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Ginseng is a plant found in North America and eastern Asia. There are many different types of ginseng, such as American ginseng, Korean red ginseng, Indian ginseng, and Siberian ginseng. American ginseng is a very popular variety [1, 2].
Flu and Other Respiratory Infections
In another trial on 100 people, Asian ginseng reduced the incidence and severity of upper respiratory infections .
In mice, Asian ginseng, its fermented extracts, and compounds (saponins and polysaccharides) increased survival after infection with different influenza viruses [5, 6, 7, 8, 9] and enhanced the effectiveness of the vaccines against them [10, 11, 12].
In mice infected with respiratory syncytial virus (RSV), ginseng extract (both oral and as a nose spray) reduced lung damage, improved lung viral clearance, increased the proliferation of T cells and dendritic cells, and reduced weight loss [13, 14, 15].
Similarly, different American ginseng extracts helped prevent respiratory tract infections in 5 clinical trials on almost 1,700 people. However, some of these studies were funded by a company that sells the extract, which indicates a potential conflict of interest [16, 17, 18, 19, 20].
Additionally, a meta-analysis warned that the evidence to support this use was insufficient due to the differences in the population samples and qualities of the studies .
Asian ginseng reduced the symptoms and duration of respiratory infections in multiple clinical trials, but the quality of these studies is questionable.
COPD and Lung Damage
According to a review of 12 studies involving 1,560 COPD patients, Asian ginseng may improve the quality of life and lung function and enhance the effectiveness of drug treatments. However, the authors warned that most studies carried out up to then (2011) had a high risk of bias .
In line with this, the latest clinical trial with Asian ginseng failed to find any benefits over placebo in people with COPD .
A TCM injection with Asian ginseng and ophiopogon root (Shenai) prevented airway muscle cell death in rats with emphysema .
Different studies have produced conflicting results on whether ginseng may improve lung function in COPD.
In asthmatic mice, ginseng extract reduced airway inflammation. An extract combining red ginseng and Salvia plebeia had similar results. However, the anti-inflammatory activity may have been mostly due to Salvia plebeia, since its component nepetin was also effective [32, 33].
The Shenai injection prevented the excessive proliferation of airway muscle cells in asthmatic rats .
Other Viral Infections
Asian ginseng extract, as an add-on to antivirals, reduced liver tissue scarring markers in a small trial on 38 people with hepatitis B .
In piglets challenged with the porcine reproductive and respiratory syndrome virus, several saponins from ginseng improved survival and reduced lung injury, fever, weight loss, anemia, internal inflammation, and viral load. These saponins also reduced the damage caused by porcine circovirus 2 in mice [40, 41, 42].
In cell-based studies, ginseng extracts and their components inhibited the following viruses:
- Influenza (H1N1, H3N2, H5N1, H7N9, and H9N2) [6, 43]
- Rhinovirus 3 
- Hepatitis A 
- Herpes simplex 1 and 2 [46, 47]
- HIV 
- RSV [13, 14]
- Bursal disease virus 
- Coxsackievirus B3 [36, 44]
- Enterovirus 71 
- Rotavirus 
- Porcine reproductive and respiratory syndrome virus .
Ginseng improved outcomes of viral infections in a small clinical trial and in multiple animal and cell studies.
Evidence suggests that ginseng boosts immune function. Those taking red ginseng powder during chemotherapy treatment had a higher 5-year disease-free survival and overall survival rate in a study on 42 people .
Ginseng extract also increased survival in patients with HIV, possibly by slowing the decrease in CD4+ T cell count, in a trial on over 250 people .
Ginseng has been found to boost markers of immune function in clinical trials.
Ginseng stem‐leaf saponins, both alone and in combination with selenium, enhanced the effects of a combined vaccine against the coronavirus infectious bronchitis virus (IBV) and the virus that causes Newcastle disease (NDV) in chicken. These saponins also enhanced the vaccine against infectious bursal disease [54, 55, 56, 57].
Ginseng extract, combined with either selenium or thimerosal, enhanced the immune response in mice vaccinated against pseudorabies. A saponin isolated from ginseng (ginsenoside Re) had similar effects [58, 59, 60, 61].
In horses vaccinated against equid herpesvirus 1, low-dose ginseng increased antibody production .
The active compounds of ginseng may improve the immune system’s response to vaccines.