Ginseng Lexi Nash, Purdue College of Pharmacy

SCIENTIFIC NAME Panax ginseng, Panax quinquefolius L 2

Lexi Nash; Student Pharmacist

COMMON NAMES American ginseng, Asian ginseng, Canadian ginseng, Chinese ginseng, Korean ginseng, Oriental ginseng, Radix ginseng2

COMMON USES Ginseng root has been used in the treatment of asthenia (abnormal physical weakness or lack of energy), atherosclerosis (thickening/hardening of the arteries caused by plaque buildup), blood and bleeding disorders, erectile dysfunction, hypertension (high blood pressure), liver dysfunction, and colitis (inflammation of the inner lining of the colon). The root can also be used to relieve the effects of aging, cancer, postmenopausal disorder, and senility. 2

Ginseng root also has a strengthening effect that can be used to raise mental and physical capacity. 2

The root also has protectant effects against stress, diabetes, neurosis, radiation sickness, and some cancers. 2

DOSAGE FORMS Ginseng root can be chewed, taken as a capsule, powder, liquid extract, decoction/tea, or infusion. 2,4

DOSE Dried root powder: take 500 milligrams to 2 grams daily up to 3 months Solid extract: take 200-600 milligrams daily Tea: drink one cup 1 to 3 times daily for 3 to 4 weeks 4

PHARMACOLOGY Ginseng root contains triterpene saponins, polyacetylenes, sesquiterpenes, polysaccharides, peptidoglycans, nitrogen-containing compounds, fatty acidic, carbohydrates, and phenolic compounds. The triterpene saponins have a stress-protective effect and are the most active compounds in the root. The saponins are metabolized by the gut microflora and its metabolite products are pharmacologically active. However, differences in a person’s gut flora may lead to differing pharmacological responses to the ginseng root. 2

BACKGROUND/HISTORY Ginseng has been used medicinally for over 2,000 years. It is the most widely recognized plant used in traditional medicine and the herbal health care market. There are three classifications of ginseng: fresh, white (dried after peeling), and red (steamed and dried). Ginseng root has a man-shaped figure, which made ancient European herbalists believe it had the properties to heal or strengthen any part of the body. Additionally, the word Panax found in its scientific name is derived from the Greek word “all-healing”. 2

Figure 1: Ginseng Root 1

Lexi Nash; Student Pharmacist

EFFECTIVENESS Ginseng has a range of effects that have been determined through a clinical trial or lack thereof. Ginseng has been determined possibly effective for cognitive function, diabetes, erectile dysfunction, immunostimulation, male infertility, quality of life, and reduction of blood alcohol concentrations. It has been deemed ineffective for exercise performance and human immunodeficiency virus. There is inconclusive data for its effectiveness in cancer, cardiovascular disease, hyperlipidemia, and menopause. 4

SAFETY/WARNINGS/TOXICITIES Ginseng root could cause hypersensitivity reactions. Caution should be taken in patients with diabetes for ginseng may lower blood sugar levels and in hyperactive patients who are taking stimulants such as caffeine. The root may also increase blood pressure and alter control in patients with hypertension. Additionally, ginseng may interfere with blood coagulation, so it should be discontinued 1-2 weeks before surgery. 4

ADVERSE/SIDE EFFECTS Ginseng can cause the following adverse effects: edema, headache, nausea, vomiting, chest tightness, ginseng abuse syndrome, gastrointestinal upset, hypertension, hypotension, euphoria, nervousness, insomnia, mania, skin eruptions, estrogenic effects, vaginal bleeding, hypoglycemia. 4

INTERACTIONS Drug-Drug: albendazole, anticoagulants, antidiabetic agents, estrogen, imatinib, loop diuretics, monoamine oxidase inhibitors, nifedipine, opioid analgesics Drug-Food: ethanol 4

SUMMARY OF ONE ARTICLE/STUDY A randomized, double-blind, placebo-controlled trial was performed to determine the antifatigue effects of Panax ginseng. In the study, 90 participants (21 men, 69 women) with chronic fatigue took either 1-2 grams of ginseng extract or the placebo for 4 weeks. Fatigue was then monitored using a self-rating numeric scale (NRS), a visual analog scale (VAS), and the patient’s serum levels were measured. After 4 weeks, participants who took 2 grams of ginseng extract showed a significantly higher mental NRS score, reduced VAS score, and reduced reactive oxidative species in serum than those who took the placebo. This indicates that Panax ginseng has antifatigue effects. 3

PROFESSIONAL/PERSONAL OPINION I think it is reasonable for a patient to try ginseng for any of its common uses. However, before using ginseng supplements, the patient should talk to their doctor and ask for recommendations on what brand/where to buy them. This would ensure the authenticity and efficacy of the product. ~L Nash

REFERENCES (1) Ginlac. Korean Ginseng. Accessed February 21, 2022. https://www.ginlac.eu/en/korean-ginseng/ (2) Ginseng, Natural Products Database. Facts & Comparisons eAnswers. Wolters Kluwer Health, Inc. Riverwoods, IL. Accessed February 19, 2022. http://online.factsandcomparisons.com (3) Kim HG, Cho JH, Yoo SR, et al. Antifatigue effects of Panax ginseng C.A. Meyer: a randomised, double-blind, placebocontrolled trial. PLoS One. 2013;8(4):e61271. Published 2013 Apr 17. doi:10.1371/journal.pone.0061271 (4) Panax Ginseng. IBM Micromedex Solutions. Truven Health Analytics, Inc. Ann Arbor, MI. Accessed February 19, 2022. http://www.micromedexsolutions.com