Panax notoginseng

Panax notoginseng is a herbaceous perennial 20 to 60 cm tall on a single upright stem. The stem carries a whorl of three to six palmately compound leaves, each divided into leaflets 3.5 to 13 cm long and 1.5 to 7 cm wide with doubly toothed, bristly edges and sparse bristles on the veins of both surfaces. The folk name three seven is usually explained by this habit: a mature plant tends to carry three leaves of seven leaflets, and a second explanation says the root wants three parts sun and seven parts shade. ^[3][22]

A single stalk 7 to 25 cm long rises from the whorl and carries a rounded umbel of 80 to 100 or more small flowers, each with two carpels and two styles joined at least to the middle. Flowering runs from July to August and the fruit ripens from August to October as a flattened red berry about 1 cm across, usually with two triangular seeds 5 to 6 mm thick. Growers cut the flower buds off the plants they mean to harvest, because the root is dug in autumn before flowering. ^[3][20]

The root is what the trade pays for. The fleshy rootstock carries one to many spindle shaped roots, and the dried main root is conical or cylindrical, 1 to 6 cm long and 1 to 4 cm across, dull grey brown or grey yellow with interrupted wrinkles, branch root scars, and warty bumps around the stem scar at the top. It is heavy, hard, and compact, breaks grey green or grey white, and tastes bitter and then sweet. Buyers grade it by size, and a bigger root means fewer roots to the 500 g and a higher price. ^[9][19][20]

Cultivation has changed the root itself. A 2022 study compared about 100 notoginseng roots sent as Qing dynasty tribute, which averaged about 5.17 g dry weight, with modern roots, and found that the largest root weight has risen from 6.25 g in the 1950s to about 25 g today, with a 20 head root now almost five times the weight of its imperial ancestor. The authors traced the gain to higher altitude, lower light, phosphorus and potassium fertiliser, and the expression of two cell wall genes that let the root swell. ^[9]

The species is a diploid with 2n = 24. Chloroplast genomes show that the Panax genus split into a diploid group that stayed in southern Asia, with P. notoginseng, P. vietnamensis, and P. japonicus, and a tetraploid group of P. ginseng and P. quinquefolius that moved north and across to North America about 2.9 to 3.2 million years ago. A 2023 comparison of the four species found that the tetraploids hold more dammarane type ginsenosides and the diploids put more of their squalene into plant sterols, which is one reason the three roots differ in chemistry and use. ^[3][4][5]

Isaac Henry Burkill described the plant in 1902 as Aralia quinquefolia var. notoginseng in the Kew Bulletin, from cultivated material, and the epithet means back ginseng or southern ginseng. In 1975 F.H.Chen raised it to a species in Acta Phytotaxonomica Sinica, and because the name was validated through other authors the full citation reads Panax notoginseng (Burkill) F.H.Chen ex C.Y.Wu & K.M.Feng in IPNI, ex C.H.Chow in GBIF, and ex C.Chow & W.G.Huang in Flora of China. The plant was named from farm plants rather than wild ones, which is rare for a medicinal species. ^[1][2][3][7]

The Chinese names carry the plant's story. Sanqi, three seven, is the name of the pharmacopoeia and the trade. Tianqi, field seven, records that the root is farmed. Li Shizhen called it jinbuhuan, not even exchanged for gold, and later primers called it the king of all herbs; shanqi, the mountain herb that glues wounds together like lacquer, is one of the oldest alternatives. In Guangxi and Guangdong the root was long known as tienchi, and in Western shops it is sanchi, tienchi ginseng, or pseudoginseng. ^[2][22]

The pharmacopoeia separates the plant into three commodities. Notoginseng Radix et Rhizoma is the main root and rhizome; the branch roots are jintiao, the rhizome alone is jiankou, and each is dried and priced on its own. The flowers and leaves are also sold, and a 2026 study found that dried notoginseng flowers cannot be told from dried Panax ginseng flowers by eye, which is why a DNA melting test was built to catch mislabelled products. ^[19][61]

Flora of China gives the native range as forests at 1,200 to 1,800 m in southeastern Yunnan and northern Vietnam, with cultivation in Fujian, southwestern Guangxi, Jiangxi, and Zhejiang. The plant is a forest understory herb of the limestone mountains along the Vietnamese border, and it wants shade, cool summers, and well drained soil. ^[3]

The farmed range is now the real range. A 2022 habitat model built on 3,475 distribution records found that the most suitable planting zone lies at about 1,400 to 1,800 m, that Yunnan holds 97 percent of the highly suitable land in China, and that Wenshan has the best traditional quality. The crop has spread from Wenshan to Honghe, Qujing, Kunming, and Yuxi, and by 2023 Honghe grew about half of China's output and Qujing a further 35 to 40 percent, while Wenshan stayed the trading centre. Yunnan grew 99 percent of the national crop in 2023, with Guangxi, Guizhou, and Sichuan together producing 345.7 tonnes. ^[8][18]

Wild plants are another matter. A 2016 genetic survey of the farms stated that no wild population had ever been found, and the 2017 red list assessment of China's 30,068 flowering plants placed Panax notoginseng among only nine species classed as Extinct in the Wild. Everything in the trade is cultivated. ^[6][7]

Four hundred years of farming

Notoginseng has been cultivated and domesticated for about 400 years in Yunnan and Guangxi, and the roots sent to the Qing court in the Jiaqing era around 1800 were already farm roots. The long history under cultivation has left the crop with low genetic diversity at both species and population level, though several old plantations hold more variation than the rest and are worth protecting for breeding. ^[7][9]

Shade, altitude, and soil

The plant is grown in beds under shade structures that copy the forest canopy. An experimental planting at Kunming used a shade and rain shelter house topped with three layers of shade net that let through 8.3 percent of the light, and the roots fed mainly in the top 40 cm of soil. Trials in forest understory and shade houses agree that the crop wants low light and that saponin content falls when the shade is too thin or the altitude too low. The geographical indication standard for Wenshan sanqi defines the product as roots grown at 1,200 to 2,000 m within the prefecture. ^[10][11][13]

The three year cycle

Seed is sown in nursery beds and the seedlings are moved to production beds, where the root grows for three years, sometimes four, before it is dug in autumn before the plant flowers. The branch roots and rhizome are cut off, the roots are washed, and the main roots are dried in the sun. A 2025 irrigation trial at Kunming put the yield of one treatment at 702 kg of dried root per hectare, and a 2026 comparison found that understory roots grown under trees held 109 mg of total saponins per gram against 91 mg in roots from intensive shade houses, though the intensive roots scored higher on the three marker saponins the pharmacopoeia measures. ^[10][11][20]

The replant problem

Notoginseng cannot follow notoginseng. The three farmed Panax species all suffer continuous cropping obstacles, where repeated planting degrades the soil, the roots leak compounds that poison the next crop, and the soil microbes shift toward pathogens, so that plants stunt, yields fall, and disease rises. A 2026 review of the problem found that no single cause explains it and that the mitigations in use, from soil treatment to microbial inoculants, are still being tested. Practitioners and traders say a used field cannot grow the crop again for about 20 years, and this constraint, with the price boom of 2009 to 2013, pushed planting out of Wenshan into Honghe and other prefectures and onto cleared forest in 14 prefectures of Yunnan. ^{[8][12][18][22]}

Black spot disease rises with altitude above the suitable range, and the newer pharmacopoeia standards test the root for 26 banned pesticides and for heavy metals, which pushes growers toward cleaner management. Arsenic in some Yunnan soils is a separate concern, and mycorrhizal fungi have been shown to keep it out of the medicinal taproot while raising saponin content. ^[8][18]

Digging and drying

Roots come out of the ground in autumn after three to four years, before flowering. The Hong Kong standard describes the commodity as the root with branch roots and rhizome removed, washed clean, and dried in the sun, and the Chinese Pharmacopoeia separates the main root, the branch roots as jintiao, and the rhizome as jiankou. Export roots have historically been coloured with coal smoke or charcoal and polished with beeswax, and the Hong Kong monograph notes that the roots on sale in Hong Kong carry that finish, which buyers should not mistake for a quality mark. ^[19][20][22]

Raw and steamed

Notoginseng is the textbook example of the Chinese principle that raw and processed forms of one herb do different jobs: raw disperses and processed tonifies. Raw root, sheng sanqi, is the form for bleeding, bruising, and blood stasis. Steamed root, shu sanqi, is the form for nourishing blood after illness or blood loss. The steaming standard for processed notoginseng powder in Yunnan province has been 100 °C for three hours since 1 April 2013. ^[24][25][26]

Heat rewrites the chemistry. Steaming strips sugars from the native saponins, so notoginsenoside R1, ginsenoside Rg1, Re, Rb1, and Rd fall, while rare dehydrated saponins such as Rg3, Rg5, Rk1, Rk3, and Rh4 appear and 20(R) isomers form; Rh4 and Rg5 reached 1 percent of the dry weight after eight hours at 120 °C. The process also lowers dencichine, the hemostatic amino acid, which is why steamed root is not the form for bleeding. Laboratory studies find the steamed root stronger against platelets and some cancer cells, and reviews in 2026 agree that the processed root gains antioxidant, anti inflammatory, and blood building activity, though they also note that there is still no dedicated quality standard for the processed product. Our guide to raw versus steamed notoginseng explains how to choose. ^{[24][25][26][27]}

Saponin extracts

Chinese hospitals use the root as a purified extract called Panax notoginseng saponins, PNS. Xuesaitong is sold as soft capsules, tablets, and an injection, and Xueshuantong as a freeze dried powder for injection and as a compound capsule. These products are concentrated saponins given under medical supervision, and the injections are not supplements and are not sold as such. The five main saponins, Rg1, Rb1, Rd, Re, and notoginsenoside R1, make up about 90 percent of the saponin content. ^{[30][32][34][43]}

Notoginseng is graded by head count, the number of dried main roots that make up 500 g, called tou. The fewer the roots to the half kilo, the bigger each root and the higher the price. The common commercial classes are 20, 40, 60, 80, and 120 heads and a class above 120, and a 2024 study counted eight market grades in all. At the Anguo market in March 2021, 120 head roots sold for about 130 yuan a kilogram, 60 heads for 150, 40 heads for 160, and 20 heads for 270. ^[9][17][23]

Size and chemistry do not line up neatly. The 2024 study of 36 batches found that the grading has no relation to the pharmacopoeia standard for total saponins, that ginsenoside Rd and notoginsenoside R1 fall as head count rises, and it proposed a simpler two grade scheme, 20 to 60 heads as superior and 80 to 200 heads as qualified, based on the ratio of Rd to total saponins. The 2022 root size study found more ginsenoside Rb1 in 20 head roots but 1.28 times more dencichine in 120 head roots, so the small roots that nobody pays a premium for carry more of the hemostatic compound. ^[9][23]

Quality standards sit beside the grades. The Chinese Pharmacopoeia requires the sum of ginsenoside Rg1, ginsenoside Rb1, and notoginsenoside R1 to be not less than 5.0 percent of the dried root, with water not above 14 percent and ash not above 6 percent. The Hong Kong standard sets separate floors of 2.0 percent Rg1, 1.7 percent Rb1, and 0.49 percent R1 and requires water soluble extractives of at least 26 percent. Shops sell the root whole, sliced, as raw and steamed powder, in capsules, and as flower tea, and our guide to how to choose notoginseng explains what the grades, the Wenshan mark, and the colour of the powder tell you. ^[19][20]

Li Shizhen and the military herb

Sanqi officially entered the Chinese materia medica in the sixteenth century, when Li Shizhen recorded it in the Bencao Gangmu. He wrote that in the South the herb was the most important military medicine for external injuries caused by swords, knives, and arrows, noted that it was already being cultivated, and named it jinbuhuan, not even exchanged for gold. The root came out of the hills of Guangxi and Yunnan where the Zhuang and Miao peoples lived, and the autonomous prefecture that bears their names is still its home. ^[14][22]

The Qing trade

The herb's importance rose greatly in the Qing dynasty, when it became the root for all disorders of the blood, and roots travelled from Guangxi and Yunnan to the court as tribute. Those tribute roots survive, and they are small: about 5 g dry weight against 25 g for the best modern root, a measure of two centuries of farming. The Jiaqing era around 1800 is when cultivation is first firmly traced. ^[9][22]

Yunnan Baiyao

In 1902 a Yunnan herbalist, Qu Huanzhang, formulated a wound powder first called the Qu Huanzhang Wanying Baibao pill, later known as Yunnan Baiyao, Yunnan white medicine. After the outbreak of full war with Japan in 1937 he donated 30,000 bottles to the Chinese army, and the powder earned its name at the Battle of Taierzhuang. Qu died in 1938, and in 1955 his widow gave the secret formula to the state without compensation. The prescription remains unpublished under national confidentiality rules, and the product is a famous proprietary formula in which notoginseng is a known and widely cited ingredient. ^{[22][30][62][63]}

The hospital century

The modern record is Chinese and clinical. Saponin extracts of the root were turned into injections and capsules for stroke and heart disease, trials accumulated from the 1990s in Chinese journals, and the species became the best selling single herb in China's patent medicine market. The 2023 stroke trial in JAMA Network Open, run at 67 hospitals, is the largest randomised trial of any Panax product and the point at which the root's hospital use met international standards of evidence. ^[30][34]

In the Chinese Pharmacopoeia notoginseng is warm, sweet, and slightly bitter, and it enters the liver and stomach channels. Its four actions are to dissipate stasis, stop bleeding, reduce swelling, and relieve pain. Its indications are coughing or vomiting blood, nosebleed, blood in the stool, abnormal uterine bleeding, bleeding from wounds, stabbing pain in the chest and abdomen, and the swelling and pain of falls and blows. ^[19][21]

The herb is the leading member of the class of stasis resolving hemostatics, remedies that stop bleeding without causing clots to linger, which is why practitioners reach for it in injury, surgery, and heavy bleeding alike. Raw root disperses stasis and stops bleeding, and steamed root nourishes blood after loss, and a soup of chicken and sanqi is a common tonic for recovery in southern China. The powder was still the primary battlefield remedy of Vietnamese soldiers in the 1960s and 1970s. ^[21][22][25]

Modern Chinese medicine has extended the herb to the heart and brain. The pattern it treats, blood stasis, maps onto the Western picture of sticky platelets, thick blood, and blocked vessels, and the saponin products described below are prescribed in Chinese hospitals under that logic. For a plain account of what the tradition claims and what the trials have tested, see notoginseng for bruises and bleeding. ^[29][30]

Saponins

The signature compounds are dammarane type triterpene saponins, and the root holds more than 200 of them, with about 270 identified across the plant. Five dominate: ginsenoside Rg1, Rb1, Rd, Re, and notoginsenoside R1 make up about 90 percent of the saponin content. Notoginseng is a protopanaxatriol root. Rg1 and R1 lead, so its profile sits closer to Korean ginseng than to the protopanaxadiol rich American root, while the leaves run the other way and hold mostly protopanaxadiol saponins at several times the concentration of the root. ^[29][31][32]

Notoginsenoside R1 is the species marker. It is a protopanaxatriol saponin with an extra xylose sugar that the other two famous Panax species lack in quantity, and it is one of the three compounds every pharmacopoeia assay measures. In laboratory and animal work it lowers tumour necrosis factor, raises the antioxidant regulator NRF2, and supports blood vessel growth, with protective effects in models of heart, brain, kidney, lung, bone, and diabetic disease. A 2025 review notes that it is poorly absorbed by mouth and that its clinical applications are limited by that, so its promise is preclinical. ^[19][33]

Swallowed saponins are poorly absorbed. They degrade in the gut and cross the intestinal wall slowly, so the blood levels after an oral dose are low, and gut bacteria strip their sugars to make smaller compounds that absorb better. This is why Chinese hospitals developed injections, why the oral products are concentrated extracts rather than plain powder, and why the rare saponins made by steaming, which are smaller and less polar, are of interest. ^[31][32]

Dencichine

Dencichine, beta N oxalyl L alpha beta diaminopropionic acid, is the hemostatic amino acid of the root. It is present in all three Panax species but raw notoginseng holds more than raw Korean or American root, steamed notoginseng holds less than raw, and the same molecule is the neurotoxin of grass pea seed, which is one argument for keeping to pharmacopoeia doses. A 2023 survey of more than 640 samples from across Yunnan found it most concentrated in the rootlets, then the main root, then the leaves and stems, and found higher levels in forest grown leaves than in field grown ones. ^[27][28]

Other compounds

The root also holds flavonoids, cyclic peptides, polysaccharides, fatty acids, and amino acids, and a 2016 review counted more than 200 isolated compounds across the classes. Most of the pharmacology is attributed to the saponins, and the hemostatic effect to dencichine with a contribution from several saponins. ^[24][29]

The circulation effects are the best understood. Notoginseng saponins reduce platelet aggregation, lower thromboxane B2, the signal that recruits platelets to a clot, and lower fibrinogen and D dimer, so the blood is less ready to clot inside a vessel. A 2017 review of 36 randomised trials found these changes against placebo and on top of antiplatelet drugs in people, and a 2022 review of 20 trials in 2,216 people found that adding a notoginseng preparation to aspirin inhibited platelets more than aspirin alone without more bleeding. These are the trial results that back the circulation reputation. ^[45][46]

In the brain the saponins act on several fronts at once. A 2026 review of the stroke literature lists lower oxidative stress, less inflammation, less cell death by apoptosis, ferroptosis, and pyroptosis, more new blood vessels, and more new nerve cells in animal models, which together are offered as the mechanism behind the better recovery seen in the stroke trials. ^[32]

Two effects run in opposite directions, which is the herb's traditional paradox. Dencichine shortens bleeding time, and the raw root is a hemostatic, while the saponins calm platelets and thin thick blood. In practice the raw root is used for both bleeding and stasis, the saponin extracts for circulation, and the steamed root for building blood, and the chemistry of each form matches its use. Our guide to what notoginseng actually does sets this out in plain language. ^[25][26][27]

Interactions with drug metabolism look modest. A 2025 study in rats carrying human gut bacteria and in human liver cells found that an oral sanqi extract had a low tendency to induce the liver enzyme CYP3A, which handles about half of all drugs, though the oxidised metabolites of the saponins did build up with repeated dosing. A 2023 review of herb drug interactions found that the saponins can alter the transport and metabolism of other drugs and called that a red flag for drugs with a narrow safety margin, while also recording synergy with antiplatelet, anticancer, and antimicrobial drugs. ^[58][59]

It helps people regain independence after an ischemic stroke

This is the best evidence notoginseng has. A 2023 trial of 2,966 people aged 18 to 75 at 67 Chinese hospitals gave 120 mg of notoginseng saponins as Xuesaitong soft capsules or placebo twice a day for three months, starting within 14 days of an ischemic stroke of mild to moderate severity. At three months 89.3 percent of the saponin group were functionally independent against 82.4 percent on placebo, an odds ratio of 1.95, and serious adverse events were 1.0 percent against 1.1 percent. This was a hospital treatment added to standard care, and the capsule is a concentrated saponin extract, not a retail supplement. ^[34]

The earlier record points the same way. A 2022 review of 17 trials in 1,942 people found that the soft capsule raised the rate of clinical improvement and the Barthel index of daily living, and a 2011 double blind trial of 140 people at four hospitals found that 200 mg of a notoginseng extract capsule three times a day with low dose aspirin improved neurological scores and daily living more than aspirin alone, with mild side effects equal in both arms. A 2026 network analysis of 50 studies in 18,424 people ranked saponins plus aspirin above aspirin alone for recovery. Most of the older trials used the Xuesaitong injection given in hospital; the reviews of those injection trials, 12 trials in 1,769 people in 2021 and a 2026 update graded low to moderate certainty, found better neurological scores and lower plasma viscosity. Most of these trials are Chinese language studies with unclear risk of bias, so the 2023 trial carries the weight. See notoginseng for heart health. ^{[35][36][37][38][39]}

It calms overactive platelets without adding bleeding

A 2017 review of 36 randomised trials found that notoginseng preparations lowered the maximum platelet aggregation rate and thromboxane B2 against placebo, against non antiplatelet drugs, and on top of antiplatelet drugs, and that adding them to antiplatelet drugs did not increase bleeding events. The review warns of large heterogeneity and poor methods, and many of its trials used injections, so its pooled numbers are directions rather than sizes. ^[45]

The newer trials are oral and sharper. A 2022 review of 20 trials in 2,216 people with coronary disease or stroke found that a notoginseng preparation plus aspirin inhibited platelet aggregation more than aspirin alone, lowered fibrinogen and D dimer, and did not raise the rate of occult blood, stomach bleeding, bruising, or blood in the urine. A 2021 trial of 42 people with stable coronary disease and chronic gastritis found that two months of saponins with aspirin inhibited platelets more than aspirin alone and eased the indigestion that aspirin causes. A 2004 double blind trial of 120 people with thick blood found the saponin capsule outperformed aspirin on the Chinese symptom score and lowered platelet activation markers over 28 days. See notoginseng for circulation. ^[46][47][48]

It eases angina and the need for nitroglycerin

A 2018 review of 17 randomised trials of oral notoginseng saponins in people with unstable angina found fewer and shorter attacks, less nitroglycerin use, better electrocardiograms, better blood lipids, and fewer of the trials' primary end point events, with adverse events described in nine trials and no safety signal. A 2013 review of 17 oral trials in 1,747 people with coronary disease found the same relief of angina symptoms and electrocardiogram changes while finding no significant drop in cardiovascular events, and warned that the trials were small and open to bias. ^[40][42]

Sixteen of the 18 trials in a 2017 review of 1,828 people used hospital injections and the reporting was generally poor, so the oral record rests on the 2018 review, which still found fewer attacks. A 2026 double blind trial of 59 people at two Beijing hospitals found that ten days of a high dose Xueshuantong injection lowered C reactive protein more than a low dose; that is an inpatient treatment and says nothing about capsules at home, but it does show the saponins act on inflammation in angina. ^[41][43]

It supports the heart after a heart attack

A 2021 review of five trials in 539 people found that a Xuesaitong injection added to standard care after an acute heart attack raised the left ventricular ejection fraction by about 3 points and lowered C reactive protein, interleukin 6, troponin T, and creatine kinase MB. All five trials used the hospital injection, so this is evidence for the hospital product and not for powder, and a multicentre trial of 300 people on an oral compound capsule after a heart attack is running to fill that gap. ^[44]

It lowers cholesterol and protein loss in diabetic kidney disease

A 2020 review of 24 randomised trials in 1,918 people with diabetic kidney disease found that notoginseng preparations added to usual medicines lowered albumin in the urine by 26.89 mg, protein in the urine by 0.32 g a day, serum creatinine by 4.52 µmol/L, total cholesterol by 1.56 mmol/L, triglycerides by 0.56 mmol/L, and LDL cholesterol by 0.94 mmol/L. The 2018 angina review also found better lipids. Every one of these trials was in people with disease, on their medicines, mostly in Chinese hospitals, and many used injections or hospital preparations, so the lipid effect is established in patients rather than in healthy people. See notoginseng for cholesterol. ^[40][50]

It thins sticky blood in chronic lung disease

A 2024 review of 20 randomised trials in 1,831 people with chronic obstructive pulmonary disease and a hypercoagulable state found that notoginseng saponin preparations lowered fibrinogen, D dimer, whole blood viscosity, and plasma viscosity, and improved the FEV1 lung function measure, without lengthening the prothrombin or partial thromboplastin times beyond safe limits. The trials are Chinese and of mixed quality, and many used injections, so the finding is a consistent signal for the saponins rather than a dose you can copy. ^[49]

It shortens bleeding after childbirth and steadies blood counts after surgery

The traditional use has the thinnest modern record. A 2002 trial of 60 women found that a Xuesaitong soft capsule for seven days after childbirth shortened bleeding time, cut blood loss at every point from 30 minutes to 24 hours after delivery, and sped the return of the uterus to size. A 2024 network analysis of 31 trials in 2,076 people after hip fracture surgery ranked sanqi powder among the three best Chinese herbal options for keeping haemoglobin up afterwards. One small trial and a ranking are a start, and the four centuries of use for wounds and bleeding are the main reason the root is reached for. See notoginseng for bruises and bleeding. ^[51][52]

It helps prevent clots after surgery alongside heparin

A prospective cohort of 281 surgical inpatients at a Beijing hospital between 2016 and 2018 found deep vein thrombosis in 15.7 percent of those given 100 mg Xuesaitong tablets three times a day with low molecular weight heparin against 27.9 percent on heparin alone, with no difference in severe bleeding and no pulmonary embolism in either group. This was not a randomised trial, so the result is a lead rather than proof, and it does show the saponins working with an anticoagulant without extra bleeding. ^[56]

It stretches endurance and softens muscle soreness

Two small trials tested the plain root. A 2005 trial of 29 untrained adults aged 20 to 35 found that 1,350 mg of notoginseng root a day for 30 days added more than seven minutes to cycling time to exhaustion and lowered peak mean blood pressure during exercise from 113 to 109 mmHg. A 2013 double blind trial of 20 well trained men found that 4,000 mg of root around a downhill run kept squat jump performance up and quadriceps pain down at 96 hours, while some inflammation markers moved the other way. Two small trials, one on each question, are early evidence. ^[53][54]

It blunts the blood sugar rise after a meal

A 2012 trial of 52 non diabetic men aged 20 to 45 found that 3 g of notoginseng a day for three days lowered the blood glucose peak 30 minutes after a glucose drink by 26.3 mg/dL and lowered the area under the glucose curve, while a single bout of cycling did not. One short trial in healthy men makes this a promising lead for the species. ^[55]

The Chinese Pharmacopoeia gives the dose of the dried root and rhizome as 3 to 9 g a day, or 1 to 3 g of powder swallowed per dose, with an appropriate amount for external use. The root is warm and the powder is taken with warm water; raw powder is the form for bleeding and stasis, and steamed powder the form for nourishing blood. ^[19][25]

The trials of the plain root used 1,350 mg a day for 30 days for endurance, 4,000 mg around a hard run for soreness, and 3 g a day for three days for blood sugar, all within the pharmacopoeia range. The hospital trials used saponin extracts rather than root: 120 mg of notoginseng saponins twice a day for three months after stroke, 200 mg of an extract capsule three times a day with aspirin for stroke, and 100 mg Xuesaitong tablets three times a day with heparin after surgery. A saponin milligram is not a root milligram, since the extract is concentrated, so match the product in your hand to the trial that used it. ^{[34][36][53][54][55][56]}

Effects on platelets and blood viscosity appear within weeks, effects on stroke recovery and angina over two to three months, and the exercise trials ran 30 days. Our guides to notoginseng dosage and how to choose notoginseng give practical detail by goal and form. ^{[34][40][45][53]}

The root is well tolerated at trial doses. In the 2,966 person stroke trial serious adverse events were 1.0 percent on the saponin capsule and 1.1 percent on placebo, the 140 person trial reported mild side effects equal in both arms, the 42 person trial found less stomach upset when saponins rode with aspirin, and the 2017 platelet review found no extra bleeding when notoginseng was added to antiplatelet drugs. The Hong Kong Polytechnic University herbal database lists the adverse effects reported in the literature as abdominal pain and diarrhoea, arrhythmia, polycythaemia, allergy, and impaired liver and kidney function, all uncommon. ^{[21][34][36][45][47]}

Blood thinners are the main interaction. The whole point of the herb is to calm platelets and thin sticky blood, so it adds to warfarin, aspirin, clopidogrel, and heparin rather than replacing them, and the trials that combined it with aspirin or heparin did so in hospital with monitoring. If you take an anticoagulant or antiplatelet drug, tell your doctor before starting notoginseng and expect your clotting to be checked. A Taiwan insurance study of 4,470 people on anticoagulants found that those also using Chinese herbs, notoginseng among them, had fewer major bleeds, which is reassuring but retrospective. ^{[45][56][57][58]}

Bleeding disorders and surgery call for care. People with a bleeding disorder should not take the herb without medical advice, and the usual advice before an operation is to stop herbs that act on platelets, so tell your surgeon what you take. Pregnancy is listed as a caution in the pharmacopoeia and no trial covers it, and no trial covers breastfeeding or children, so the traditional advice to avoid it in those periods stands; heavy menstrual bleeding is one of the pharmacopoeia's indications, which means a practitioner, not a self chosen dose, decides its use there. ^[19][21][58]

Drug metabolism looks less of a worry than for many herbs. The 2025 study found a low propensity for the oral extract to induce CYP3A, and the 2023 interaction review found more synergy than conflict, while still flagging drugs with a narrow safety margin such as some anticancer agents. Keep to pharmacopoeia doses, because dencichine, the hemostatic compound, is the same molecule that makes grass pea seed neurotoxic in famine diets, and the root is safe at the doses in use. ^[27][58][59]

Substitution is the real hazard. Tu san qi, a name that covers Gynura japonica, is often confused with sanqi, and its pyrrolizidine alkaloids cause hepatic sinusoidal obstruction syndrome; a 2021 review counted about 2,156 such liver injury cases in China from 1980 to 2019 and found that more than half were caused by Gynura. Chuan sanqi, Tupistra chinensis, has also been sold in its place and has toxic properties of its own. Buy the root whole or from a maker who names the species and tests it, because true Panax notoginseng carries no pyrrolizidine alkaloids. Yunnan Baiyao is a multi herb proprietary formula whose maker acknowledged an aconite component in 2014 after undeclared aconitum alkaloids were found in Hong Kong, so its cautions are its own and not the root's. The notoginseng side effects guide covers the cautions in more depth. ^{[22][60][62][64]}

Forms of notoginseng

Three forms serve three jobs. Raw root and raw powder, sheng sanqi, keep the native saponins and the dencichine, and are the form for bleeding, bruises, and circulation. Steamed root and steamed powder, shu sanqi, hold the rare dehydrated saponins and less dencichine, and are the form for nourishing blood after illness or blood loss. Saponin extracts, Xuesaitong and Xueshuantong, are the concentrated hospital products that carry most of the clinical record, as capsules and tablets for the home and as injections for the ward. The flowers are sold as a cooling tea and the leaves as a source of protopanaxadiol saponins. ^{[19][24][25][30]}

Related species and plants called sanqi

Plant	Family and native range	What it contains	Use and notes
Panax notoginseng (sanqi, tianqi, notoginseng)	Araliaceae; southeastern Yunnan and northern Vietnam	Protopanaxatriol rich saponins, notoginsenoside R1, dencichine; diploid	The blood and circulation root of Chinese medicine; the subject of this article [3][4][27][32]
Panax ginseng (Korean, Chinese ginseng)	Araliaceae; Korea, northeast China, Russian Far East	Protopanaxatriol rich profile; tetraploid; less dencichine than raw notoginseng	The warm tonic root; dried flowers cannot be told from notoginseng flowers by eye; see notoginseng versus Korean ginseng [4][27][61]
Panax quinquefolius (American ginseng)	Araliaceae; eastern North America	Protopanaxadiol rich profile; tetraploid; less dencichine than raw notoginseng	The cool tonic root; see notoginseng versus American ginseng [4][27]
Panax vietnamensis (Vietnamese ginseng) and P. japonicus	Araliaceae; Vietnam, Japan, southern China	Diploids of the southern group	Close relatives; P. japonicus rhizome is sometimes sold as wild sanqi [4]
Tu san qi (Gynura japonica)	Asteraceae; southern China	Pyrrolizidine alkaloids	Not a Panax; causes liver injury; the main cause of herb related hepatic sinusoidal obstruction in China [60]
Chuan san qi (Tupistra chinensis)	Asparagaceae; southwestern China	Steroidal compounds	Not a Panax; sold in place of sanqi in some Cantonese pharmacies; toxic reactions reported [22]

The three species article, the three Panax species, sets out which root suits which goal. ^[4][5]

Notoginseng is a Chinese crop sold in China. The species holds first place in sales volume among single herbs in China's patent medicine market, with a market worth more than 10 billion yuan, and it is a constituent of Compound Danshen Dripping Pills, Yunnan Baiyao, and the Xuesaitong and Xueshuantong lines. Yunnan grew 99 percent of the 23,380 tonnes harvested in 2023, and Wenshan prefecture, the historic origin, is still the trading centre even though Honghe now grows about half the crop. In 2023 Wenshan reported 2.3 million mu of notoginseng planting and a biomedical industry built on the root worth tens of billions of yuan. ^[15][18][30]

Prices run in long cycles. The 120 head grade rose from 50 to 500 yuan a kilogram between 2009 and 2010 after bad weather and heavy buying, passed 700 yuan in 2012, and peaked at 800 yuan in 2013. Planting followed the price to nearly a million mu in 2015 and 2016, output reached 30,000 to 40,000 tonnes a year against a consumption of about 10,000 tonnes, stocks piled up, and by 2020 Wenshan's planted area had fallen 30 percent in a year, output 50 percent, and output value 60 percent to 2.68 billion yuan, with 120 head roots at 110 to 112 yuan. Prices rebounded 45 percent in 2023 to about 133 yuan a kilogram, with stocks of about 53,870 tonnes still hanging over the market. ^[16][18]

The Wenshan name is protected. China's national standard for the geographical indication product Wenshan sanqi, GB 19086, dates from 2003 and was revised in 2008, and it defines the product as roots grown and harvested at 1,200 to 2,000 m within the prefecture. Wenshan sanqi holds both a geographical indication certification mark and GI product protection, was listed by the AQSIQ as a protected geographical indication product, and was selected in 2020 into the first group of products under the China EU agreement on geographical indications. By early 2021, 20 companies were authorised to use the prefecture's combined origin mark. Yunnan Baiyao opened a digital notoginseng industrial park supply chain listing in Wenshan in March 2021. ^{[13][14][15][16][17]}

The 2017 red list assessment of China's angiosperms, which evaluated 30,068 species under IUCN criteria, placed Panax notoginseng among nine species classed as Extinct in the Wild. The species was described from cultivated plants, a 2016 genetic study of the farms stated that no wild population had been found, and Flora of China gives a native range in forests at 1,200 to 1,800 m in southeastern Yunnan that is now farmland and plantation. The crop survives in abundance; the wild plant is gone. ^[3][6][7]

The farmed gene pool is narrow. The 2016 RAD sequencing study found low genetic diversity at both species and population level and almost no differentiation between farms, the result of 400 years of selection from a small founding stock, and it urged that the few old plantations with higher diversity be protected as a breeding resource. A conservation garden or careful reintroduction to the native forests of the Vietnamese border has been proposed. ^[7]

The land is the other pressure. Continuous cropping obstacles mean a field cannot carry the crop again for many years, so the boom of 2009 to 2015 pushed planting out of Wenshan onto new land across 14 prefectures of Yunnan, with forest cleared for shade houses. A 2026 review found the replant problem to be a tangle of soil degradation, autotoxicity, and microbial change with no single fix, while trials of understory planting beneath pine and other trees, mycorrhizal inoculation, and microbial soil amendments offer ways to grow the root with less new land. The 2023 land policy in Yunnan restricting the conversion of farmland may limit planting further. ^{[8][11][12][18]}

The name is a riddle that every seller explains. Three seven, sanqi, is said to describe three leaves of seven leaflets, or a root that takes three to seven years, or a plant that wants three parts sun to seven parts shade. Li Shizhen gave it the grander name jinbuhuan, not even exchanged for gold, and Qing primers made it the king of all herbs. Tianqi, field seven, is the honest name, because the root has been a farm crop for 400 years and is one of the few famous medicinal plants that science has never found in the wild. ^[7][22]

Yunnan Baiyao carries the root's reputation around the world. Qu Huanzhang's 1902 wound powder went to the front in 1937, its formula went to the state in 1955, and the product became a national confidential formula whose ingredients were kept secret like a soft drink recipe. Notoginseng was long known to be its principal herb, a list of eight purported active ingredients surfaced on American websites in 2010, and in 2013 Hong Kong's Department of Health recalled five Yunnan Baiyao products for undeclared aconitum alkaloids, after which the maker acknowledged an aconite component. The bottle's single red pill for sudden heavy bleeding is the detail travellers remember. ^{[22][62][63][64]}

Wenshan has made the root its identity. The Zhuang and Miao autonomous prefecture holds the geographical indication, the national standard, the international trading centre, and a digital industrial park, and its growers have ridden a price cycle from 50 to 800 yuan a kilogram and back. Across China the root sits in soup pots and in hospital pharmacies alike, the largest randomised trial of any ginseng product has given it an international record, and the circulation root of the three Panax species has four centuries of use behind it. ^{[15][16][18][34]}