee|first1=Hye Won|last2=Lee|first2=Myeong Soo|last3=Kim|first3=Tae-Hun|last4=Alraek|first4=Terje|last5=Zaslawski|first5=Chris|last6=Kim|first6=Jong Wook|last7=Moon|first7=Du Geon|date=April 19, 2021|title=Ginseng for erectile dysfunction|journal=The Cochrane Database of Systematic Reviews|volume=2021|issue=4|pages=CD012654|doi=10.1002/14651858.CD012654.pub2|issn=1469-493X|pmc=8094213|pmid=33871063}}</ref><ref name="mlp-pan">{{cite web |date=9 October 2023 |title=Panax ginseng |url=https://medlineplus.gov/druginfo/natural/1000.html |access-date=21 February 2024 |publisher=MedlinePlus, National Library of Medicine, US National Institutes of Health}}</ref><ref name="mlp-us">{{cite web |date=19 January 2023 |title=American ginseng |url=https://medlineplus.gov/druginfo/natural/967.html |access-date=21 February 2024 |publisher=MedlinePlus, National Library of Medicine, US National Institutes of Health}}</ref> [[Clinical research]] indicates there are no confirmed effects on memory, fatigue, [[menopause]] symptoms, and [[insulin response]] in people with mild [[diabetes]].<ref name="nccih2"/> A 2021 review indicated that ginseng had "only trivial effects on erectile function or satisfaction with intercourse compared to placebo".<ref name=":0" /> Although the roots are used in [[traditional Chinese medicine]], the leaves and stems contain larger quantities of the [[phytochemical]]s than the roots, and are easier to harvest.<ref>{{cite journal|author1=Hongwei Wang |author2=Dacheng Peng |author3=Jingtian Xie |year=2009|title=Ginseng leaf-stem: bioactive constituents and pharmacological functions|journal=Chinese Medicine|volume=4|issue=20|page=20|doi=10.1186/1749-8546-4-20|pmid=19849852 |pmc=2770043 |doi-access=free }}</ref> The constituents include [[steroid]] [[saponin]]s known as [[ginsenoside]]s, as well as [[polyacetylene]]s, [[polysaccharide]]s, [[peptidoglycan]]s, and [[polyphenol]]s, among other compounds.<ref name="drugs" /><ref name="mlp-pan" /><ref name="pmid30000873" /><ref name="Attele">{{cite journal|last1=Attele|first1=AS|last2=Wu|first2=J.A.|last3=Yuan|first3=C.S.|year=1999|title=Ginseng pharmacology: multiple constituents and multiple actions.|journal=Biochemical Pharmacology|volume=58|issue=11|pages=1685–1693|doi=10.1016/s0006-2952(99)00212-9|pmid=10571242}}</ref><ref>{{Cite web |title=Nước hồng sâm hàn quốc |trans-title=Korean red ginseng water |url=https://kojamart.com/nuoc-hong-sam/ |access-date=2025-05-11 |website=KOJAMART |language=vi}}</ref> Ginsenosides from the leaves and stem ({{lang|zh|人参茎叶总皂苷}}) is an approved over-the-counter medication in China. The indication is written in traditional Chinese medicine language.<ref>{{cite web |title=人参茎叶总皂苷片 说明书 |url=https://ypk.39.net/808083/manual/ |website=39药品通|trans-title=Asian ginseng root and stem saponin tablets, package insert}}</ref>

===FDA warning letters===
As of 2019, the United States [[Food and Drug Administration|FDA]] and [[Federal Trade Commission]] have issued numerous [[FDA warning letter|warning letters]] to manufacturers of ginseng dietary supplements for making false claims of health or anti-disease benefits, stating that the "products are not [[generally recognized as safe]] and effective for the referenced uses" and are illegal as unauthorized "new drugs" under federal law.<ref name="fda1">{{cite web |author1=William A. Correll Jr |author2=Mary K. Engle |title=Warning letter: TEK Naturals |url=https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm630654.htm |archive-url=https://web.archive.org/web/20190212010554/https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm630654.htm |url-status=dead |archive-date=February 12, 2019 |publisher=Inspections, Compliance, Enforcement, and Criminal Investigations, Office of Compliance, Center for Food Safety and Applied Nutrition, US Food and Drug Administration; US Federal Trade Commission |access-date=April 1, 2019 |date=February 5, 2019}}</ref><ref name="fda2">{{cite web |author=William R. Weissinger|title=Warning letter: Baker's Best Health Products, Inc. |url=https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm606875.htm |archive-url=https://web.archive.org/web/20180725220200/https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm606875.htm |url-status=dead |archive-date=July 25, 2018 |publisher=Inspections, Compliance, Enforcement, and Criminal Investigations, Office of Compliance, Center for Food Safety and Applied Nutrition, US Food and Drug Administration |access-date=April 1, 2019 |date=April 25, 2018}}</ref><ref name="fda3">{{cite web |author=Cheryl A. Bigham|title=Warning letter: Amerigo Labs LLC |url=https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm604177.htm|archive-url=https://web.archive.org/web/20180423191745/https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/ucm604177.htm|url-status=dead|archive-date=April 23, 2018|publisher=Inspections, Compliance, Enforcement, and Criminal Investigations, Office of Compliance, Center for Food Safety and Applied Nutrition, US Food and Drug Administration |access-date=April 1, 2019 |date=April 4, 2018}}</ref>

=== Animal feed ===
A tincture of Korean ginseng is approved by the [[EFSA]] for use in horses, dogs, and cats as a sensory additive (animal feed flavoring). Within the provided dose limits, the tincture is considered non-toxic.<ref>{{cite journal |last1=Bampidis |first1=Vasileios |last2=Azimonti |first2=Giovanna |last3=Bastos |first3=Maria de Lourdes |last4=Christensen |first4=Henrik |last5=Durjava |first5=Mojca |last6=Kouba |first6=Maryline |last7=López-Alonso |first7=Marta |last8=Puente |first8=Secundino López |last9=Marcon |first9=Francesca |last10=Mayo |first10=Baltasar |last11=Pechová |first11=Alena |last12=Petkova |first12=Mariana |last13=Ramos |first13=Fernando |last14=Villa |first14=Roberto Edoardo |last15=Woutersen |first15=Ruud |last16=Brantom |first16=Paul |last17=Chesson |first17=Andrew |last18=Schlatter |first18=Josef |last19=Westendorf |first19=Johannes |last20=Dirven |first20=Yvette |last21=Manini |first21=Paola |last22=Dusemund |first22=Birgit |title=Safety and efficacy of a feed additive consisting of a tincture derived from the roots of Panax ginseng C.A.Mey. (ginseng tincture) for horses, dogs and cats (FEFANA asbl) |journal=EFSA Journal |date=1 April 2024 |volume=22 |issue=4 |doi=10.2903/j.efsa.2024.8730|pmc=11000137 }}</ref> A dried extract of Korean ginseng was declined by the EFSA, since its manufacturer cannot provide data on its complete composition.<ref>{{cite journal |last1=Bampidis |first1=Vasileios |last2=Azimonti |first2=Giovanna |last3=Bastos |first3=Maria de Lourdes |last4=Christensen |first4=Henrik |last5=Fašmon Durjava |first5=Mojca |last6=Kouba |first6=Maryline |last7=López-Alonso |first7=Marta |last8=López Puente |first8=Secundino |last9=Marcon |first9=Francesca |last10=Mayo |first10=Baltasar |last11=Pechová |first11=Alena |last12=Petkova |first12=Mariana |last13=Ramos |first13=Fernando |last14=Sanz |first14=Yolanda |last15=Edoardo Villa |first15=Roberto |last16=Woutersen |first16=Ruud |last17=Brantom |first17=Paul |last18=Chesson |first18=Andrew |last19=Westendorf |first19=Johannes |last20=Manini |first20=Paola |last21=Pizzo |first21=Fabiola |last22=Dusemund |first22=Birgit |title=Safety and efficacy of a feed additive consisting of a dried extract from the roots of Panax ginseng C.A. Meyer (P. ginseng dry extract) for use in cats and dogs (C.I.A.M.) |journal=EFSA Journal |date=1 April 2021 |volume=19 |issue=4 |doi=10.2903/j.efsa.2021.6526|pmc=8082721 }}</ref>

== Safety and side effects ==
Ginseng supplements are not subjected to the same pre-market approval process in the US by the Food and Drug Administration (FDA) as pharmaceutical drugs. FDA mandates that manufacturers must ensure the safety of their ginseng supplements before marketing, without the necessity to substantiate the safety and efficacy of these supplements in a [[Pre-market approval|pre-market scenario]].<ref name="pmid30000873">{{cite book|pmid=30000873 |title=Ginseng|publisher=National Institute of Child Health and Human Development|year=2006|series=Drugs and Lactation Database (LactMed)|location=Bethesda,MD|id={{NCBIBook|NBK501814}}}}</ref> Ginseng supplements can be complex, often containing multiple constituents. It is not uncommon to observe discrepancies between the ingredients listed on the product label and the actual components or their quantities present in the supplement.<ref name="pmid30000873" /> While manufacturers can employ independent organizations to authenticate the quality of a product or its ingredients, such verification does not equate to a certification of the product's safety or effectiveness. These independent quality checks primarily focus on the integrity of the product in terms of its composition and do not extend to safety evaluations or purported clinical efficacy.<ref name="pmid30000873" />

Ginseng generally has a good safety profile and the incidence of [[adverse effect]]s is minor when used over the short term.<ref name=drugs/><ref name="kim2">{{cite journal|vauthors=Kim YS, Woo YY, Han CK, Chang IM |year=2015|title=Safety Analysis of Panax Ginseng in Randomized Clinical Trials: A Systematic Review|journal=Medicines|volume=2|issue=2|pages=106–126|doi=10.3390/medicines2020106|pmid=28930204|pmc=5533164|doi-access=free}}</ref> The FDA has classified ginseng as "generally recognized as safe" (GRAS), indicating its general tolerability in adult populations.<ref name="pmid30000873"/>

The risk of interactions between ginseng and [[medical prescription|prescription medications]] is believed to be low, but ginseng may have [[adverse effects]] when used with [[blood thinner]]s.<ref name=drugs/><ref name="nccih2"/> Ginseng interacts with certain blood thinner medications, such as [[warfarin]], leading to decreased blood levels of these drugs.<ref name="pmid30000873"/> Ginseng can also potentiate the effects of sedative medications.<ref name="pmid30000873"/> Concerns exist when ginseng is used over a longer term, potentially causing side effects such as skin rashes,<ref name="pmid30000873" /> headaches, [[insomnia]], and [[digestion|digestive]] problems.<ref name="drugs" /><ref name="nccih2" /><ref name="kim2" /> The long-term use of ginseng may result in nervousness, anxiety, diarrhea, confusion, depression, or feelings of depersonalization,<ref name="pmid30000873" /> [[nausea]], and fluctuations in blood pressure (including hypertension).<ref name="drugs" /><ref name="liu" /> There have been reports of gynecomastia and breast pain associated with ginseng use.<ref name="pmid30000873" /> Other side effects include breast pain and [[vagina|vaginal bleeding]].<ref name="drugs" /><ref name="liu" /><ref name="pmid30000873" />  As of 2023, there is a lack of data regarding the safety and efficacy of ginseng in lactating mothers and infants.<ref name=drugs/> Given its potential estrogenic activity and the absence of safety data during lactation, ginseng is not recommended for use during breastfeeding.<ref name=drugs/><ref name="pmid30000873" /> Ginseng also has adverse drug reactions with [[phenelzine]],<ref>{{cite journal|year=2001|title=Interactions between herbal medicines and prescribed drugs: a systematic review|journal=Drugs|volume=61|issue=15|pages=2163–75|doi=10.2165/00003495-200161150-00002|pmid=11772128|vauthors=Izzo AA, Ernst E|s2cid=46983699}}</ref> and a potential interaction has been reported with [[imatinib]],<ref name="pmid20332334">{{cite journal|vauthors=Bilgi N, Bell K, Ananthakrishnan AN, Atallah E|year=2010|title=Imatinib and Panax ginseng: a potential interaction resulting in liver toxicity|journal=The Annals of Pharmacotherapy|volume=44|issue=5|pages=926–8|doi=10.1345/aph.1M715|pmid=20332334|s2cid=25229077}}<!--| access-date = 2015-03-16--></ref> resulting in [[hepatotoxicity]], and with [[lamotrigine]].<ref name="pmid25756365">{{cite journal|year=2015|title=Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome Probably Induced by a Lamotrigine-Ginseng Drug Interaction|journal=Pharmacotherapy|volume=35|issue=3|pages=e9–e12|doi=10.1002/phar.1550|pmid=25756365|vauthors=Myers AP, Watson TA, Strock SB|s2cid=31240689}}</ref>

=== Overdose ===
The common ginsengs (''P.&nbsp;ginseng'' and ''P.&nbsp;quinquefolia'') are generally considered to be relatively safe even in large amounts.<ref name="shergis">{{cite journal|last1=Shergis|first1=J. L.|last2=Zhang|first2=A. L.|last3=Zhou|first3=W|last4=Xue|first4=C. C.|year=2013|title=''Panax ginseng'' in randomised controlled trials: A systematic review|journal=Phytotherapy Research|volume=27|issue=7|pages=949–65|doi=10.1002/ptr.4832|pmid=22969004|s2cid=29710658}}</ref> One of the most common and characteristic symptoms of an acute overdose of ''P. ginseng'' is bleeding. Symptoms of mild overdose may include dry mouth and lips, excitation, fidgeting, irritability, tremor, palpitations, blurred vision, headache, insomnia, increased body temperature, increased blood pressure, edema, decreased appetite,  dizziness, itching, eczema, early morning diarrhea, bleeding, and fatigue.<ref name="CMHP">Chinese Medical Herbology and Pharmacology, by John K. Chen, Tina T. Chen</ref><ref name=shergis/>

Symptoms of severe overdose with ''P. ginseng'' may include [[nausea]], vomiting, [[irritability]], restlessness, urinary and bowel incontinence, fever, increased blood pressure, increased respiration, decreased sensitivity and reaction to light, decreased heart rate, cyanotic (blue) facial complexion, red facial complexion, seizures, convulsions, and [[delirium]].<ref name="CMHP" /><ref name=shergis/>

== Terminology and etymology ==
The English word "ginseng" comes from the [[Teochew Min|Teochew Chinese]] {{lang|nan|jîn-sim}} ({{script|Hani|人蔘}}; where this transliteration is in [[Pe̍h-ōe-jī]]). The first [[Chinese characters|character]] {{Zh|c=人|s=|t=|labels=no}} ([[pinyin]] ''rén''; {{IPA|cmn|ʐə̌n|label=[[Modern Standard Mandarin]] pronunciation:}} or {{IPA|cmn|ɻə̌n|}}) means "person"<ref>{{cite web |title=Ginseng |url=https://www.etymonline.com/search?q=ginseng |publisher=Online Etymology Dictionary |access-date=August 2, 2021 |date=2021}}</ref> and the second character {{Zh|c=蔘|s=|t=|labels=no}} ({{Zh|c=|s=|t=|p=shēn}}; {{IPA|cmn|ʂə́n|label=[[Modern Standard Mandarin|MSM]]:}}) means "plant root" in a forked shape.<ref>The word 參 ''shēn'' "plant root" itself, from [[Old Chinese]] *''srəm'', has been compared to words meaning 'root' in other languages of the [[Sino-Tibetan languages|Sino-Tibetan]] family such as [[Japhug]] ''tɤ-zrɤm'' "root", see {{cite journal|last= Jacques|first= Guillaume|author-link= Guillaume Jacques   |year= 2015  |title=On the cluster *sr in Sino-Tibetan |journal= Journal of Chinese Linguistics|volume=43|issue=1  |pages= 215–223|url= https://www.academia.edu/11754167 |doi= 10.1353/jcl.2015.0001|s2cid= 96458481}}
</ref>

The Korean loanword '''''insam''''' comes from the cultivated ginseng ({{Korean|hangul=인삼|hanja=人蔘|rr=insam|lit=human ginseng}}), which is less expensive than wild ginseng.{{cn|date=October 2023}} The botanical genus name ''Panax'', meaning "all-healing" in Greek, shares the same origin as "[[panacea]]" and was applied to this genus because [[Carl Linnaeus]] was aware of its wide use in [[Chinese medicine]] as a [[muscle relaxant]].{{cn|date=October 2023}}

{{Infobox Chinese
 | title = Ginseng
 | name1 = Chinese name
 | t = 1. 人蔘<br />2. 野山參<br />3. 水參<br />4. 白參<br />5. 紅參
 | s = 1. 人参<br />2. 野山参<br />3. 水參<br />4. 白蔘<br />5. 红蔘
 | l = {{Ordered list|human root (ginseng)|wild mountain root (wild ginseng)|water root (fresh ginseng)|white root (dried ginseng)|red root (dried steamed ginseng)}}
 | p = 1. rénshēn<br />2. yěshānshēn<br />3. shuǐshēn<br />4. báishēn<br />5. hóngshēn
 | w = 1. jên<sup>2</sup>-shên<sup>1</sup><br />2. yeh<sup>3</sup>-shan<sup>1</sup>-shên<sup>1</sup><br />3. shui<sup>3</sup>-shên<sup>1</sup><br />4. pai<sup>2</sup>-shên<sup>1</sup><br />5. hung<sup>2</sup>-shên<sup>1</sup>
 | altname = Cantonese name
 | c2 = 1. 人參<br />2. 野生人參
 | l2 = {{Ordered list|human root (ginseng)|wild human root (wild ginseng)}}
 | y2 = 1. yàhn sām<br />2. yéh sāang yàhn sām
 | j2 = 1. jan<sup>4</sup>-sam<sup>1</sup><br />2. je<sup>5</sup>-saang<sup>1</sup>-jan<sup>4</sup>-sam<sup>1</sup>
 | altname3 = Hokkien name
 | c3 = 人參
 | poj3 = jîn-sim
 | hangul = 1. 인삼<br />2. 산삼<br />3. 장뇌삼<br />4. 수삼<br />5. 백삼<br />6. 홍삼<br />7. 태극삼
 | hanja = 1. 人蔘<br />2. 山蔘<br />3. 長腦蔘<br />4. 水蔘<br />5. 白蔘<br />6. 紅蔘<br />7. 太極蔘
 | rr = 1. insam<br />2. sansam<br />3. jangnoesam<br />4. susam<br />5. baeksam<br />6. hongsam<br />7. taegeuksam
 | mr = 1. insam<br />2. sansam<br />3. changnoesam<br />4. susam<br />5. paeksam<br />6. hongsam<br />7. t'aegŭksam
 | lk = {{Ordered list|human root (ginseng)|mountain root (wild ginseng)|long brain root (wild cultivated ginseng)|water root (fresh ginseng)|white root (dried ginseng)|red root (dried steamed ginseng)|[[taegeuk]] root (dried blanched ginseng)}}
}}

=== Other plants sometimes called ginseng ===
True ginseng plants belong only to the genus ''Panax''.<ref name="CMHP" /> Several other plants are sometimes referred to as ginseng, but they are from a different [[genus]] or even [[family (biology)|family]]. Siberian ginseng is in the same family, but not genus, as true ginseng. The active compounds in Siberian ginseng are [[eleutherosides]], not ginsenosides. Instead of a fleshy root, Siberian ginseng has a woody root.
* ''[[Angelica sinensis]]'' (female ginseng, ''dong quai'')
* ''[[Codonopsis pilosula]]'' (poor man's ginseng, ''dangshen'')
* ''[[Eleutherococcus senticosus]]'' (Siberian ginseng)
* ''[[Ficus microcarpa]]'' (Ginseng ficus)
* ''[[Gynostemma pentaphyllum]]'' (five-leaf ginseng, ''jiaogulan'')
* ''[[Kaempferia parviflora]]'' (Thai ginseng, ''krachai dum'')
* ''[[Lepidium meyenii]]'' (Peruvian ginseng, ''maca'')
* ''[[Oplopanax horridus]]'' (Alaskan ginseng)
* ''[[Pfaffia paniculata]]'' (Brazilian ginseng, ''suma'')
* ''[[Pseudostellaria heterophylla]]'' (Prince ginseng)
* ''[[Schisandra chinensis]]'' (five-flavoured berry)
* ''[[Trichopus zeylanicus]]'' (Kerala ginseng)
* ''[[Withania somnifera]]'' (Indian ginseng, ''ashwagandha'')
* ''[[Eurycoma longifolia]]'' (Malaysian ginseng, ''tongkat ali'')

== See also ==
{{Commons}}
* [[Herbalism]]
* [[List of herbs with known adverse effects]]

==References==
{{notelist}}
{{Reflist}}

==Further reading==
* Pritts, K.D. (2010). ''Ginseng: How to Find, Grow, and Use America´s Forest Gold''. Stackpole Books.  {{ISBN|978-0-8117-3634-3}}
* [[David A. Taylor (writer)|David Taylor]] (2006). ''Ginseng, the Divine Root: The Curious History of the Plant That Captivated the World''. Algonquin Books.  {{ISBN|978-1-56512-401-1}}

{{Dietary supplement}}
{{Medicinal herbs & fungi}}
{{Stimulants}}
{{Non-timber forest products}}

[[Category:Dietary supplements]]
[[Category:Herbs]]
[[Category:Medicinal plants of Asia]]
[[Category:Non-timber forest products]]
[[Category:Panax]]
[[Category:Plant common names]]
[[Category:Plants used in traditional Chinese medicine]]