Eleutherococcus senticosus goes by several names: Siberian ginseng, eleuthero, or just “Ci Wu Jia” in Chinese medicine. It’s been used for thousands of years in Russia, China, Korea and Japan, mostly for dealing with fatigue and stress.

Here’s the thing about eleuthero: it’s classified as an “adaptogen”, which is a category of herbs that supposedly help your body cope with physical and mental stress. The idea is that adaptogens don’t push your body in one direction, but rather help it find balance. Whether that’s marketing speak or genuine pharmacology is still being debated.

What’s not debatable is that eleuthero contains a complex mix of compounds, including eleutherosides, polysaccharides, and various flavonoids. These have measurable biological effects. The question is whether those effects translate into meaningful health benefits.

What is Eleutherococcus senticosus?

Eleuthero grows in the cold coniferous forests of northeast Asia, primarily in China, Russia, Korea and Japan. It belongs to the same plant family (Araliaceae) as Panax ginseng and American ginseng, though botanically speaking, it’s a different genus entirely. This is why calling it “Siberian ginseng” is actually a bit misleading, and the term was banned in the United States in 2002 to prevent confusion with true ginseng.

The root and stem bark are the parts used medicinally. You’ll typically find eleuthero sold as tinctures, capsules, tablets, or dried root for tea. The active compounds include eleutherosides (a group of glycosides), lignans, polysaccharides, phenylpropanoids, and triterpene saponins.

Traditional uses have included treating fatigue, boosting immunity, improving mental function, and helping the body recover from illness. Modern research has attempted to verify some of these claims with varying degrees of success.

Proven benefits of eleuthero

I should be honest here: most research on eleuthero involves either compound formulas (eleuthero mixed with other herbs) or small sample sizes. Finding studies where eleuthero alone is tested against placebo in large populations is difficult. That said, here’s what the research does show.

1. May help with upper respiratory infections

Upper respiratory infections (the common cold, basically) are caused by numerous viruses including rhinoviruses, coronaviruses, and influenza. We’ve all been there: sore throat, stuffy nose, that miserable general feeling.

A systematic review of four randomised controlled trials found that andrographis combined with eleuthero extract might work as an alternative treatment for uncomplicated acute upper respiratory infections [1]. Another randomised double-blind trial with 177 patients found that a combination formula containing eleuthero had better cough-relieving effects than placebo and even outperformed the conventional cough medicine bromhexine [2].

The catch? These studies used combination formulas, not eleuthero alone. We can’t say for certain that eleuthero is the ingredient doing the heavy lifting. It might be, or it might be something else in the mix.

2. Cognitive function improvements

A randomised double-blind placebo-controlled study tested ADAPT-232, a formula containing eleuthero, Rhodiola rosea, and Schisandra chinensis on 40 healthy women aged 20-68 [3]. The results showed improvements in attention, speed, and accuracy during cognitive tests conducted under stressful conditions.

Again, this was a combination formula. But given that all three ingredients are classified as adaptogens traditionally used for mental performance, there’s biological plausibility here. The study participants weren’t experiencing dramatic cognitive enhancement; they were performing somewhat better on specific tests under stress. That’s a more modest but potentially more honest finding.

3. Athletic performance

A double-blind randomised study tested eleuthero in nine men doing cycling exercises over eight weeks [4]. The eleuthero group showed improved endurance, better cardiovascular function, and changes in how their bodies used glycogen (stored sugar) for fuel.

Nine men is a very small sample size. I wouldn’t make any confident claims based on this alone. But the findings at least suggest that the traditional use of eleuthero for combating fatigue might have some physiological basis.

4. Bone metabolism in osteoporosis

Osteoporosis is a condition where bones become weak and brittle, significantly increasing fracture risk. It’s particularly common in postmenopausal women due to declining oestrogen levels.

A six-month randomised controlled trial with 81 postmenopausal women with osteoporosis or osteopenia found that eleuthero extract plus calcium increased serum osteocalcin levels compared to calcium alone [5]. Osteocalcin is a marker of bone formation activity.

However, the study found no significant change in actual bone mineral density over the six months. This might mean eleuthero has positive effects on bone metabolism that take longer than six months to translate into measurable bone density changes. Or it might mean the effect isn’t clinically meaningful. Longer studies would help clarify this.

5. Knee osteoarthritis

Osteoarthritis involves cartilage breakdown in joints, causing pain, stiffness, and reduced mobility. The knees are commonly affected.

A seven-week randomised double-blind study with 57 patients tested a formula containing eleuthero, Panax notoginseng, and Rehmannia [6]. Patients reported improved pain scores and better knee function compared to placebo.

This is another combination formula study. But for people suffering from knee osteoarthritis who are looking for alternatives to conventional anti-inflammatory drugs, it at least suggests this herbal combination might be worth discussing with a healthcare provider.

6. Hangover symptoms

I’ll admit this one caught my attention. Hangovers happen when blood alcohol drops to zero after drinking, leaving you with headache, fatigue, difficulty concentrating, nausea, and general misery. They affect productivity, safety, and quality of life.

A randomised placebo-controlled double-blind crossover trial found that eleuthero extract didn’t help the body metabolise alcohol faster, but it did improve scores on hangover severity scales for tiredness, headache, dizziness, stomach pain, and nausea [7].

This doesn’t mean eleuthero is a cure for hangovers. The best cure remains not drinking too much in the first place. But it’s an interesting finding that suggests eleuthero might help with some symptoms of physical stress and recovery.

7. Familial Mediterranean fever

This is a rare inherited condition causing recurring episodes of fever and inflammation, primarily affecting people of Mediterranean descent (Jews, Armenians, Turks, Arabs). Without treatment, patients risk developing amyloidosis, a serious complication.

A one-month double-blind study with 24 patients tested ImmunoGuard, a formula containing eleuthero, andrographis, schisandra, and liquorice [8]. Patients experienced reduced symptom duration, frequency, and severity.

This is a niche application, but for the small population affected by this condition, it’s potentially useful information. As always, it was a combination formula rather than eleuthero alone.

8. Bipolar disorder (as adjunct therapy)

Bipolar disorder involves cycles of mania and depression. Standard treatments include mood stabilisers like lithium and various medications.

A six-week double-blind study compared two treatments in 76 adolescents with bipolar disorder: eleuthero plus lithium versus fluoxetine (Prozac) plus lithium [9]. The response rates were similar (67.6% vs 71.8%), as were remission rates (51.4% vs 48.7%). However, the eleuthero group experienced fewer adverse reactions and tolerated treatment better.

This doesn’t mean you should swap your prescribed medication for eleuthero. But for clinicians managing bipolar disorder, particularly in adolescents where side effects are a concern, this study at least opens a conversation about adjunct therapies.

9. Chronic fatigue syndrome

Chronic fatigue syndrome involves severe, unexplained exhaustion that doesn’t improve with rest. The cause remains unknown, though theories include viral infections and psychological stress. It affects millions of people, predominantly women.

A controlled study with 96 chronic fatigue patients suggested eleuthero might partially relieve mild fatigue [10]. However, the researchers themselves noted the experimental design wasn’t rigorous enough and the sample size was too small to draw firm conclusions.

This is the kind of preliminary research that suggests further study might be worthwhile, but doesn’t justify strong recommendations.

10. Quality of life in elderly people

As populations age, maintaining quality of life becomes increasingly important. This goes beyond treating specific diseases to encompass overall wellbeing, mental health, and social function.

A small double-blind study with 20 older adults found that eleuthero improved scores on mental health and social functioning measures over eight weeks [11]. Seventy percent of the eleuthero group thought the treatment was effective, compared to 20% in the placebo group.

Interestingly, the difference between groups gradually decreased with continued use. This might suggest the benefits plateau over time, or that placebo effects gradually increased as participants became more invested in the study.

11. Blood lipid improvements

High cholesterol, particularly high LDL cholesterol, increases cardiovascular disease risk. The ratio of LDL to HDL cholesterol is also important; higher ratios mean higher risk.

A six-month study with 40 postmenopausal women found that eleuthero plus calcium reduced LDL cholesterol and improved the LDL/HDL ratio compared to calcium alone [12]. Participants also showed improved markers of oxidative stress and reduced lymphocyte DNA damage.

These are modest but potentially meaningful improvements for cardiovascular risk. The study was small, but the findings are biologically plausible given what we know about eleuthero’s antioxidant properties.

Side effects of eleuthero

For most adults taking eleuthero short-term by mouth, it appears relatively safe. But “relatively safe” doesn’t mean risk-free.

Reported side effects include:

Drowsiness or insomnia (yes, both, which tells you how variable individual responses can be)
Headache
Nervousness or irritability
Gastrointestinal upset, nausea, diarrhoea
Heart rhythm changes
Muscle cramps
Skin reactions

High doses may raise blood pressure. This is particularly important given that many people taking adaptogens for stress might already have blood pressure concerns.

The NHS recommends that supplements like this be used cautiously and ideally discussed with a healthcare provider, particularly if you have existing health conditions or take medications [13].

Safety precautions and contraindications

The contraindications list for eleuthero is long, and with good reason. This herb has real biological activity, which means it can interact with medications and affect various conditions.

1. Allergies: Don’t use if you’re allergic to eleuthero or other plants in the Araliaceae family.

2. Bleeding disorders and surgery: Eleuthero may have anticoagulant effects. Avoid for two weeks before surgery and don’t combine with blood-thinning medications including aspirin, clopidogrel, diclofenac, ibuprofen, naproxen, warfarin, heparin, or enoxaparin.

3. Herbal interactions: Don’t combine with other herbs that affect blood clotting, including red yeast rice, ginkgo biloba, garlic supplements, and saw palmetto.

4. Pregnancy and breastfeeding: Safety is unknown. Avoid.

5. Children: Safety is unknown. Avoid.

6. Liver or kidney dysfunction: Safety is unknown. Avoid.

7. Autoimmune diseases: Eleuthero may stimulate the immune system, potentially worsening conditions like rheumatoid arthritis, lupus, multiple sclerosis, or Crohn’s disease.

8. Sedatives and psychiatric medications: Don’t combine with benzodiazepines, barbiturates, antidepressants, or lithium without medical supervision.

9. Psychotic conditions: May worsen symptoms in people with mania or schizophrenia.

10. Hormone-sensitive conditions: Some eleuthero compounds may have oestrogen-like effects. Avoid if you have breast cancer, ovarian cancer, uterine cancer, endometriosis, or uterine fibroids.

11. Heart conditions: High doses may cause irregular heartbeat or blood pressure changes. Use with caution if you have heart disease, or avoid entirely.

12. Diabetes medications: May affect blood sugar control. If you take diabetes medications, monitor your blood glucose closely.

13. Blood pressure medications: May interfere with blood pressure control. Avoid if you have hypertension or hypotension.

14. Alcohol: May increase drowsiness from alcohol.

15. Digoxin: May interfere with this heart medication’s effectiveness.

16. Radiation therapy: May have photosensitising effects. Avoid during radiation treatment.

Cytochrome P450 interactions: Eleuthero may affect how your liver metabolises certain medications. This is a long list including some antidepressants (fluoxetine, fluvoxamine, amitriptyline), pain medications (codeine, fentanyl, methadone), heart medications (propranolol, metoprolol), statins (lovastatin), antifungals (ketoconazole, itraconazole), and many others. If you take prescription medications, check with your pharmacist before using eleuthero.

The bottom line

Eleuthero has a long history of traditional use and some supporting research, but the evidence base is limited by small studies and the frequent use of combination formulas. It’s not a miracle herb, but it’s also not without biological activity.

If you’re considering eleuthero, the most important steps are to discuss it with your healthcare provider, check for interactions with any medications you take, and be realistic about what it might achieve. The research suggests modest benefits for some conditions, not dramatic transformations.

The long contraindications list exists because this herb genuinely affects body systems. That’s actually a point in favour of its activity, even if it means more people need to avoid it.

References

Poolsup N, et al. Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials. J Clin Pharm Ther. 2004;29(1):37-45. PubMed
Gabrielian ES, et al. A double-blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine. 2002;9(7):589-97. PubMed
Aslanyan G, et al. Double-blind, placebo-controlled, randomised study of single dose effects of ADAPT-232 on cognitive functions. Phytomedicine. 2010;17(7):494-9. PubMed
Kuo J, et al. The effect of eight weeks of supplementation with Eleutherococcus senticosus on endurance capacity and metabolism in human. Chin J Physiol. 2010;53(2):105-11. PubMed
Davydov M, Krikorian AD. Eleutherococcus senticosus (Rupr. & Maxim.) Maxim. (Araliaceae) as an adaptogen: a closer look. J Ethnopharmacol. 2000;72(3):345-93. PubMed
Teekachunhatean S, et al. Chinese herbal recipe versus diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial. BMC Complement Altern Med. 2004;4:19. PubMed
Lee MH, et al. Red ginseng relieves the effects of alcohol consumption and hangover symptoms in healthy men: a randomized crossover study. Food Funct. 2014;5(3):528-34. PubMed
Amaryan G, et al. Double-blind, placebo-controlled, randomized, pilot clinical trial of ImmunoGuard—a standardized fixed combination of Andrographis paniculata Nees, with Eleutherococcus senticosus Maxim, Schisandra chinensis Bail. and Glycyrrhiza glabra L. extracts in patients with Familial Mediterranean Fever. Phytomedicine. 2003;10(4):271-85. PubMed
Weng S, et al. A double-blind, randomized controlled trial of Eleutherococcus senticosus versus fluoxetine for the treatment of bipolar depression in adolescents. J Clin Psychiatry. 2011;72(6):831-8. PubMed
Hartz AJ, et al. Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychol Med. 2004;34(1):51-61. PubMed
Cicero AF, et al. Effects of Siberian ginseng (Eleutherococcus senticosus maxim.) on elderly quality of life: a randomized clinical trial. Arch Gerontol Geriatr Suppl. 2004;(9):69-73. PubMed
Lee YJ, et al. Effect of Eleutherococcus senticosus on postmenopausal women with cardiovascular risk factors: a randomized controlled clinical study. Maturitas. 2008;59(4):350-8. PubMed
NHS. Herbal medicines. 2019. Available at: https://www.nhs.uk/conditions/herbal-medicines/