Ginseng is widely used to strengthen the immune system, and increase strength
and vigor. Both American and Asian ginsengs belong to the species Panax
and are similar in their chemical composition. Siberian ginseng
(Eleutherococcus senticosus), on the other hand, although part of the
same plant family called Araliaceae, is an entirely different plant and
does not contain ginsenosides, the active ingredients found in both Asian and
American ginseng. (Note: Asian ginseng is also known as Red Korean ginseng.)
One similarity that American, Asian, and Siberian ginsengs all share is that
each of these herbs is considered to be an adaptogen, a substance that
strengthens the body, helping it return to normal when it has been subjected to
stress. Therefore, they are considered to be valuable supports for those
recovering from illness or surgery, especially the elderly.
The root of American ginseng is light tan and gnarled. Its resemblance to the
human body may have led herbalists to the folkloric belief that ginseng could
cure all ills. In fact panax means all illness and ginseng has been used across
the ages in many different cultures as a "cure-all".
Research on ginseng has focused on a number of conditions, some of which are
ADHD An early study suggests that American ginseng, in
combination with ginkgo, may prove to be of value in helping to treat ADHD. More
research in this area is needed.
Alcohol Intoxication Ginseng could be helpful in treating
alcohol intoxication. The herb may accomplish this by speeding up the metabolism
(break down) of alcohol and, thus, allowing it to clear more quickly from the
body. Or, as animal research suggests, Asian ginseng may reduce the absorption
of alcohol from the stomach.
Alzheimer's Disease Individual reports and animal studies
indicate that either American ginseng or Asian ginseng may slow the progression
of Alzheimer's and improve memory and behavior. Studies of large groups of
people are needed to best understand this possible use of ginseng.
Cancer A study comparing groups of people over time suggests
that regular intake of ginseng may reduce one's chances of getting various types
of cancer, especially lung, liver, stomach, pancreatic and ovarian. In this
particular study, this benefit was not observed for breast, cervical, or bladder
cancers. However, a test tube study suggests that American ginseng may enhance
the effects of medications used to treat breast cancer. And, preliminary results
suggest that ginseng may improve treatment of colon cancer in animals. A greater
number of well-designed studies including, ultimately, large numbers of people
are needed before conclusions can be drawn about whether ginseng offers some
protection from cancer or not.
Cardiovascular Health Asian ginseng in particular may decrease
endothelial cell dysfunction. Endothelial cells line the inside of blood
vessels. When these cells are disturbed, referred to as dysfunction, they can
cause blockage of blood flow in a variety of ways. This disturbance or
disruption may even lead to heart attack or stroke. The potential for ginseng to
quiet down the blood vessels may prove to be protective against heart and other
forms of cardiovascular disease.
Although not proven, ginseng may also raise HDL (the good cholesterol), while
reducing total cholesterol levels.
Finally, there is some controversy about whether, under certain
circumstances, ginseng may help improve blood pressure. Ginseng is generally
considered to be a substance to avoid if you have hypertension because it can
raise blood pressure. In a couple of studies, however, of red Korean (Asian)
ginseng, high doses of this herb actually lowered blood pressure. Some feel that
the usual doses of ginseng may increase blood pressure while high doses may have
the opposite effect of decreasing blood pressure. Much more information is
needed in this area before a conclusion can be drawn. And, if you have high
blood pressure or heart disease, it is not safe to try ginseng on your own,
without specific instructions from a knowledgeable clinician.
Depression Because of its ability to help resist or reduce
stress, some herbal specialists may consider ginseng as part of the treatment
Diabetes While both Asian and American ginsengs appear to
lower blood sugar (glucose) levels, American ginseng has been the more studied
in scientific trials. One study found that people with type 2 (adult onset)
diabetes who took American ginseng before or together with a high sugar load
experienced less of a rise in blood glucose levels after they consumed all of
Fertility/Sexual Performance Ginseng is widely believed to be
capable of enhancing sexual performance. However, studies in people to
investigate this are limited. In animal studies, ginseng has increased sperm
production, sexual activity, and sexual performance. A study of 46 men has also
shown an increase in sperm count as well as motility.
Immune System Enhancement Ginseng is believed to enhance the
immune system, which could, in theory, help the body fight off infection and
disease. In one study, in fact, giving people ginseng before getting the
flu-vaccine did boost their immune response to the vaccine compared to those who
received a placebo.
Menopausal Symptoms Ginseng may have estrogen-like activity.
Two well-designed studies evaluating red Korean (Asian) ginseng suggest that
this herb may relieve some of the symptoms of menopause, improving mood
(particularly feelings of depression) and sense of well-being.
Mental Performance and Mood Enhancement Individuals who use
ginseng often report that they feel more alert. Preliminary studies do suggest
that this feeling has scientific merit. Early research shows that ginseng may
improve performance on such things as mental arithmetic, concentration, memory,
and other measures. More research in this area, although not easy to do, would
On the other hand, for those who report that ginseng elevates their mood, the
science thus far does not support that this herb changes your mood if you are
Physical Endurance There have been a number of studies in
people looking at the effects of ginseng on athletic performance. Results have
not been consistent, with some studies showing increased strength and endurance,
others showing improved agility or reaction time, and still others showing no
effect at all. Nevertheless, athletes often take ginseng to increase both
endurance and strength.
Respiratory Disease In patients with severe chronic
respiratory disease (such as emphysema or chronic bronchitis), daily treatment
with ginseng improved respiratory function, as evidenced by increased endurance
Stress Ginseng has long been valued for its ability to help
the body deal with stress. A study of 501 men and women living in Mexico City
found significant improvements in quality of life measures (energy, sleep, sex
life, personal satisfaction, well-being) in those taking ginseng.
The ginseng plant has leaves that grow in a circle around a straight stem.
Yellowish-green umbrella-shaped flowers grow in the center and produce red
berries. Wrinkles around the neck of the root tell how old the plant is. This is
important because ginseng is not ready for use until it has grown for four to
What's It Made Of?
Ginseng products are made from ginseng root and the long, thin offshoots
called root hairs. The main chemical ingredients of American ginseng are
ginsenosides and polysaccharide glycans (quinquefolans A, B, and C).
White ginseng (dried, peeled) is available in water, water-and-alcohol, or
alcohol liquid extracts, and in powders or capsules.
It is important when buying ginseng to read the label carefully and make sure
that you are purchasing the type of ginseng that you want. If you are looking
for American orAsian ginseng, look for a Panax species, not Siberian
ginseng (Eleutherococcus senticosus) which, although there is some
overlap, has different actions and side effects overall.
How to Take It
This herb is not recommended for use in children because of its stimulant
Dried root: 500 to 2000 mg daily (can be purchased in 250 mg
Tea/infusion: Pour 1 cup boiling water over 1 tsp finely chopped
ginseng root. Steep for 5 to 10 minutes. Prepare and drink one to three times
daily for three or four weeks.
Tincture (1:5): 1 to 2 teaspoons
Liquid extract (1:1): ¼ to ½ teaspoon
Standardized extract (4% total ginsenosides): 100 mg twice daily
In healthy individuals who wish to increase physical or mental performance,
to prevent illness, or to improve resistance to stress, ginseng should be taken
in one of the above dosages for two to three weeks, followed by a break of two
For help recovering from an illness, the elderly should take 500 mg twice
daily for three months. Alternatively, they may take the same dosage (500 mg
twice daily) for a month, followed by a two-month break. This can then be
repeated if desired.
The use of herbs is a time-honored approach to strengthening the body and
treating disease. Herbs, however, contain active substances that can trigger
side effects and interact with other herbs, supplements, or medications. For
these reasons, herbs should be taken with care, under the supervision of a
practitioner knowledgeable in the field of botanical medicine.
Both American and Asian ginsengs are stimulants and may cause nervousness or
sleeplessness, particularly if taken at high doses. Other reported side effects
include high blood pressure, insomnia, restlessness, anxiety, euphoria,
diarrhea, vomiting, headache, nosebleed, breast pain, and vaginal bleeding. To
avoid hypoglycemia (low blood sugar), even in non-diabetics, ginseng should be
taken with food.
The American Herbal Products Association (AHPA) rates ginseng as a class 2d
herb, which indicates that specific restrictions apply. In this case,
hypertension (high blood pressure) is the specific restriction. People with
hypertension should not take ginseng products without specific guidance and
instruction from a qualified practitioner. At the same time, people with low
blood pressure as well as those with an acute illness or diabetes (because of
the risk of a sudden drop in blood sugar), should use caution when taking
Safety of taking ginseng during pregnancy is unknown; therefore, it is not
recommended when pregnant or breast feeding.
Ginseng should be discontinued at least 7 days prior to surgery. This is for
two reasons. First, ginseng can lower blood glucose levels and, therefore,
create problems for patients fasting prior to surgery. Also, ginseng may act as
a blood thinner, thereby increasing the risk of bleeding during or after the
If you are currently being treated with any of the following medications, you
should not use ginseng without first talking to your healthcare provider:
Blood Thinning Medications There have been reports that
ginseng may possibly decrease the effectiveness of the blood-thinning
medication, warfarin. In addition, ginseng may inhibit platelet activity and,
therefore, should probably not be used with aspirin either.
Caffeine While taking ginseng, it is wise to avoid caffeine or
other substances that stimulate the central nervous system because the ginseng
may increase their effects, possibly causing nervousness, sweating, insomnia, or
Haloperidol Ginseng may exaggerate the effects of this
anti-psychotic medication, so they should not be taken together.
Morphine Ginseng may block the pain killing effects of
Phenelzine and other MAOIs for Depression There have been
reports of a possible interaction between ginseng and the antidepressant
medication, phenelzine (which belongs to a class known as monoamine oxidase
inhibitors [MAOIs]), resulting in symptoms ranging from manic-like episodes to
headache and tremulousness.
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Review Date: April 2002
Reviewed By: Participants in the review process include: Constance Grauds, RPh (April
1999), President, Association of Natural Medicine Pharmacists, San Rafael, CA;
Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley
Hospital, Harvard University and Senior Medical Editor Integrative Medicine,
Boston, MA; Gary Kracoff, RPh (Pediatric Dosing section February 2001), Johnson
Drugs, Natick, MA; Steven Ottariano, RPh, Veteran's Administrative Hospital,
Londonderry, NH; Anne McClenon, ND (April 1999), Compass Family Health Center,
Plymouth, MA; David Winston, Herbalist (April 1999), Herbalist and Alchemist,
Inc., Washington, NJ; Elizabeth Wotton, ND (April 1999), private practice,
Sausalito, CA. All interaction sections have also been reviewed by a team of
experts including Joseph Lamb, MD (July 2000), The Integrative Medicine Works,
Alexandria, VA;Enrico Liva, ND, RPh (August 2000), Vital Nutrients, Middletown,
CT; Brian T Sanderoff, PD, BS in Pharmacy (March 2000), Clinical Assistant
Professor, University of Maryland School of Pharmacy; President, Your
Prescription for Health, Owings Mills, MD; R. Lynn Shumake, PD (March 2000),
Director, Alternative Medicine Apothecary, Blue Mountain Apothecary &
Healing Arts, University of Maryland Medical Center, Glenwood, MD; Ira Zunin,
MD, MPH, MBA (July 2000), President and Chairman, Hawaii State Consortium for
Integrative Medicine, Honolulu, HI.
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before administering any drug, herb, or supplement discussed