Ginseng

Related Terms

• 2-Furanmethanol, 20-(R)-R, (20S)-protopanaxadiol-3-O-(6-O-malonyl-beta-D-glucopyranosyl(1-->2)-beta-D-glucopyranoside-20-O-beta-D-xylopyranosyl(1-->3)-beta-D-glucopyranosyl(1-->6)-beta-D-glucopyranoside, 20-(S)-Re, 28-glu-oleanolic acid ester, acetylenic alcohol, acidic polysaccharides, adenosine, aglycones, Allheilkraut (German), alpha-maltosyl-beta-D-fructofuranoside, aluminum, American ginseng (AG), American wild ginseng, antioxidants, Araliaceae (family), Asian ginseng, Asiatic ginseng, calcium, capsaicin 4-O-(6-O-beta-D-xylopyranosyl)-beta-D-glucopyranoside, capsaicin 4-O-beta-D-glucoside, ceramide, chikusetsu ginseng, chikusetsusaponin IV, chikusetsusaponin IVa, chikusetsusaponin-L8, chitinolytic enzymes, chosen ninjin, citral, class I chitinase, cobalt, copper, CPPQ (coarse polysaccharide from Panax quinquefolius L.), CVT-E002, dae-jo-hwan (DJW), dammarane-type glycosides, dammarane-type tetracyclic triterpenoid saponins, dammarane-type triterpene ketone (panaxadione), dwarf ginseng, fatty acids, five-fingers, five-leaf ginseng, G115®, ginsan, ginsenan PA (phagocytosis-activating polysaccharide), ginseng acidic polysaccharide, ginseng radix, ginseng saponins, ginseng tetrapeptide, Ginsengwurzel (German), ginsenoside, ginsenoside F1, ginsenoside F2, ginsenoside F3, ginsenoside F4, ginsenoside Ia, ginsenoside R0, ginsenoside Ra1, ginsenoside Ra2, ginsenoside Rb1, ginsenoside Rb2, ginsenoside Rb3, ginsenoside Rc, ginsenoside Rd, ginsenoside Rd2, ginsenoside Re, ginsenoside Rf, ginsenoside Rg1, ginsenoside Rg2, ginsenoside Rg3, ginsenoside Rg5, ginsenoside Rg6, ginsenoside Rh1, ginsenoside Rh2, ginsenoside Rh3, ginsenoside Rh4, ginsenoside Rk1, ginsenoside Rk3, ginsenoside Ro, ginsenoside Rs3, ginsenoside Rs4, ginsenoside Rs5, ginsenosides compound (shen-fu), GTTC (ginseng and tang-kuei ten combination), hakusan (Japanese), hakushan, higeninjin, hong shen (Chinese), hua qi shen (Chinese), hungseng, hungsheng, hunseng, insam (Korean), iron, jenseng, jen-shen, jinpi, kao-li-seng, Korean ginseng, Korean red ginseng (KRG), Kraftwurzel (German), limonene, magnesium, malonylginsenoside Ra3, maltol, man root, manganese, memory enhancer, minjin, molybdenum, mountain ginseng, nhan sam (Vietnamese), ninjin (Japanese), ninzin, niuhan, North American ginseng, notoginseng, notoginsenoside, notoginsenoside-Fe, notoginsenoside R1, notoginsenoside R2, notoginsenoside R4, oleanolic acid, ophioponins, Oriental ginseng, otane ninjin (Japanese), panajaponin, panax de Chine (French), Panax ginseng, Panax ginseng C.A.Mey., Panax notoginseng, Panax psuedoginseng, Panax quinquefolium (common misspelling), Panax spp., Panax trifolius L., Panax vietnamensis (Vietnamese ginseng), panaxadial, panaxans, panaxatriol, panaxosides, panaxydol, panaxynol, panaxytriol, pannag (Hebrew), peptidoglycans, phenolic compounds, phosphorus, polyacetylenes, polyacetylenic compounds, poly-furanosyl-pyranosyl-saccharides, poly-hydroxyl octadecenoic acid, potassium, protopanaxadiol ginsenosides, protopanaxatriol, protopanaxatriol saponins, protopanaxatriol (PPT)-type ginsenosides, quinqueginsin, racine de ginseng (French), Re, red ginseng, renshen, ribonucleases, rozu (Japanese), sanchi ginseng, sang, san-pi, sanqi, saponins, schinsent, sei yang sam, seng, sesquiterpenoids, shanshen, shen-fu (Chinese), shenghaishen, shenlu, shen-sai-seng, shenshaishanshen, siyojin, sodium, sterol glucosides, stress-buster, sun ginseng, superoxide dismutase, t'ang-sne, tartar root, terpineol, tienchi ginseng, to-kai-san, triperpenoid saponins, triterpenoids, true ginseng, tyosenninzin, vanadium, vanillic acid, Vietnamese ginseng, vitamins, volatile oil, Western ginseng, Western sea ginseng, white ginseng, wild ginseng, woodsgrown (wild-stimulated) ginseng root, xi shen, xi yang shen, yakuyo ninjin, yakuyo ninzin, yang shen, yeh-shan-seng, yuan-seng, yuansheng, zhuzishen, zinc.
• Siberian ginseng ( Eleutherococcus senticosus ) synonyms: Acanthopanax senticosus, ci wu jia, ciwujia, devil's bush, devil's shrub, eleuthera, eleuthero, eleuthero ginseng, eleutherococ, Eleutherococci radix, Eleutherococcus, phytoestrogen, shigoka, touch-me-not, ussuri, ussurian thorny pepperbush, wild pepper, wu-jia, wu-jia-pi.
• American ginseng ( Panax quinquefolius L.) synonyms: Amerikan ginseng (Turkish), amerikanischer Ginseng (German), amerikkalainen ginseng (Finnish), anchi ginseng, Aralia quinquefolia Decne. & Planch. (botanical synonym), Araliaceae (family), Canadian ginseng, CVT-E 002®, five fingers, five-leafed ginseng, garantoquen, ginseng, ginseng d'Amérique (French), ginsenosides poly-furanosyl-pyranosyl-saccharides, man-root, man's health, North American ginseng, Occidental ginseng, Ontario ginseng, Panax quincefolius, Panax quinquefolius L., red berry, redberry, sang, shang (traditional Chinese medicine (TCM)), tartar root, western ginseng, wild American ginseng, Wisconsin ginseng, xi yang shen (TCM, Chinese).
• Panax ginseng synonyms: Aralia (botanical synonym), Aralia ginseng Mey., Araliaceae (family), Asian ginseng, Asiatic ginseng, Chinese ginseng, G115®, Gincosan, Ginsai®, ginseng asiatique (French), ginseng radix, ginseng root, ginsengjuuri (Finnish), guigai, Japanese ginseng, jintsam, Korean ginseng, Korean Panax ginseng, Korean red, Korean red ginseng, kuhuang shenmai (KHSM) injection, ninjin (Japanese), Oriental ginseng, Panax, Panax ginseng C.A.Mey., Panax schinseng, Panax schinseng Nees, Panax spp., radix ginseng rubra, red ginseng, ren shen (TCM), renshen (TCM), renxian, sang, schinsent, seng, shen, shengmai, shengmai chenggu capsule, shengmai injection (SI), shengmai san (SMS), shengmai-san, shengmaisan, shengmaiyin, shenmai, shenmai huoxue decoction (SMHXD), shenmai injection (SMI), white ginseng.
• Selected products: AD-fX®, ArginMax® (Panax quinquefolius L., Panax ginseng, and other ingredients), bu zhong yi qi wan (Panax ginseng root and other ingredients), CKBM (Panax ginseng, Schisandra chinensis, fructus Crataegi, Ziziphus jujube, and processed Saccharomyces cerevisiae), Cold-fX® (polyfuranosyl-pyranosyl-saccharides from the root of Panax quinquefolius L.), Gericomplex® (Panax ginseng and a vitamin/mineral complex), Gincosan® (standardized GK501® Ginkgo biloba and the standardized G115® ginseng extract), Ginsana® (standardized G115® ginseng extract), GURU™ energy drink (Ginkgo biloba, Echinacea, Panax ginseng, and guarana), Memory Enhancer® (Panax ginseng and other ingredients), Phyto-Female Complex (standardized extracts of black cohosh, dong quai, milk thistle, red clover, American ginseng, chaste tree berry), sheng mai san (radix ginseng and other ingredients), sheng mai yin (ginseng root), winter wheat (Ophiopogon japonicus) root tuber, Chinese magnoliarine (Schisandra chinensis) fruit), shengmai yin (Panax ginseng, Schisandra fruit, Ophiopogon japonicus), shi-quan-da-bu-tang (Rehmannia glutinosa, Paeonia lactiflora, Ligusticum wallichii, Angelica sinensis, Glycyrrhiza uralensis, Poria cocos, Atractylodes macrocephala, Panax ginseng, Astragalus membranaceus, and Cinnamomum cassia), sho-saiko-to (Asian ginseng root extract, schisandra fruit extract, ginger root extract, and other ingredients).
• Note: This review is focused on Panax ginseng species. Kaempferia parviflora is referred to as Thai ginseng and is in the ginger family; it is not related to Panax ginseng and is not included in this monograph. In Russia, Siberian ginseng (Eleutherococcus senticosus) was promoted as a cheaper alternative to ginseng, as it was believed to have identical benefits. However, it is void of the ginsenosides contained in Panax spp. Other species may be referred to as ginseng as well, but they are from a different family or genus; examples include Pseudostellaria heterophylla (prince ginseng), Angelica sinensis (female ginseng, or dong quai), Withania somnifera (Indian ginseng, or ashwagandha), Pfaffia paniculata (Brazilian ginseng), Lepidium meyenii (Peruvian ginseng, or maca), and Gynostemma pentaphyllum (southern ginseng, or jiaogulan). These species are not covered in this review.

Background

• The term ginseng refers to several species of the genus Panax of the Araliaceae family. The two most commonly used ginseng species are Asian ginseng (Panax ginseng C.A.Mey.) and American ginseng (Panax quinquefolius L.). Panax species should not be confused with Siberian ginseng (Eleutherococcus senticosus), which is from a different botanical family.
• The word "ginseng" is derived from ren-shen, the Chinese word for the plant, which means "essence of the earth in the form of a man" or "man-root," referring to the root's human-like shape.
• Panax ginseng has been used in traditional Chinese medicine (TCM) for more than 2,000 years. Its diverse uses include increasing appetite and strength, enhancing memory and physical performance, reducing fatigue and stress, and improving overall quality of life. Shengmai (also called shenmai) is a combination of Panax ginseng, Schisandra fruit, and Ophiopogon japonicus that has also been used in TCM to treat conditions such as coronary heart disease and chronic obstructive pulmonary disease (COPD).
• American ginseng (Panax quinquefolius L.) has been used as a folk remedy by many Native American tribes, as a mild stimulant and digestive aid and for diverse ailments, including headache, female infertility, fever, and earache.  
• Ginseng has been used traditionally as a treatment for cancer and, in modern times, has been suggested as a cancer preventative.
• The primary active ingredients of Panax are ginsenosides. When purchasing ginseng products, most experts recommend looking for a product labeled as Panax ginseng, standardized to 4-7% ginsenosides.

Evidence

*Key to grades: 

A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

For full grading rationale, click here.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare professional before starting a new therapy. Consult a healthcare professional immediately if you experience side effects.

Allergies

• Avoid with known allergy or hypersensitivity to Panax species, their constituents, or to other members of the Araliaceae family.
• Allergic reactions to Korean red ginseng and cross-reactions with other members of the Araliaceae family have been reported. Anaphylaxis-like symptoms, with breathing problems, low blood pressure, and rash, have occurred after ingestion of Panax ginseng syrup.

Side Effects and Warnings

• Panax ginseng or American ginseng (Panax quinquefolius L.) is likely safe when used in healthy individuals in suggested doses for a short period. Shenmai injection (Panax ginseng, Schisandra fruit, and Ophiopogon japonicus) has been used for two weeks without serious adverse effects.
• Agranulocytosis, followed by life-threatening bacterial infection and, in one case, death, has been reported in patients taking an over-the-counter ginseng-containing combination product that was later shown to contain phenylbutazone and aminopyrine, known inducers of agranulocytosis. Independently reported severe drops in white blood cell counts may be due to similar contamination.
• Asthma and rhinitis due to occupational exposure to ginseng dust has been reported.
• Ginseng may cause agitation, amenorrhea, breast symptoms (pain, enlargement, nipple enlargement, breast enlargement in men), breathing problems, cerebral arteritis (reversible), chest pain, decreased heart rate, delayed ejaculation, depression, diarrhea, dizziness, drowsiness, dry mouth, enhanced blood alcohol clearance, enhanced sexual performance/responsiveness, erectile dysfunction, estrogen-like effects, excitability, extremely high fever, euphoria, eye disturbances (pupil dilation, difficulty focusing), feeling of well-being, flushing, gastrointestinal symptoms (abdominal pain, bloating, constipation, diarrhea, discomfort, nausea, vomiting), headache, heartburn, hives, increased motor and cognitive efficiency, impotence, increased libido, irritability, jaundice, light protection/sensitization, liver toxicity, loss of appetite, mania, migraine, muscle and joint pain, neonatal androgenization (after maternal use), neonatal intoxication and death, nervousness, nosebleeds, palpitations, perioperative effects, rapid heartbeat, restlessness, sedation, seizures, skin reactions (dermatitis, eczema, rash, skin eruptions, rose spots, pruritus, mild pain and burning, Stevens-Johnson syndrome), sleep disorders (e.g., trouble falling or staying asleep), teratogenic effects (in animals), throat irritation, transient ischemic attack following high blood pressure crisis, tremulousness, vaginal bleeding, vertigo, or worsened symptoms of schizophrenia.
• Ginseng may cause low or high blood pressure. Caution is advised in patients taking drugs, herbs, or supplements that raise or lower blood pressure.
• Because ginseng may contain estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
• Ginseng may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
• Ginseng may interfere with the way the body processes certain drugs, herbs, or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may change in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
• Use cautiously in patients with sleep disorders, as ginseng may cause insomnia.
• Use cautiously in patients using agents that may increase the risk of abnormal heart rhythms.
• Use cautiously in those using light-sensitizing agents or those with fair skin, as high doses of ginseng may have a light-sensitizing effect.
• Use cautiously in patients with mental health disorders, such as schizophrenia or depression, or in those taking medication for these disorders, as ginseng has caused mania or depression.
• Use cautiously in patients taking opiates, as ginseng has antagonized the effects of morphine and cocaine.
• Use cautiously in individuals prone to seizures. According to case reports, seizures following heavy consumption of energy drinks, which may contain ginseng, have been reported.
• Use Korean ginseng cautiously in individuals who have "heat" disorders, such as ulcers, high blood pressure, tension headaches, and symptoms associated with high stress levels, as well as those with symptoms of nervousness, mental imbalance, inflammation, or fever.
• Use Panax ginseng cautiously in patients using alcohol, as ginseng reduced blood concentration of alcohol (ethanol) and enhanced blood alcohol clearance.
• Use cautiously in patients with immune disorders or those using immunosuppressants, as ginseng has immune-stimulating effects and, theoretically, may interfere with the effects of immunosuppressants.
• Use cautiously during the perioperative period, as ginseng is known to have an effect on the perioperative period. Anesthetists should inquire about a patient's use of ginseng.
• Use suggested amounts cautiously in children, due to inadequate safety evidence.
• Avoid in patients with bleeding disorders or those taking drugs, herbs, or supplements that may increase the risk of bleeding, as ginseng may increase the risk of bleeding. Dosing adjustments may be necessary.
• Avoid use of large amounts of ginseng extract in infants.
• Avoid in patients with known allergy or hypersensitivity to Panax species, their constituents, or to other members of the Araliaceae family. Allergic reactions to Korean red ginseng and cross-reactions with other members of the Araliaceae family have been reported. Anaphylaxis-like symptoms have occurred after ingestion of Panax ginseng syrup.
• Avoid in patients who are pregnant or breastfeeding. Although not well studied in humans, ginseng may have teratogenic and embryotoxic effects.

Pregnancy and Breastfeeding

• Avoid in pregnant or breastfeeding women, due to a lack of available scientific evidence and safety information.
• Ginseng does not appear to interfere with normal embryonic development or cause birth defects. However, the safety of ginseng during pregnancy and breastfeeding has not been systematically evaluated. Chinese tradition suggests that ginseng not be used during pregnancy and breastfeeding. A number of reports caution against its use in pregnant and breastfeeding women. Although not well studied in humans, the ginsenoside Rb1 may cause birth defects in animals.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare professional before starting a new therapy.

Interactions with Drugs

• Ginseng may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
• Ginseng may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
• Ginseng may affect blood pressure. Caution is advised in patients taking drugs that raise or lower blood pressure.
• Ginseng may interfere with the way the body processes certain drugs (such as midazolam or diclofenac) using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may change in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Patients taking any medication should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
• Because ginseng may contain estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
• Ginseng may also interact with ACE inhibitors, alcohol, Alzheimer's agents, analgesics, anesthetics, antianxiety agents, antiarrhythmics, antiasthmatics, antibiotics, antidepressants (monoamine oxidase inhibitors (MAOIs)), antiemetics, antifungals, antihistamines, anti-inflammatories, antilipemics, antineoplastics, antiobesity agents, antiparasitics, antipsychotics, antiretrovirals, antiulcer agents, antivirals, caffeine, calcium channel blockers, cardiac glycosides, CNS depressants, CNS stimulants, corticosteroids, disulfiram, diuretics, hepatotoxins, immunosuppressants, impotence agents, influenza vaccine, metronidazole, opiates, phenytoin, photosensitizers, protease inhibitors, QT-prolonging drugs, radioprotective drugs, steroids, sympathomimetics, and vasodilators.

Interactions with Herbs and Dietary Supplements

• Ginseng may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
• Ginseng may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may change in the blood. It may also alter the effects that other herbs or supplements potentially may have on the P450 system.
• Ginseng may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
• Ginseng may affect blood pressure. Caution is advised in patients taking herbs or supplements that may raise or lower blood pressure.
• Because ginseng may contain estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
• Ginseng may also interact with acupuncture, alcohol, Alzheimer's agents, analgesics, anesthetics, antiallergy agents, antiarrhythmics, antiasthmatics, antibacterials, antidepressants (monoamine oxidase inhibitors (MAOIs)), antiemetics, antihistamines, anti-inflammatories, antilipemics, antineoplastics, antiobesity herbs and supplements, antioxidants, antiparasitics, antipsychotics, antiulcer agents, antivirals, anxiolytics, aphrodisiacs, ashwagandha (Withania somnifera), caffeine, cardiac glycosides, cardiovascular agents, Carthamus tinctorius, dehydroepiandrosterone (DHEA), diuretics, epicatechin, Ginkgo biloba, glycyrrhiza, hepatotoxins, immunosuppressants, impotence herbs and supplements, mate, opioids, photosensitizers, radioprotective agents, radix Astragali, red clover, sedatives, steroids, stimulants, sympathomimetics, vasodilators, and vitamin C.

Authors

• This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Selected References

Natural Standard developed the above evidence-based information based on a systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Abebe W, Herman W, Konzelman J. Herbal supplement use among adult dental patients in a USA dental school clinic: prevalence, patient demographics, and clinical implications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111(3):320-325.
2. Barton DL, Soori GS, Bauer BA, et al. Pilot study of Panax quinquefolius L. (American ginseng) to improve cancer-related fatigue: a randomized, double-blind, dose-finding evaluation: NCCTG trial N03CA. Support Care Cancer 2010;18(2):179-187.
3. Biondo PD, Robbins SJ, Walsh JD, et al. A randomized controlled crossover trial of the effect of ginseng consumption on the immune response to moderate exercise in healthy sedentary men. Appl Physiol Nutr Metab 2008;33(5):966-975.
4. Carabin IG, Burdock GA, Chatzidakis C. Safety Assessment of Panax Ginseng. International Journal of Toxicology 2000;19 (4).
5. Choo MK, Park EK, Han MJ, et al. Antiallergic activity of ginseng and its ginsenosides. Planta Med 2003;69(6):518-522.
6. Gagnier JJ, Moher D, Boon H, et al. Randomized controlled trials of herbal interventions underreport important details of the intervention. J Clin Epidemiol 2011;64(7):760-9
7. Kennedy DO, Haskell CF, Wesnes KA, et al. Improved cognitive performance in human volunteers following administration of guarana (Paullinia cupana) extract: comparison and interaction with Panax ginseng. Pharmacol Biochem Behav 2004;79(3):401-411.
8. Kim J, Chung SY, Park S, et al. Enhancing effect of HT008-1 on cognitive function and quality of life in cognitively declined healthy adults: a randomized, double-blind, placebo-controlled, trial. Pharmacol Biochem Behav 2008;90(4):517-524.
9. Kim YS, Jin SH. Ginsenoside Rh2 induces apoptosis via activation of caspase-1 and -3 and up-regulation of Bax in human neuroblastoma. Arch Pharm Res 2004;27(8):834-839.
10. Kimura Y, Okuda H, Arichi S. Effects of various ginseng saponins on 5-hydroxytryptamine release and aggregation in human platelets. J Pharm Pharmacol 1988;40(12):838-843.
11. King ML, Adler SR, Murphy LL. Extraction-Dependent Effects of American Ginseng (Panax quinquefolium) on Human Breast Cancer Cell Proliferation and Estrogen Receptor Activation. Integrative Cancer Therapies 2006;5(3):236-243.
12. Lee YJ, Jin YR, Lim WC, et al. Ginsenoside Rc and Re stimulate c-fos expression in MCF-7 human breast carcinoma cells. Arch Pharm Res 2003;26(1):53-57.
13. McElhaney JE, Goel V, Toane B, et al. Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo controlled trial. J Altern Complement Med 2006;12(2):153-157.
14. Predy GN, Goel V, Lovlin R, et al. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ 2005;173(9):1043-1048.
15. Rotem C, Kaplan B. Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study. Gynecol Endocrinol 2007;23(2):117-122.

Ginkgo Biloba

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