Wise Mind Herbs

The information on this page has been prepared with reference to published scientific literature, not by a medically qualified expert. It is not medical advice. Any decision to use a supplement or herb-based product is your responsibility. Consult a suitably qualified medical professional, especially if you have underlying conditions. Remember, nothing is for everyone, and not everything sold is what it claims to be. Some things work for some people, some of the time.

Panax ginseng

Ginseng refers to several species of slow-growing perennial plants with fleshy roots, primarily valued for their purported medicinal properties. The most extensively researched varieties include Asian ginseng (Panax ginseng), American ginseng (Panax quinquefolius), and Siberian ginseng (Eleutherococcus senticosus, not a true ginseng). This review synthesizes findings from peer-reviewed scientific literature regarding ginseng's health benefits, appropriate dosing, safety profile, and pharmaceutical applications.

Image source and license: https://commons.wikimedia.org/wiki/File:Panax_quinquefolius.jpg.
Modified by Peter Jorgensen.

Botanical Classification and Common Names

True ginsengs belong to the genus Panax in the family Araliaceae. The name "Panax" derives from the Greek words "pan" (all) and "akos" (cure), reflecting traditional beliefs in ginseng's wide-ranging medicinal properties. Common varieties include:

• Asian/Korean/Chinese ginseng (Panax ginseng C.A. Meyer)
• American ginseng (Panax quinquefolius L.)
• Japanese ginseng (Panax japonicus C.A. Meyer)
• Vietnamese ginseng (Panax vietnamensis Ha et Grushv.)
• Notoginseng/Sanchi ginseng (Panax notoginseng Burkill)

Plants commonly confused with true ginseng include:

• Siberian ginseng/Eleuthero (Eleutherococcus senticosus) - not a true ginseng but often marketed similarly
• Brazilian ginseng (Pfaffia paniculata) - from a different plant family
• Indian ginseng/Ashwagandha (Withania somnifera) - unrelated to true ginseng
• Southern ginseng (Gynostemma pentaphyllum) - from the cucumber family

Active Compounds

The primary bioactive compounds in ginseng are ginsenosides (triterpene saponins), with more than 150 identified across various species. Other active components include polysaccharides, peptides, polyacetylenic alcohols, and fatty acids. Different ginseng species contain varying profiles of ginsenosides, contributing to their distinct therapeutic effects. Asian ginseng typically contains higher concentrations of Rg1 (stimulating) while American ginseng has higher Rb1 (relaxing) content.

Evidence-Based Health Benefits

Scientific research has investigated ginseng's effects on numerous health conditions with varying levels of evidence. The strongest evidence exists for the following benefits:

• Cognitive function enhancement: Moderate evidence supports improved memory, attention, and mental processing in both healthy individuals and those with cognitive impairment
• Antifatigue effects: Multiple studies demonstrate reduced mental and physical fatigue
• Immune system modulation: Enhancement of natural killer cell activity and antibody responses
• Blood glucose regulation: Improved glycemic control in type 2 diabetes patients
• Sexual function: Modest improvement in erectile dysfunction, particularly with Korean red ginseng
• Stress resilience: Adaptogenic properties that help the body resist physical, chemical, and biological stressors

Conditions with preliminary or inconsistent evidence include:

• Cardiovascular health: Modest reductions in blood pressure and improvement in lipid profiles
• Cancer prevention: In vitro and animal studies show anti-cancer properties, but human evidence remains limited
• Respiratory conditions: Some evidence for reduced symptom severity in chronic obstructive pulmonary disease
• Menopausal symptoms: Modest relief of hot flashes and improvement in quality of life measures
• Anti-inflammatory effects: Reduction in inflammatory markers in some studies
• Athletic performance: Mixed evidence for enhanced endurance or recovery

It's important to note that ginseng has not been conclusively proven to "cure" any condition, despite promising effects in alleviating symptoms across multiple health domains.

Recommended Dosages

Dosage recommendations vary by ginseng type, preparation method, and condition being treated. Most clinical studies have used the following ranges:

• Asian/Korean ginseng (Panax ginseng): 200-400 mg daily of extract standardized to 2-3% ginsenosides, taken for 2-3 months followed by a 2-4 week break
• American ginseng (Panax quinquefolius): 100-1000 mg daily of extract standardized to 5% ginsenosides
• Siberian ginseng (Eleutherococcus senticosus): 300-1200 mg daily of extract standardized to 0.8% eleutherosides

For specific conditions, therapeutic doses often used in clinical trials include:

• Cognitive function: 200-400 mg of Panax ginseng extract daily
• Diabetes management: 200-400 mg of Panax ginseng daily
• Erectile dysfunction: 900-1000 mg of Korean red ginseng (heat-treated Panax ginseng) 3 times daily
• Fatigue reduction: 200-2000 mg of Panax ginseng daily

Dosage Research Beyond Efficacious Range

Few studies have systematically investigated doses substantially above the commonly recommended therapeutic ranges. Some research has examined doses up to 3000 mg daily of Panax ginseng for short durations, typically finding no additional benefits beyond the standard dosage range. However, there remains a significant knowledge gap regarding long-term high-dose consumption. Animal toxicity studies suggest a relatively wide safety margin, but human data on prolonged high-dose use is limited. The risk of side effects appears to increase with doses exceeding 2500 mg per day, without corresponding therapeutic advantages.

Side Effects and Safety Concerns

Ginseng is generally considered safe for most adults when used appropriately. However, various side effects have been reported:

• Common side effects: Insomnia, headache, digestive disturbances, nervousness
• Less common: Palpitations, high blood pressure, breast tenderness, vaginal bleeding, skin rash
• Rare but serious: Allergic reactions, liver dysfunction

Contraindications and special precautions include:

• Pregnancy and breastfeeding: Insufficient safety data, generally not recommended
• Autoimmune conditions: May stimulate immune activity, potentially worsening symptoms
• Hypertension: Inconsistent effects on blood pressure, caution advised
• Bleeding disorders: May inhibit platelet aggregation, increasing bleeding risk
• Hormone-sensitive conditions: Contains compounds with estrogen-like effects
• Diabetes: May lower blood glucose, requiring medication adjustment
• Surgery: Discontinue at least 7 days before scheduled procedures due to bleeding risk

Drug Interactions

Significant interactions have been documented with:

• Anticoagulants/antiplatelets: Increased bleeding risk
• Antidiabetic medications: Enhanced hypoglycemic effects
• Stimulants (including caffeine): Potential additive stimulatory effects
• Immunosuppressants: May counteract immunosuppressive activity
• MAO inhibitors: Case reports of headache, tremor, and mania
• CYP450 substrate drugs: May alter metabolism of medications processed by these enzymes

Commercial Pharmaceutical Products

Several pharmaceutical products containing standardized ginseng extracts are available globally:

• Ginsana®: Standardized G115 extract of Panax ginseng
• ColdFX®: Proprietary extract of American ginseng (CVT-E002)
• Ginexin®: Korean red ginseng extract formulation
• Gincosan®: Combination of Ginkgo biloba and Panax ginseng extracts
• HT008-1: Proprietary notoginseng extract for vascular conditions

Additionally, several synthetic adaptogenic compounds inspired by ginsenosides have been developed for pharmaceutical applications, including ADAPT-232 (containing Eleutherococcus senticosus alongside rhodiola and schisandra) and various semi-synthetic ginsenoside derivatives under investigation for specific therapeutic targets.

Conclusion

Ginseng demonstrates promising effects across multiple health domains, particularly for cognitive function, fatigue reduction, and metabolic regulation. However, the quality of evidence varies considerably, with many studies limited by small sample sizes, methodological issues, and inconsistent product standardization. Future research should focus on identifying optimal dosing regimens, specific ginsenoside profiles for particular conditions, and long-term safety profiles. Patients should consult healthcare providers before using ginseng, particularly if taking medications or managing chronic health conditions.

References

Kim, J. H., Yi, Y. S., Kim, M. Y., & Cho, J. Y. (2017). Role of ginsenosides, the main active components of Panax ginseng, in inflammatory responses and diseases. Journal of ginseng research, 41(4), 435-443.

Komishon, A. M., Shishtar, E., Ha, V., Sievenpiper, J. L., de Souza, R. J., Jovanovski, E., ... & Vuksan, V. (2016). The effect of ginseng (genus Panax) on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials. Journal of human hypertension, 30(10), 619-626.

Lee, H. W., Ang, L., & Lee, M. S. (2022). Using ginseng for menopausal women's health care: A systematic review of randomized placebo-controlled trials. Complementary Therapies in Clinical Practice, 48, 101615.

Mancuso, C., & Santangelo, R. (2017). Panax ginseng and Panax quinquefolius: From pharmacology to toxicology. Food and Chemical Toxicology, 107, 362-372.

Shergis, J. L., Zhang, A. L., Zhou, W., & Xue, C. C. (2013). Panax ginseng in randomised controlled trials: a systematic review. Phytotherapy Research, 27(7), 949-965.

Truong, V. L., & Jeong, W. S. (2022). Red ginseng (Panax ginseng Meyer) oil: A comprehensive review of extraction technologies, chemical composition, health benefits, molecular mechanisms, and safety. Journal of Ginseng Research, 46(2), 214-224.

Yang, L., Hou, A., Zhang, J., Wang, S., Man, W., Yu, H., ... & Jiang, H. (2020). Panacis quinquefolii radix: a review of the botany, phytochemistry, quality control, pharmacology, toxicology and industrial applications research progress. Frontiers in Pharmacology, 11, 602092.

Zhang, X., Chen, X., Wang, L., He, C., Shi, Z., Fu, Q., ... & Hu, S. (2021). Review of the efficacy and mechanisms of traditional Chinese medicines as a therapeutic option for ionizing radiation induced damage. Frontiers in Pharmacology, 12, 617559.