# American ginseng for cancer-related fatigue

Source: https://onco.cc/technologies/american-ginseng-fatigue/  
OnCo record `american-ginseng-fatigue` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In a randomised placebo-controlled trial of 364 people, eight weeks of Wisconsin American ginseng modestly improved cancer-related fatigue, mainly in those still on treatment. The 2024 fatigue guideline says it may be offered during treatment; quality of the product matters.

## Summary

Panax quinquefolius (American ginseng) was tested in a double-blind randomised trial of 364 patients with cancer-related fatigue (Barton et al., JNCI 2013): 2,000 mg per day of pure ground Wisconsin root for eight weeks improved fatigue scores compared with placebo, with the benefit concentrated in patients receiving active treatment and no excess toxicity. A smaller earlier dose-finding trial pointed the same way. The 2024 SIO-ASCO fatigue guideline says American ginseng may be offered for fatigue during treatment (not after). Commercial products vary widely in ginsenoside content and some contain Asian ginseng (Panax ginseng), which has oestrogenic activity of concern in hormone-sensitive cancers; the trial product was a standardised North American root. Ginseng may interact with warfarin and imatinib.

## Fields

- Kind: Technology
- Status: phase-2
- Last checked: 2026-09-10
- Tags: complementary; supportive-care; evidence:moderate
- Principle: Ginsenosides are proposed to modulate cortisol regulation and inflammatory cytokines that drive cancer-related fatigue; the mechanism in humans is not established.
- Strengths: Large placebo-controlled trial; Named in SIO-ASCO 2024 as an option during treatment
- Limitations: Single confirmatory trial; Product quality varies; avoid Asian ginseng in hormone-sensitive cancers; Possible interactions with warfarin and imatinib

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/American_ginseng
- Wisconsin ginseng to improve cancer-related fatigue, randomised double-blind trial N07C2 (JNCI 2013): https://doi.org/10.1093/jnci/djt181
- SIO-ASCO guideline: integrative oncology care of cancer-related fatigue (JCO 2024): https://doi.org/10.1200/JCO.24.00575
- MSK About Herbs: American ginseng: https://www.mskcc.org/cancer-care/integrative-medicine/herbs/american-ginseng

## Connected records

- fronts: [Diet, Exercise & Lifestyle](https://onco.cc/fronts/nutrition-lifestyle/), [Recovery & Rejuvenation](https://onco.cc/fronts/rejuvenation/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Dietary supplements during cancer treatment: interactions and harms](https://onco.cc/technologies/dietary-supplements-treatment-interactions/), [Evidence-based integrative oncology](https://onco.cc/technologies/integrative-oncology/), [Fatigue after cancer treatment: what actually works](https://onco.cc/technologies/cancer-related-fatigue-management/)
- drugs: [Imatinib](https://onco.cc/drugs/imatinib/)
- bottlenecks: [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)
- key papers: [Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2](https://onco.cc/key-papers/paper-barton-j-natl-cancer-inst/)

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