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Traditional Chinese medicine

CodonopsisCodonopsis pilosula

Codonopsis (dang shen) is the milder root that stands beside ginseng in Chinese spleen formulas; we found no gut trial of it alone, only mixed-formula data.

Botanical name
Codonopsis pilosula
Part used
root, dried and sliced
Also called
pinyin Dang shen (党参); Poor man’s ginseng, Codonopsis radix
Used in
Traditional Chinese medicine
Taken for
Appetite, Loose stools and diarrhea, Indigestion
Sold as
decoction, dried slices, powder, granule extract, tonic pill

The plant

Codonopsis, or dang shen, is the dried root of a climbing perennial in the bellflower family. The Chinese Pharmacopoeia accepts three sources: Codonopsis pilosula, its variety modesta, and Codonopsis tangshen. The root is sold in slices that are simmered in soups and decoctions. It is also an official food-and-medicine plant in China, which means it is allowed in ordinary cooking as well as in medicine.

The nickname “poor man’s ginseng” reflects the way the materia medica treats it: a milder qi tonic that can take the place of true ginseng in many formulas, especially for a spleen that is weak without being in the collapse that ginseng is reserved for. Dang shen is sold as dried slices, powder and granule extract, and as an ingredient in ready-made tonic pills.

How the traditions use it

Traditional Chinese medicine (about TCM)

In the English materia medica we cite, dang shen is sweet and neutral, entering the spleen and lung channels, with the actions of tonifying the middle qi and lung qi, generating fluids and nourishing blood. For the gut the tradition uses it for what it calls spleen qi deficiency, a pattern of poor appetite, tiredness after meals and loose stools, and it appears as the ginseng substitute in Si Jun Zi Tang and its relatives. All of this is the tradition’s own framing. The traditional lists of antagonisms pair it with li lu (veratrum), as they do ginseng.

What is in it

A review in Phytomedicine reports more than 100 compounds in the root in at least 21 classes, with lobetyolin as its characteristic component, plus polysaccharides and saponins. Cell and animal studies report effects on immunity and on the stomach and intestine, working through pathways such as PI3K/Akt and NF-kB. Those are laboratory findings, not trial results in people. The review adds that the active components are absorbed slowly with moderate bioavailability and concentrate in the gut, liver and kidneys.

What the human trials show

We could not find a placebo-controlled trial of codonopsis alone with a gut outcome. The human data are formulas that contain it, and the signal is mixed.

The clearest pooled result is from a meta-analysis of herbal formulas added to chemotherapy in people with colorectal cancer: 22 trials and 1,995 patients, with reduced chemotherapy-related digestive toxicity overall (RR 0.78, 95% CI 0.72 to 0.84), but no significant effect in the double-blind trials. A sensitivity analysis linked five herbs to significant reductions in toxicity: codonopsis, atractylodes macrocephala, astragalus, licorice and tangerine peel. That is an association across mixed formulas.

A 136-patient double-blind, placebo-controlled trial of Jianpi Yiwei granules, a formula containing codonopsis and atractylodes macrocephala, was run for digestive reactions (nausea, anorexia, bloating, constipation) in lung cancer patients on carboplatin; the abstract describes the design and gives no outcome figures.

The Si Jun Zi family of formulas, in which the tradition lets dang shen stand in for ginseng, has meta-analytic support in chronic atrophic gastritis: 32 studies with 2,780 patients found clinical efficacy RR 1.241 (1.199 to 1.285) for a modified Si Jun Zi Tang against Western drugs. We could not confirm that those formulas used codonopsis rather than ginseng.

Not tested: codonopsis alone versus placebo for dyspepsia, diarrhea or any other digestive symptom.

StudyDoseWhat it found
Meta-analysis of 22 trials, 1,995 colorectal cancer patients on chemotherapy (herbal formulas, codonopsis one of five herbs linked to benefit) PMID 33869014Various formulasDigestive toxicity RR 0.78 (0.72 to 0.84); not significant in double-blind trials
Multicenter double-blind placebo-controlled RCT, 136 lung cancer patients on carboplatin (Jianpi Yiwei granules, containing codonopsis and atractylodes) PMID 41114481Granule formula with standard antiemeticsAbstract gives design and primary outcome (nausea and anorexia control) but no result figures
Meta-analysis of 32 studies, 2,780 patients with chronic atrophic gastritis (modified Si Jun Zi Tang) PMID 38669406Modified formula; doses variedClinical efficacy RR 1.241 (1.199 to 1.285) vs Western drugs; H. pylori eradication RR 1.297
Review of Codonopsis Radix: ethnopharmacology, chemistry, toxicity and clinical use PMID 41275746Not applicableThree Pharmacopoeia species; more than 100 compounds; stomach and intestine protection reported in laboratory work

How much the studies and the texts used

No trial gives a dose of codonopsis alone. The Jianpi Yiwei granules in the 136-patient trial were given alongside standard antiemetics, and the Si Jun Zi trials in the gastritis meta-analysis used a modified formula whose gram weights differed from study to study. The traditional preparation is a water decoction of the sliced root, simmered with other herbs and drunk warm in divided doses. Powder and granule extracts are sold ready-made, and the root is also added to soups; none of these preparations is tied to a trial-based dose.

Doses here describe what studies and pharmacopoeias used. They are not a recommendation for any person; a clinician or pharmacist who knows your medicines and conditions is the right person to ask.

Side effects and cautions

We found no trial-based side-effect data for codonopsis alone. The Phytomedicine review notes that its components are metabolized with a relatively low burden on the liver and kidneys, and the formula trials we read did not single out adverse events attributable to it. Pregnancy and breastfeeding were not addressed in the sources we read. On product quality, a review of toxic heavy metals and undeclared drugs in Asian herbal medicines found reports of both in some Indian and Chinese preparations, but judged the data mostly anecdotal and insufficient to define how common they are; none of it concerns dang shen specifically.

Interactions

No interaction study of codonopsis with a medicine turned up in our reading, and the reviews we read name none. Dang shen is the traditional stand-in for ginseng, but we could find no study of it with warfarin, so the ginseng-warfarin findings (see the ginseng page) have not been shown for it. Formulas that contain it usually also contain licorice or ginseng, and their interaction notes apply to the finished product.

Codonopsis on the shelf: the products that contain it

The products here name codonopsis among their actives. How much of it a serving holds, and whether that matches any trial, is on each page.

Health Concerns Six Gentlemen 4.4 out of 5 from 41 ratings from Amazon · $1.99 per day at two capsules three times a day ($29.90 for 90 on the brand site, $29.99 on Amazon, a 15-day bottle)

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Often paired or compared

TCM Ginseng Panax ginseng TCM Astragalus Astragalus mongholicus (syn. A. membranaceus) TCM Atractylodes Atractylodes macrocephala (bai zhu); A. lancea (cang zhu) TCM Jujube Ziziphus jujuba

What people want to know

Is codonopsis the same as ginseng?

No. It is a different plant in the bellflower family. The Chinese materia medica treats it as a milder qi tonic that can stand in for ginseng in many spleen formulas.

Why is it called poor man’s ginseng?

Because it costs less and is used as a gentler substitute for ginseng in formulas. The name is a description of its role in the tradition, not a measurement of any equivalence.

Does codonopsis have human trials for digestion?

We could not find a controlled trial of the root alone for a digestive symptom. It appears in formulas such as Jianpi Yiwei granules, which have been tested in chemotherapy-related digestive upset.

Which Chinese species are accepted?

The Chinese Pharmacopoeia lists Codonopsis pilosula, its variety modesta, and Codonopsis tangshen. A label that gives only the common name may not say which one it is.

Is dang shen safe to eat in soup?

It is an official food-and-medicine plant in China and is used in ordinary cooking. We could not find controlled safety data for supplements, so the safety record is that of traditional food use and formula trials.

Sources