Panax quinquefolius

Panax quinquefolius is a herbaceous perennial 20 to 50 cm tall on a single upright stem. The stem carries a whorl of one to four palmately compound leaves, each on a stalk and each divided into three to five, rarely six, oval pointed leaflets 6 to 15 cm long and 2 to 8 cm wide with finely toothed edges and stiff hairs on the veins beneath. Growers call the leaves prongs. A seedling has one leaf of three leaflets, a one prong plant has five leaflets, a two prong plant ten, a three prong plant fifteen, and a four prong plant twenty. ^[4][5][12]

Plants do not flower until the two prong stage, and three prong plants are typical by about the fifth year in a forest. A single stalk 1 to 12 cm long rises from the whorl and carries a rounded umbel of 6 to 25 small greenish white flowers, each with five petals and five stamens. Flowering runs from May to June in North Carolina, early June to mid July in Pennsylvania, and late June to July in Quebec. The fruits are flattened bright red drupes 7 to 10 mm across that ripen in August and September, each with one to three seeds, and birds take them. ^[4][5][12]

The root is what the trade pays for. A thin rhizome, the neck, joins the stem to a fleshy, elongated, often forked taproot, and each autumn the dying stem leaves a scar on the neck, so a buyer can count the age of a root. Older wild roots are slender and wrinkled with a long scarred neck, while farmed roots are short and smooth. Federal export rules and most buyers require the neck to stay on the root. ^[4][12]

The plant lives slowly. Seed stays dormant for about 18 to 20 months before it sprouts, seedling deaths reach 70 to 90 percent in northern populations, small rodents eat the seed, and only about 0.55 percent of seeds grow into a mature plant, which takes seven to 15 years. A plant can live for more than 60 years, and foresters in North Carolina put the span at 60 to 80 years. ^{[4][6][11][18]}

The species is a tetraploid, as is Panax ginseng, while P. notoginseng and P. vietnamensis are diploid. A 2023 comparison of the four species found that the genes which cyclise squalene toward ginsenosides are more active in the two tetraploids, and that the tetraploids hold more dammarane type ginsenosides, so the ancient doubling of the genome seems to have pushed the chemistry that makes the root valuable. ^[28]

Linnaeus published Panax quinquefolius in the second volume of Species Plantarum on 1 May 1753, and the American plant is the type species of the genus. The epithet means five leaved, for the usual count of leaflets. The genus sits in the family Araliaceae with ivy, aralia, and the devil's club. ^[1][2]

The name has a tail of synonyms. The Jesuit Joseph-François Lafitau proposed Aureliana canadensis in 1717, and botanists at the royal garden in Paris rejected it the same year. Decaisne and Planchon moved the plant into Aralia in 1854, Alphonso Wood coined Ginseng quinquefolium in 1871, and Rafinesque left behind Panax americanus and several varieties. Canadian status reports used the neuter spelling Panax quinquefolium until 2000, and that spelling still appears in papers. ^[2][6][22]

In Chinese the root is xiyangshen, 西洋參, "west ocean ginseng", as distinct from renshen, the native root of Manchuria and Korea. The 1757 materia medica Bencao Congxin classed the two as opposites, renshen warm and the American root cool, a judgement shaped partly by the fact that the root entered China through hot Guangzhou. In Quebec the plant is ginseng à cinq folioles, and Lafitau recorded the Mohawk name garent-oguen and built his claim that the American and Chinese plants were the same on a comparison of that word with gin-seng. ^[4][22][23]

In Appalachia the plant is simply sang or seng, and the people who dig it are sang hunters. Lookalikes catch beginners: Virginia creeper and boxelder seedlings have similar leaves, but ginseng never has a woody stem and always grows from a single root, and the smaller dwarf ginseng, Panax trifolius, has stalkless leaflets, white flowers, and yellow fruit. ^{[5][11][20][27]}

The species ranges across the eastern half of North America. NatureServe maps it from Maine west through southern Ontario to Minnesota and eastern South Dakota, and south to Georgia, Alabama, Mississippi, Louisiana, and eastern Oklahoma, with its heartland in the Appalachians and the Ozarks. There are at least 4,000 recorded occurrences, but most hold very few plants, and the total population is far smaller than it was before European settlement. The plant is critically imperilled in Kansas, Louisiana, Nebraska, Oklahoma, Rhode Island, and South Dakota, and is possibly gone from the District of Columbia. ^[3]

In Canada it grows only in southern Ontario and southwestern Quebec, where it is a plant of rich sugar maple forests with bitternut hickory, basswood, red oak, white ash, and butternut. Quebec has recorded it at nearly 200 sites, more than half of them small or in disturbed sugar bushes. In Ontario the populations lie along the Niagara Escarpment and the eastern edge of the Canadian Shield. ^[4][6]

The plant wants deep shade, about 75 percent or more, on cool north and east facing slopes with moist, well drained, humus rich soil of near neutral pH. Wisconsin foresters list sugar maple, basswood, butternut, red oak, maidenhair fern, bloodroot, blue cohosh, and Jack in the pulpit as the neighbours that mark a good site. In the United States the plant grows in hardiness zones 4a to 8b, and in North Carolina it is a plant of the Piedmont and the mountains. ^[4][5][11]

Seed and stratification

Fresh seed will not sprout the next spring. The embryo needs 12 to 16 months of alternating warm and cold before the seed opens, so ripened seed takes 18 to 22 months to germinate in the ground. Growers buy or make stratified seed, which has already been through that cycle in moist sand, and sow it in October as the leaves fall so that it sprouts the following spring. There are roughly 6,500 to 7,000 seeds in a pound, a pound costs about 45 to 130 dollars, and most seed on the market is a by product of the shade farms. ^[11][12][13]

Field cultivation under shade

The farm crop copies the forest floor with cloth. In Wisconsin growers raise beds about four feet wide under lath or polypropylene shade that cuts 70 to 90 percent of the light and stands about seven feet above the ground, sow 80 to 100 pounds of seed to the acre, and dig the roots after three to five years. A well run planting yields about a ton of dried root an acre and 150 to 250 pounds of seed, but it costs about 20,000 dollars and 600 hours of labour an acre each year, with no return until the third or fourth year. ^[10]

Ontario's growers work sandy loam at pH 6.0 to 6.5 under shade that lets through 18 to 26 percent of full sunlight. They sow in the field from August to October at 89 to 112 kg of seed per hectare, apply about 40 kg of nitrogen per hectare each spring, and lift the whole bed in a single harvest in September or October after three or four years. Root weight rises with age, but disease pressure usually decides when a garden comes out. ^[8]

Replant disease and rotation

Ginseng cannot follow ginseng. Ontario's advice is blunt: a field that has grown the crop cannot grow it again, even decades later. Root rot caused by Fusarium and Ilyonectria fungi builds up in the soil, ginsenosides that leak from the roots poison the next crop and shift the soil microbes toward pathogens, and a 2026 review of the problem across the three main Panax species found that no single cause explains it. Ontario's other main diseases are Phytophthora leaf blight and root rot, Cylindrocarpon root rot, Rhizoctonia crown rot, Alternaria blight, and Botrytis. ^[8][34][35]

Woods grown and wild simulated

Forest growers trade time for price. Woods cultivated ginseng is grown in tilled beds under natural shade for five to nine years and sells for about 150 dollars a pound, with a range of 25 to 300 depending on how wild the root looks. Wild simulated ginseng is seed scattered in untilled forest soil with no fertiliser or sprays and left for eight to twelve years, and its roots, which are hard to tell from wild ones, sold for about 350 dollars a pound in a Pennsylvania budget. Wisconsin's extension programme teaches the method on 10 by 10 foot plots sown with 500 to 700 seeds, raked, scuffed, broadcast, and covered in October; the plants flower in year five or six and reach harvest size in seven to ten years. ^[11][12][13]

Ontario has banned both methods since 2008 to protect its wild stands, and only field cultivation under artificial shade is permitted there. ^[7]

Growing regions

Wisconsin grows more than 90 percent of the cultivated crop of the United States, and 90 to 95 percent of Wisconsin's crop comes from Marathon County around Wausau, which the state calls the ginseng capital of the country and which supplies about a tenth of the world's root. The industry began in 1904 when the four Fromm brothers of Hamburg township moved 100 wild plants from the forest into a shaded plot, after attempts in the 1870s had failed to disease. ^[10][24]

Ontario's industry sits in the sandy soils of the southwest around Simcoe, where the growers' association counts more than 150 members and claims the largest production of the species in the world. British Columbia planted its first field at Lytton in 1982, peaked in 1994 with 128 growers and a crop worth about 30 million dollars, and then shrank as prices fell. China now grows the species widely, and a 2026 chemical survey found that roots from Shandong are the closest to North American ones. ^[9][25][36]

Digging and washing

Field roots come out of the ground in a single lift in September or October. Wild roots are dug by hand in the autumn seasons that the states set, which in Wisconsin run from 1 September to 1 November, and the stalk must stay on the plant until it reaches the digger's home. Growers lift forest roots with a garden fork or their fingers, wash them gently without a brush, and spread them on screens. ^[8][12][14]

Drying

Dried root weighs about a third of its fresh weight, and Indiana converts green pounds to dry at a rate of 0.32. Wisconsin growers dry on wire netting shelves in a heated, ventilated room, starting at 60 to 80 °F for the first few days and then holding about 90 °F for three to six weeks while turning the roots often. Heat drying, peeling, and plastic storage are the old mistakes to avoid, and finished roots keep dry, rodent proof, and just above freezing. ^{[10][12][13][16]}

Extracts

Two proprietary extracts carry most of the clinical record. Cereboost is a root extract standardised to 10.65 percent ginsenosides, used at 100 to 400 mg in the cognition trials. CVT-E002, sold as COLD-fX in Canada, is a water extract standardised to 80 percent poly furanosyl pyranosyl saccharides, a polysaccharide fraction rather than a saponin one, and was used at 200 mg twice a day in the cold trials. The Toronto diabetes trials used ground root in capsules or an extract at 1 g per meal, and the cancer fatigue trial used Wisconsin root powder at 2,000 mg a day. ^{[40][42][46][50][61]}

Buyers sort American ginseng into at least 40 grades by root shape, colour, taste, and age, though most growers know little of the grades and sell in bulk. Age and appearance decide the price more than weight, and a wild looking root with a long neck and many scars is the top of the market. ^[12][13]

The price ladder is steep. Field cultivated root sold for about 12 to 20 dollars a dry pound in 1999 and 20 to 45 dollars in 1990, woods cultivated root for about 150, and wild simulated root for about 350. Wild root sold in Indiana for an average of 691.67 dollars a dry pound at the middle of the 2023 season, at about 293 roots to the pound, and undried green roots have fetched up to 400 dollars a pound from buyers who want them fresh. The export value of wild American root rose from 149 to 401 US dollars a kilogram between 2004 and 2009. ^{[7][10][12][13][16][19]}

Shops sell the root whole, sliced for tea and soup, as powder, in capsules, and as standardised extracts. Our guides to wild versus cultivated American ginseng and how to choose American ginseng explain what the grades and labels mean. ^[12][13]

Lafitau and the Mohawk

The Jesuit Pierre Jartoux described Manchurian ginseng in a letter of 12 April 1711 and guessed from the forests that the plant might grow in Canada. Joseph-François Lafitau, a Jesuit at the Mohawk mission of Kahnawake near Montreal, read the letter on a visit to Quebec in October 1715, searched the next spring, and in the summer of 1716 saw the plant in fruit by a house he was building. A Mohawk woman he had hired to search recognised it as a common Iroquois remedy and used it to cure a chronic fever, and his informants picked the plant out from Jartoux's engraving. ^[21][22]

Lafitau sent a memoir and specimens in brandy to Paris, where the Académie heard it in January 1717 with much doubt, and in 1718 he printed his Mémoire on the ginseng of Tartary found in Canada. The report set off a rush of collectors that nearly wiped the plant out of the St Lawrence valley within a few decades. ^[21][22]

The China trade

The 1757 Bencao Congxin gave the American root its own place in Chinese medicine as the cool ginseng. On 22 February 1784 the Empress of China left New York for Guangzhou with about 30 tons of American ginseng in its hold, the first American trade voyage to China, and returned with tea, porcelain, and silk at a profit of about 25 percent. Ginseng and furs were among the few American goods that China wanted, and by 1820 a magazine reported exports of at least 500 hundredweight a year. ^[23]

Daniel Boone was in the trade. Diggers still tell how Boone and his men lost several tons of ginseng when their boat sank in the Ohio River in 1788 and simply dug another load; the historian John Faragher calls the sinking apocryphal and says Boone carried his damaged cargo on to Pennsylvania. Through the nineteenth century more than 95 percent of the wild root dug in the United States went to China, mountain families sold it to country stores for pennies a pound, and firms such as the Wilcox Drug Company of Boone, North Carolina, founded in 1900, grew into the largest American buyers of botanicals. ^[19][20]

American doctors were unimpressed. Jacob Bigelow wrote in 1818 that the root's virtues did not justify the Chinese esteem, and an 1826 article called the Chinese view an extravagant fondness. The gap between the two medicines, and the money in the trade, meant that nobody tested the root seriously for another 150 years. ^[23]

Farming and science

Cultivation came late. Wisconsin's attempts in the 1870s failed to disease, and the Fromm brothers' 1904 planting founded the Marathon County industry. British Columbia's first field went in at Lytton in 1982. The modern evidence began in Toronto in 2000, when Vladimir Vuksan's group at St Michael's Hospital showed that 3 g of root lowered after meal blood sugar, continued with the Edmonton cold trials of CVT-E002 from 2004, and reached a phase III cancer fatigue trial run through the Mayo Clinic's cooperative group in 2013. ^{[10][25][38][46][50]}

In Chinese medicine xi yang shen replenishes qi and nourishes yin, clears heat, and generates fluids. It is the root for a tired person who also runs hot, dry, or restless, where the warm renshen would be too much. The classification as cool dates from 1757 and rested partly on the belief that the root came from a hot country, since it arrived through Guangzhou; a 2025 review of the trials and animal studies on body temperature after the two species found that the scientific evidence for the warm and cool labels is scarce. ^[23][35][37]

In North America the root was medicine before it was trade. The Mohawk of Kahnawake used it for fever, William Bartram recorded in the 1790s that the Cherokee urged diggers to take no more than one root in four and to leave a seed behind, and Native Americans across the range used it for a variety of purposes. In Appalachia sang digging became a family skill passed down through generations and a source of cash that mountain people called green gold. ^[5][20][21]

Ginsenosides

The signature compounds are ginsenosides, triterpene saponins that fall into four classes by their skeleton: protopanaxadiol (PPD) types such as Rb1, Rb2, Rc, and Rd; protopanaxatriol (PPT) types such as Rg1 and Re; oleanane types such as Ro; and ocotillol types. American ginseng is a PPD root. Rb1 outweighs Rg1 many times over, and a Toronto batch with a Rb1 to Rg1 ratio of 8.1 and 1.66 percent total ginsenosides was judged a weak one, so that ratio, and the PPD to PPT ratio, are the usual chemical signatures that separate the American species from the PPT rich Korean root. ^[29][32]

The profile matters for what the root does. In a 2004 study of eight kinds of ginseng in 12 healthy people, the PPD to PPT ratio was the only measured chemical predictor of the effect on blood sugar after glucose. Wild and cultivated roots differ too: a 2022 metabolomic comparison found ocotillol types more abundant and diverse in wild American ginseng, PPD and oleanane types more widespread in cultivated root, and five ginsenosides 2.3 to 54.5 times higher in the wild roots. ^[31][33]

Pseudoginsenoside F11

Pseudoginsenoside F11 is an ocotillol type saponin with a 20,24 epoxy bridge that is unique to American ginseng, which makes it the marker chemists use to catch Korean root sold as American. In animals it protects nerve cells in models of Alzheimer's disease, Parkinson's disease, and stroke, guards the heart and kidney, and acts on the PPARγ receptor. A 2026 review notes that it is poorly absorbed by mouth and that there are no human studies, so its promise is preclinical. ^[30]

Polysaccharides and metabolites

The root also holds polysaccharides, and the Canadian cold extract CVT-E002 is built on them rather than on saponins. Swallowed ginsenosides are poorly absorbed until gut bacteria strip their sugars, and the protopanaxadiol metabolite compound K, made from Rb1, is credited with the antiproliferative effects seen in the laboratory. ^[26][29][47]

The exact mechanism is unknown. Laboratory work shows ginsenosides acting on the central nervous system, on immune cells, and on glucose metabolism, and the clinical effects follow those three lines. ^[26]

On blood sugar the root lowers the rise after a meal when taken shortly before it, and an eight week trial in people with type 2 diabetes also found a rise in blood nitrate and nitrite, a marker of nitric oxide, alongside lower systolic pressure and LDL cholesterol. The glucose effect tracks the ginsenoside profile, which is why a weak batch does nothing. ^[32][33][40]

On the brain a 2026 review of the trials finds that the extract raises activation of frontoparietal circuits during memory tasks, that its effects are consistent with cholinergic modulation, and that it changes the composition of the gut microbiome. The 2022 Cereboost trial ran the extract through a model of the human colon at the same time and saw more acetate, propionate, and butyrate and more Akkermansia and Lactobacillus, a possible gut brain route. The 2010 trial that started this line found no change in blood glucose, and its authors stressed that the effects were distinct from those of Asian ginseng. ^[42][44][45]

On immunity the polysaccharide extract raised the rate of antibody seroconversion against common respiratory viruses in people with leukaemia, which fits the lower rate of confirmed influenza in the nursing home trials. For a plain language account of these mechanisms see what American ginseng actually does. ^[46][49]

It lowers the rise in blood sugar after a meal

This is the best replicated finding for the species. A 2000 study in 10 people without diabetes and 9 with type 2 diabetes found that 3 g of root taken 40 minutes before a 25 g glucose drink cut the area under the glucose curve by about 18 percent in the healthy group and 19 to 22 percent in the diabetic group. A 2001 study in 12 healthy adults found that 1, 2, and 3 g worked equally well, and only when taken 40 minutes before the drink rather than with it. ^[38][39]

Longer use helps too. A 2019 trial in 24 people with type 2 diabetes on their usual drugs found that 1 g of extract with each meal, 3 g a day, for eight weeks lowered HbA1c by 0.29 points, fasting glucose by 0.71 mmol/L, systolic pressure by 5.6 mmHg, and LDL cholesterol by about 12 percent, with no change in liver or kidney tests. The catch is the batch: in a 2007 study of 9 g doses from five Ontario farms, the roots lowered peak glucose by an average of 1.0 mmol/L, but two of the five batches fell short of the expected effect. See American ginseng for blood sugar. ^[40][41]

It helps working memory and calm attention

A 2010 study of 32 healthy young adults found that single doses of 100, 200, or 400 mg of the Cereboost extract improved working memory at every test over six hours, and that 100 mg improved choice reaction accuracy and self rated calmness, with no change in blood glucose. A 2015 study of 52 adults aged 40 to 60 found better working memory three hours after 200 mg. A 2022 trial of 61 young adults found the same acute gains, found them larger after two weeks of daily use, and found better scores on an attention task and less mental fatigue after the two weeks. ^[42][43][44]

A 2026 review of the double blind trials concludes that the clearest effects at 100 to 400 mg are on attention and working memory in healthy adults and in people with schizophrenia. The trials are small and come from one research group, so the effect is real but its size in daily life is not settled. See American ginseng for focus. ^[45]

It may mean fewer colds in winter

The cold trials used the polysaccharide extract CVT-E002. Two trials in 2004 enrolled 198 nursing home residents with an average age of 81 to 83, most of them vaccinated, and gave 200 mg twice a day for 8 to 12 weeks; laboratory confirmed influenza struck 1 of 97 on the extract and 7 of 101 on placebo. A 2005 trial of 323 adults aged 18 to 65 who had caught at least two colds the year before found 0.68 colds per person on two capsules a day for four months against 0.93 on placebo, 10 percent against 23 percent with two or more colds, and 10.8 against 16.5 days of symptoms. A 2006 trial of 43 people over 65 living at home found that in the last two months of a four month course 32 percent reported a respiratory illness against 62 percent on placebo, lasting 5.6 against 12.6 days. ^[46][47][48]

The limits matter. A 2012 trial of 293 people with chronic lymphocytic leukaemia found no reduction in days of illness, though sore throats were milder and more people seroconverted to common viruses. The trials all come from one maker's extract, and the benefit is modest. A 2008 trial of 75 children aged 3 to 12 found standard doses well tolerated with no serious adverse events. See American ginseng for colds. ^[49][61]

It eases fatigue in people being treated for cancer

A 2013 trial of 364 cancer survivors at 40 centres found that 2,000 mg a day of Wisconsin ginseng for eight weeks improved the general fatigue score by 20 points against 10.3 on placebo, with the largest gains in people still on active treatment and no difference in side effects. The 2024 American Society of Clinical Oncology guideline on cancer fatigue says American ginseng may be recommended for adults undergoing cancer treatment. ^[50][51]

Elsewhere the record is thin or negative. A 2020 trial of 32 head and neck cancer survivors found no benefit from 1,000 mg a day for eight weeks, and a 2011 trial of 56 people with multiple sclerosis found no change in fatigue at 100 to 400 mg a day over six weeks. We found no large trial of the species for everyday tiredness in healthy adults, so claims about energy rest on the cancer trial and on the mental fatigue scores in the cognition studies. See American ginseng for fatigue. ^[44][52][53]

It does not raise blood pressure

An old worry that ginseng raises blood pressure does not hold for this species. A 2006 trial in 52 people with hypertension found that 3 g a day for 12 weeks had no effect on 24 hour ambulatory blood pressure or on a marker of kidney function. A 2013 trial in 64 people with type 2 diabetes and treated hypertension found that 3 g of extract a day for 12 weeks lowered arterial stiffness by 5.3 percent and systolic pressure by about 12 percent. ^[54][55]

Exercise and immunity in healthy adults

Smaller studies give modest results. A 2005 crossover study in 13 male students found that four weeks of the root reduced the leak of creatine kinase from muscle during an exhausting run but did not improve endurance. A 2009 study in 25 postmenopausal women found that 1 g of root powder a day for four months did not change heart rate, blood pressure, or glucose at rest or after a walk, and raised markers of oxidative stress rather than lowering them. Cell and animal work on heart failure, colitis, and Alzheimer's disease is active but has not reached human trials of the plain root. ^[30][58][60]

The trials used three kinds of dose. For blood sugar the dose is 1 to 3 g of ground root, usually 3 g, taken about 40 minutes before a meal, or 1 g of extract with each meal for 3 g a day over eight weeks. For attention and working memory the dose is 100 to 400 mg of a standardised extract, most often 200 mg, as a single dose or daily for two weeks. For colds the dose is 200 mg of the polysaccharide extract twice a day through the winter months, and for cancer related fatigue it is 2,000 mg of root powder a day in two divided doses for eight weeks. ^{[38][39][40][42][44][46][47][50]}

Effects on blood sugar appear within the hour, effects on working memory within one to three hours, and effects on fatigue and colds after four to eight weeks. The 2006 blood pressure trial and the 2019 diabetes trial both ran 3 g a day for eight to twelve weeks without safety signals. Our guides to American ginseng dosage and how to choose American ginseng give practical detail by goal. ^[40][42][54]

The root is well tolerated at trial doses. The 364 person cancer fatigue trial found no difference in side effects between ginseng and placebo, the leukaemia trial found the extract well tolerated, the children's trial found no serious adverse events, and a 2017 review of the two species concludes that the safety profile is favourable. One four month study in postmenopausal women found raised markers of oxidative stress at 1 g a day, which is a reason not to treat the root as a daily antioxidant. ^{[49][50][58][59][61]}

The firm interaction is with warfarin. A 2004 randomised trial in 20 healthy volunteers found that two weeks of American ginseng lowered the peak INR by 0.19 and reduced blood levels of warfarin, and a 2017 review of nine trials of herbs with warfarin found that American ginseng altered the drug's effect while Korean red ginseng did not. If you take warfarin, talk with your doctor before starting or stopping American ginseng and expect an INR check. ^[26][56][57]

Blood sugar is the second caution. The root lowers glucose after meals, so it can add to the effect of diabetes drugs, and the Toronto group advised people without diabetes to take it with the meal rather than well before it to avoid an unwanted low. Memorial Sloan Kettering also lists possible falls in prothrombin time and INR on laboratory tests and a possible induction of the liver enzyme CYP3A4, though the clinical relevance of the enzyme effect is not known. ^[26][38]

Pregnancy and breastfeeding have no trial data for this species, so the usual advice is to avoid it in those periods and to keep children's use to a doctor's guidance. A laboratory study found that ginseng stimulated breast cancer cells, but at a dose that cannot be reached by mouth, and the reviewers judge the finding of no clinical relevance; people with hormone sensitive cancers should still ask their oncologist. ^[26][61]

Quality is the last caution. In the 2004 study of eight types of ginseng, Asian ginseng raised peak glucose, wild American ginseng raised late glucose, and the unrelated Siberian ginseng raised it too, so a product that is not what its label says can do the opposite of what you expect. Two of five Ontario batches fell short on blood sugar in 2007, and a batch with a depressed ginsenoside profile did nothing in 2003, so buy root or extract from a maker who tests and states its ginsenoside content. The American ginseng side effects guide covers the cautions in more depth. ^[32][33][41]

Forms of American ginseng

Four production systems feed the market. Field cultivated root grows three to four years in raised beds under shade cloth. Woods cultivated root grows six to nine years in tilled forest beds. Wild simulated root grows nine to twelve years or more in untilled forest soil and looks almost wild. Wild root is dug from natural stands under state licence. The forest roots carry more of the ocotillol type ginsenosides and sell for ten times the field price or more, while field root supplies the capsules, teas, and extracts tested in trials. ^[13][31][33]

Related species and plants called ginseng

Plant	Family and native range	What it contains	Use and notes
Panax quinquefolius (American ginseng)	Araliaceae; eastern North America	PPD rich ginsenosides, high Rb1, low Rg1; pseudoginsenoside F11; polysaccharides	The cool ginseng of Chinese medicine; the subject of this article [29][30][37]
Panax ginseng (Asian, Korean, Chinese ginseng)	Araliaceae; Korea, northeast China, Russian Far East	PPT rich profile with more Rg1; tetraploid like the American species	The warm ginseng; raised peak glucose in the eight type study; see American versus Korean ginseng [28][33][37]
Panax notoginseng (sanqi, tianqi)	Araliaceae; southern China	Saponins and polysaccharides; diploid	Chinese remedy for bleeding and circulation; shares the replant problem; see American ginseng versus notoginseng [28][34]
Panax vietnamensis (Vietnamese ginseng)	Araliaceae; central Vietnam	Diploid; ocotillol types	Wild Vietnamese root tended to lower glucose in the eight type study [28][33]
Panax trifolius (dwarf ginseng)	Araliaceae; eastern North America	A small tuber; not traded	4 to 8 inches tall, white flowers, yellow fruit, stalkless leaflets; never collected to scarcity [27]
Eleutherococcus senticosus ("Siberian ginseng", eleuthero)	Araliaceae; Russian Far East, northeast China	No ginsenosides	A shrub, not a Panax; raised blood glucose in the eight type study [33]

The three species article, the three Panax species, sets out which root suits which goal. ^[37]

Canada and the United States grow almost all of the world's American ginseng, and nearly all of it leaves. Canada exported 2.67 million kg of field cultivated root worth about 70 million Canadian dollars in 2008, has banned the export of wild root since 1989, and sells mainly through Hong Kong to mainland China, Taiwan, and Singapore. Ontario's association describes its members as the premier supplier of the species, and any Ontario grower with more than a quarter acre must join it and pay an acreage fee. British Columbia was the third growing region of North America at its 1994 peak and has since largely left the crop. ^{[7][8][9][25]}

Wisconsin's crop is a China crop. Central Wisconsin grows about 90 percent of the United States harvest, about 85 percent of it is exported to China, and the trade was worth more than 30 million dollars a year to the state's growers before China's 15 percent retaliatory tariff of 2018. Most of the crop ships to Hong Kong, where it enters duty free before redistribution across East Asia, while most of the ginseng used in the United States is Korean root coming the other way. Wisconsin's growers pay a 15 cent a pound assessment to fund promotion and research. ^[10][24]

Wild roots are a separate market. In 2009 the United States exported 90,600 kg of wild root worth about 36 million US dollars, an estimated 41 million roots, against 284,000 kg of cultivated root, and the wild price rose from 149 to 401 dollars a kilogram over the five years before. Appalachian diggers earned more than 30 million dollars a year on average in the 2000s, and Chinese and Korean exporters buy thousands of pounds a year from local dealers, with Korean buyers now asking for undried roots for restaurants in Seoul. Indiana certified 1,552 pounds of dried wild root from 1,629 diggers through 16 dealers in the 2023 season, its lowest year on record. ^[7][16][19]

NatureServe ranks the species G3G4, vulnerable to apparently secure, a rank last reviewed in February 2025. The plant is widely distributed with at least 4,000 occurrences, but the occurrences are small, population sizes have fallen considerably since settlement, and the rank is S1 or S2 in a dozen states and both Canadian provinces. ^[3]

Canada lists the plant as Endangered. COSEWIC rated it Threatened in 1988, Endangered in 1999, and confirmed that status in 2000 after finding that a quarter of the Ontario populations surveyed in 1988 had vanished by 1997 and half had declined. A viable colony needs about 170 plants; by that measure Ontario had seven viable populations and Quebec 15, and of 418 recorded Canadian populations only 49 are viable. Quebec listed the plant as threatened and banned collection and trade in 2001, and Ontario banned wild harvest and the planting of wild simulated and woods grown ginseng in 2008. The threats are illegal digging, lost forest, deer and slugs, invasive plants, and intensive maple syrup production. ^[4][6][7]

In the United States the trade is run under CITES. The species went onto Appendix II on 1 July 1975, and each year the Fish and Wildlife Service must find that export will not harm the species before it approves the harvest of 19 states and one tribe, with four more states allowing cultivated root only. Since 1999 wild and wild simulated roots must be at least five years old to be exported. The states add their own rules: Wisconsin allows digging only from 1 September to 1 November, only of plants with three or more true leaves and a fruiting stalk, requires the digger to plant the seeds where the parent grew, bans harvest on state land, and licenses the dealers who certify roots for export. ^{[14][15][16][17]}

The wild plant is still losing ground. The Forest Service stopped issuing harvest permits in the Nantahala and Pisgah national forests in 2021 after monitoring showed populations falling each year, and the pause held through the 2024 season because a plant that takes up to ten years to set seed cannot stand the pressure; digging there now carries a fine of up to 5,000 dollars and six months in federal prison. Estimates say that up to 90 percent of the wild root on the international market is dug illegally, and the agencies answer with sting operations, dye marks, and tracking chips in protected roots. Restoration beds, seed from shade farms, and wild simulated planting on private woodland are the hopeful side of the ledger. ^[11][18][19]

Sang digging is a mountain tradition. Appalachian families have passed the skill down for generations, men and women dug the root to add to a household income, and collectors sold to country stores and factories that cleaned, dried, and stored it for export. The Cherokee rule that Bartram recorded, take one root in four and leave a seed, is the oldest conservation advice for the plant, and the tale of Daniel Boone's lost cargo is told by diggers as a story of self reliance rather than of history. ^[19][20]

The root carries two names across the Pacific. In China it is the west ocean ginseng, valued as a cooling tonic since the eighteenth century, and in Lafitau's day it was garent-oguen, the plant the Mohawk women at Kahnawake knew before the Jesuit did. The nineteenth century American physician's scorn for the Chinese esteem has reversed in the twenty first, as the trials from Toronto, Edmonton, and Rochester have given the root a scientific record. ^{[21][22][23][38][46][50]}

Wisconsin celebrates its crop. Wausau held its first International Ginseng Festival in September 2017 and drew visitors from China, the Hsu family's farm is one of the largest growers and distributors in the country, and Marathon County calls itself the ginseng capital of the United States. In Canada the Ontario growers' association works from Simcoe, and COLD-fX, the polysaccharide extract from the Alberta trials, became a household brand. Korean restaurants now buy green Appalachian roots to serve fresh, and the Chinese market that opened in 1784 remains the one that sets the price. ^{[9][10][19][24][46]}