Eleuthero (Siberian ginseng)
Summary
Eleuthero, often sold as Siberian ginseng, is marketed as an adaptogen for stress, fatigue and stamina. Placebo-controlled trials have mostly been null: it added nothing to stress-management training, did not ease chronic fatigue overall, and did not improve bike or running performance (grade C–D). It was well tolerated and did not alter two major drug-metabolizing enzymes.
Key facts
- Root of Eleutherococcus senticosus, a shrub in the ginseng family promoted as an adaptogen[10]
- No benefit added to stress-management training in 144 adults; no overall effect on chronic fatigue[1][2]
- 485 mg twice daily for 14 days did not change CYP2D6 or CYP3A4 activity[8]
- A case report linked it to falsely high digoxin readings; ginsengs are known to interfere with some digoxin assays[9][11]
- 7 graded human outcomes on this page
- October 13, 2026
How it works
ProposedEleuthero is promoted as an adaptogen, a concept proposed by Soviet scientists in the late 1950s; a 2000 review notes the definition overlaps with explanations of the placebo effect. A lab study found its compound eleutheroside E activated the Tie2 receptor on lymphatic cells, a proposed basis for an anti-swelling effect. Neither idea is established in people.[10][7]
What the human research says
Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.
At a glance: strongest evidence per outcome
| Outcome | Grade | Effect | Strongest evidence | Rows |
|---|---|---|---|---|
| Stress & fatigue | Grade C | No effect | RCT · n = 144 · 2013 | 2 rows |
| Bone | Grade D | Mixed | RCT · n = 81 · 2009 | 1 row |
| Leg swelling | Grade D | Improved | Crossover RCT · n = 50 · 2016 | 1 row |
| Healthy aging | Grade D | Mixed | RCT · n = 20 · 2004 | 1 row |
| Exercise | Grade D | No effect | RCT · n = 20 · 1996 | 2 rows |
Every graded row
| Outcome | Effect | Grade | Best evidence | PMID |
|---|---|---|---|---|
| Stress-related fatigue and concentration (added to stress-management training) | No effect | Grade C | RCT · n = 144 · 2013 Adults with fatigue and reduced work capacity from chronic stress Form: Eleutherococcus root extract · Dose: 120 mg/day · Duration: 8 weeks Almost all measures improved over time in every group with no meaningful benefit from adding eleuthero; the authors call any added effect negligible. All treatments were well tolerated. | 23740477 (opens PubMed)Source [1] |
| Fatigue severity in long-standing unexplained fatigue | No effect | Grade D | RCT · n = 96 · 2004 Adults with at least 6 months of unexplained fatigue (Iowa, USA) Form: Siberian ginseng · Dose: Dose not stated in the abstract · Duration: 2 months Fatigue fell in both groups without a significant difference overall; a subgroup with less severe fatigue did better (P=0.04, unadjusted). | 14971626 (opens PubMed)Source [2] |
| Bone turnover and bone density after menopause | Mixed | Grade D | RCT · n = 81 · 2009 Postmenopausal women under 65 with osteopenia or osteoporosis (Korea) Form: Acanthopanax (Eleutherococcus) senticosus extract plus 500 mg calcium · Dose: 3 g/day · Duration: 6 months Serum osteocalcin rose versus calcium alone (P=0.041), but bone mineral density did not change. Adverse events did not differ. | 19452124 (opens PubMed)Source [6] |
| Lower-leg swelling in healthy women (single dose) | Improved | Grade D | Crossover RCT · n = 50 · 2016 Healthy women Form: Siberian ginseng powder · Dose: Single dose (amount not stated in the abstract) · Duration: Measured 2 and 4 hours after intake Lower-leg swelling was significantly less at 2 and 4 hours than in the control condition. | 27333960 (opens PubMed)Source [7] |
| Quality of life in older adults with high blood pressure | Mixed | Grade D | RCT · n = 20 · 2004 Adults 65+ treated for hypertension and taking digitalis Form: E. senticosus dry extract · Dose: 300 mg/day · Duration: 8 weeks Social functioning scores were higher at 4 weeks but the difference faded by 8 weeks. Blood pressure and digitalis levels did not change; no adverse events. | 15207399 (opens PubMed)Source [3] |
| Submaximal and maximal running performance | No effect | Grade D | RCT · n = 20 · 1996 Highly trained distance runners Form: Eleutherococcus liquid extract · Dose: 3.4 mL/day · Duration: 6 weeks No differences in heart rate, oxygen use, perceived exertion, time to exhaustion or lactate versus placebo. | 8778554 (opens PubMed)Source [5] |
| Fat use and 10-km cycling time trial | No effect | Grade D | Crossover RCT · n = 9 · 2000 Highly trained male cyclists Form: Siberian ginseng · Dose: 1,200 mg/day · Duration: 7 days before each trial No differences in fuel use, heart rate, lactate or time-trial performance versus placebo. | 11099371 (opens PubMed)Source [4] |
Forms
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Dry root extract capsules | Varies[8] | No human absorption study found; a standardized extract at 485 mg twice daily did not change CYP2D6 or CYP3A4 drug metabolism.[8] | Well tolerated at 120 mg/day for 8 weeks and 300 mg/day in older adults.[1][3] | Stress, fatigue, aging and exercise trials (120–1,200 mg/day) |
| Liquid extract | Varies[5] | Not studied for absorption.[5] | No adverse findings reported in the 6-week runner trial abstract.[5] | Endurance running |
| High-dose extract (3 g/day) | Varies[6] | Not studied for absorption.[6] | Adverse events did not differ from calcium alone over 6 months.[6] | Bone turnover after menopause |
Studied doses
Doses studied in human trials ranged from 120 mg/day of root extract for 8 weeks and 300 mg/day in older adults up to 1,200 mg/day for a week in cyclists and 3 g/day for 6 months in postmenopausal women.[1][3][4][6]
Interactions
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
Medicines
- DigoxinCase reportA 74-year-old man had repeatedly raised digoxin readings while taking Siberian ginseng that normalized when he stopped; whether this was a true rise or a test artefact is unclear.[9]
- Drugs metabolized by CYP2D6 or CYP3A4PK studyA standardized extract did not change dextromethorphan (CYP2D6) or alprazolam (CYP3A4) handling in 12 volunteers.[8]
Who should be careful
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.
How to read the label
Cost per studied dose, without the sales pitch
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Cost per studied dose
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Frequently asked questions
Is Siberian ginseng real ginseng?
No. Eleuthero (Eleutherococcus senticosus) belongs to the same plant family but is a different plant from Panax ginseng.[10]
Does eleuthero help stress or burnout?
In 144 adults with stress-related fatigue, 120 mg/day added no meaningful benefit to stress-management training over 8 weeks.[1]
Does eleuthero improve athletic performance?
Two small trials in trained cyclists and runners found no effect on performance, fuel use or heart rate.[4][5]
Does eleuthero interact with medicines?
A standardized extract did not change CYP2D6 or CYP3A4 drug metabolism. A case report linked it to raised digoxin readings.[8][9]
Does eleuthero help chronic fatigue?
Not overall. In 96 adults with long-standing fatigue, results did not differ from placebo, though people with milder fatigue may have done better.[2]
Sources
- [1]No benefit adding eleutherococcus senticosus to stress management training in stress-related fatigue/weakness, impaired work or concentration, a randomized controlled study.. Pharmacopsychiatry, 2013. RCT
- [2]Randomized controlled trial of Siberian ginseng for chronic fatigue.. Psychol Med, 2004. RCT
- [3]Effects of Siberian ginseng (Eleutherococcus senticosus maxim.) on elderly quality of life: a randomized clinical trial.. Arch Gerontol Geriatr Suppl, 2004. RCT
- [4]The effect of siberian ginseng (Eleutherococcus senticosus) on substrate utilization and performance.. Int J Sport Nutr Exerc Metab, 2000. crossover-RCT
- [5]Effect of Eleutherococcus senticosus on submaximal and maximal exercise performance.. Med Sci Sports Exerc, 1996. RCT
- [6]The effects of Acanthopanax senticosus extract on bone turnover and bone mineral density in Korean postmenopausal women.. J Bone Miner Metab, 2009. RCT
- [7]Antiedema effects of Siberian ginseng in humans and its molecular mechanism of lymphatic vascular function in vitro.. Nutr Res, 2016. crossover-RCT
- [8]Siberian ginseng (Eleutheroccus senticosus) effects on CYP2D6 and CYP3A4 activity in normal volunteers.. Drug Metab Dispos, 2003. PK-study
- [9]Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng.. CMAJ, 1996. observational
- [10]Eleutherococcus senticosus (Rupr. & Maxim.) Maxim. (Araliaceae) as an adaptogen: a closer look.. J Ethnopharmacol, 2000. review
- [11]Effect of Chinese medicines Chan Su, Asian ginseng, Siberian ginseng, and American ginseng on a new digoxin immunoassay based on luminescent oxygen channeling technology.. Ther Drug Monit, 2011. animal-study
What changed
- Adversarial review pass: every evidence row's numbers re-checked against its abstract (Europe PMC for abstracts PubMed truncates, PMC full text where open), grades checked against the grading rubric, and safety and overclaim wording re-read. No changes needed.
- First draft. Every PMID checked against NCBI E-utilities esummary (title and year taken from the record) and abstracts read for the cited rows.
- Strict second-pass self review (no separate reviewer agent was available for this batch): every PMID re-fetched via esummary and every evidence row, dose and safety line re-read against its abstract or fact sheet. No NIH ODS or NCCIH fact sheet covers eleuthero. The digoxin case is reported with the authors' uncertainty about true versus assay-related elevation. The 2011 assay study (a lab study) found negligible ginseng interference on the newer LOCI digoxin assay, which is reflected in the wording. Retraction and erratum flags checked on all PMIDs: none.