Codonopsis Uses and Plant Monograph
Codonopsis is a vine that looks so delicate when growing, but is actually an incredible powerhouse of nourishing medicine. It’s an herb with an extensive history of use in Traditional Chinese Medicine as a remedy for poor appetite and digestive issues, chronic respiratory irritation, fatigue, deficient immunity, and convalescence.
Codonopsis Uses & Plant Profile Summary
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Botanical Name: Codonopsis pilosula
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Other Common Names: Codonopsis, dang shen (not to be confused with dan shen or red sage), bellflower, Chinese bellflower, “poor-man’s ginseng”, tojin (Japanese); in Traditional Chinese Medicine (TCM), a blend of Codonopsis species is utilized and labeled as the singular “Codonopsis Radix”
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Family: Campanulaceae
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Parts Used: root
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Energetics: moistening, neutral to warming
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Taste: sweet
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Plant Properties: adaptogen, mild demulcent, expectorant/pectoral, hypoglycemic, immune tonic, lung yin tonic, spleen Qi tonic.
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Plant Uses: adaptogen, mild demulcent, expectorant/pectoral, hypoglycemic, immune tonic, lung yin tonic, spleen Qi tonic.
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Plant Preparations: tincture, decoction, food
As an herb that touches many body systems, and builds vitality, codonopsis has started gaining more attention in Western herbalism as an accessible and delicious adaptogen. It’s relatively easy to source and a pleasure to grow in your own garden. I work with codonopsis frequently in my practice because it tastes good and is easy to incorporate into extractions or food, and I love introducing folks to this sweet little vine that offers surprisingly deep nourishment.
Applications
The main indications for using this herb are signs of irritation and heat with accompanying dryness. There are a variety of ways this can present in different body systems, which we will go through below. If you are using tongue assessment, the classic signs are a red or pink tongue body that is elongated and pointed and appears dry.1
A note on Codonopsis clinical research: As a primary herb in Traditional Chinese Medicine (TCM), codonopsis is part of many classic formula blends. There has been extensive clinical research on many of these TCM formulas, with interesting and applicable results, but there is not the same breadth of study for single extracts of codonopsis. As of this writing, there are still primarily only animal studies that have been done to back up the claims made for this plant in traditional and folk medicine. Additionally, due to the differing phytochemistry of the 40 some species of the Codonopsis genus, only studies on C. pilosula have been included below.
Spleen Qi Tonic
In Traditional Chinese Medicine (TCM), the Spleen channel is associated with absorption and assimilation of nutrients and energy from the food we consume. (While the actual spleen organ does have a role in digestion, the TCM Spleen does not actually refer to the physical organ itself.) “Spleen Qi” is essentially the energy and movement of these processes in the upper GI tract.2 When there is “Spleen Qi Deficiency,” that means that assimilation is not happening effectively, which leads to reduced absorption of nutrients, which then accumulate and create congestion/dampness/phlegm (the word choice is dependent on which energetic system you are working in). This often manifests as a lack of appetite or queasiness, especially in the morning. There is often general nausea, fatigue, and gas or bloating. Sometimes low grade diarrhea or loose stools are present. The tongue might be swollen with scallops along the sides. Through an Ayurvedic lens, the digestive “fire” is not “cooking” food enough, so waste (amma) accumulates and clogs the body.3
In these instances of depletion and deficiency, it can be too forceful to just take some strong bitters to jumpstart digestive juices flowing. Codonopsis is a perfect ally here, with its sweet and gentle taste that is easy on the stomach as it gently but firmly rebuilds the digestive fire and power of the upper gastrointestinal (GI) tract to break down and digest food. As a slightly warming herb, codonopsis shines when the digestive tract has become cold and sluggish resulting in the diarrhea, gas, bloating, and nausea mentioned earlier. As a moistening herb, it helps soothe irritation of the GI lining that can lead to digestive insufficiency. It’s most ideal for folks with dry constitutions, but even when there is dampness in the GI, codonopsis is still an appropriate herb. Just add some gentle warming bitters or aromatics (such as a bit of angelica root or cardamom pod) for some dispersing and moving energy to balance the formula.4
Codonopsis is also excellent for some other specific upper GI complaints that are the classic hot and irritated energetic picture. Paired with licorice root, it’s wonderful for protecting against and healing stomach ulcers.5 I also use it in formulas for acid reflux and GERD. It’s also great cooked into food for convalescence after GI surgeries. Several years ago, I consumed large amounts of congee with codonopsis after major abdominal surgery as an easy way to get extra herbal nutrients and support my digestive function after lots of pain medications. Likewise, it’s a lovely herb to include in formulas or food after clearing an intense GI illness or parasite infection.
An Adaptogen
Codonopsis’ common name “poor man’s ginseng” comes from its adaptogenic qualities. As mentioned above, it’s a great herb to build digestive power, which increases nutrient absorption, which in turn gives the body more energy and vitality. When the body is adequately nourished, we can be more resilient to stressors and heal from injuries and illness more effectively, which are all outcomes associated with the action of “adaptogen.” As such, codonopsis is a great ally for chronic fatigue syndrome, debility and weakness after illness, and during intense stress.
In addition to adequate assimilation and absorption, our bodies also need enough sleep in order to maintain a resilient nervous system and complete tissue repair and regeneration. Sometimes, sleep disturbances and insomnia are a result of deficiency. It’s the feeling of being “too tired to sleep,” when there is extreme exhaustion but the body is too depleted to fall into the relaxation and trust of deep sleep. This is a time when rather than cooling and sedating nervines, a person might really need warming and nourishing herbs to settle and hold the nervous system to allow for sleep. Codonopsis is a wonderful ally here, not because it’s directly relaxing or sedative, but because it balances some of that deficiency, bringing an herbal cushion of warmth and sweetness to rest in. To me, this is a big piece of where the classification of “adaptogen” for codonopsis makes so much sense.
In Traditional Chinese Medicine (TCM), it’s used for organ prolapse because Qi is the force that keeps organs held in their places, and if Qi is deficient, then tissue collapse can occur. Codonopsis, as a Qi tonic (not just for the Spleen!) is thought to strengthen and tonify the flow of Qi, thus helping organs return to their proper positions. Similarly, codonopsis is also associated in TCM with building Blood, and therefore building vitality.6
Sometimes the adaptogen ginseng (Panax ginseng or Panax quinquefolius) is too strong of a plant for someone; or it may not be the plant to choose because of sourcing and sustainability concerns. In these instances, codonopsis is a perfect substitute or analogue!
A Gentle Expectorant and Respiratory Tonic
In Traditional Chinese Medicine, herbs that are sweet and moistening are often considered Lung Yin tonics. This is because the flavor “sweet” is associated with the Lung (and Spleen) meridians.7 Indeed, codonopsis is a wonderful tonic for the lungs and respiratory system. This is especially true when there is a connection to digestive function. For example, when chronic acid reflux damages and inflames esophageal tissue, this often leads to excess mucus and phlegm production as the body tries to heal and protect that tissue. As a result, people can experience a chronic cough that comes from an inability to fully clear that mucus, which can lead to shortness of breath and respiratory inflammation. Codnopsis can help restore digestive balance (as explained above), which in turn calms irritation in the respiratory system.
In the way that tonic herbs work to balance a body system, codonopsis occupies the unique niche of being suited to both soothe and moisten dry respiratory conditions and to warm and move along damp and stagnant respiratory phlegm. To that first point, this is a great herb to use either while quitting smoking, or as a harm reduction approach to use while people continue smoking. Likewise, it’s a lovely choice for convalescence from respiratory illnesses, from pneumonia to COVID-19.
Adjunct Therapeutic for Cancer Treatment
Codonopsis has been used extensively in Traditional Chinese medicine as part of cancer treatment formulas, usually combined with 4–12 other herbs, including but not limited to astragalus, reishi, atractylodes, goji, and solomon’s seal.8,9 It can be hard to tease out which of those many herbs is directly acting on cancer cells, and which are providing other therapeutic actions during treatment such as immune modulation, tissue repair, or digestive support. However, there have been some recent clinical trials done on just codonopsis extract to determine its effect on human cancer cells lines and the results are promising. An in vitro study from 2012 showed extracts of the polysaccharides from codonopsis inhibited proliferation of a line of human epithelial ovarian cancer cells.10 The same isolated polysaccharide also shows immunomodulating activity on human gastrointestinal cells.11 Finally, a computer model demonstrated that the pectic polysaccharides in codonopsis exhibit cytotoxicity (causing cell damage or death) to human lung adenocarcinoma cells.12
I have given codonopsis in a decoction alongside eleuthero and astragalus to a client who was undergoing treatment for stage IV lung cancer, which had led to digestive upset and lack of appetite. She reported that taking the decoction daily helped with bringing back her appetite and with food “feeling more settled” in her stomach. Codonopsis felt particularly indicated for this client because not only was she experiencing side effects from treatment that this herb is indicated for (nausea, lack of appetite), but also because of its affinity for the lungs.
Constituents
- Carbohydrates: inulin, fructose, polysaccharides
- Saponins
- Sesquiterpene glycosides: codonopsequilosides A-C
- Phenylpropanoids
- Phytosterols
- Triterpenoids: taraxerol, oleanic acid, codonopilate
- Flavones: hesperidin13
Botanically Speaking
Image sources: image 1, image 2
Plant Preparations and Dosage Suggestions
Codonopsis is such a fantastic medicinal because it is so palatable! When cooked, the flavor is akin to a parsnip or other sweet root vegetable. Likewise, in tincture or decoction, it brings an unmistakable but grounded sweetness. In commerce, the whole roots will be pliable and wrinkled, and the cut roots are in small dime- to nickel- sized rounds. Starwest Botanicals is generally a reliable source for the cut and dried roots.
- Decoction: 6–15g/day, simmer for at least 30 mins.14 I love adding other adaptogenic tonics such as astragalus or medicinal mushrooms into the blend. Sprinkling in some aromatic spices or herbs such as cardamom, coriander, or ginger is also delicious and boosts carminative action! I also like to turn the decoction into a syrup (either for kiddos or just to make it more pleasant to take!) by adding an equal amount of honey after simmering.
- Tincture: dried root in 1:4 or 1:5 in 35–40% alcohol, 2–4 ml up to 3x daily15
- Food: add root pieces to soups, stews, beans, rice, or porridge. The root will be tender within 20 mins, and start to dissolve into the broth within an hour of simmering.
Special Considerations
No safety considerations or herb-drug interactions noted. In Traditional Chinese Medicine, codonopsis is considered safe during pregnancy and lactation.
Footnotes
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