Image for Ginseng (American ginseng, Asian ginseng, Chinese ginseng, Korean red ginseng, Panax ginseng: Panax spp., including P. ginseng and P. quinquefolius, excluding Eleutherococcus senticosus)
Ginseng (American ginseng, Asian ginseng, Chinese ginseng, Korean red ginseng, Panax ginseng: Panax spp., including P. ginseng and P. quinquefolius, excluding Eleutherococcus senticosus)
Natural Standard Flashcard. Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This flashcard is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Summary

  • Ginseng refers to several species of the genus Panax. The two most commonly used species are Asian ginseng and American ginseng. Panax species should not be confused with Siberian ginseng, which is from a different plant family.
  • Panax ginseng has been used in traditional Chinese medicine (TCM) for more than 2,000 years. It has been used to increase appetite and strength, enhance memory and physical performance, reduce fatigue and stress, and improve overall quality of life.
  • American ginseng (Panax quinquefolius) has been used as a folk remedy by many Native American tribes for illness including headaches, fever, and earache.
  • Ginseng has been used traditionally as a treatment for cancer and, in modern times, to prevent cancer. There is good evidence for ginseng use in decreasing cold symptoms and improving mental performance.
  • The active ingredients of Panax are ginsenosides. When buying ginseng products, most experts recommend looking for a product labeled as Panax ginseng.

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grade*

GRADING SYSTEM LINK

Immune enhancer

B

Mental performance

B

Adaptogen (resist effects of stress)

C

Alzheimer's disease

C

Aplastic anemia (blood marrow disorder)

C

ADHD

C

Bad breath

C

Birth outcomes (brain damage due to lack of oxygen)

C

Blood clotting disorders

C

Cancer treatment (used with chemotherapy)

C

Cancer prevention

C

Cardiomyopathy (disease of the heart muscle)

C

Chronic hepatitis B

C

Coronary artery disease

C

Dementia

C

Fatigue

C

Fistula (abnormal opening between organs)

C

Heart attack

C

Heart conditions

C

Heart disease (present at birth)

C

Heart failure

C

Heart infection caused by virus

C

High blood pressure

C

High blood sugar in healthy people

C

High cholesterol

C

HIV (used with common therapy)

C

Kidney disease in diabetes

C

Kidney disorders

C

Liver protection

C

Lung disease

C

Menopause

C

Nervous system disorders

C

Osteoarthritis (joint disorder)

C

Pregnancy (problems with baby development)

C

Pressure inside the skull

C

Quality of life

C

Radiation side effects

C

Recovery from surgery (breast cancer)

C

Recovery from surgery (liver cancer)

C

Sexual arousal (in women)

C

Sex drive/erectile dysfunction

C

Sleep

C

Staph infection (MRSA)

C

Stress

C

Stroke prevention

C

Swollen tonsils

C

Type 2 diabetes

C

Weight loss

C

Well-being

C

Wrinkle prevention

C

Exercise performance

D

Safety

  • Over-the-counter ginseng-containing combination products may be contaminated with phenylbutazone and aminopyrine.
  • Use cautiously in patients taking agents that raise or lower blood pressure, in patients with diabetes or low blood sugar or those taking agents that affect blood sugar, in patients using drugs processed by the liver, in people using estrogens, in patients with immune disorders or those using immunosuppressants, in patients using agents that may increase the risk of abnormal heart rhythms, in those with fair skin or using light-sensitizing agents, in patients with mental health disorders, in patients taking opiates or phenelzine, in patients prone to seizures, in those with sleep or "heat" disorders, and in children. Use cautiously during the time before, during, and after surgery.
  • Avoid in patients with bleeding disorders or those taking agents that may increase the risk of bleeding. Avoid in patients with known allergy to Panax species, their components, or to other members of the same plant family. Avoid in pregnant or breastfeeding women. Avoid use of large amounts in infants.

Possible side effects

  • Absence of menstrual period, agranulocytosis (bone marrow failure), agitation, asthma, breast symptoms (pain, enlargement, nipple enlargement, breast enlargement in men), breathing problems, chest pain, damage to unborn baby, decreased or increased heart rate, delayed ejaculation, depression, dizziness, drowsiness, dry mouth, enhanced blood alcohol clearance, enhanced sexual performance/responsiveness, erectile dysfunction, excitability, euphoria, eye disturbances (pupil dilation, difficulty focusing), fever, flushing, gastrointestinal symptoms (abdominal pain, bloating, constipation, diarrhea, discomfort, heartburn, loss of appetite, nausea, vomiting), headache, immune-stimulating effects, increased motor and cognitive function, inflammation of the brain arteries (reversible), insomnia, irritability, jaundice, light protection/sensitization, liver toxicity, migraine, muscle and joint pain, neonatal androgenization (after maternal use, developing male characteristics in the baby), neonatal intoxication and death, nervousness, restlessness, runny nose, sedation, skin reactions (dermatitis, eczema, rash, skin eruptions, rose spots, itching, mild pain and burning, hives, Stevens-Johnson syndrome), sleep disorders (trouble falling or staying asleep), throat irritation, temporary loss of blood flow to the brain after a high blood pressure crisis, and trembling.

Possible interactions

  • ACE inhibitors; acupuncture; alcohol; agents for allergy, anxiety, asthma, cancer, cholesterol, depression, inflammation, obesity, psychosis, vomiting, ulcers and viral, fungal, or parasitic infections; agents processed by the liver or may damage the liver; agents that affect blood pressure; agents that affect the heart, nervous, and immune systems; agents that cause sensitivity to light; agents that dilate blood vessels; agents that increase sex drive; agents that increase the risk of abnormal heart rhythms; agents that increase the risk of bleeding; agents that lower blood sugar; agents that protect against radiation; Alzheimer's agents; antibiotics; antioxidants; ashwagandha (Withania somnifera); astragalus; caffeine; calcium channel blockers; cardiac glycosides; Carthamus tinctorius; dehydroepiandrosterone (DHEA); disulfiram (Antabuse®); diuretics (improve urine flow); epicatechin; Ginkgo biloba; glycyrrhiza; guarana; hypnotics; impotence agents; influenza vaccine; mate; metronidazole; numbing agents; opiates; pain relievers; phenelzine; phenytoin; protease inhibitors; red clover; sedatives; steroids; stimulants; vitamin C; or herbs and supplements with similar effects.

Dosing

Adults (18 years and older)

  • Ginseng has been taken by mouth as Panax ginseng, American ginseng (Panax quinquefolius), Korean red ginseng, Panax notoginseng, capsules of root extract or powder, shengmai yin (Panax ginseng, Schisandra fruit, and Ophiopogon japonicus), ginseng-rhizome saponin, saponin Panax ginseng fruit (SPGF), Panax notoginseng extract, standardized ginseng extracts G115® and Cereboost™, alcohol extract, fresh Panax ginseng root, Korean red ginseng rootlets/body/water extract, combination product Ginkoba M/E®, and lactic acid bacteria-fermented ginseng.
  • Ginseng has been injected into the vein as ginseng, cultivated wild ginseng pharmacopuncture (CWGP), xuesaitong injection (Panax notoginseng preparation), ginseng polysaccharides, and shenmai injection (Panax ginseng, Schisandra fruit, and Ophiopogon japonicus).

Children (under 18 years old)

  • There is no proven safe or effective dose for ginseng in children.
  • Panax ginseng has been taken by mouth and ginsenoside compound has been injected into the vein.
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.