With a battery of bioactive compounds, this eastern adaptogen has shown potential in fighting the common cold, improving bipolar disorder, and reducing the markers of diabetes. How strong is the evidence? Read on to find out.
What is Eleuthero?
Also known as Siberian ginseng, eleuthero is an herb with the scientific names Eleutherococcus senticosus or Acanthopanax senticosus. Around the world, it may also be called Ciwujia, Shigoka, Goka, Ezoukogi, or Kan Jang (when combined with green chiretta). It is a staple of traditional medicine in the Far East, especially in China, Korea, and eastern Russia [1, 2, 3, 4, 5, 6].
According to these traditions, eleuthero is an adaptogen: a substance that keeps the body functioning normally under stress .
Eleuthero belongs to the same plant family as Asian and American ginseng (Araliaceae). However, Asian and American ginseng both belong to a different genus further up the botanical tree called Panax, while eleuthero belongs to Eleutherococcus. Being a distant cousin of these other ginsengs, eleuthero contains a different set of bioactive compounds .
- May ease the symptoms of bipolar disorder
- May improve memory
- May prevent insulin resistance
- May help the immune system fight the common cold
- Considered very safe to use in healthy adults
- Possible drug interactions
- Limited clinical research for many purported benefits
The roots, berries, and leaves of eleuthero each contain multiple bioactive compounds. The specific compounds in each part of the plant may be different, and so their health benefits may also vary. Most studies on the health benefits of eleuthero focus on the root and bark .
Eleuthero berries contain high levels of antioxidants and potential cancer-fighting compounds; they are also high in important minerals like potassium, calcium, and magnesium. These berries have long been added to fermented wines in China and Russia .
The most important bioactive compounds in eleuthero belong to a chemical family called eleutherosides; these are eleutherosides A through E. Of these, the ones with the greatest effect are eleutherosides B (syringin) and E .
These two compounds may be responsible for eleuthero’s anticancer and anti-diabetic effects .
Sesamin is an active compound that was first discovered in sesame seeds. Sesamin from eleuthero may help protect nerve and brain cells from damage. Sesamin may also improve liver function and reduce cholesterol [12, 13].
Researchers isolated isofraxidin from eleuthero bark and consider it may have the potential to fight liver cancer .
Ursolic acid is found in many different plants, including eleuthero. It can be taken as a supplement and is reported to decrease inflammation, fight cancer, prevent diabetes, protect the heart, and lower cholesterol. Researchers are currently investigating their anticancer effects [17, 18, 19].
Potential Benefits (Possibly Effective)
Siberian ginseng has produced promising clinical results for each of the potential benefits in this section, but the FDA has not approved eleuthero for any medical purpose or health claim, and there is no guarantee of the quality of any given supplement. Talk to your doctor before supplementing with Siberian ginseng.
1) Bipolar Disorder
In a promising clinical trial of 76 teenagers with bipolar disorder, 1.5 g Siberian ginseng and lithium produced improvements comparable to 20 mg fluoxetine and lithium, a standard treatment .
Both the response rates and remission rates were statistically equivalent between treatment groups, while the Siberian ginseng group reported fewer side effects .
2) Immune System & Infection
Eleuthero may improve the function of the immune system and help the body fight off infection.
In animal studies, supplementation with eleuthero root extract increased the production of molecules called immunoglobulins G and M (IgG and IgM). IgG and IgM bind to pathogens like viruses and bacteria, flagging them for destruction. This process protects the body from infection and disease .
Traditional practitioners use eleuthero extract for viral infections, including the common cold and flu. In limited clinical trials, an extract of Siberian ginseng appeared to reduce the symptoms of the common cold if it was taken within 72 hours of symptoms appearing [24, 25, 26].
One study suggests that eleuthero may kill RNA viruses like those that cause the cold and flu, but not DNA viruses like herpes. In combination, eleuthero’s antiviral and immune-boosting effects could make it a good option for some infections. Supplementing with eleuthero may help your body fight off the common cold and flu .
In one study, 400 mg of Siberian ginseng extract per day for six months appeared to decrease the rate of infection with herpes simplex virus type 2. People who took the extract also experienced reduced frequency and severity of symptoms .
Cadmium is a toxic heavy metal that suppresses the immune system. During exposure, cadmium builds up in the spleen and decreases the number of white blood cells in this organ. The more cadmium is built up, the fewer white blood cells are found in the spleen, and the weaker the immune system becomes. In mice, eleuthero extract reversed the effects of cadmium poisoning and cleared cadmium from the spleen .
Eleuthero extract may improve blood sugar levels, insulin sensitivity, and fatty acid levels – all of which help prevent diabetes. In one clinical study, people taking 480 mg/day of Siberian ginseng extract had decreased blood sugar both fasting and after meals. They also had lower HbA1c, triglycerides, and total cholesterol .
In diabetic mice, eleutheroside E promoted the function of the pancreatic cells that make insulin, reduced blood glucose levels, and reduced insulin resistance. Eleutheroside B also normalized blood sugar, insulin, and other disease markers in diabetic rats [33, 34, 35].
Other Potential Benefits with Insufficient Evidence
Eleuthero has produced positive results for the benefits in this section in at least one human study, but larger and more robust studies are required to confirm its effectiveness. Furthermore, the FDA has not approved eleuthero for any medical purpose or health claim, and there is no guarantee of the quality of any given supplement. Talk to your doctor before supplementing with Siberian ginseng.
Many people who supplement with eleuthero do so for its energy-boosting effects. Eleutherosides activate AMPK, which speeds up the metabolism and breaks down fats to produce energy. Eleuthero may also activate BDNF, which increases the brain’s ability to grow and adapt to change [6, 37, 38].
4) Athletic Performance
In the short term, exercise suppresses the immune system and increases serotonin production in the midbrain. Increased serotonin in the midbrain decreases how often dopamine neurons fire, which makes exercise more taxing and can increase the required recovery time [44, 45, 46].
In human athletes, eleuthero improved several markers of performance. It increased the amount of time each athlete can maintain an effort; it increased maximum heart rate, a measure of exercise intensity; it decreased glucose and increases free fatty acids in the blood during exercise. As a result, eleuthero may improve a process called glycogen sparing: shifting your fuel from carbs to fats [39, 47].
However, these potential benefits are controversial. Some researchers insist that the studies on eleuthero’s effects on athletic performance suffer from design flaws .
In a study of 30 elderly people being treated for high blood pressure, eleuthero supplements modestly improved brain function .
In animals with Alzheimer’s disease, high doses of eleuthero improved memory and learning. Eleutherosides B and E increased acetylcholine in the hippocampus region of rat brains, thereby improving communication between neurons [51, 52].
High levels of stress damage the brain’s ability to learn, form new memories, and retrieve existing memories. The stress-reducing effects of eleuthero may help restore memory deficits when these deficits are caused by stress [53, 54].
Within four hours of taking eleuthero, healthy women had reduced swelling in their lower legs. Eleutheroside E appears to activate a receptor called Tie2, which stabilizes lymph vessels and improves the function of the lymphatic system .
Cyclooxygenase 2, or COX-2, is an enzyme that increases inflammation and pain. Commonly used NSAIDs mainly work by blocking it. The extract of eleuthero fruit activates an enzyme called heme oxygenase 1 (HO-1), which blocks COX-2 and thereby reduces inflammation [58, 59, 60].
Familial Mediterranean Fever
Familial Mediterranean Fever, or FMF, is a genetic condition that causes episodes of inflammation marked by fever, pain, and redness of the skin. In combination with other herbs, eleuthero may reduce the symptoms of FMF in children .
Alcohol hangover puts a lot of stress on the body and causes symptoms like exhaustion, dizziness, and nausea. Eleuthero extract may help the body return to normal function and reduce symptoms during a hangover, based on data from one human study .
In a study of Korean women, eleuthero supplements increased osteocalcin, a hormone that increases bone-building activity. However, this study did not find direct, significant increases in bone mineral density .
In a rat study of osteoporosis, eleuthero bark extract prevented losses in bone mineral density. More research is required to determine whether eleuthero effectively maintains bone mineral density in humans .
Animal Research (Lacking Evidence)
No clinical evidence supports the use of Siberian ginseng for any of the conditions listed in this section. Below is a summary of the existing animal and cell-based research, which should guide further investigational efforts. However, the studies listed below should not be interpreted as supportive of any health benefit.
9) Parkinson’s Disease
Parkinson’s disease causes damage and degeneration in the basal ganglia region of the brain. This degeneration leads to the movement problems typical of people with Parkinson’s disease. Eleuthero may help prevent these symptoms: in animal studies, whole extract and isolated compounds like sesamin protected nerve and brain cells from damage and death. This protective effect is likely caused by eleuthero’s ability to increase dopamine levels in the brain. More research is required; this health benefit has not yet been studied in humans [66, 12, 67, 68].
In animal studies, eleuthero increased mental function and decreased the time needed to recover from stressful events such as forced swimming, sleep deprivation, or moving to a new environment [69, 70, 38].
Eleuthero may activate BDNF, which helps the brain adapt to change. Eleutherosides increase AMPK, which boosts energy and helps us keep going when we’re stressed and tired. Sesamin, a less abundant compound, also protects the body against inflammation and tissue damage. Finally, eleuthero activates HSP70 and increases the body’s resistance to tissue damage. Added together, these effects likely explain eleuthero’s anti-stress effects [38, 6, 71, 42].
This health benefit is somewhat controversial. Some studies suggest that eleuthero sometimes increases and sometimes decreases the stress response. Others suggest that no anti-stress benefit exists at all [72, 73].
This controversy may be explained by its hormetic effects. Hormesis is an innate enhancement mechanism our bodies carry – it’s when a mild temporary stressor triggers a shift to higher performance. Adaptogens like eleuthero may be mild hormetic stressors .
Still, further research will be required to shine a light on whether and to what extent eleuthero supplements are effective at fighting stress.
Eleuthero extract is an antioxidant: it reduces free radicals and supports cellular health. Several compounds in eleuthero extract bind to and neutralize free radicals, preventing oxidative stress and cellular damage .
11) Mosquito Bites
Essential oil from eleuthero leaves stops mosquitoes from biting. The complete oil is about three-quarters as effective as DEET at preventing mosquito bites; an isolated compound called α-bisabolol is as effective as DEET. Only one study has ever been performed on the potential insect repellent property of eleuthero; further research is required .
Eleuthero extract increases immune function in healthy people and in people with cancer; some researchers believe that it may reduce these long-term infection risks and help the body fight off a malignant tumor [76, 77].
When researchers exposed healthy bacteria to cancer-causing poisons, eleuthero extract dropped their mutation rate by more than half. Eleuthero extract may also protect cells from mutations due to radiation exposure, but this effect is small [78, 79].
More directly, eleuthero has been studied for potential against human stomach, lung, and throat cancer cells in a lab setting. Furthermore, eleuthero blocks estrogen receptors in cell studies; future research will investigate whether it could be useful in estrogenic cancer types [5, 80, 81].
Researchers have also recently used eleuthero to synthesize a silver nanoparticle that increases oxidative stress and selectively kills cancer cells. This natural-source nanoparticle was more effective in a lab setting than either a commercial silver nanoparticle or Cisplatin, a common chemotherapy drug .
None of this research should be taken as grounds to use eleuthero in an attempt to fight cancer. If you believe that Siberian ginseng could be part of a complementary health strategy, talk to your doctor.
Estrogens in Cancer Cells
Eleutheroside E appears to act against the effects of estrogens in cancer cells. In a study using human cancer cells, eleuthero extract and eleutheroside E significantly decreased estrogen receptors [83, 81, 84].
Although this herb is also suggested as an option to reduce “estrogen dominance,” there’s no solid research to back up its anti-estrogen effects in women, nor are there enough data to support the vastly over-hyped theory of estrogen dominance [85, 86].
Eleuthero’s mechanism of action is complex because it contains an abundance of active compounds. Each compound may have unique effects, and these effects may add up or counteract each other.
Eleutherosides may activate AMPK, an important “switch” in energy metabolism. AMPK reduces fat storage and increases insulin sensitivity. Through AMPK, eleutherosides may be able to restore insulin signaling in people with diabetes [87, 6, 88, 89].
Heat Shock Protein Activation
Eleuthero may increase heat shock proteins like HSP70 and HSP72. This could help explain its ability to reverse the effects of stress: heat shock proteins protect cells and keep them alive in conditions that would otherwise damage or kill them [42, 90].
Eleuthero extract increases catecholamines (especially dopamine and norepinephrine) in the parts of the brain responsible for managing stress. The exact way it influences their levels and activity is unknown, but this mechanism may underlie eleuthero’s mental health benefits [68, 91, 92].
Brain-derived neurotrophic factor, or BDNF, is a protein active in the hippocampus of the brain. It helps nervous tissue grow and reorganize itself, and it protects the brain from damage. Low BDNF is linked to depression and anxiety. Eleuthero increases BDNF in the hippocampus, which could explain its reputation as a brain-boosting supplement [37, 38].
Research connecting eleuthero and BDNF is extremely new. Only two studies have ever tested these effects – one cell study in 2013 and one rat study in 2018 – and while both have shown promising benefits, we cannot yet say that eleuthero will activate BDNF in humans [37, 38].
Sirtuin 3 Activation
Sesamin activates a protein called sirtuin 3, or SIRT3, which regulates energy metabolism and prevents cell death. Through SIRT3, sesamin may protect tissues from inflammation and death after an injury [71, 93, 94].
Safety & Side Effects
Overall, eleuthero is generally regarded as safe. In mice, it takes an extremely high dose to cause death (over 25 g per kg of body weight). If translated to humans, an average adult would have to eat more than 1.5 kg of dry root for it to be dangerous .
Eleuthero has very few side effects. Rarely, people taking eleuthero in combination with other herbal supplements may experience sleepiness, cold extremities, increased blood pressure, increased heart rate, or heart palpitations [96, 97, 98].
Children, Pregnancy, and Breastfeeding Mothers
Eleuthero, in combination with other herbs, appears to be safe for children with Familial Mediterranean Fever. Healthy children would probably tolerate eleuthero well, but people should probably avoid giving supplements to children unless a doctor recommends it .
The safety of eleuthero for pregnant women is also unclear. Some research suggests that eleuthero may protect against birth defects caused by alcohol, but this has only been studied in rats. Eleuthero is probably safe during pregnancy, but it’s always better to be cautious. If you are pregnant or breastfeeding, talk to your doctor before supplementing with eleuthero .
Possible Disease Interactions
Consult your doctor if you are concerned about the potential side effects and safety of a supplement.
Eleuthero has both immune-boosting and anti-inflammatory properties, but its effects on autoimmune disorders are largely unknown. A combination of eleuthero and Andrographis paniculata, called Kan Jang, acts in synergy to suppress autoimmune disease pathways .
While this effect may be beneficial in theory, the interaction with drugs used for autoimmune diseases is unknown. If you suffer from an autoimmune disease like lupus, Hashimoto’s or Graves’ disease, talk to your doctor before supplementing with Siberian ginseng.
This is not necessarily an exhaustive list of potential interactions between Siberian ginseng and prescription drugs. Talk to your doctor before starting any new supplements to avoid unexpected interactions.
CYPs are liver enzymes that break down drugs and toxins and remove them from the body. Eleutherosides block two of these enzymes, CYP2C9, and CYP2E1; any compound that these enzymes metabolize will take longer to break down and get rid of [102, 103].
This enzyme breaks down dozens of drugs, including NSAIDs like ibuprofen, diabetes drugs like tolbutamide and glyburide, blood pressure medication like losartan, anticoagulants like warfarin, and many others. Eleuthero can reduce CYP2C9 activity, and therefore may increase the effects of these drugs .
This enzyme breaks down alcohol, some anesthetics, acetaminophen (Tylenol), some industrial toxins, theophylline, chlorzoxazone, and others. Eleuthero can reduce CYP2C9 activity, and therefore may increase the effects of these drugs and toxins .
CYP Interactions Summary
- NSAIDs like ibuprofen
- Diabetes drugs like tolbutamide and glyburide
- Blood pressure medication like losartan
- Anticoagulants like warfarin
- Some anesthetics
- Acetaminophen (Tylenol)
- Some industrial toxins
Note that many of these interactions have not specifically been tested, and are theoretical. Furthermore, this is not an exhaustive list of drugs broken down by CYP2C9 and CYP2E1. Always check with your doctor before supplementing with eleuthero if you are taking any medication.
Pay especially close attention and consult your doctor before supplementing if you take any of the following:
Digoxin is a drug prescribed to treat problems with heart rhythm. Although reports of this interaction are rare, eleuthero may dangerously increase the effect of digoxin. Some of eleuthero’s active compounds may have similar mechanisms and effects to digoxin; rather than increasing digoxin levels, eleuthero may simply add to its effects. Do not supplement with eleuthero if you are taking digoxin [105, 106].
Hexobarbital is a sedative drug. In the 1940s and 1950s, it was widely used to induce anesthesia before surgery. Hexobarbital is quite dangerous and much less common today. Some research suggests that eleuthero could more than double the effect of hexobarbital. If you choose to take eleuthero supplements before any kind of surgery, it is very important to tell your doctor [107, 108].
Lithium and Eleuthero
In a study of Chinese teenagers with bipolar disorder, researchers combined either eleuthero extract or fluoxetine (Prozac) with the teens’ lithium treatment. For a similar degree of benefit, people who took eleuthero with lithium had fewer side effects than those who took fluoxetine with lithium. The mechanism of this combination is unknown .
More research is needed to determine if this combination is safe and beneficial. If you’re taking lithium and/or SSRIs, talk to your doctor before supplementing.
Limitations and Caveats
Eleuthero is an ancient part of traditional medicine in eastern Asia, but its involvement in modern science is fairly new; Soviet scientists conducted some promising studies before 1990, but many of these have yet to be repeated.
Of the existing research pool, many studies focus on single isolated compounds or on herbal combinations like Kan Jang. Eleuthero extracts can also be produced from bark, root, leaves, or berries, and the differences between these extracts have yet to be fully explored.
Some of the studies mentioned above suffer from design flaws or small sample sizes. Much of the available research comes from cell studies (especially cancer cell studies), with fewer live animal studies and even fewer human trials. Finally, even the human studies may be flawed: the dosage of Siberian ginseng varied wildly, and in some “no effect” studies, participants took tiny doses of eleuthero.
Eleuthero and its active compounds may increase and decrease the expression of a wide variety of genes. These genes are involved in carbohydrate metabolism, cell-to-cell communication, and small molecule biochemistry .
In a study of human cancer cells exposed to eleuthero extract, the following genes had increased expression :
- Several G-protein-coupled receptors (GPRs) that receive signals from outside of a cell: GPR111, GPR128, GPR 148, and GPRC6A.
- GRM6, which produces metabolic glutamate receptor 6. This protein helps you see in low light; mutations at GRM6 can cause congenital stationary night blindness .
- PDE4D, which produces an enzyme that degrades the messenger molecule cAMP. Mutations at PDE4D can increase susceptibility to stroke and cause problems in the bones, brain, and hormones. Note that in healthy people, eleuthero may decrease PDE4D [110, 111].
- PIK3C2G, which produces a protein that regulates cell division. This gene may be involved in type II diabetes .
- PLCB1, which produces a protein that helps send and receive signals between brain cells. Mutations at PLCB1 can cause infantile epileptic encephalopathy .
- SERPINA1, which produces a protein that blocks certain enzymes in certain parts of the body, including the lungs. Mutations in SERPINA1 can cause lung damage as an enzyme called neutrophil elastase breaks down tiny air sacs called alveoli .
- HSPA1B produces a type of heat shock protein that protects cells against damage during periods of stress .
- FOXA1 produces a protein called forkhead box A1, which controls the expression of some proteins in the liver .
None of these effects have yet been studied in healthy animals or people. These studies only indicate that these genes could be worth studying in people taking eleuthero.
In a study of human cancer cells exposed to eleuthero extract, the following genes had decreased expression :
- Several GPRs that receive signals from outside of a cell: GPR17, GPR37, GPR65, GPR101, and GPR112.
- ADCY2, which produces a protein that activates the messenger molecule cAMP .
- PLCD4, which produces a phospholipase C enzyme that activates two messenger molecules. PLCD4 is often increased in cancer cells .
- CETP, which produces cholesteryl ester transfer protein, which is involved in cholesterol metabolism. This protein transfers molecules from HDL (the “good” cholesterol) to LDL (the “bad” cholesterol). Blocking CETP may reduce bad cholesterol levels in the blood and increase lifespan [119, 120].
- ESR1, which produces one type of estrogen receptor. Estrogen is important for female sexual development and reproduction; however, when estrogen or its receptors are too high, it can cause breast cancer and osteoporosis .
- Three of the SERPINB genes: SERPINB2, SERPINB4, and SERPINB9. All of these genes are often expressed in cancer cells and may help cancers survive and grow .
- HTR3D, which produces a part of the serotonin receptor 5-HT3 .
None of these effects have yet been studied in healthy animals or people. These studies only indicate that these genes could be worth studying in people taking eleuthero.
Catechol-O-methyltransferase, or COMT, is an enzyme that breaks down dopamine and other catecholamines. People with different levels of COMT activity may respond differently to eleuthero .
The COMT gene has an important SNP called V158M (rs4680), which changes the effectiveness of the COMT enzyme. People with two copies of the A allele have the least COMT activity and the highest dopamine; these people belong to the “worrier” type. People with two copies of the G allele have the most COMT activity and the lowest dopamine; these people belong to the “warrior” type. Many people also fall somewhere in the middle of this scale .
Eleuthero increases available dopamine in the basal ganglia; this effect may help neutralize the effects of high COMT activity. People with the “warrior” type may possibly benefit more from eleuthero supplements .
Familial Mediterranean Fever
Familial Mediterranean Fever, or FMF, is a genetic condition that has been successfully improved with a combination of immune-boosting, anti-inflammatory herbs including eleuthero .
People with FMF have a mutation in the MEFV gene. MEFV produces a protein called pyrin, which probably helps control and stop inflammation in healthy people. There are more than 80 different MEFV mutations that cause FMF; the most common is M694V (rs61752717). People with two copies of the G allele at this SNP will develop Familial Mediterranean Fever and may benefit from eleuthero extract .
Supplementation & Dosage
Eleutherococcus bark, root, leaves, and berries all contain bioactive compounds, but most supplements are derived from the root. Siberian ginseng root is readily available in capsule and powder form; traditional herbalists also brew a tea from the leaves. Essential oil from Siberian ginseng may have health benefits and prevent mosquito bites, but it is difficult to find.
There is no standardized dosage for eleuthero because the extract is not standardized and different studies may use different parts of the plant. No sufficiently powered study has been conducted to find a safe and effective dose for any medical purpose.
Most extracts are made from Eleutherococcus root, which is considered very safe to consume .
And although megadoses of eleuthero root might not be harmful, this doesn’t mean they’re necessary or desirable. Based on limited clinical research, people with mild to moderate fatigue may benefit from as little as 2 – 4 g/day, equivalent to 2 – 3 mg of eleutherosides. Other American sources recommend 6 – 12 g of dried root per day, and some Chinese sources recommend 9 – 27 g of dried root per day .
Eleuthero, also called Siberian ginseng, is an East Asian shrub with promising bioactive compounds in its root, bark, leaves, and berries. Its major chemical components are eleutherosides.
Siberian ginseng has produced the most promising results for people with bipolar disorder, the common cold, and diabetes.
Eleuthero is a safe supplement, most often available as a root extract capsule. People may respond differently to different doses of eleuthero. Practitioners suggest starting at about 2-4 g of eleuthero supplement per day; older Chinese sources recommend up to 27 g of the dried root.
Purchasing eleuthero from a reliable source will minimize the risk of consuming a mislabelled product. The eleuthero root products below come from companies with some of the best track records regarding quality control and testing.
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