Related Terms

• Bastard ginseng, bellflower, bonnet bellflower, Campanulaceae (family), chuan dang, codonoposide, condonoposide 1c, Codonopsis eupolyphaga, Codonopsis lanceolata, Codonopsis modesta, Codonopsis nervosa var., Codonopsis ovata Benth., Codonopsis philosula, Codonopsis pilosula, Codonopsis pilosula (Franch.) Nannf., Codonopsis pilosula (Franch.) Nannf. var. volubilis, Codonopsis pilosula modesta, Codonopsis pilosular, Codonopsis silvestris, Codonopsis tangshen, Codonopsis tubulosa, dangshen, friedelin, poor man's ginseng, radix codonopsis, radix Codonopsis pilosula, alpha-spinasterol, tang shen, tang-shen, tangshenoside, tangshenoside I, taraxerol.

Background

• Codonopsis is a small perennial native to Asia, which is especially abundant in the Shanxi and Szechuan provinces of China. Codonopsis has been used in China for over 2,000 years as a tonic for the lungs and spleen, and to strengthen and nourish the blood and balance metabolic function.

• Historically, codonopsis is thought to have properties similar to ginseng. The Chinese name for codonopsis, dangshen, indicated that it was ginseng from the Shandang region; shen is the key term to describe ginseng or a ginseng-like herb. Like ginseng, codonopsis is referred to as an adaptogen, a substance that non-specifically enhances and regulates the body's ability to withstand stress. Adaptogens increase the body's general performance in ways that help the whole body resist disease. Codonopsis is thought to benefit the entire body by boosting strength, increasing stamina and alertness, rejuvenating the body, strengthening the immune system, aiding recovery from chronic illness, reducing stress, and stimulating the appetite.

• At this time, there is insufficient high quality evidence in humans to support the use of codonopsis for any indication.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Anorexia, anoxic brain injury, antioxidant, appetite stimulant, ascites (fluid in the abdomen), asthma, blood circulation, brain damage, cancer, chronic diarrhea, coagulation disorders, contraception, cough, diabetes, dyspnea (difficulty breathing), endurance, gastric cancer, gastric ulcers, HIV, hypertension (high blood pressure), immune function, kidney disorders, liver damage, lowered blood cell counts, memory, metabolic enhancement, motility disorders, myocardial injury, nerve regeneration, obesity, palpitations, senility, solar ultra-violet protection, stress, systemic lupus erythematosus (SLE), thyroid disorders, tonic, uterus contraction, vomiting, weight gain.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older):

• There is no proven safe or effective dose for adults. Traditionally, 3-9 grams of codonopsis decoction has been used; some conditions may require dosages up to 30 grams per day.

Children (younger than 18 years):

• There is no proven safe or effective dose for children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

• Avoid in individuals with a known allergy or hypersensitivity to Codonopsis pilosula, its constituents, or related species from the Campanulaceae family.

Side Effects and Warnings

• There is insufficient clinical information available regarding the safety of codonopsis. Few adverse effects in humans have been reported for codonopsis.

• Use cautiously in patients with bleeding disorders or who are taking anticoagulant or antiplatelet agents.

• Use cautiously in patients who are taking laxatives or stool softeners or who have inflamed bowel or appendicitis. Traditionally, codonopsis is used to promote digestion and cleanse the intestinal tract.

• Use cautiously in patients using antacids or gastric reflux medications, as Codonopsis pilosula may reduce gastric acid-pepsin secretion.

• Use cautiously in patients using oral medication, as Codonopsis pilosula extract may inhibit gastrointestinal movement.

• Avoid using in women who are trying to become pregnant.

Pregnancy and Breastfeeding

• Codonopsis is not recommended in pregnant or breastfeeding women due to a lack of available human scientific evidence.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

• Although not well studied in humans, Codonopsis pilosula may reduce gastric acid-pepsin secretion. Caution is advised in patients taking antacid medications due to possible additive effects.

• In humans, codonopsis has been observed to inhibit platelet aggregation. Caution is advised in patients taking drugs that may also increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavis®), and non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

• Codonopsis has exhibited anti-fertility activity in rats. Caution is advised when taking codonopsis with any fertility medications.

• Traditionally, codonopsis is used to promote digestion and cleanse the intestinal tract. Caution is advised in patients taking laxatives due to possible additive effects.

• Codonopsis pilosula extract may inhibit gastrointestinal movement. Thus, caution is advised when taking codonopsis with any agents taken by mouth, because the effect of the agents may be altered.

Interactions with Herbs and Dietary Supplements

• Although not well studied in humans, Codonopsis pilosula may reduce gastric acid-pepsin secretion. Caution is advised in patients taking herbs or supplements with antacid activity due to possible additive effects.

• In humans, codonopsis has been observed to inhibit platelet aggregation. Caution is advised in patients taking other herbs or supplements thought to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

• Codonopsis has exhibited anti-fertility activity in rats. Caution is advised when taking codonopsis with any herbs or supplements with intended fertility effects.

• Traditionally, codonopsis is used to promote digestion and cleanse the intestinal tract. Caution is advised in patients taking other herbs or supplements with laxative activity due to possible additive effects.

• Codonopsis pilosula extract may inhibit gastrointestinal movement. Thus, caution is advised when taking codonopsis with any agents taken by mouth, because the effect of the agents may be altered.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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2. Gong QM, Wang SL, Gan C. [A clinical study on the treatment of acute upper digestive tract hemorrhage with wen-she decoction]. Zhong.Xi.Yi.Jie.He.Za Zhi. 1989;9(5):272-3, 260. View Abstract

3. Huang C, Ouyang YD, Fang YW, et al. [Study on spectral properties of Chinese herbal medicines additives in cosmetic]. Guang.Pu.Xue.Yu Guang.Pu.Fen.Xi. 2004;24(12):1649-1651. View Abstract

4. Lee KT, Choi J, Jung WT, et al. Structure of a new echinocystic acid bisdesmoside isolated from Codonopsis lanceolata roots and the cytotoxic activity of prosapogenins. J Agric.Food Chem 7-17-2002;50(15):4190-4193. View Abstract

5. Lee KW, Jung HJ, Park HJ, et al. Beta-D-xylopyranosyl-(1-->3)-beta-D-glucuronopyranosyl echinocystic acid isolated from the roots of Codonopsis lanceolata induces caspase-dependent apoptosis in human acute promyelocytic leukemia HL-60 cells. Biol Pharm Bull. 2005;28(5):854-859. View Abstract

6. Li X, Hou L, Shan Y, et al. [Effect of changtong oral liquids on the fibrinolytic activity of rabbits with experimental intestinal adhension]. Zhong.Yao Cai. 2002;25(6):416-417. View Abstract

7. Liu JH, Bao YM, Song JJ, et al. Codonopsis pilosula (Franch) Nannf total alkaloids potentiate neurite outgrowth induced by nerve growth factor in PC12 cells. Acta Pharmacol Sin. 2003;24(9):913-917. View Abstract

8. Ng TB, Liu F, Wang HX. The antioxidant effects of aqueous and organic extracts of Panax quinquefolium, Panax notoginseng, Codonopsis pilosula, Pseudostellaria heterophylla and Glehnia littoralis. J Ethnopharmacol 2004;93(2-3):285-288. View Abstract

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11. Wang ZT, Du Q, Xu GJ, et al. Investigations on the protective action of Condonopsis pilosula (Dangshen) extract on experimentally-induced gastric ulcer in rats. Gen.Pharmacol 1997;28(3):469-473. View Abstract

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15. Yu S, Xue XD, Yang SL, et al. [The protective effect of Rhadiola Astragalus Codonopsis Compound on myocardium in early stage of severe burn at plateau in rats]. Zhonghua Shao Shang Za Zhi. 2004;20(3):134-137. View Abstract