Asian ginseng (Alina Arzumanian, Purdue Health and Human Sciences – Nursing

Alina Arzumanian, Nursing Student, Spring 2022

Scientific Name:

Panax Ginseng; Araliaceae (Araliaceae, 2021)

(Asian Ginseng, 2020)

Common Name: Asian ginseng (Araliaceae, 2021)

Background

Asian ginseng is one of the most widely recognized plants used in traditional medicine. It has been used for over 2,000 years for a variety of different uses. It is classified into white (dried after peeling), fresh, and red (steamed and dried). While there are many uses, today it is most used for apoptogenic or stress protective effect (Ginseng, 2021).

Purported/Common Uses

Effectiveness

o Water-soluble components make absorption quick and immediate after ingestion o Effects may be seen in a few days (Learn About Ginseng in 5 Minutes, 2020) o Not all studies of Asian ginseng are not high quality so the evidence there is of effectiveness is limited (Asian Ginseng, 2020)

Safety (Asian Ginseng, 2022)

o Likely safe—short-term use and oral use o Short term use: up to six months o Potentially not safe when used long-term (over six months) o Can be used safely in infants o Caution with use in pregnancy—contact HCP o Contact HCP before using if you take other medications o Other toxicities o Manic episodes, uterine bleeding, gynecomastia, long QT syndrome, atrial fibrillation, and hypertensive crisis (Ratan et al., 2021) Ginseng root is used for several different pathologies. It has been known for its apoptogenic, immunomodulatory, antineoplastic, cardiovascular, CNS, endocrine, and ergogenic effects (Ginseng, 2021).

Mechanism of Action

Studies have shown that much of Asian ginseng’s pharmacological effects come from ginsenosides. This includes the inhibitory and excitatory effects on the nervous system, antineoplastic effects, immunomodulatory effects, and nitric oxide release (Park et al., 2018).

Dosage Forms:

- Crude root powder in a capsule - Extract in liquid form

Typical Dosage:

- Crude root: 0.5-3 g/day - Extract: 100-800 mg

(Ginseng, 2021)

Interactions (Asian Ginseng, 2022) All of the following drugs have moderate interactions and may either be enhanced or decreased with use of Asian ginseng and vice versa: anticoagulants/antiplatelets, antidiabetic drugs, caffeine, cytochrome P450 1A1 (minor), 2D6, 3A4, estrogens, fexofenadine—minor, furosemide, Imatinib, Immunosuppressants, Insulin, lopinavir/ritonavir—minor, midazolam, monoamine oxidase inhibitors, nifedipine, QT Interval-prolonging drugs, raltegravir, selegiline, stimulant drugs, warfarin

(Asian Ginseng, 2022) General Side Effects

• Generally well tolerated when used for up to 6 months Cardiovascular Side Effects

• High BP • Low BP • Edema Dermatologic Side Effects • Oral--itching/hypersensitivity Endocrine Side Effects

• May be potential estrogenic effects GI Side Effects

• Decreased appetite • Diarrhea • Abdominal pain • Nausea

GU Side Effects

• Amenorrhea

Hepatic Side Effects • Uncommon: cholestatic hepatitis Immunologic Side Effects • Anaphylaxis--hypotension and rash Neurologic/CNS Side Effects • Insomnia: most common side effect

Based off my research, I believe that the pharmacological properties of Asian ginseng have been proven to have contributed to positive patient outcomes in the healthcare field. The clinical trials done have shown its benefits and have also shown its risks. These risks need to be taken into account when considering Asian ginseng in your medication regimen. It is important to contact your primary provider before taking this supplement due to its long list of drug interactions. Despite these interactions and side effects, I believe that ginsenosides, one of the more significant components of Asian ginseng, have demonstrated to be effective and safe for conditions involving the cardiovascular, endocrine, and neurologic system.

~A. Arzumanian Research: (Ratan et al., 2021) Ginseng has been used for disease treatment in East Asian countries for many years. Certain compounds in this herbal supplement have been found to have a therapeutic effect in hypertensive disorders, stress, and neurological disorders. A variety of bioactive components of this herbal supplement have contributed to its positive outcomes on disease processes. A research article explained that a double-blind randomized controlled clinical trial found that ginseng administration played a role in the significant decrease in the level of serum ROS and methane dicarboxylic aldehyde activity which are associated with certain types of cancers, asthma, atherosclerosis, diabetes, inflammatory joint diseases, dementia, and certain eye diseases. Additionally, another study within this article described that those who took ginseng after curative surgery found that they had a 35% higher chance of diseasefree living for 5 years and up to a 38% higher survival rate than those who did not. In terms of cardiovascular disease outcomes, ginseng has been shown to help maintain proper blood circulation and decrease blood pressure—contributing to a lower rate of heart failure and hypertensive conditions. Japan, Korea, and China have used Ginseng in treatment for diabetes mellitus and evidence has shown that it reduces fasting blood glucose as well as stimulating insulin secretion. This article concluded that ginseng has “great pharmaceutical potential to prevent and treat different diseases.”

Lexicomp. 2021. Ginseng. [online] Available at: <http://online.lexi.com.ezproxy.lib.purdue.edu/lco/action/doc/retrieve/docid/fc_rnp2/3750164?cesid=1gfcZqY29wd&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dginseng%26t%3Dname%26va%3Dginseng> [Accessed 23 February 2022].

Park, S., Park, J., Kim, H., Lee, C., Lee, H., Kang, K. and Kim, C., 2018. Systems-level mechanisms of action of Panax ginseng: a network pharmacological approach. Journal of Ginseng Research, [online] 42(1), pp.98-106. Available at: <https://www.sciencedirect.com/science/article/pii/S1226845317302634?via%3Dihub> [Accessed 23 February 2022].

Natural Medicines. 2022. Asian Ginseng. [online] Available at: <https://naturalmedicines-therapeuticresearch-com.ezproxy.lib.purdue.edu/databases/commercial-products/commercial-product.aspx?cpid=63237> [Accessed 23 February 2022].

National Center for Complementary and Integrative Health. 2020. Asian Ginseng. [online] Available at: <https://www.nccih.nih.gov/health/asian-ginseng> [Accessed 23 February 2022].

Feel. 2020. Learn About Ginseng in 5 Minutes. [online] Available at: <https://wearefeel.com/blogs/learn/what-is-ginseng> [Accessed 23 February 2022].

Ratan, Z., Haidere, M., Hong, Y., Park, S., Lee, J., Lee, J. and Cho, J., 2021. Pharmacological potential of ginseng and its major component ginsenosides. Journal of Ginseng Research, [online] 45(2), pp.199-210. Available at: <https://www.sciencedirect.com/science/article/pii/S1226845320300592> [Accessed 23 February 2022].

Araliaceae. 2021. [online] Available at: <https://en.wikipedia.org/wiki/Araliaceae> [Accessed 24 February 2022].