Codonopsis

What Is Codonopsis?

Codonopsis is a twining perennial in the bellflower family whose root, dang shen, is one of the gentle qi tonics of Chinese medicine. It is taken for fatigue, poor appetite, loose stools and weak digestion, and is often called “poor man’s ginseng” because it is used in place of the costlier Panax root ^{22Reference 22Bone K · 2003A Clinical Guide to Blending Liquid Herbs: Herbal Formulations for the Individual Patient}.

Codonopsis pilosula grows wild in the forests, thickets and mountain meadows of much of China, Korea, Mongolia and the Russian Far East, and is cultivated on a large scale in China for its root ^{32Reference 32Hong DY et al.Codonopsis pilosulaView study →}. It is an officially recognised medicinal and edible herb in China ^{1Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →}.

The root’s studied constituents include polysaccharides, the polyacetylene lobetyolin and the phenylpropanoid tangshenoside I ^{1,31Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →Reference 31Liang W et al. · 2024ReviewCodonopsis radix: a review of resource utilisation, postharvest processing, quality assessment, and its polysaccharide compositionView study →}. Research has focused on immunity and the gut, almost entirely in animals and cells ^{1,2,3,4,5,6,7,8Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →Reference 2Xie X et al. · 2025AnimalAn inulin-type fructan from Codonopsis pilosula ameliorates cyclophosphamide-induced immunosuppression and intestinal barrier injury in miceView study →Reference 3Gao Z et al. · 2025Specific inulin in Codonopsis pilosula exerts immunological enhancement by promoting cellular uptake and regulating p65-dependent MAPK and NF-κB pathwaysView study →Reference 4Xia Z et al. · 2025AnimalImmunomodulatory effects and multi-omics analysis of Codonopsis pilosula extract in septic ratsView study →Reference 5Wang ZT et al. · 1997AnimalInvestigations on the protective action of Codonopsis pilosula (Dangshen) extract on experimentally-induced gastric ulcer in ratsView study →Reference 6Chen Q et al. · 2025The effect and mechanism of Codonopsis Radix and its active components tangshenoside I and lobetyolin on preventing gastric ulcer based on spectrum-effect relationshipView study →Reference 7Zhou J et al. · 2024An inulin-type fructan CP-A from Codonopsis pilosula alleviates TNBS-induced ulcerative colitis based on serum-untargeted metabolomicsView study →Reference 8Yang Q et al. · 2026Codonopsis pilosula (Dangshen) alleviates ulcerative colitis through activation of the aryl-hydrocarbon-receptor signaling pathway by the gut bacterium Alistipes onderdonkii and its metabolite 5-HIAAView study →}.

Three related taxa are sold as dang shen, and the Chinese Pharmacopoeia accepts all three ^{1Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →}. Codonopsis lanceolata is a separate species with its own uses, and research on it does not carry over to dang shen ^{21Reference 21Cho K et al. · 2009AnimalProtective effect of Codonopsis lanceolata root extract against alcoholic fatty liver in the ratView study →}.

How Is Codonopsis Used?

Codonopsis is used as the dried root, usually decocted, either alone or in tonic formulas. It is mild enough to be taken over long periods, and in China it is also recognised as an edible herb ^{1Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →}.

Western herbalists use it much as they use ginseng, as a tonic in convalescence and fatigue, and especially where blood-cell production needs support, including during chemotherapy or radiotherapy.

Traditional Uses

Traditional Chinese Medicine

NameDang Shen 党参

TasteSweet

TemperatureNeutral

ChannelsSpleenLung

Codonopsis is dang shen (党参). It is sweet and neutral and enters the spleen and lung channels. It tonifies qi, strengthens the spleen and stomach, and generates fluids ^{24Reference 24Hempen CH · 2009A Materia Medica for Chinese Medicine: Plants, Minerals, and Animal Products}. It is a qi and blood builder rather than a stimulant, and is used in place of Panax ginseng across parts of Asia ^{22Reference 22Bone K · 2003A Clinical Guide to Blending Liquid Herbs: Herbal Formulations for the Individual Patient}.

Traditionally it is given for chronic cough, fatigue and tired limbs, diarrhoea, vomiting, poor appetite, tuberculosis, psychoneurosis, dyspepsia, and prolapse of the uterus, stomach or anus ^{22Reference 22Bone K · 2003A Clinical Guide to Blending Liquid Herbs: Herbal Formulations for the Individual Patient}.

Indications

• Fatigue and tired limbs [root; TCM]
• Poor appetite, dyspepsia and loose stools [root; TCM]
• Chronic cough [root; TCM]
• Prolapse of the uterus, stomach or rectum [root; TCM]
• Convalescence and general weakness [root; TCM, Western herbal use]
• Low blood counts [root; TCM, Western herbal use]
• Weak immunity [root polysaccharides]
• Gastric ulcer and inflamed bowel [root extract]
• Memory and learning [root glycosides] ⚠Caution: The only human trial gave codonopsis glycosides together with ginkgo, so the result cannot be credited to codonopsis alone ²⁰.
• Fatty liver [root polysaccharides]

Botany

Codonopsis is a herbaceous perennial in the bellflower family, Campanulaceae ^{32Reference 32Hong DY et al.Codonopsis pilosulaView study →}. It grows from a carrot-shaped or spindle-shaped root, 15–30 cm long and 1–3 cm thick, which is often branched ^{32Reference 32Hong DY et al.Codonopsis pilosulaView study →}.

Its slender, hairless stems twine through surrounding plants and reach 1–2 m ^{32Reference 32Hong DY et al.Codonopsis pilosulaView study →}. The leaves are ovate, 1–7 cm long, grey-green underneath and edged with small rounded teeth ^{32Reference 32Hong DY et al.Codonopsis pilosulaView study →}.

The flowers grow singly at the ends of the branches. Each is a broad yellow-green bell about 2 cm long, spotted purple inside ^{32Reference 32Hong DY et al.Codonopsis pilosulaView study →}. The fruit is a capsule 1–2.4 cm long holding many small, red-brown to dark brown seeds ^{32Reference 32Hong DY et al.Codonopsis pilosulaView study →}.

Flora of China recognises three subspecies. The plant long sold as C. tangshen (chuan dang shen) is now treated as C. pilosula subsp. tangshen; its calyx is almost entirely free of the ovary ^{32,33Reference 32Hong DY et al.Codonopsis pilosulaView study →Reference 33Hong DY et al.Codonopsis pilosula subspView study →}.

Distribution

Codonopsis grows in forests, thickets, meadows and scrub at forest margins, at 900–3,900 m ^{32Reference 32Hong DY et al.Codonopsis pilosulaView study →}. Its range covers much of northern, central and southwestern China, from Heilongjiang and Inner Mongolia to Sichuan and Yunnan, and extends to Korea, Mongolia and the Russian Far East ^{32Reference 32Hong DY et al.Codonopsis pilosulaView study →}.

Subspecies tangshen grows in scrub at 900–2,300 m in central China and is cultivated on a large scale ^{33Reference 33Hong DY et al.Codonopsis pilosula subspView study →}. The main cultivated dang shen comes from Gansu and Shanxi provinces, where the roots are dried by a traditional “rubbing and sweating” process ^{31Reference 31Liang W et al. · 2024ReviewCodonopsis radix: a review of resource utilisation, postharvest processing, quality assessment, and its polysaccharide compositionView study →}.

Growing Conditions

Cultivation snapshot for Codonopsis

LifeperennialZoneUSDA 3–8

• Twining herbaceous perennial; sun to part shade; cold-hardy across roughly USDA zones 3–8; likes light, fertile, well-drained soil with steady moisture.

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Harvesting, Collection & Preparation

The Chinese Pharmacopoeia accepts three sources of dang shen: C. pilosula, C. pilosula var. modesta and C. tangshen (now C. pilosula subsp. tangshen) ^{1Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →}. Lobetyolin is the characteristic marker compound. Codonopyrrolidum A and B and tangshenoside I are used to tell the sources apart ^{1,23Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →Reference 23Lin LC et al. · 2013Chemical constituents comparison of Codonopsis tangshen, Codonopsis pilosula varView study →}.

After harvest the roots are traditionally dried by repeated rubbing and sweating. Some are fumigated with sulphur, and the Chinese Pharmacopoeia limits sulphur dioxide residues in the root to 400 mg/kg ^{31Reference 31Liang W et al. · 2024ReviewCodonopsis radix: a review of resource utilisation, postharvest processing, quality assessment, and its polysaccharide compositionView study →}.

Phytochemistry

More than 100 compounds from at least 21 classes have been identified in codonopsis root ^{1Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →}. The main groups are polysaccharides, polyacetylenes, phenylpropanoids, alkaloids and triterpenoids ^{1,31Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →Reference 31Liang W et al. · 2024ReviewCodonopsis radix: a review of resource utilisation, postharvest processing, quality assessment, and its polysaccharide compositionView study →}.

The polysaccharides include inulin-type fructans and arabinogalactans ^{2,3,19,31Reference 2Xie X et al. · 2025AnimalAn inulin-type fructan from Codonopsis pilosula ameliorates cyclophosphamide-induced immunosuppression and intestinal barrier injury in miceView study →Reference 3Gao Z et al. · 2025Specific inulin in Codonopsis pilosula exerts immunological enhancement by promoting cellular uptake and regulating p65-dependent MAPK and NF-κB pathwaysView study →Reference 19Zhu Y et al. · 2025A highly branched arabinogalactan from Codonopsis pilosula: structural insights and hematopoietic-protective mechanismView study →Reference 31Liang W et al. · 2024ReviewCodonopsis radix: a review of resource utilisation, postharvest processing, quality assessment, and its polysaccharide compositionView study →}. Polysaccharide content across the whole plant has been reported at up to about 6% ^{31Reference 31Liang W et al. · 2024ReviewCodonopsis radix: a review of resource utilisation, postharvest processing, quality assessment, and its polysaccharide compositionView study →}.

The polyacetylene lobetyolin is the herb’s characteristic marker compound ^{1Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →}. The phenylpropanoid glycosides include tangshenoside I and syringin, and the alkaloids include perlolyrin ^{26,31Reference 26He JY et al. · 2015ReviewThe genus Codonopsis (Campanulaceae): a review of phytochemistry, bioactivity and quality controlReference 31Liang W et al. · 2024ReviewCodonopsis radix: a review of resource utilisation, postharvest processing, quality assessment, and its polysaccharide compositionView study →}.

The pyrrolidine alkaloids codonopyrrolidum A and B, together with tangshenoside I, distinguish the different sources of dang shen ^{1,23Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →Reference 23Lin LC et al. · 2013Chemical constituents comparison of Codonopsis tangshen, Codonopsis pilosula varView study →}.

The chemistry of C. lanceolata, which contains triterpenoid saponins such as echinocystic acid glycosides, has been studied separately ^{28,29Reference 28Lee KT et al. · 2002Structure of a new echinocystic acid bisdesmoside isolated from Codonopsis lanceolata rootsReference 29Ichikawa M et al. · 2009Simultaneous determination of seven saponins in the roots of Codonopsis lanceolata by LC-MS}.

Constituent Summary

Constituents of the dried root of Codonopsis pilosula.

Pharmacology & Research

Codonopsis pilosula has several hundred published papers behind it, almost all preclinical. Most are cell and rodent studies of the root’s polysaccharides, with the marker compound lobetyolin a distant second.

The most consistent findings are immune support and protection of the stomach and bowel, using water extracts and isolated fructans ^{1,2,3,4,5,6,7,8Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →Reference 2Xie X et al. · 2025AnimalAn inulin-type fructan from Codonopsis pilosula ameliorates cyclophosphamide-induced immunosuppression and intestinal barrier injury in miceView study →Reference 3Gao Z et al. · 2025Specific inulin in Codonopsis pilosula exerts immunological enhancement by promoting cellular uptake and regulating p65-dependent MAPK and NF-κB pathwaysView study →Reference 4Xia Z et al. · 2025AnimalImmunomodulatory effects and multi-omics analysis of Codonopsis pilosula extract in septic ratsView study →Reference 5Wang ZT et al. · 1997AnimalInvestigations on the protective action of Codonopsis pilosula (Dangshen) extract on experimentally-induced gastric ulcer in ratsView study →Reference 6Chen Q et al. · 2025The effect and mechanism of Codonopsis Radix and its active components tangshenoside I and lobetyolin on preventing gastric ulcer based on spectrum-effect relationshipView study →Reference 7Zhou J et al. · 2024An inulin-type fructan CP-A from Codonopsis pilosula alleviates TNBS-induced ulcerative colitis based on serum-untargeted metabolomicsView study →Reference 8Yang Q et al. · 2026Codonopsis pilosula (Dangshen) alleviates ulcerative colitis through activation of the aryl-hydrocarbon-receptor signaling pathway by the gut bacterium Alistipes onderdonkii and its metabolite 5-HIAAView study →}. Anti-ageing, antioxidant and neuroprotective work uses D-galactose-aged and Alzheimer’s-model mice ^{11,12,13,14Reference 11Wang X et al. · 2024AnimalCodonopsis pilosula water extract delays D-galactose-induced aging of the brain in mice by activating autophagy and regulating metabolismView study →Reference 12Zhang B et al. · 2026Codonopsis pilosula polysaccharide (CPP) alleviates D-Gal-induced aging and gut microbiota dysbiosisView study →Reference 13Cai Y et al. · 2025AnimalCodonopsis pilosula polysaccharides alleviate neuronal apoptosis induced by endoplasmic-reticulum-stress-activated PERK-ATF4-CHOP signaling in APP/PS1 miceView study →Reference 14Yang L et al. · 2024Neuroprotective effect of Codonopsis pilosula polysaccharide on Aβ(25-35)-induced damage in PC12 cells via the p38 MAPK signaling pathwaysView study →}.

One human trial has been published. It gave codonopsis total glycosides together with Ginkgo biloba to healthy adults ^{20Reference 20Singh B et al. · 2004Dangshen (Codonopsis pilosula) and Bai guo (Ginkgo biloba) enhance learning and memoryView study →}.

1. Immunomodulation

This work centres on the root’s carbohydrates. In mice made immunosuppressed with cyclophosphamide, an inulin-type fructan from the root restored immune-organ weights, raised serum IgG and cytokines (IL-2, IL-4, IL-6, TNF-α, IFN-γ) and repaired intestinal-barrier damage ^{2Reference 2Xie X et al. · 2025AnimalAn inulin-type fructan from Codonopsis pilosula ameliorates cyclophosphamide-induced immunosuppression and intestinal barrier injury in miceView study →}.

A second inulin-type fructan activated THP-1 macrophages through MAPK and NF-κB signalling and enhanced immunity in immunosuppressed mice. A commercial inulin of almost identical size and sugar composition had almost no activity, a difference the authors traced to smaller particle size and better uptake into cells ^{3Reference 3Gao Z et al. · 2025Specific inulin in Codonopsis pilosula exerts immunological enhancement by promoting cellular uptake and regulating p65-dependent MAPK and NF-κB pathwaysView study →}.

In septic rats, a root extract protected the thymus and spleen, raised CD4 expression, and raised red cells, lymphocytes and haemoglobin ^{4Reference 4Xia Z et al. · 2025AnimalImmunomodulatory effects and multi-omics analysis of Codonopsis pilosula extract in septic ratsView study →}.

Every study is animal or in vitro, and immune endpoints differ between models.

2. Gastroprotective

A C. pilosula extract protected against gastric ulcers caused by stress, acetic acid and sodium hydroxide in rats and reduced acid and pepsin secretion. It had little effect on ulcers from pyloric ligation or indomethacin ^{5Reference 5Wang ZT et al. · 1997AnimalInvestigations on the protective action of Codonopsis pilosula (Dangshen) extract on experimentally-induced gastric ulcer in ratsView study →}.

Ethanol extracts of all three dang shen sources protected rats against ethanol-induced gastric ulcers, and tangshenoside I and lobetyolin were identified as likely active compounds ^{6Reference 6Chen Q et al. · 2025The effect and mechanism of Codonopsis Radix and its active components tangshenoside I and lobetyolin on preventing gastric ulcer based on spectrum-effect relationshipView study →}.

In inflammatory-bowel models, the inulin-type fructan CP-A eased TNBS-induced colitis in rats through the mTOR/p70S6K pathway ^{7Reference 7Zhou J et al. · 2024An inulin-type fructan CP-A from Codonopsis pilosula alleviates TNBS-induced ulcerative colitis based on serum-untargeted metabolomicsView study →}. Dang shen also eased colitis in mice, an effect that depended on gut bacteria, including Alistipes onderdonkii, and aryl-hydrocarbon-receptor signalling ^{8Reference 8Yang Q et al. · 2026Codonopsis pilosula (Dangshen) alleviates ulcerative colitis through activation of the aryl-hydrocarbon-receptor signaling pathway by the gut bacterium Alistipes onderdonkii and its metabolite 5-HIAAView study →}.

Gap: the human evidence for gut benefit exists only inside multi-herb formulas, where codonopsis cannot be separated out. Everything specific to the root is rodent work.

3. Anti-Inflammatory

Across colitis, fatty-liver and ageing models, C. pilosula extracts and polysaccharides lower TNF-α, IL-6 and other inflammatory markers ^{7,8,9Reference 7Zhou J et al. · 2024An inulin-type fructan CP-A from Codonopsis pilosula alleviates TNBS-induced ulcerative colitis based on serum-untargeted metabolomicsView study →Reference 8Yang Q et al. · 2026Codonopsis pilosula (Dangshen) alleviates ulcerative colitis through activation of the aryl-hydrocarbon-receptor signaling pathway by the gut bacterium Alistipes onderdonkii and its metabolite 5-HIAAView study →Reference 9Chen Q et al. · 2025AnimalCodonopsis pilosula polysaccharides attenuate lipid accumulation and inflammatory response in the NAFLD mouse by regulating AMPK/ACC/SREBP1 signaling pathwayView study →}.

The polyacetylene lobetyolin, given by injection, protected mice against LPS-induced sepsis by reducing inflammatory cytokines from macrophages ^{17Reference 17Chen Z et al. · 2024AnimalLobetyolin protects mice against LPS-induced sepsis by downregulating the production of inflammatory cytokines in macrophageView study →}.

The anti-inflammatory effect is almost always a secondary readout rather than the main endpoint, and there are no human data.

4. Antioxidant

In D-galactose-aged mice, a water extract delayed brain ageing and improved learning and memory ^{11Reference 11Wang X et al. · 2024AnimalCodonopsis pilosula water extract delays D-galactose-induced aging of the brain in mice by activating autophagy and regulating metabolismView study →}, and purified polysaccharides reduced oxidative stress and neuroinflammation ^{12Reference 12Zhang B et al. · 2026Codonopsis pilosula polysaccharide (CPP) alleviates D-Gal-induced aging and gut microbiota dysbiosisView study →}.

Similar redox changes accompany the diabetic and fatty-liver models ^{9,10Reference 9Chen Q et al. · 2025AnimalCodonopsis pilosula polysaccharides attenuate lipid accumulation and inflammatory response in the NAFLD mouse by regulating AMPK/ACC/SREBP1 signaling pathwayView study →Reference 10Effects of Codonopsis pilosula crude pol et al. · 2023AnimalJournal of Functional FoodsView study →}.

Antioxidant endpoints are almost always secondary measures, with no human data.

5. Neuroprotective

In APP/PS1 mice, a model of Alzheimer’s disease, C. pilosula polysaccharides reduced neuronal apoptosis through the PERK-ATF4-CHOP endoplasmic-reticulum-stress pathway and improved water-maze performance ^{13Reference 13Cai Y et al. · 2025AnimalCodonopsis pilosula polysaccharides alleviate neuronal apoptosis induced by endoplasmic-reticulum-stress-activated PERK-ATF4-CHOP signaling in APP/PS1 miceView study →}.

A water extract delayed brain ageing in D-galactose-aged mice by activating autophagy ^{11Reference 11Wang X et al. · 2024AnimalCodonopsis pilosula water extract delays D-galactose-induced aging of the brain in mice by activating autophagy and regulating metabolismView study →}. In cultured PC12 cells, the polysaccharide protected against amyloid-β(25-35) toxicity via p38 MAPK ^{14Reference 14Yang L et al. · 2024Neuroprotective effect of Codonopsis pilosula polysaccharide on Aβ(25-35)-induced damage in PC12 cells via the p38 MAPK signaling pathwaysView study →}.

The only human study was a double-blind trial in 60 healthy adults. A capsule of 75 mg codonopsis total glycosides with 40 mg ginkgo extract, taken twice daily, improved memory acquisition and retention more than placebo, and the authors reported it did better than ginkgo alone ^{20Reference 20Singh B et al. · 2004Dangshen (Codonopsis pilosula) and Bai guo (Ginkgo biloba) enhance learning and memoryView study →}.

Gap: the human trial tested a glycoside fraction in combination with ginkgo, not the whole root on its own. Everything mechanistic is animal or cell-line.

6. Hepatoprotective

In mice fed a high-fat diet, C. pilosula polysaccharides reduced liver fat, blood lipids, ALT and AST, and inflammatory markers through AMPK/ACC/SREBP1 signalling ^{9Reference 9Chen Q et al. · 2025AnimalCodonopsis pilosula polysaccharides attenuate lipid accumulation and inflammatory response in the NAFLD mouse by regulating AMPK/ACC/SREBP1 signaling pathwayView study →}.

A widely cited study of alcoholic fatty liver in rats used Codonopsis lanceolata, a different species, and does not apply to this herb ^{21Reference 21Cho K et al. · 2009AnimalProtective effect of Codonopsis lanceolata root extract against alcoholic fatty liver in the ratView study →}.

7. Anti-Fatigue

In a single mouse study, ethanol extract, water extract, polysaccharides, inulin and oligosaccharides were compared in weight-loaded swimming and hypoxia tests. Only the polysaccharide fraction significantly prolonged swimming time, and it raised liver and muscle glycogen ^{18Reference 18Xie Q et al. · 2020AnimalAntifatigue and antihypoxia activities of oligosaccharides and polysaccharides from Codonopsis pilosula in miceView study →}.

It is a single unreplicated rodent study, and there is no human anti-fatigue trial.

8. Hematopoietic

Chinese medicine uses codonopsis as a blood tonic. One study isolated a highly branched arabinogalactan (CP2A) from the root and found it protected blood-cell formation in a zebrafish model by damping the P53 pathway ^{19Reference 19Zhu Y et al. · 2025A highly branched arabinogalactan from Codonopsis pilosula: structural insights and hematopoietic-protective mechanismView study →}. In septic rats, a root extract raised red cells, lymphocytes and haemoglobin ^{4Reference 4Xia Z et al. · 2025AnimalImmunomodulatory effects and multi-omics analysis of Codonopsis pilosula extract in septic ratsView study →}.

Most other blood-building data come from multi-herb formulas in which codonopsis is one of several ingredients.

Gap: no human study has measured blood counts with codonopsis alone, and there is no head-to-head comparison with ginseng.

9. Anticancer

A C. pilosula polysaccharide solution inhibited the growth and migration of liver-cancer cells and reduced tumour growth in mice by suppressing the CDK1/PDK1/β-catenin pathway ^{15Reference 15Li N et al. · 2024Molecular mechanisms of Codonopsis pilosula in inhibiting hepatocellular carcinoma growth and metastasisView study →}. Isolated lobetyolin suppressed liver-cancer cell growth through DUSP1-ERK1/2 signalling ^{16Reference 16Hu J et al. · 2024Lobetyolin suppresses the proliferation of hepatocellular carcinoma through activating DUSP1-ERK1/2 signaling pathwayView study →}.

There is no clinical evidence. Human oncology use appears only inside multi-herb supportive-care formulas.

Mechanisms

Codonopsis root polysaccharides, including inulin-type fructans, have been studied for their activity on macrophages and immune cells, the gut lining and gut bacteria ^{2,3,7,8Reference 2Xie X et al. · 2025AnimalAn inulin-type fructan from Codonopsis pilosula ameliorates cyclophosphamide-induced immunosuppression and intestinal barrier injury in miceView study →Reference 3Gao Z et al. · 2025Specific inulin in Codonopsis pilosula exerts immunological enhancement by promoting cellular uptake and regulating p65-dependent MAPK and NF-κB pathwaysView study →Reference 7Zhou J et al. · 2024An inulin-type fructan CP-A from Codonopsis pilosula alleviates TNBS-induced ulcerative colitis based on serum-untargeted metabolomicsView study →Reference 8Yang Q et al. · 2026Codonopsis pilosula (Dangshen) alleviates ulcerative colitis through activation of the aryl-hydrocarbon-receptor signaling pathway by the gut bacterium Alistipes onderdonkii and its metabolite 5-HIAAView study →}. They are water-soluble, so a decoction extracts them.

The marker compound lobetyolin has been studied separately in cell and mouse models of inflammation and liver cancer ^{16,17Reference 16Hu J et al. · 2024Lobetyolin suppresses the proliferation of hepatocellular carcinoma through activating DUSP1-ERK1/2 signaling pathwayView study →Reference 17Chen Z et al. · 2024AnimalLobetyolin protects mice against LPS-induced sepsis by downregulating the production of inflammatory cytokines in macrophageView study →}.

Clinical Trials

No registered clinical trial of C. pilosula as a single herb was identified. The one published randomised controlled trial tested the herb’s total glycosides in combination with Ginkgo biloba ^{20Reference 20Singh B et al. · 2004Dangshen (Codonopsis pilosula) and Bai guo (Ginkgo biloba) enhance learning and memoryView study →}. Other human data come from multi-herb formulas.

Last checked: July 2026.

Dosage

These are the doses the studies used, not recommendations. The traditional decoction range is given separately below.

Traditional Dosage

Safety & Pregnancy

Codonopsis has a long record as a food and a medicine and is reported to be well tolerated at customary doses. Its toxicology has been studied only in animals.

Full Safety Detail

Tolerability. Codonopsis is an officially recognised medicinal and edible herb in China and is described as having hardly any adverse effects in clinical practice ^{1,4Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →Reference 4Xia Z et al. · 2025AnimalImmunomodulatory effects and multi-omics analysis of Codonopsis pilosula extract in septic ratsView study →}. There is no human safety trial of the root on its own; its toxicology comes from animal studies ^{1Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →}.

Chinese medicine cautions. It is contraindicated in damp-heat and in ascending liver-yang patterns ^{24Reference 24Hempen CH · 2009A Materia Medica for Chinese Medicine: Plants, Minerals, and Animal Products}.

Medicines. No interaction with drug-metabolising enzymes has been shown. The root’s active components are absorbed slowly and distributed mainly to the gut, liver and kidneys ^{1Reference 1Bai J et al. · 2025ReviewCodonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applicationsView study →}. No single-herb interaction study has been done, and nearly all human use is within multi-herb formulas.

Allergy. People with a known sensitivity to the bellflower family (Campanulaceae) should take normal care.

References

1. Bai J, Xie N, Hou Y, et al. Codonopsis Radix: a comprehensive review for its ethnopharmacology, phytochemistry, pharmacodynamics, pharmacokinetics, toxicity and potential clinical applications. Phytomedicine. 2025. https://pubmed.ncbi.nlm.nih.gov/41275746/
2. Xie X, Gu Y, Liu Y, et al. An inulin-type fructan from Codonopsis pilosula ameliorates cyclophosphamide-induced immunosuppression and intestinal barrier injury in mice. International Journal of Biological Macromolecules. 2025. https://pubmed.ncbi.nlm.nih.gov/40250123/
3. Gao Z, Ren J, Ke C, et al. Specific inulin in Codonopsis pilosula exerts immunological enhancement by promoting cellular uptake and regulating p65-dependent MAPK and NF-κB pathways. Journal of Agricultural and Food Chemistry. 2025. https://pubmed.ncbi.nlm.nih.gov/40758307/
4. Xia Z, Li G, Zhai Y, et al. Immunomodulatory effects and multi-omics analysis of Codonopsis pilosula extract in septic rats. Journal of Ethnopharmacology. 2025. https://pubmed.ncbi.nlm.nih.gov/39368762/
5. Wang ZT, Du Q, Xu GJ, et al. Investigations on the protective action of Codonopsis pilosula (Dangshen) extract on experimentally-induced gastric ulcer in rats. General Pharmacology. 1997;28(3):469–473. https://pubmed.ncbi.nlm.nih.gov/9068993/
6. Chen Q, Sun Y, Hu X, et al. The effect and mechanism of Codonopsis Radix and its active components tangshenoside I and lobetyolin on preventing gastric ulcer based on spectrum-effect relationship. Journal of Ethnopharmacology. 2025. https://pubmed.ncbi.nlm.nih.gov/40653041/
7. Zhou J, Wang J, Li D, et al. An inulin-type fructan CP-A from Codonopsis pilosula alleviates TNBS-induced ulcerative colitis based on serum-untargeted metabolomics. American Journal of Physiology. Gastrointestinal and Liver Physiology. 2024. https://pubmed.ncbi.nlm.nih.gov/38193197/
8. Yang Q, Pang W, Ma L, et al. Codonopsis pilosula (Dangshen) alleviates ulcerative colitis through activation of the aryl-hydrocarbon-receptor signaling pathway by the gut bacterium Alistipes onderdonkii and its metabolite 5-HIAA. American Journal of Chinese Medicine. 2026. https://pubmed.ncbi.nlm.nih.gov/41692705/
9. Chen Q, Lin H, Huang X, et al. Codonopsis pilosula polysaccharides attenuate lipid accumulation and inflammatory response in the NAFLD mouse by regulating AMPK/ACC/SREBP1 signaling pathway. Tissue & Cell. 2025. https://pubmed.ncbi.nlm.nih.gov/40451044/
10. Effects of Codonopsis pilosula crude polysaccharides by hypoglycemic and modulating gut microbiome in a high-fat diet and streptozotocin-induced mouse model of T2DM. Journal of Functional Foods. 2023;111:105893. https://doi.org/10.1016/j.jff.2023.105893
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