Botanical Name: Ginseng Radix Panax ginseng C.A. Meyer	Common names: Korean Ginseng
Family: Araliaceae	Asian Ginseng
Genus: Panax	Chinese Ginseng
	Ren Shen
	Panax Schinseng
	Jiln Ginseng

The specific name ‘Ginseng’ is thought to originate from the Chinese names ‘Jin-chen’, ‘Jen-chen’ or ‘Schinseng’. There is an ongoing question over the labeling of some plants as "Ginseng". Currently, the word "Ginseng" is used to sell a variety of herbs associated with certain therapeutic qualities. This can be confusing as they do not all demonstrate the same biochemical properties. Panax, derived from a Greek word meaning cure-all, is thought by some to be the only "true" Ginseng, and is certainly the most famous.

A list of Relevant Ginseng types is given below:

Genus Panax	Common Name
Panax quinquefolium	American Ginseng
Panax pseudoginseng, Panaxnotoginseng,	San-Chi ginseng
Panax pseudoginseng sp. Himalaicum	Himalayan ginseng, Tien-chi ginseng
Panax japonicus, P. japonicum	Japanese ginseng
Panax trifolium	Dwarf ginseng
Panax zingeberinsis
Panax stipuleanatus
Panax vietnamensis
:
Other Genera and substitutions
Eleutherococcus senticosus	Siberian ginseng
Rumex hymenosepalus	Wild red desert ginseng
Pfaffia paniculata (Aramanthaceae)	Brazilian ginseng
Pseudostellaria heterophylla	Sometimes used as a ginseng substitute
Caulophyllum thalictroides	Yellow or Blue Ginseng, Blue Cohosh
Triosteum perfoliatum	Fever Root, sometimes called Ginseng
Codonopsis tangshen (Campanulaceae)	Sometime used as a ginseng substitute

Panax ginseng is indigenous to Manchuria, Chinese Tartary, and other areas of Eastern Asia. ^1,2 By some it is considered one of the most utilized and highly regarded of the medicinal Chinese herbs, and its usage can be traced back over approximately 5,000 years.

It is a smooth herbaceous perennial belonging to the ivy family Araliaceae. It has a large, fleshy, and very slow-growing root which usually grows to 2 to 3 inches in length 1/2 to 1 inch in thickness. It is spindle-shaped and annulated with a round summit. The color is pale yellow to brown. It’s erect stem grows to over 1 foot and usually has three leaves divided by 5 leaflets and a singular terminal umbel. It produces bright red pea-sized berries in clusters. In the wild it can be found growing in the deciduous hardwood forests of Asia. It prefers shade and is slow to germinate both in captivity and the wild. Roots are usually harvested in the fall. It is thought that the roots should not be harvested until they are at least 5 years old or older for optimum medicinal strength [Ginsenoside (an active constituent) ^3,4,5,6 content has been said to increase within the root up until it’s 6 ^th year, with slow or no increase from that point on]. In one study "the contents of panaxadiol-and panaxatriol-saponins gradually increase with the growth year, whereas an oleananesaponin, ginsenoside-Ro, drastically increases at the 6 ^th year and goes to 15-fold." ³

Originally harvested from the wild, now cultivated worldwide, ginseng mostly originates from China, Korea and Japan. Both the red and white varieties originate from the same genus, but are prepared differently. White ginseng is dried, and has been outperformed by red ginseng containing a higher content of saponins, and which is steamed before drying. Red Ginseng has been shown to contain a higher content of saponins and has outperformed white ginseng in most therapeutic studies. ^7,8,9,25

Wild roots are thought to have stronger therapeutic qualities and at least one study backs this claim. ¹⁰ Even without further studies the wild roots sell for thousands of dollars each. The more the root resembles the human form, the higher the value. However, for most of us, roots that have been allowed to mature for 5 years or longer in good soil and environmental conditions, and harvested at the correct time of year ^3,4,5,6 are thought to have stronger therapeutic qualities.

Other factors to be aware of when purchasing Ginseng is the diversity within the Genus. The healing abilities contributed to Ginseng may not be present in some or may be present but in significantly different potencies. A good example of this is the difference between Panax ginseng (documented as having 44 chromosomes) and Panax Japonicus (documented with 24). ¹⁷³ Differences in DNA ^11,12,13,14 and therefore biochemical constituents most probably mark a difference in the plant’s assigned healing characteristics.

Ginsenosides are usually considered the main constituents to the therapeutic effect of Ginseng (see Pharmacology and Clinical Studies), and when procuring the herb in forms other than the natural root (i.e. capsules, tonics, etc.), the amount and types of ginsenosides included should be noted. They include Rgl, Re, Rf, Rbl, Rc, Rb2 and Rd. Although not clinically documented it is thought that at least seven of these ginsenosides should be present within the product and in a high percentage. Improper storage or preparation of the herb is thought to reduce the ginsenoside content.

When purchasing Panax ginseng labels should be checked for clear identification of the plant genus utilized, as substitution occurs. Even if the correct genus is listed, toxic or stimulant adulterations, absence of the constituent ginsenosides, mixing species, labeling that is either erroneous or lacking in information make it adviseable to look for the U.S.P. notation on a product showing that the manufacturer follows standards established by the U.S. Pharmacopoeia.

Second to the raw herb concentrated and standardized products may be the most reliable. Also, carefully prescribed and utilized standardized product have, to date, shown little or no side effects while there have been reports of severe incidents with adulterated products.

 

Medicinal Qualities

E. Ginseng root (Ginseng radix) has been an approved herb since 1991 by The Complete German Commission E Monographs (B. ANZ. No. 11). ¹⁶ The United States Pharmacopoeia/National Formulary published a monograph and compendial standard for Ginseng (in the Ninth Supplement to the USP 23­NF 18) as p.r. of it’s Botanical monograph series. (Note: the USP was established in 1820 to create standards for the use and quality of pharmaceuticals and combined with the National Formulary in 1980). ^18,19

Throughout the ages ¹⁵ medicinal and magical qualities ascribed to Panax acted as a tonic, maintaining a healthy body, rejuvenating and prolonging life and acting as a sexual enhancer balancing "Yin" and "Yang".

There is large amount of good research currently being done on Panax ginseng and it’s medicinal effects. Since the 1990s differentiation and research on the various varieties of Panax is also being reported and the use of advanced techniques of layer, gas and high performance liquid chromatography have enabled efficient separation and isolation techniques allowing accurate research and development of Ginseng products. ^20,21,22

Ginseng has been listed by some as useful in the treatment of diabetes, anemia, cancer, depression, insomnia, shock, fatigue, hypertension, effects of radiation, effects of morphine and cocaine use, environmental, physical and mental stress, and chronic illness. It has been said to act as a stimulant, promote endurance, increase life expectancy, relax the nervous system, improve mental awareness, encourage proper hormonal functions, improve lipid levels, lower cholesterol, improve nerve growth, and increase resistance to disease. It is said to act as an antioxidant, autoimmune stimulant, psychotropic and have anti-tumor actions ²³ (see Pharmacology and Clinical Studies).

Research has shown that Ginseng may have the ability to act as an "adaptogen", prolonging life by combating viral infections and Pseudomonas aeruginosa. Research continues to support ginseng’s protective role against anti-cancer treatments and drugs, perhaps even countering the side effects of chemotherapy. There is some thought that Ginseng may be useful "clinically for the prevention of abuse and dependence of opioids and psychostimulants." ¹³⁷

Panax ginseng is still a main staple in Chinese medicine. "There have been more than 300 original papers (written) in Chinese and in English during the last 10 years in China" ²² as well as studies in Europe and America that may support this usage. Though some subjects s.c. as "Quality of Life" remain controversial due to the inability to measure accurately an intangible term, there is no doubt that ginseng has therapeutic qualities. ²³

Taste: Sweetish, bitter, can be licorice-like

Parts utilized: Root – fresh or dried; leaf (all of the plant can be used, however the root is the most highly regarded for it’s medicinal effects)

 

Biochemical Constituents

2-Glucoginsenoside-RF; Alpha Maltosyl Beta-D-Fructofuranoside; Beta Elemene; Beta Sitosterol-3-0-Beta-D-Glucoside; Beta Sitosteryl-Glucoside; Biotin; Campesterol-6’-Linolenyglucoside; Campesterol-6’-Linolylglucoside; Campesterol-6’-Palmitylglucoside; Campesterol-6’-Stearylglucoside; Carbon Disulfide; Carbohydrates; D-Fructose; D-Glucose; Disaccharides; Fumaric Acid; Ginsenoside; Ginsenoside F-1; Ginsenoside F-2; Ginsenoside F3; Ginsenoside M-7-CD; Ginsenoside R-O; Ginsenoside RA-2; Ginsenoside RB-1; Ginsenoside RB-2; Ginsenoside RB-3; Ginsenoside RC; Ginsenoside RD; Ginsenoside RE; Ginsenoside RF; Ginsenoside RG-1; Ginsenoside RG-2; Ginsenoside RG-12; Ginsenoside RHI; Heptadeca-1-EN-4.6-DIYN-3,9-DIOL; Kaempferol; Luteolin-7-Glucoside; Maleic Acid; Malic Acid; Monosaccharides; N-Nonacosane; Neoclovene; O-Alpha-D-Glucopyranosyl(Fructofuranoside); O-Alpha-D-Glucopyranosyl (Glucopyranose); Octacosan-1-OL; Oleanolic Acid; Panacene; Panasenoside; Panaxic Acid; Panaxin; Panaxydol; Panxynol; Panaxytriol Polysaccharides (panaxane A to U); Sitosterol-6’Linolenylgluside; Sitosterol-6’-Linolylgluside; Sitosterol-6- Oleylglucoside; Sitosterol-6’- Palmitylglucoside; Sitosterol-6’-Stearylglucoside; Stigmasterol-6’- Linolenylglucoside; Stigmaterol-6’-Linolylglucoside; Stigmaterol-6’-Oleylglucoside; Stigmasterol-6’-Palmitylglucoside; Stigmasterol-6’-Stearylglucoside; Trifolin. ²³

Biochemical Constituents Studies:

"The dried roots and rhizomes of ginseng (P. ginseng C. A. Meyer) contain many physiologically important constituents s.c. as ginseng saponins, ginseng oils and phytosterol, carbohydrates and sugars, organic acids, nitrogenous substances, amino acids and peptides, vitamins and minerals, and certain enzymes that have been isolated and characterized. Among these, ginseng saponins are proven to be the principal and most active constituents. So far 13 saponins have been isolated and identified and these, which have been called ginsenosides or panaxosides, are triterpenes of dammarane and oleanane structures." ^39,41,43 Also, compound K (C-K), is a major metabolite of ginsenoside Rb1 (G-Rb1) from Panax ginseng root …" ³⁰. "Germanium is believed to be abundant, but little toxic, in natural drugs s.c. as ginseng." ³¹

"Ginseng root, a traditional oriental medicine, contains more than a dozen biologically active saponins called ginsenosides, including one present in only trace amounts called ginsenoside-Rf ." ²⁹ Ginsenosides (Rf, Rh3, Rh4, R1, R2, Rbl, -Rb2, -Rd, Rg2, Rg4) have been isolated and quantified in several studies. ^{25,27,32,33,37,38,42,50}

It has been found that "ginsenosides are therapeutic dammarane-type oligoglycosides isolated from the water-soluble portion of the dried roots and leaves of Panax ginseng C. A. Meyer (Araliaceae)" ²⁸. A study of dammarane oligopeptides from ginseng isolated a new biologically active peptide which exhibits somnogenic effect ²⁶.

The ginsenoside composition of the main root, lateral root, rhizome, leaves and seeds of Panax ginseng cultivated in Jilin, China was studied. Total saponin content showed a mid-range value as compared to those in ginsengs reported in literature. A high percentage of Rg1 in the main root of fresh and sun-dried specimens from the same batch "might account for the traditional preference of this plant p.r. despite its lowest percentage of saponin in the whole plant." ⁴⁰

Tests have found 17 amino acids, which reach their peak point during sprouting period in April. ²⁴

Polysaccharides from the root of ginseng have shown considerable dose-dependendent immunological, phagocytic, and anti-complement activities in several studies. ^{34, 35,36}

Above Ground Parts:

Numerous studies have shown that polysaccharides found in the leaves of the Panax ginseng have immunological, anti-ulcer and anti-complement activities. ^{44, 45, 48, 49}

In studies isolation and identification of compounds from the fruit of cultivated Panax ginseng was made "on the basis of physicochemical constants and spectral evidences." ^{46, 47}

 

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It should be noted that lengths of administration and dosages may change based on the severity of the symptoms and the type of problem.

The clinical efficacy of the dosages listed below need more dose-related studies to be substantiated however, they are traditionally appropriate.

Ginseng may need to be taken for a period of time before it’s effects are realized. It has been said that it may take from one week to a month before the effects of Ginseng usage may be felt.

Traditionally, many herbalist have recommended a regime that consists of short breaks from ginseng usage if the herb is being used over an extended period. These breaks in usage are usually 2-3 weeks longs and may be substantiated by some studies that have been conducted to date (see Adverse Effects and Warnings).

The below table consists of common average recommended dosages for ginseng usage. However, as an adjunct to this low dosages are usually 0.5–1.0 grams/day – and high dosages 3.0–4.5 grams/day with the avgerage dosage for ginseng usage being 1 to 2 grams a day.

 

TABLE 1 - Usual Dosage for Tablets/Capsules

Adults:	Equivalent to 1-2 grams root/day or 100 mg, 200 or 400 mg/day of standardized ginseng extract (standardized to saponin or ginsenoside content – usually 7%) where 100 mg of the preparation is equivalent to 500 mg P ginseng root
Children:	No Studies conducted to date – Use with Extreme Care

 

TABLE 2 - Usual Dosage for fresh root - chewed

Adults:	1-2 grams root/day – may be boiled gently for a short time to soften it up before chewing
Children:	No Studies conducted to date – Use with Extreme Care

 

TABLE 3 - Usual Dosage for Tea/Infusion

Adults:	1-2 gram root/day or 0.5 tbsp comminuted drug to one cup boiling water up to 4 times /day Or make a tea by simmering 2 ounces of fresh ginseng in four cups of water for 2 hours– drink one cup 2-4 times/day
Children:	No Studies conducted to date – Use with Extreme Care.

 

TABLE 4 - Usual Dosage for Liquid Extract

Adults:	Liquid Extract – 5 ml. in one cup after meals – equivalent to 1-2 grams/day
Children:	No Studies conducted to date – Use with Extreme Care.

 

Dosage Studies:

A total of 227 volunteers received daily oral capsule doses of either placebo or 100 mg of standardized ginseng extract Ginsana G 115 for a period of 12 weeks, within which time they received an anti influenza polyvalent vaccination. "As a result the frequency of influenza or common cold between weeks 4 and 12 was 42 cases in the placebo group whereas it was only 15 cases in the G115 group, the difference being statistically highly significant…. Natural killer (NK) activity levels at weeks 8 and 12 were nearly twice as high in the G115 group as compared to the placebo group." ¹³⁹

"…results of this study do not support an ergogenic effect on peak aerobic exercise performance following a 3-week supplementation period of 200 mg 7% Panax ginseng in healthy young adults with moderate exercise capacities and unrestricted diets." ¹⁰⁵

"In an RDBPCT, college-aged volunteers who took 100 mg of ginseng twice daily for 12 weeks experienced a statistical improvement in the speed at which they were able to perform mathematical calculations, but did not experience improvement in motor function or other cognitive functions. No adverse effects were reported. It is concluded that G 115 may be superior to placebo in improving certain psychomotor functions in healthy subjects." ¹⁰⁶

How Supplied:

Internal use - It is usually taken as a comminuted drug, herb powder, Liquid or solid preparation

External use - Liquid and semi-solid preparations

 

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61. Kim HS; Hong YT; Oh KW; Seong YH; Rheu HM; Cho DH; Oh S; Park WK; Jang CG: Inhibition by ginsenosides Rb1 and Rg1 of methamphetamine-induced hyperactivity, conditioned place preference and postsynaptic dopamine receptor supersensitivity in mice Gen Pharmacol 1998 May;30(5):783-9
62. Akao T; Kanaoka M; Kobashi K Appearance of compound K, a major metabolite of ginsenoside Rb1 by intestinal bacteria, in rat plasma after oral,, Biol Pharm Bull 1998 Mar;21(3):245-9
63. Wang LC; Lee TF: Effect of ginseng saponins on exercise performance in non-trained rats., Planta Med 1998 Mar;64(2):130-3
64. Kim KH; Lee YS; Jung IS; Park SY; Chung HY; Lee IR; Yun YS: Acidic polysaccharide from Panax ginseng, ginsan, induces Th1 cell and macrophage cytokines and generates LAK cells in synergy with rIL-2. Planta Med 1998 Mar;64(2):110-5
65. Sonoda Y; Kasahara T; Mukaida N; Shimizu N; Tomoda M; Takeda: Stimulation of interleukin-8 production by acidic polysaccharides from the root of Panax ginseng. T Immunopharmacology 1998 Jan;38(3):287-94
66. Sohn J; Lee CH; Chung DJ; Park SH; Kim I: Hwang WI Effect of petroleum ether extract of Panax ginseng roots on proliferation and cell cycle progression of human renal cell carcinoma cells. Exp Mol Med 1998 Mar 31;30(1):47-51
67. Wang BX, Yang M, Jin YL, Cui ZY, Wang Y Yao: Studies on the hypoglycemic effect of ginseng polypeptide. Hsueh Hsueh Pao 1990;25(6):401-5 [Article in Chinese]
68. Kaku T, Miyata T, Uruno T, Sako I, Kinoshita A: Chemico-pharmacological studies on saponins of Panax ginseng C. A. Meyer. II. Pharmacological part. Arzneimittelforschung 1975 Apr;25(4):539-47
69. Chen X, Salwinski S, Lee TJ: "Extracts of Ginkgo biloba and ginsenosides exert cerebral vasorelaxation via a nitric oxide pathway.", Clin Exp Pharmacol Physiol, v24, n12, Dec 1997
70. Kim HJ, Chun YJ, Park JD, Kim SI, Roh JK, Jeong TC: "Protection of rat liver microsomes against carbon tetrachloride-induced lipid peroxidation by red ginseng saponin through cytochrome P450 inhibition.", Planta Med, v63, n5, Oct 1997
71. Chen X: "Cardiovascular protection by ginsenosides and their nitric oxide releasing action., Clin Exp Pharmacol Physiol, v23, n8, Aug 1996
72. Park HJ, Lee JH, Song YB, Park KH: "Effects of dietary supplementation of lipophilic fraction from Panax ginseng on cGMP and cAMP in rat platelets and on blood coagulation.", Biol Pharm Bull, v19, n11, Nov 1996
73. Rimar S, Lee-Mengel M, Gillis CN: "Pulmonary protective and vasodilator effects of a standardized Panax ginseng preparation following artificial gastric digestion.", Pulm Pharmacol, v9, n4, Aug 1996
74. Kim HS, Kang JG, Seong YH, Nam KY, Oh KW: "Blockade by ginseng total saponin of the development of cocaine induced reverse tolerance and dopamine receptor supersensitivity in mice.", Pharmacol Biochem Behav, v50, n1, Jan 1995
75. Lin JH, Wu LS, Tsai KT, Leu SP, Jeang YF, Hsieh MT: "Effects of ginseng on the blood chemistry profile of dexamethasone-treated male rats.", Am J Chin Med, v23, n2, 1995
76. Liu M, Zhang J: "Effects of ginsenoside Rb1 and Rg1 on synaptosomal free calcium level, ATPase and calmodulin in rat hippocampus.", Chin Med J (Engl), v108, n7, Jul 1995
77. Mochizuki M, Yoo YC, Matsuzawa K, Sato K, Saiki I, Tono-oka S, Samukawa K, Azuma I: "Inhibitory effect of tumor metastasis in mice by saponins, ginsenoside-Rb2, 20(R)- and 20(S)-ginsenoside-Rg3, of red ginseng.", Biol Pharm Bull, v18, n9, Sep 1995
78. Bhattacharya SK, Mitra SK: "Anxiolytic activity of Panax ginseng roots: an experimental study.", J Ethnopharmacol, v34, n1, Aug 1991
79. Wei R, Chen C, Dong J, Qiu S, Cao Z: "[Effect of radix Astragali and radix ginseng in enhancing the metabolism of human myocardial cells in vitro]. [Chinese]", Chung Kuo Chung Yao Tsa Chih, v17, n3, Mar 1992.
80. Matsuda H, Samukawa K, Kubo M: "Anti-hepatitic activity of ginsenoside Ro.", Planta Med, v57, n6, Dec 1991
81. Suzuki Y, Ito Y, Konno C, Furuya T: "[Effects of tissue cultured ginseng on gastric secretion and pepsin activity]. [Japanese]", Yakugaku Zasshi, v111, n12, Dec 1991
82. Kim HS, Jang CG, Lee MK: "Antinarcotic effects of the standardized ginseng extract G115 on morphine.", Planta Med, v56, n2, Apr 1990
83. Takaku T, Kameda K, Matsuura Y, Sekiya K, Okuda H: "Studies on insulin-like substances in Korean red ginseng.", Planta Med, v56, n1, Feb 1990
84. Filaretov AA, Bogdanova TS, Podvigina TT, Bodganov AI: "Role of pituitary-adrenocortical system in b.d. adaptation abilities.", Exp Clin Endocrinol, v92, n2, Dec 1988
85. Kimura Y, Okuda H, Arichi S: "Effects of various ginseng saponins on 5-hydroxytryptamine release and aggregation in human platelets.", J Pharm Pharmacol, v40, n12, Dec 1988
86. Watanabe J, Oh KW, Kim HS, Takahashi M, Kaneto H: "A non-opioid mechanism in the inhibitory effect of ginseng saponins on electrically evoked contractions of guinea-pig ileum and mouse vas deferens.", J Pharmacobiodyn, v11, n6, Jun 1988
87. Hata T, Kita T, Kawabata A, Itoh E, Kawashima Y: "Effect of ginseng-20S-prosapogenin on tissue blood flow measured by the hydrogen clearance method in sympathicotonic- or parasympathicotonic-type stressed mice.", J Pharmacobiodyn, v8, n12, Dec 1985
88. Konno C, Murakami M, Oshima Y, Hikino H: "Isolation and hypoglycemic activity of panaxans Q, R, S, T and U, glycans of Panax ginseng roots", J Ethnopharmacol, v14, n1, Sep 1985
89. Jie YH, Cammisuli S, Baggiolini M: "Immunomodulatory effects of Panax ginseng C. A. Meyer in the mouse", Agents Actions, v15, n3-4, Oct 1984
90. Yamamoto M, Uemura T, Nakama S, Uemiya M, Kumagai A: "Serum HDL-cholesterol-increasing and fatty liver-improving actions of Panax ginseng in high cholesterol diet-fed rats with clinical effect on hyperlipidemia in man.", Am J Chin Med, v11, n1-4, 1983
91. Kimura M, Waki I, Chujo T, Kikuchi T, Hiyama C, Yamazaki K, Tanaka O: "Effects of hypoglycemic components in ginseng radix on blood insulin level in alloxan diabetic mice and on insulin release from perfused rat pancreas.", J Pharmacobiodyn, v4, n6, Jun 1981
92. Kimura M, Waki I, Tanaka O, Nagai Y, Shibata S: "Pharmacological sequential trials for the fractionation of components with hypoglycemic activity in alloxan diabetic mice from ginseng radix.", J Pharmacobiodyn, v4, n6, Jun 1981
93. Ota T, Maeda M, Odashima S, "Mechanism of action of ginsenoside Rh2: uptake and metabolism of ginsenoside Rh2 by cultured B16 melanoma cells.", J Pharm Sci, v80, n12, Dec 1991
94. Cui JF, Garle M, Bjorkhem I, Eneroth P: "Determination of aglycones of ginsenosides in ginseng preparations sold in Sweden and in urine samples from Swedish athletes consuming ginseng.", Scand J Clin Lab Invest, v56, n2, Apr 1996
95. Akagawa G, Abe S, Tansho S, Uchida K, Yamaguchi H: "Protection of C3H/HE J mice from development of Candida albicans infection by oral administration of Juzen-taiho-to and its component, Ginseng radix: possible roles of macrophages in the host defense mechanisms.", Immunopharmacol Immunotoxicol, v18, n1, Feb 1996
96. Abe S; Tansho S; Ishibashi H; Inagaki N; Komatsu Y; Yamaguchi H: Protective effect of oral administration of a traditional medicine, Juzen-Taiho-To, and its components on lethal Candida albicans infection in immunosuppressed mice. Immunopharmacol Immunotoxicol 1998 Aug;20(3):421-31
97. Song Z, Johansen HK, Faber V, Moser C, Kharazmi A, Rygaard J, Hoiby N, "Ginseng treatment reduces bacterial load and lung pathology in chronic Pseudomonas aeruginosa pneumonia in rats", Antimicrob Agents Chemother, v41, n5, May 1997
98. Song ZJ, Johansen HK, Faber V, Hoiby N, "Ginseng treatment enhances bacterial clearance and decreases lung pathology in athymic rats with chronic P. aeruginosa pneumonia.", APMIS, v105, n6, Jun 1997
99. Yoshimura H, Watanabe K, Ogawa N, "Psychotropic effects of ginseng saponins on agonistic behavior between resident and intruder mice.", Eur J Pharmacol, v146, n2-3, Feb 9 1988
100. Yoshimura H, Watanabe K, Ogawa N, "Acute and chronic effects of ginseng saponins on maternal aggression in mice.", Eur J Pharmacol, v150, n3, Jun 10 1988
101. Bittles AH, Fulder SJ, Grant EC, Nicholls MR, "The effect of ginseng on lifespan and stress responses in mice", Gerontology, v25, n3, 1979
102. Caso Marasco A; Vargas Ruiz R; Salas Villagomez A: Double-blind study of a multivitamin complex supplemented with ginseng extract, Begona Infante C, Drugs Exp Clin Res 1996;22(6):323-9
103. Banerjee U, Izquierdo JA, "Antistress and antifatigue properties of Panax ginseng: comparison with piracetam", Acta Physiol Lat Am, v32, n4, 1982
104. Bahrke M, Morgan W: Evaluation of the ergogenic properties of ginseng. Sports Med. 1994;18:229-248
105. Allen JD; McLung J; Nelson AG; Welsch M: Ginseng supplementation does not enhance healthy young adults'' peak aerobic exercise performance., J Am Coll Nutr 1998 Oct;17(5):462-6
106. D’Angelo L., Grimaldi R, Caravaggi M, Marcoli M, Perucca E, Lecchini S, Frigo GM, Crema A: A double-blind, placebo-controlled clinical study on the effect of a standardized ginseng extract on psychomotor performance in healthy volunteers. J Ethnopharmacol 1986 Apr-May 16:1 15-22,
107. Pieralisi G; Ripari P; Vecchiet L: Effects of a standardized ginseng extract combined with dimethylaminoethanol bitartrate, vitamins, minerals, and trace elements on physical performance during exercise. Clin Ther 1991 May-Jun;13(3):373-82
108. Grandhi A, Mujumdar AM, Patwardhan B, "A comparative pharmacological investigation of Ashwagandha and Ginseng.", J Ethnopharmacol, v44, n3, Dec 1994.
109. Morris AC, Jacobs I, McLellan TM, Klugerman A, Wang LC, Zamecnik J, "No ergogenic effect of ginseng ingestion.", Int J Sport Nutr, v6, n3, Sep 1996.The purpose of this study was to examine the effects of ginseng extract ingestion on physiological responses to intense exercise
110. Kim YC; Kim SR; Markelonis GJ; Oh TH: Ginsenosides Rb1 and Rg3 protect cultured rat cortical cells from glutamate-induced neurodegeneration [published erratum appears in J Neurosci Res 1998 Oct 1;54(1):123], J Neurosci Res 1998 Aug 15;53(4):426-32
111. Zhao R; McDaniel WF: Ginseng improves strategic learning by normal and brain-damaged rats. Neuroreport 1998 May 11;9(7):1619-24
112. Wen TC, Yoshimura H, Matsuda S, Lim JH, Sakanaka M, "Ginseng root prevents learning disability and neuronal loss in gerbils with 5-minute forebrain ischemia.", Acta Neuropathol (Berl), v91, n1, 1996.
113. Nitta H, Matsumoto K, Shimizu M, Ni XH, Watanabe H, "Panax ginseng extract improves the performance of aged Fischer 344 rats in radial maze task but not in operant brightness discrimination task.", Biol Pharm Bull, v18, n9, Sep 1995.
114. Wang A, Cao Y, Wang Y, Zhao R, Liu C, "[Effects of Chinese ginseng root and stem-leaf saponins on learning, memory and biogenic monoamines of brain in rats]. [Chinese]", Chung Kuo Chung Yao Tsa Chih, v20, n8, Aug 1995.
115. Lasarova MB, Mosharrof AH, Petkov VD, Markovska VL, Petkov VV, "Effect of piracetam and of standardized ginseng extract on the electroconvulsive shock-induced memory disturbances in "step-down" passive avoidance.", Acta Physiol Pharmacol Bulg, v13, n2, 1987.
116. Sotaniemi EA, Haapakoski E, Rautio A, "Ginseng therapy in non-insulin-dependent diabetic patients.", Diabetes Care, v18, n10, Oct 1995.
117. Xie ZC, Qian ZK, Liu ZW, "[Effect of ginseng on antiperoxidate injury in myocardium and erythrocytes in streptozocin-induced diabetic rats]. [Chinese]", Chung Kuo Chung Hsi I Chieh Ho Tsa Chih, v13, n5, May 1993.
118. Waki I, Kyo H, Yasuda M, Kimura M, "Effects of a hypoglycemic component of ginseng radix on insulin biosynthesis in normal and diabetic animals.", J Pharmacobiodyn, v5, n8, Aug 1982.
119. Zhang JS, Sigdestad CP, Gemmell MA, Grdina DJ, "Modification of radiation response in mice by fractionated extracts of Panax ginseng.", Radiat Res, v112, n1, Oct 1987.
120. Taik-Koo Y, Soo-Yong C. Preventive effect of ginseng intake against various human cancers: a case-control study on 1987 pairs. Cancer Epidemiol Biomarkers Prev. 1995;4:401-408.)
121. Bespalov VG, Aleksandrov VA, Davydov VV, Limarenko AIu, Molokovskii DS, Petrov AS, Slepian LI, Trilis IaG, "[Inhibition of mammary gland carcinogenesis using a tincture from biomass of ginseng tissue culture]. [Russian]", Biull Eksp Biol Med, v115, n1, Jan 1993.
122. Bespalov VG, Davydov VV, Limarenko AIu, Slepian LI, Aleksandrov VA, "[The inhibition of the development of experimental tumors of the cervix uteri and vagina by using tinctures of the cultured-cell biomass of the ginseng root and its germanium-selective stocks]. [Russian]", Biull Eksp Biol Med, v116, n11, Nov 1993.
123. Tode T, Kikuchi Y, Kita T, Hirata J, Imaizumi E, Nagata I, "Inhibitory effects by oral administration of ginsenoside Rh2 on the growth of human ovarian cancer cells in nude mice.", J Cancer Res Clin Oncol, v120, n1-2, 1993.
124. Kumar R, Grover SK, Divekar HM, Gupta AK, Shyam R, Srivastava KK, "Enhanced thermogenesis in rats by Panax ginseng, multivitamins and minerals.", Int J Biometeorol, v39, n4, Nov 1996.
125. Lee BH; Lee SJ; Hui JH; Lee S; Sung JH; Huh JD; Moon C: In vitro antigenotoxic activity of novel ginseng saponin metabolites formed by intestinal bacteria. Planta Med 1998 Aug;64(6):500-3
126. Chin R. Ginseng and common pregnancy disorders. Asia Oceanica J Obstet Gynecol. 1991;17:379-380
127. Han KH; Choe SC; Kim HS; Sohn DW; Nam KY; Oh BH; Lee MM; Park YB; Choi YS; Seo JD; Lee YW: Effect of red ginseng on blood pressure in patients with essential hypertension and white coat hypertension. Am J Chin Med 1998;26(2):199-209
128. Wang WK; Chen HL; Hsu TL; Wang YY: Alteration of pulse in human subjects by three Chinese herbs., Am J Chin Med 1994;22(2):197-203
129. Kim SH; Jeong KS; Ryu SY; Kim TH: Panax ginseng prevents apoptosis in hair follicles and accelerates recovery of hair medullary cells in irradiated mice in Vivo 1998 Mar-Apr;12(2):219-22
130. Xiaoguang C; Hongyan L; Xiaohong L; Zhaodi F; Yan L; Lihua T; Rui H: Cancer chemopreventive and therapeutic activities of red ginseng., J Ethnopharmacol 1998 Feb;60(1):71-8
131. Nakajima S; Uchiyama Y; Yoshida K; Mizukawa H; Haruki E: The effects of ginseng radix rubra on human vascular endothelial cells Am J Chin Med 1998;26(3-4):365-73
132. See DM, Broumand N, Sahl L, Tilles JG, "In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients.", Immunopharmacology, v35, n3, Jan 1997
133. Luo YM, Cheng XJ, Yuan WX, "Effects of ginseng root saponins and ginsenoside Rb1 on immunity in cold water swim stress mice and rats.", Chung Kuo Yao Li Hsueh Pao, v14, n5, Sep 1993.
134. Yeung HW, Cheung K, Leung KN, "Immunopharmacology of Chinese medicine 1, ginseng induced immunosuppression in virus-infected mice.", Am J Chin Med, v10, n1-4, 1982.
135. Cui X; Sakaguchi T; Ishizuka D; Tsukada K; Hatakeyama K: Orally administered ginseng extract reduces serum total cholesterol and triglycerides that induce fatty liver in 66% hepatectomized rats, J Int Med Res 1998 Aug-Sep;26(4):181-7
136. Takahashi M; Tokuyama S: Pharmacological and physiological effects of ginseng on actions induced by opioids and psychostimulants. Methods Find Exp Clin Pharmacol 1998 Jan-Feb;20(1):77-84
137. Kim HS, Kang JG, Rheu HM, Cho DH, Oh KW, "Blockade by ginseng total saponin of the development of methamphetamine reverse tolerance and dopamine receptor supersensitivity in mice.", Planta Med, v61, n1, Feb 1995
138. Lee FC, Ko JH, Park JK, Lee JS, "Effects of Panax ginseng on blood alcohol clearance in man.", Clin Exp Pharmacol Physiol, v14, n6, Jun 1987
139. Scaglione F, Cattaneo G, Alessandria M, Cogo R, "Efficacy and safety of the standardised Ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold [corrected] [published erratum appears in Drugs Exp Clin Res 1996;22(6):338].", Drugs Exp Clin Res, v22, n2, 1996:65-72
140. Salvati G, Genovesi G, Marcellini L, et al: Effects of Panax ginseng C. A. Meyer saponins on male fertility. Panminerva Med. 1996;38:249-254
141. Fahim MS, Fahim Z, Harman JM, Clevenger TE, Mullins W, Hafez ES, "Effect of Panax ginseng on testosterone level and prostate in male rats.", Arch Androl, v8, n4, Jun 1982
142. Choi HK; Seong DH; Rha KH: Clinical efficacy of Korean red ginseng for erectile dysfunction., Int J Impot Res 1995 Sep;7(3):181-6
143. Choi YD; Xin ZC; Choi HK: Effect of Korean red ginseng on the rabbit corpus cavernosal smooth muscle. Int J Impot Res 1998 Mar;10(1):37-43
144. Hopkins MP, Androff L, Benninghoff AS, "Ginseng face cream and unexplained vaginal bleeding.", Am J Obstet Gynecol, v159, n5, Nov 1988
145. Kim C, Choi H, Kim CC, Kim JK, Kim MS, "Influence of ginseng on mating behavior of male rats.", Am J Chin Med, v4, n2, Summer 1976
146. Yoshimura H; Kimura N; Sugiura K: Preventive effects of various ginseng saponins on the development of copulatory disorder induced by prolonged individual housing in male mice. Methods Find Exp Clin Pharmacol 1998 Jan-Feb;20(1):59-64
147. Ding DZ; Shen TK; Cui YZ, Chung Kuo Chung Hsi I Chieh Ho Tsa Chih: Effects of red ginseng on the congestive heart failure and its mechanism, 1995 Jun;15(6):325-7
148. Zhan Y; Xu XH; Jiang YP, Chung Hua I Hsueh Tsa Chih: Protective effects of ginsenoside on myocardiac ischemic and reperfusion injuries, 1994 Oct;74(10):626-8, 648
149. Toh HT, "Improved isolated heart contractility and mitochondrial oxidation after chronic treatment with Panax ginseng in rats.", Am J Chin Med, v22, n3-4, 1994.
150. Lee DC, Lee MO, Kim CY, Clifford DH, "Effect of ether, ethanol and aqueous extracts of ginseng on cardiovascular function in dogs.", Can J Comp Med, v45, n2, Apr 1981
151. Zuin M, Battezzati PM, Camisasca M, Riebenfeld D, Podda M, "Effects of a preparation containing a standardized ginseng extract combined with trace elements and multivitamins against hepatotoxin-induced chronic liver disease in the elderly.", J Int Med Res, v15, n5, Sep-Oct 1987.
152. Thommessen B; Laake K: No identifiable effect of ginseng (Gericomplex) as an adjuvant in the treatment of geriatric patients. Aging (Milano), 8(6):417-20 1996 Dec
153. Liang H, Wang Z, Tian F, Geng B, "[Effects of Astragalus polysaccharides and ginsenosides of Ginseng stems and leaves on lymphocytes membrane fluidity and lipid peroxidation in traumatized mice]. [Chinese]", Chung Kuo Chung Yao Tsa Chih, v20, n9, Sep 1995.
154. Zhang WY, Teng H, Zheng Y, "[Ginseng saponin treatment for intrauterine growth retardation]. [Chinese]", Chung Hua I Hsueh Tsa Chih, v74, n10, Oct 1994.
155. Yi RL, Li W, Hao XZ, "[Inductive differentiation effect of ginsenosides on human acute non-lymphocytic leukemic cells in 58 patients]. [Chinese]", Chung Kuo Chung Hsi I Chieh Ho Tsa Chih, v13, n12, Dec 1993.
156. Petkov VD, Cao Y, Todorov I, Lazarova M, Getova D, Stancheva S, Alova L, "Behavioral effects of stem-leaves extract from Panax ginseng C. A. Meyer.", Acta Physiol Pharmacol Bulg, v18, n2, 1992.
157. Sun XB, Matsumoto T, Yamada H, "Purification of an anti-ulcer polysaccharide from the leaves of Panax ginseng.", Planta Med, v58, n5, Oct 1992.
158. Wei BH, "[Treatment of shock with traditional Chinese medicine and Western medicine]. [Review] [23 refs] [Chinese]", Chung Hsi I Chieh Ho Tsa Chih, v2, n4, Oct 1982.
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161. Greenspan EM, "Ginseng and vaginal bleeding [letter].", JAMA, v249, n15, Apr 15 1983
162. Miller LG: Herbal Medicinals: Selected Clinical Considerations Focusing on Known or Potential Drug-Herb Interactions.,Arch Intern Med, 1998, Nov 9;158(20):2200-11
163. Siegel R. Ginseng abuse syndrome. JAMA. 1979;241:1614-1615
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166. Ding DZ; Shen TK; Cui YZ, Chung Kuo Chung Hsi I Chieh Ho Tsa Chih: Effects of red ginseng on the congestive heart failure and its mechanism, 1995 Jun;15(6):325-7
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Copyright 1999 Rxlist - All rights reserved

Note: Adverse reactions with Ginseng usage are considered relatively rare and it is usually considered to have a low toxicity.

• Insomnia ²³
• Post menopausal Bleeding ^144,161,164
• Mastalgia ¹⁶⁴
• Headache (in conjunction with phenelzine intake) ¹⁶²
• Tremulousness (in conjunction with phenelzine intake) ¹⁶²
• Manic episodes (in conjunction with phenelzine intake) ^162,167,168
• Gestational diabetes ¹⁶⁵
• Hypertony ¹⁵⁹
• Diarrhea ¹⁵⁹
• Nervousness ¹⁵⁹
• Cerebral arteritis (one possible case reported) ¹⁷⁰
• May induce immunological unresponsiveness in one arm of the immune system ¹³⁴

 

^{Ginseng Abuse Syndrome – the cases reported on Ginseng abuse syndrome are controversial due to the possibility the ginseng consumed had adulterants, that the ginseng types are unknown including how they were processed, and that the reports may not have been verified. The following are the side effects reported for this Syndrome:}

• ^{Intoxication induced by Ginseng causing:158}

Adverse Reactions Studies:

A case of postmenopausal bleeding attributed to the use of topical ginseng is reported. Ginseng appears to have an estrogen-like effect on genital tissues. ¹⁴⁵

"… Thus, ginseng pretreatment can induce immunological unresponsiveness in one arm of the immune system. Such selective immunosuppression effect of the total saponins of ginseng may be related to their steroid-like structure." ¹³⁴

" ginseng may cause headache, tremulousness, and manic episodes in patients treated with phenelzine sulfate. Ginseng should also not be used with estrogens or corticosteroids because of possible additive effects." ¹⁶²

"…. at least 1 fatality has been attributed to contamination of a ginseng product with the potent and unpredictable herbal stimulant ephedra. While clear conclusions about the safety of ginseng cannot be drawn from the uncontrolled 1979 case series that coined the term "ginseng abuse syndrome." ¹⁶³

"ginseng can act as a mild stimulant and should probably be avoided in association with other stimulants or in patients with cardiovascular disease. Rare endocrinologic effects include mastalgia and postmenopausal bleeding, both of which cease with discontinuation of ginseng." ¹⁶⁴

"A case-control study of 88 pairs of women (matched only for age and parity) found a significantly lower rate of pregnancy-induced hypertension, but a 3-fold higher incidence of gestational diabetes among ginseng consumers." ¹⁶⁵

In a study with 227 volunteers receiving daily oral capsule doses of either placebo (113) or 100 mg of standardized ginseng extract Ginsana G 115 (114) for a period of 12 weeks laboratory values of 24 safety parameters showed no significant differences between the end and the beginning of the 12-week study in either of the groups. There were only 9 adverse events in the study, the principal one being insomnia." ¹³⁹

" The results suggested that Red Ginseng and digoxin had synergism for treatment of congestive heart failure, and Red Ginseng was an effective and safe adjuvant without any side effects." ¹⁶⁶

A "28-year-old woman who had a severe headache after ingesting a large quantity of ethanol-extracted ginseng. Cerebral angiograms showed "beading" appearance in the anterior and posterior cerebral and superior cerebellar arteries, consistent with cerebral arteritis. The close temporal association between intake of ginseng and cerebral arteries suggests a causal relationship." ¹⁷⁰

Other references on Adverse effects:

Dega H, Laporte JL, Frances C, Herson, Chosidow O: Ginseng as a cause for Stevens-Johnson syndrome? [letter] [see comments], Lancet, May 11, 1996, v347, n9011

Gonzalez-Seijo JC, Ramos YM, Lastra I: Manic episode and ginseng: report of a possible case [letter]. J Clin Psychopharmacol, Dec 1995 v15, n6

Chen KJ: "The effect and abuse syndrome of Ginseng.", J Tradit Chin Med, v1, n1, Sep 1981

Becker BN,Greene J: Evanson J, Chidsey G, Stone WU, et al: Ginseng induced diuretic resistance, JAMA, 1996, 276, 605-607

Hammond TG: Whitworth JA :Adverse reactions to ginseng [letter]., Med J Aust,May 2, 1991 v1 , n9

Dukes MN: Ginseng and mastalgia [letter], Br Med J, June 17, 1978, v1, n6127

Nielsen AS: Hypertension caused by ginseng tablets? (letter)]. [Danish]", Ugeskr Laeger, Feb 8, 1988, v150, n6

 

Body as a Whole – The possibility of an allergic reaction to the herb should be kept in mind during therapy; Headaches

Cardiovascular System –Palpitations

Digestive System – Nausea, Vomiting, Diarrhea

Endocrine System – Post menopausal Bleeding , Mastalgia, Immune system suppression

Metabolic and Nutritional – Gestational diabetes

Nervous System – Restlessness, Irritability, Insomnia

Skin and Appendages – Rash

Special Senses – Vertigo

 

As with all Herbs and Drugs, the potential for interaction by a variety of mechanisms (e.g., pharmacodynamic, pharmacokinetic drug inhibition or enhancement, etc) is a possibility.

 

• Ginseng is contraindicated in patients taking phenelzine sulfate. ^162,167,168

• Ginseng may be contraindicated if used with estrogens or corticosteroids. ¹⁶²

• Ginseng may be interact with the blood thinning medication warfarin, however this is not clinically proven. ¹⁷¹

• Traditionally Ginseng was thought to be incompatible with the intake of Faeces Trogopterori (Rhizoma Trogopterorum or Wu Ling Zhi)391, however this is under debate. ^160,169

• There has been one case reported of interaction with furosemide, however this may have been due to a germanium contaminant. ¹⁷⁴

 

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(see also Contraindications)

• Red Ginseng may potentiate the effects of caffeine and other stimulants ¹⁵⁹

• May be contraindicated if pregnant ¹⁵⁹

• There is no clinical data concerning it’s safety for usage in pregnancy. There is a least one study indicating a threefold increase in the study groups incident of gestational diabetes." ¹⁶⁵ If pregnant please consult your physician.

• Ginseng may effect blood glucose levels, if a patient has Diabetes mellitus, consult a physician before usage.

• Do not use if nursing (no clinical data available)

• Should not be used for children under the age of 2 years old (no clinical data available)
• Use only with physician approval if utilizing with children over the age of 2 years old.

• Ginseng, as with any herbal or prescription drug, may interact with other medications you are be taking. If taking other medications, please consult your physician.

• Ginseng may be toxic in very large quantities (Ginseng Abuse Syndrome) and/or with intake over a long period of time, however this is still under debate (see Adverse Effects).

Traditionally in Chinese medicine has been advised to avoid Ginseng usage if:

• A person has extremely high blood pressure
• A person has a tendency to get spontaneous nose bleeds,
• A person has a tendency to have excessive menstrual bleeding
• A person who often experiences a hot dry feeling

 

CONTRAINDICATIONS

• Ginseng is contraindicated for hypertension ¹⁵⁹
• Ginseng is contraindicated in patients taking phenelzine sulfate ^162,167,168
• In Chinese Medicine, traditionally, ginseng is considered contraindicated if the patient is taking Rhizome et Radix Frat (Li Lu) ¹⁷²
• Traditionally Ginseng was thought to be incompatible with the intake of Faeces Trogopterori (Rhizoma Trogopterorum or Wu Ling Zhi) ¹⁷², however this is under debate ^160,169
• Traditionally Ginseng has been contraindicated in cases of high blood pressure.
• Traditionally Ginseng has been contraindicated in cases of excessive menstrual bleeding.
• Ginseng may be contraindicated if used with estrogens or corticosteroids ¹⁶²
• Ginseng may be contraindicated if taking blood thinning medication s.c. as warfarin, however this is not clinically proven ¹⁷¹
• Usage of stimulants may be contraindicated if a patient has cardiovascular disease and is taking Ginseng ¹⁶⁴
• Ginseng, as with any herbal or prescription drug, may interact with other medications you are be taking. If taking other medications, please consult your physician.
• May be contraindicated if pregnant. ¹⁵⁹ There is no clinical data concerning it’s safety for usage in pregnancy. There is a least one study indicating a threefold increase in the study groups incident of gestational diabetes. ¹⁶⁵
• If pregnant please consult your physician.
• Ginseng may be contraindicated in patients with Diabetes mellitus ¹⁶² but is currently being studied for its therapeutic value.

 

USAGE IN PREGNANCY

• Extreme care should be taken and a physician consulted before usage if pregnant - Safety for use in pregnancy has not been established. May be contraindicated if pregnant ¹⁵⁹. There is a least one study indicating a threefold increase in the study groups incident of gestational diabetes. ¹⁶⁵

 

General

As with any herbal or prescription drug, if a rash, nausea, or other adverse effect develops from usage, stop taking the herb immediately and consult your physician.

 

Laboratory Tests

You should always notify your physician when undertaking any herbal therapy for a prolonged period. It is always recommended that periodic assessments occur during any therapy, some of which may include laboratory testing.

 

Carcinogenesis, Mutagenesis, and Impairment of Fertility

Studies in animals on Impairment to fertility have not been performed with this herb.

 

Pregnancy

Studies have not been conducted on the effect of this herb on Pregnancy therefore Extreme Caution should be taken and a physician consulted before usage. There is a least one study indicating a threefold increase in the study groups incident of gestational diabetes. ¹⁶⁵

 

Labor and Delivery

Studies have not been conducted on the effect of this herb on Labor and Delivery therefore Extreme Caution should be taken and a physician consulted before usage.

 

Nursing Mothers

Studies in animals have not been performed with this herb. As many ingested substances are excreted in human milk, caution should be exercised and a physician consulted before using the herb while nursing.

 

Pediatric Use

Studies have not been conducted on the effect of this herb on children therefore Extreme Caution should be taken and a physician consulted before usage with children.

 

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Ginseng Abuse Syndrome – the cases reported on Ginseng abuse syndrome are controversial due to the possibility the ginseng consumed had adulterants, that the ginseng types are unknown including how they were processed, and that the reports may not have been verified. The following are the side effects reported for this Syndrome:

• Intoxication induced by Ginseng causing: ¹⁵⁸

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PUBLISHED STUDIES

Clinical Pharmacology Studies:

"Certain natural products and Asian herbal remedies have been used in Asia to attenuate neurodegenerative diseases, including senile dementia. We have examined derivatives of several natural products for potential neuroprotective activity in an in vitro test system. …It was found that cell damage was reduced significantly by pretreatment with ginsenosides Rb1 and Rg3." ⁵⁴

"Several recent studies have suggested that the antioxidant and organ-protective actions of ginseng are linked to enhanced nitric oxide (NO) synthesis in endothelium of lung, heart, and kidney and in the corpus cavernosum. Enhanced NO synthesis thus could contribute to ginseng-associated vasodilatation and perhaps also to an aphrodisiac action of the root." ¹⁷ In a separate study ginseng total saponins (GTS) were injected intracerebroventricularly in mice. Results of this study "suggest that GTS, 20(S)-Rg3 and Rc may inhibit the i.c.v. injection stress-induced hypothalamo-pituitary-adrenal response by inducing NO production in the brain." ⁵⁶

A study investigated the effects of ginseng total saponins (GTS) and five ginsenosides on voltage-dependent Ca2+ channels and membrane capacitance using rat adrenal chromaffin cells. It was "found that GTS and ginsenosides exerted inhibitory effects on both Ca2+ currents and deltaCm in rat adrenal chromaffin cells. These results suggest that ginseng saponins regulate catecholamine secretion from adrenal chromaffin cells and this regulation could be the cellular basis of antistress effects induced by ginseng." ⁵⁷

"We have examined the binding of 44% saponin from Panax ginseng, and extracts from Eleuthrococcus senticosus (Siberian ginseng) to classical steroid receptors in vitro. Both extracts had demonstrable affinity for progestin, mineralocorticoid and glucocorticoid receptors; the Siberian ginseng also bound to estrogen receptors. Highest affinity binding was to glucocorticoid receptors… Such interactions may explain the reported glucocorticoid-like effects of ginseng in vivo." ⁵¹

The ginsenosides Rb1 and Rg1, the major components of ginseng saponin were found to modulate hyperactivity, conditioned place preference (CPP) and dopamine receptor supersensitivity in mice following a single or repeated administration. ⁶¹

"A possible role of cytochrome P450 (P450) inhibition by red ginseng saponins in carbon tetrachloride (CCl4)-induced lipid peroxidation was investigated in liver microsomes prepared from male Sprague Dawley rats… Silymarin revealed more potent protection against CCl4-induced lipid peroxidation… Taken together, our present results indicated that the inhibitory effects of red ginseng saponin on P450 enzymes may have a critical role in CCl4-induced lipid peroxidation in rat liver microsomes and that the mechanism of hepatoprotection by red ginseng saponin may be distinct from that of silymarin." ⁷⁰

"Effects of Panax ginseng on plasma and hepatic lipids were investigated in the high cholesterol diet-fed rats and in patients with hyperlipidemia. Oral administration of red ginseng powder reduced plasma total cholesterol, triglyceride and NEFA, while plasma HDL-cholesterol was elevated. Platelet adhesiveness was also reduced by ginseng administration. The plasma lipid-improving actions were also observed in patients with hyperlipidemia. Hepatic cholesterol and triglyceride contents were decreased and phospholipid increased by ginseng administration in the high cholesterol diet-fed rats, corresponding to improvement of the fatty liver." ⁹⁰

"We examined the inhibitory effect of two saponin preparations from Red ginseng , 20(R)- and 20(S)-ginsenoside-Rg3, in comparison with that of ginsenoside-Rb2, on lung metastasis produced by two highly metastatic tumor cells, B16-BL6 melanoma and colon 26-M3.1 carcinoma, in syngeneic mice…. findings suggest that both ginseng saponins, 20(R)- and 20(S)-ginsenoside-Rg3, possess an ability to inhibit the lung metastasis of tumor cells, and the mechanism of their antimetastatic effect is related to inhibition of the adhesion and invasion of tumor cells, and also to anti-angiogenesis activity." ⁷⁷

"The effects of various ginseng saponins isolated from red ginseng roots, on aggregation and 5-hydroxytryptamine release (5-HT) human platelets have been investigated… The results suggest that ginsenoside Rg1 in red ginseng roots may be active as a drug in the treatment of atherosclerosis and thrombosis." ⁸⁵

"Ginseng was associated with a significant increase in serum hormones (testosterone, dihydroxytestosterone, follitropin, and lutropin) and in sperm numbers and motility in 46 men with oligospermia." ⁵²

Red ginseng was found to promote the proliferation of human vascular endothelial cells, inhibit the production but promote the decomposition of endothelin, which is known to constrict blood vessels and raise blood pressure as well as accelerate the synthesis of nitric oxide, which is known to have an angio-tonic effect. It is suggested that Red ginseng has the effect of accelerating endothelial cells proliferation and of promoting physiological activities." ⁵³

The action of the dammarane triterpene glycosides Rb1 and Rg1 and their aglycones 20(S) protopanaxatriol and 20(S) protopanaxadiol from Korean ginseng on permeability of bilayer lipid membranes formed of minelayers was studied. …It was found that Rb1 was able to increase the conductivity of the lipid membranes. ⁵⁵

"The effect of Panax ginseng extracts on cell-mediated immune functions in man has been investigated. Three groups, each consisting of twenty healthy volunteers, were treated under conditions of double blindness with capsules containing lactose (Control Group B), with capsules containing 100 mg of aqueous extract of the drug (Group A), and with capsules containing 100 mg of standardized extract of the drug (Group C)." It was found that chemotaxis increased as did natural killer cell activity. ⁶⁰

To elucidate the immunomodulating activities of this plant, this study examined the direct effects of four acidic polysaccharides isolated in previous studies, on cytokine (interleukin-8; IL-8) production by a human monocytic cell line, THP-1, and human blood monocytes in vitro, as IL-8 is a potent inflammatory cytokine involved in neutrophil chemotaxis and activation. It was "found that one component, ginsenan S-IIA, is a potent inducer of IL-8 production by human monocytes and THP-1 cells…" ⁶⁵

"Korean red ginseng powder was found to contain adenosine and an acidic substance which inhibited epinephrine-induced lipolysis and stimulated insulin-mediated lipogenesis from glucose (3, 4)… Based on these results, we suggest to call these substances (adenosine and pyro-glutamic acid) ‘selective modulators’." ⁸³

"We have investigated anti-proliferative effects of lipid soluble Panax ginseng components on human renal cancer cell lines." It was found that lipid soluble components of Panax ginseng roots block cell cycle progression at G1 to S phase transition in human renal cancer. ⁶⁶

"Extracts from the leaves of Ginkgo biloba (EGb) and ginsenosides (GS) have been reported to be effective at increasing vascular relaxation… The actions of EGb and GS on the vascular functions of porcine basilar arteries were investigated in vitro… our data support the potential of these compounds as therapeutic strategies in cerebral ischaemia and other related vascular dysfunctions." ⁶⁹

"…It is postulated that cardiovascular protection by GS may be partly mediated by the release of NO, a potent antioxidant, and that the GS-enhanced release of NO from endothelial cells, especially from perivascular nitric oxidergic nerves in the CC, may partly account for the aphrodisiac effect of Panax ginseng used in traditional Chinese medicine." ⁷¹

"…studied the effect of dietary supplementation of a lipophilic fraction from Panax ginseng on rat platelet aggregation and bloodcoagulation…found that the level of lipids s.c. as triglyceride, total cholesterol, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol was decreased in serum suggesting that dietary LF regulates the levels of cGMP and cAMP…. Accordingly, our data demonstrate that dietary LF has an antithrombotic effect in vivo." ⁷²

"We have previously demonstrated that purified ginsenosides produce pulmonary vasodilation and prevent effects of free radical injury on the lung. Undigested, gastric digested and combined gastric and intestinal digested G115 significantly dilated lungs. We examined the effect of artificially digested standardized ginseng preparation G115 in perfused rabbit lungs…. Artificially digested G115 is a pulmonary vasodilator which protects against free radical injury, suggesting that oral G115 has the same effects." ⁷³

"Two experiments using different concentrations of dexamethasone were performed in this study resulting in significantly decreased AST and ALT levels in dexamethasone-treated rats. It implies that ginseng has a liver-protective effect. Meanwhile, ginseng therapy restores the adrenal and thyroid functions of rats inhibited by dexamethasone treatment." ⁷⁵

In a study treatment with Rbl and Rgl elicited an obvious decrease of [Ca2+]i content, especially in aged rats. In addition, Rb1 and Rgl significantly stimulated the activity of Na+, K+-ATPase while Rbl inhibited the activity of Ca2+, Mg2+-ATPase and calmodulin. In view of the close relationship of [Ca2+]i level with aging, the changes of [Ca2+]i induced by Rbl and Rgl, as shown by our results, might provide an explanation of the mechanisms of their antiaging function." ⁷⁶

"….in Radix Ginseng treated human myocardial cell cultures the level of LDH and SDH elevated in varying degrees and in Radix Ginseng treated cells the cAMP showed higher levels but in Radix Ginseng treated ones the same was not observed. This suggests that the metabolism of myocardial cells is enhanced by Radix Ginseng." ⁷⁹

"Effects of the tissue cultured and cultivated ginseng on gastric secretion and pepsin activity were investigated. Fifty percent ethanol extracts of both cultured and cultivated ginsengs reduced gastric secretion and acid output in pylorus-ligated rats. They did not affect pepsin activity…. These results suggest that both tissue cultured and cultivated ginsengs may have an inhibitory effect on gastric secretion. The effect seems to be due to the inhibition of acid secretion via the central nervous system." ⁸¹

"The study was undertaken to determine the antagonism of morphine analgesia by the standardized ginseng extract G115 from Panax ginseng, the inhibitory effects of orally administered G115 on the development of morphine-induced tolerance and physical dependence, the hepatic glutathione levels, the inhibitory effects of intraperitoneally administered G115 on the dopamine receptor supersensitivity, and the reverse tolerance to the locomotor accelerating effect of morphine. G115 significantly inhibits the development of morphine-induced tolerance and physical dependence, the hepatic glutathione level decrease induced by morphine multiple injections, the development of morphine-induced dopamine receptor supersensitivity, and reverse tolerance to the locomotor accelerating effect of morphine. It did not, however, antagonize morphine analgesia." ⁸²

"From a water extract of the Oriental crude drug "ninjin" (ginseng), Panax ginseng roots from Nagano, Japan, five glycans, panaxans Q, R, S, T and U, have been obtained. These constituents displayed marked hypoglycemic action in normal and alloxan-induced hyperglycemic mice." ⁸⁸

 

Systemic Bioavailability—

"The uptake and metabolism of ginsenoside Rh2 (Rh2) by B16 melanoma cells were studied… The effects of Rh2 and