When I began to study herbs, my first class discussed the difference between the many ginsengs. It was information overload at that stage of my learning, but since then I’ve used them all. If the prospect of selecting the right ginseng for a specific set of symptoms seems overwhelming, this blog is for you.

Why is ginseng a big deal anyway?

Ginseng is a powerful tonic that improves energy, stamina, immunity, organ functions, and for some, libido. Most people experience one or more of these symptoms, particularly as they get older.

Why not take a Western tonic instead?

Contrary to the Traditional Chinese Medicine (TCM) concept of a tonic, a Western “tonic” describes the strength of an herb’s various properties instead of its actions on the body. For example, Western bitter “tonics” do not actually strengthen the stomach and its processes, but rather, they stimulate hydrochloric acid in the stomach and as a result, aid digestion.

It’s important to distinguish between Chinese and Western tonics because they may make symptoms worse if used incorrectly. For instance, Western blood “tonics” such as yellow dock are cool, bitter and drying and so can actually cause blood deficiency symptoms because these properties are injurious to the blood. Yes, the iron in yellow dock can build blood, but it and other Western blood “tonic” herbs should be combined with molasses, a warming and blood-enriching substance also high in iron, to ameliorate their cooling and drying effects.

The closest category in Western herbalism to Chinese Qi tonics is adaptogens, or herbs that help the body adapt to various stressors such as heat, cold, exertion, trauma, sleep deprivation, toxic exposure, radiation, infection, and psychological stress. Ginseng may be the premiere adaptogen. However, not all adaptogens are Qi tonics.

Can anyone take ginseng?

Tonics such as ginseng, while suited for any condition associated with deficiency, are generally only taken by people over the age of 40 when deficiencies often begin to appear. If taken at too young an age, it might actually cause stagnation. Instead, younger people generally need to eliminate excess (see “When should you NOT take ginseng?” section below). However, there are always some exceptions. As one grows older, tonic herbs may be beneficial when used in moderate amounts on a daily basis.

How do you choose good quality ginseng?

As with most tonic herbs, the quality of ginseng is determined in several ways: It should have long thick roots, be in one whole piece, and have a yellowish white cortex. The shape of the root itself is considered as well; it is more valued as it comes to resemble a human figure (the translation of ginseng’s pinyin name, ren shen, means “man shape”).

With ginseng, the older the root, the stronger its medicine. Age is determined by counting the leaf notches on the flowering stalk. each one equaling a year. Ideally, ginseng is not harvested or used until it’s at least 7 years old. Of course, the older the ginseng, the more it costs. In China I saw several ancient ginseng roots that were huge, over 18-24” long and costing up to $30,000 each.

When should you take ginseng?

Ginseng should only be used when there is weakness and deficiency. Deficiency describes a weakened person who generally experiences chronic ailments. It could involve a lack or insufficiency of energy, blood, cooling/moistening fluids or metabolic heat, all of which are fundamental properties in the body. As a Qi tonic, ginseng is used when there’s lack of energy, either in terms of fatigue or organ function weakness. Conditions of deficiency take a longer time to heal because the body needs to be strengthened again.

Chinese white ginseng or Korean red ginseng are taken in the cool months – fall, winter and early spring. Ginseng substitutes such as codonopsis are taken in the summer instead. American ginseng or glehnia are mainly taken in the warmer months, spring and summer. Tienqi ginseng may be taken any time of year.

When should you NOT take ginseng?

Do not give ginseng to the very young. Avoid taking Chinese white ginseng or Korean red ginseng during hot weather or during summer. Do not take ginseng if there is any excess or stagnation. Excess is a state of too much of something in the body such as too much energy, blood, fluids, heat or food, or their toxic congestion (stagnation). Symptoms include obesity, constipation, hypertension, severe infections, purulent yellowish and smelly discharges and edema. Excess patterns are simpler to treat than deficiency ones because it is easier and quicker to eliminate than to build.

Tonify or Eliminate?

In general, avoid tonifying during an acute inflammatory disease, fever, cold or flu as it could drive the illness deeper, like “locking a robber in the house.”

It’s possible to have low energy or poor digestion from causes other than deficiencies. Sometimes there is congestion instead so the energy is not circulating well and thus, not readily available. In these cases, one should eliminate and never tonify. Other times, some people have both weakness and stagnation co-existing. Always clear stagnation or excess first before tonifying any underlying weakness. Just because someone’s energy is low doesn’t mean ginseng should be taken. Many people actually experience a blockage of energy flow and so feel tired. In these cases, ginseng would only give more strength to the excess or stagnation, like adding more cars to a traffic jam, and so the person would get worse. Instead, emphasize herbs that clear heat and promote detoxification.

In certain cases of prolonged or serious diseases, however, one may need to use both tonic and eliminating herbs at the same time. However, the emphasis should be on the eliminating herbs with a small amount of tonic included,

So tell me about the different kinds of ginsengs already!

Ginseng is indicative of an entire class of herbs that have similar vitalizing properties. In China, the five “ginsengs” aren’t all related plant species but share similar characteristics and so are substituted for each other. These are: 1) Panax ginseng, 2) Codonopsis pilosula, 3) Panax quinquefolium, 4) Panax pseudoginseng, and 5) Glehnia littoralis.

Chinese white ginseng (Panax ginseng, ren shen)

When people think of the herb ginseng, this is it. It is the true ginseng and grows in the rugged mountains of Tibet or is cultivated in China and Korea. Because it is regarded as a universal panacea, it is named “panax.”

Family: Araliaceae

Energy and flavors: Slightly warm, sweet, slightly bitter
Organs and channels affected: Lung, Spleen, Heart
Chemical constituents: Panaxatriol, panasadiol, other panoxisides, panoquilon, panaxin, ginsenin, glucose, fructose, maltose, sucrose, nicotinic acid, riboflavin, thiamine

Properties and actions: Tonic, adaptogen, demulcent, sialagogue; powerfully tonifes Qi, nourishes Yin, calms the Shen, stops bleeding
Contraindications: Heat, congestion, absence of signs of Qi deficiency, hypertension, parasites.

Caution: During acute ailments such as colds or flu

Overdose symptoms: Tightness of the chest, spasms, rashes, vertigo, fever, bleeding, headache, palpitations, insomnia, and elevated blood pressure. The antidote is mung bean soup.
Note: Taking green or black tea, citrus, strong spices, cabbage family vegetables, turnips, and radishes the same day as ginseng neutralizes its effects.

Dosage and preparation: 3-9g; 20-60 drops tincture (1:2 @50%ABV), TID

Ginseng nourishes all deficiencies. It is used for low energy, lethargy, weak digestion, lack of appetite, shortness of breath, wheezing, profuse sweating (not from exercise), cold limbs, blood loss, impotence, chronic diarrhea, heavy bleeding, and prolapse.

Korean red ginseng: This is Chinese white ginseng that has been prepared by first steaming and then sun-drying or drying by heating. This makes it warmer in energy and more metabolism-enhancing.

How do you take panax ginseng?

Single herb use: The simplest of these is to cook ginseng in a congee or rice porridge or to drink as a tea.

In formula: Ginseng is often combined with other herbs in formula such as the well-known and used, Ginseng and Astragalus Combination (Bu Zhong Yi Qi Tang).

For those at death’s door: Taking a high dose of ginseng root daily prolongs life. Emperors of old saved the best quality ginseng and took it on their deathbed so they could await relatives traveling from long distances to bid their last farewells. Michael Tierra has twice used ginseng for this purpose and the results were amazing. Giving an entire high quality ginseng root daily in decoction, patients who were nearly comatose were able in a day or two to sit up and interact with their relatives for several days before they died.

For regenerating long-lasting vitality: A specific Taoist therapy is to first take Rehmannia Six Combination (Liu Wei Di Huang), a Yin tonic, two to three times daily for a week, along with a strict diet that avoids sugar, fat, fruits, most green vegetables, and cabbage family foods. On the seventh day, an entire high quality wild or forest-grown ginseng root is ingested as a tea, minus the top part from which ginseng would sprout each year (this is cooling and an antidote to ginseng overdose).

American ginseng (Panax quinquefolium; xi yang shen)

Unlike Chinese ginseng (white or red), American ginseng has a cooling and moistening energy. It is a “Yin” tonic. Yin tonics nourishes the parasympathetic nervous system, supply vital nourishing components to aid formation of bodily substances and fluids, and, along with yang tonics, provide hormonal precursors that the body can use to reassemble into hormones, neural transmitters and other substances for healthy endocrine and reproductive functions.

Family: Araliaceae

Energy and flavors: Cool, sweet, slightly bitter
Organs and channels affected: Lung, Kidney, Heart
Properties and actions: Tonic, adaptogen; tonifies Yin and Qi, clears Deficiency Heat
Contraindications: Cold-damp conditions; Fire conditions from stagnation
Dosage and preparation: 3-6 g; 10-40 drops tincture (1:5 @40% ABV), TID

American ginseng is used for long-term wheezing, lung weakness, dry non-productive cough, coughing up of blood-streaked sputum, irritability, thirst, chronic fatigue, aftermath of fevers, laryngitis with dry throat and thirst at night, and weakness. As with Chinese ginseng, American ginseng roots that are at least seven years old are used.

Codonopsis (Codonopsis pilosula, dang shen)

Codonopsis is often called “poor man’s ginseng” because it is milder, less expensive, and safer to use on a year-round basis. Because of this, it is substituted in two to three times for the amount of Chinese or Korean ginseng. Its principle action is on the lungs and spleen. It has a damp, stagnating energy and so is less indicated for individuals with phlegm, mucus or edema.

Family: Campanulaceae

Energy and flavors: Sweet, neutral
Organs and channels affected: Lung, Spleen
Chemical constituents: Saponins, alkaloids, sucrose, glucose, inulin
Properties and actions: Stimulant, immunomodulator, adaptogen, lowers blood pressure, tonic; tonifies qi, nourishes blood
Contraindications: Acute conditions such as colds or flu
Dosage and preparation: 6-9 g; 20-60 drops tincture (1:5 @50%ABV), TID. To approximate the same tonification level of Panax ginseng, use two to three times the amount.

Codonopsis is specifically used for lack of appetite, fatigue, diarrhea, vomiting, and prolapsed organs. It also stimulates the production of red blood cells and so is particularly beneficial for women who need qi tonification and blood nourishment. It also increases strength and endurance. In contrast to Panax ginseng, may actually lower blood pressure rather than raise it. It tonifies the lungs and counteracts lung dryness, treating wasting and consumptive diseases with thirst. It can be used in small amounts with eliminating and purging herbs to protect the qi from becoming depleted. After codonopsis is cooked, it may be eaten.

Tienchi (Panax notoginseng; P. pseudoginseng, san qi)

Tienqi is a commercial name; the common pinyin is san qi.

Family: Araliaceae

Energy and flavors: Sweet, slightly bitter; warm
Organs and channels affected: Liver, stomach
Chemical constituents: Saponins, alkaloids, sucrose, glucose, inulin
Properties and actions: hemostatic, gently moves blood, anagesic
Caution: During pregnancy; can cause gastrointestinal symptoms in some – discontinue use if this occurs.
Dosage and preparation: 3-9 g; 1-1.5g in pills and powders up to three times/day. For severe bleeding, each dose can be up to 3-6g; 20-60 drops tincture (1:5 @50%ABV), TID

Tienchi ginseng specifically stops bleeding, moves blood, and alleviates pain. It is found in the famous Chinese trauma medicine Yunnan Bai Yao, effective for injuries, blood clots, bruises, and chronic or acute bleeding. Tienchi ginseng has been an undervalued herb in the West while the Chinese consider its ability to stop bleeding and yet gently move blood at the same time, even in hemorrhage, ideal for traumatic injuries and the prevention and treatment of many cardiovascular problems, including heart attack and stroke. Tien qi also dilates the coronary arteries and is anti-cancer, used for swellings and tumors.

Glehnia (Adenophora seu glehnia; sha shen)

Family: Apiaceae

Energy and flavors: Slightly cold, sweet, slightly bitter
Organs and channels affected: Lung, Stomach
Chemical constituents: Essential oil, B-sitosterol, alkaloid, starch, stigmasterol Properties and actions: Tonic, analgesic; tonifies Yin, clears Deficiency Heat Contraindications: Cough caused by Wind-Cold; weak, Cold Lung and Stomach Dosage and preparation: Decoction, 9-15g. Standard tincture (1:5 @50% ABV).

Glehnia is used for dry throat or mouth, thirst, constipation, a feeling of heat steaming up from the bones, dry nonproductive cough, irritability, and consumption. It promotes the secretion of fluids and clears heat from deficiency. Glehnia may be substituted for Prince root ginseng (pseudostellaria, which I will address in my next blog on “non-ginsengs”).

Which ginseng should you take?

First, ask why you want to take ginseng; the answer will help you determine which would be most effective and appropriate for you. The following may help you decide.

1. If you have true deficiencies with symptoms of low energy, tiredness, a pale complexion, frequent clear urination, a pale tongue with a thin white coat, and weak digestion, then take 6-9 g of Chinese white or Korean red ginseng, two times daily.
2. For optimum energy levels, general health, or to counteract the debilitating effects of stress, take 2-4 g once or twice daily of either Chinese white or Korean red ginseng, or 6-12 g of codonopsis (dang shen).
3. If you are stressed, nervous, or have a tendency toward feeling overwhelmed and depleted, avoid taking Chinese white or Korean red ginseng as they may be too warming or stimulating, and instead, take the cooler American ginseng.
4. If you have circulatory and heart problems, angina, blood clots, high cholesterol, difficulty recovering from injuries, Crohn’s disease, or symptoms of bleeding with low energy, take, 1-2 g twice daily of tienchi ginseng.
5. For Yin Deficiency symptoms such as hyper-nervous energy, feelings of heat at the extremities, night sweats, dryness, thirst, possible dry cough, or diseases similar to consumption, tuberculosis, and/or AIDS, take 2-3 g twice daily of either American ginseng (Panax quinquefolii; xi yang shen), glehnia (Adenophora seu glehnia; sha shen), or prince root ginseng (Pseudostellaria heterophylla, tai zi shen).
6. If you are a woman with low energy, you may safely take ginseng but if you have symptoms of a pale complexion, scanty or no periods, oversensitivity to environmental and emotional factors, and don’t have pronounced weak digestive symptoms, you may have Blood deficiency instead (“Blood is the mother of Qi”). You might do better combining Panax ginseng with Blood tonic herbs such as dang gui (Angelica sinensis), or white peony (Paeonia lactiflora, bai shao).

Stay tuned for my next blog on “non-ginsengs” in a couple of weeks!