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Panax ginseng: A Fatigue-Fighting Adaptogen

  • July 26, 2017
  • By Ramona Richard, MS, NC
  • 4 minute read


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The History of Ginseng

American ginseng and Chinese ginseng (Panax quinquefolium and Panax ginseng) are two species of plant commonly referred to as simply ginseng or Panax. Ginseng has been used for hundreds of years in traditional medicine to combat fatigue, promote emotional wellness, resist physical stress, and alleviate various ailments.[1] The plant was first used therapeutically due to a concept called the Doctrine of Signatures; the belief that a plant’s physical characteristics hint at its healing powers. The root of the ginseng plant resembles a “jen shen”, or little man. Thus, extracts from the root were thought to be curative for the whole body.[2] Indeed, ginseng has proven itself to be one of the most potent and popular supplements in the world. There was even a point in history when ginseng was more valuable than gold. Ginseng reached the Americas in the 1740s, where it became hugely popular, and within 30 years the plant was wiped out due to overharvesting. In fact, the exploration of the Appalachian region was driven in part by Daniel Boone’s quest to find more ginseng! Now, Americans spend roughly 500 million dollars per year on ginseng products, and wild American ginseng is considered an endangered species.[3] So, why is this little root in such high demand? Ginseng is a powerful and safe adaptogen, and one of its most common uses is in combating fatigue.

Fatigue & The HPA Axis

Everyone feels tired at times, but for some, tiredness regularly comes at inopportune times. Fatigue can be caused by simple daily stressors such as lack of sleep or poor diet, but many people suffer from fatigue due to chronic illness or medication use. Like many systemic conditions, fatigue often stems from the HPA axis.[4] The HPA axis, or the hypothalamic-pituitary-adrenal axis, is the body’s control center for mounting stress responses and regulating many neuroendocrine pathways. When the HPA axis “slows down”, fatigue can manifest. The HPA axis commonly becomes dysregulated from chronic stress.[5] Our bodies were meant to mount stress responses when faced with a threat or stressor, however, contemporary lifestyles often cause the body to mount a stress response almost non-stop. Cortisol is the body’s stress hormone and often gets a bad rapport, but this hormone is necessary for energy, appetite, inflammatory responses, and blood sugar regulation. Cortisol release is under the control of the hypothalamus, which stimulates the pituitary gland to send a message to the adrenal glands to secrete cortisol. Cortisol can then downregulate its own release by putting a brake on the HPA axis. When the HPA axis and cortisol function are dysregulated, such as in Chronic Fatigue Syndrome, fatigue becomes a significant issue.[6] HPA axis dysregulation is also associated with inflammation, which can further exacerbate fatigue and decreased stamina.[7] Another major cause of fatigue is oxidative stress. When the body does not have enough antioxidants to combat oxidative stress, a whole plethora of symptoms can arise, and fatigue is one of the most common.[8]

Ginseng for Fatigue

Ginseng contains several components known to modulate the aforementioned culprits in fatigue. Ginseng has been shown to downregulate inflammatory pathways and modulate cortisol’s effect on the HPA axis. Adaptogens such as ginseng are capable of increasing cellular energy and helping cells utilize energy without over or under stimulation. ATP, the body’s cellular form of energy, has been shown to increase with adaptogen use.[9] Ginseng is also considered an actoprotector, a subclass of adaptogens. Actoprotectors improve mental and physical efficiency without increasing oxygen consumption. Ginsenosides, or the compounds responsible for the medicinal effects of ginseng, act on the adrenals to prevent excess corticosteroid production. They have also been shown to increase neurotransmitter activity and improve blood circulation in the brain.[10] Ginseng polysaccharides have been shown to significantly increase stamina and endurance without causing the body to mount a stress response.[11] Panaxytriol, another component of ginseng, is an antioxidant which helps the body combat oxidative stress.[12] Ginseng use has very promising outcomes when used in conjunction with cancer treatments such as radiation or chemotherapy. 59-96% of patients receiving chemotherapy report fatigue, and 65-100% of patients receiving radiation report fatigue. Ginseng alleviates fatigue when taken during chemotherapy and radiation treatments.[13] Panaxytriol alone was able to reduce weight loss and nerve damage from chemotherapy as well.[14] When used with or without cancer treatment, ginseng helps the body to use triglycerides for energy, mobilize fat, and save glucose.[15] Ginseng, unlike many other supplemental herbs, does not interfere with cytochrome p450 and has no discernable unwanted side effects![16] Supplementing with ginseng is a safe and effective way to combat fatigue and promote overall wellness. The plant has been used for hundreds of years to produce these desired outcomes, and we now have the scientific evidence to back up its efficacy.

[1] Wang, J., Li, S., Fan, Y., Chen, Y., Liu, D., Cheng, H., . . . Zhou, Y. (2010). Anti-fatigue activity of the water-soluble polysaccharides isolated from Panax ginseng C. A. Meyer. Journal of Ethnopharmacology, 130(2), 421-423. doi:10.1016/j.jep.2010.05.027

[2] Castleman, M. (2009). 130 Healing Herbs. In The New Healing Herbs (pp. 201-204).

[3] Castleman, Ibid.

[4] Barton, D. L., Liu, H., Dakhil, S. R., Linquist, B., Sloan, J. A., Nichols, C. R., . . . Loprinzi, C. L. (2013). Faculty of 1000 evaluation for Wisconsin Ginseng (Panax quinquefolius) to Improve Cancer-Related Fatigue: A Randomized, Double-Blind Trial, N07C2. J Natl Cancer Inst, 105(16), 1230-1238. doi:10.3410/f.718031506.793482842

[5] Tomas, C., Newton, J., & Watson, S. (2013). A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome. ISRN Neuroscience, 2013, 784520.

[6] Tomas, Ibid.

[7] Barton, op. cit.

[8] Kim, H.-G., Cho, J.-H., Yoo, S.-R., Lee, J.-S., Han, J.-M., Lee, N.-H., … Son, C.-G. (2013). Antifatigue Effects of Panax ginseng C.A. Meyer: A Randomised, Double-Blind, Placebo-Controlled Trial. PLoS ONE, 8(4), e61271.

[9] Panossian, A., Hamm, R., Kadioglu, O., Wikman, G., & Efferth, T. (2013). Synergy and antagonism of active constituents of ADAPT-232 on transcriptional level of metabolic regulation of isolated neuroglial cells. Frontiers in neuroscience, 7.

[10] Oliynyk, S., & Oh, S. (2013). Actoprotective effect of ginseng: improving mental and physical performance. Journal of Ginseng Research, 37(2), 144–166.

[11] Wang, op. cit.

[12] Stoye, E. (2011, August 16). Ginseng extract may help cancer sufferers. Retrieved June 12, 2017, from

[13] Barton, op. cit.

[14] Stoye, op. cit.

[15] Wang, op. cit.

[16] Barton, op. cit.

Clinical Contributor

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Disclaimer: The information provided is only intended to be general educational information to the public. It does not constitute medical advice. If you have specific questions about any medical matter or if you are suffering from any medical condition, you should consult your doctor or other professional healthcare provider.

Ramona Richard, MS, NC

Ramona Richard, MS, NC

Ramona Richard graduated with honors from the University of California with a Bachelor’s Degree in psychology and graduated summa cum laude with a Master’s Degree in Health and Nutrition Education. She also holds a Standard Designated Teaching Credential from the State of California, is a California state-certified Nutrition Consultant and a member of the National Association of Nutrition Professionals.

Ramona has participated in nutrition education in both public and private venues, including high school and college presentations, radio and public speaking for the past 20 years. She is the owner of Radiance, a nutrition consulting company, the Director of Education for Sanesco International, and a medical technical writer.

Disclaimer: The information provided is only intended to be general educational information to the public. It does not constitute medical advice. If you have specific questions about any medical matter or if you are suffering from any medical condition, you should consult your doctor or other professional healthcare provider.

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