Ginseng is any one of eleven distinct species of slow-growing perennial plants with fleshy roots, belonging to the Panax genus in the family Araliaceae. It grows in the Northern Hemisphere in eastern Asia (mostly Korea, northern China (Manchuria), and eastern Siberia), typically in cooler climates; Panax vietnamensis, discovered in Vietnam, is the southernmost ginseng found. This article focuses on the Series Panax ginsengs, which are the adaptogenic herbs, principally Panax ginseng and P. quinquefolius. Ginseng is characterized by the presence of ginsenosides.
Siberian Ginseng (Eleutherococcus senticosus) is in the same family, but not genus, as true Ginseng. Like Ginseng, it is considered to be an adaptogenic herb. The active compounds in Siberian Ginseng are eleutherosides, not ginsenosides. Instead of a fleshy root, Siberian Ginseng has a woody root
Both American ginseng (Panax quinquefolius) and Asian ginseng (Panax ginseng) roots are taken orally as adaptogens, aphrodisiacs, nourishing stimulants, and in the treatment of type II diabetes, as well as for sexual dysfunction in men. The root is most often available in dried form, either whole or sliced. Ginseng leaf, although not as highly prized, is sometimes also used; as with the root, it is most often available in dried form.
This ingredient may also be found in some popular energy drinks, often the “tea” varieties; in these products, ginseng is usually present in subclinical doses and does not have measurable medicinal effects. It can be found in cosmetic preparations as well, but has not been shown to have clinically effective results.
Modern science and ginseng
Ginsenosides are the active compounds that distinguish the Panax species. However, even though the root of the ginseng plant is the most valued form, it is the leaves that contain the highest amounts of ginsenosides. Therefore, the measure of potency and purity for ginseng products by the levels of ginsenosides is a poor determinant. There are many manufacturers of ginseng products who, knowingly or unknowingly, actually use counterfeit products or ginseng leaves instead of roots. Herbal companies who follow Good Manufacturing Practices (GMP) regularly test for the quality, potency, and species authentication of herbs using cross-sectional microscopic examination, thin layer chromatography, and high performance liquid chromatography (HPLC). One study found HPLC is especially useful in the differentiation and authentication of Panax ginseng from Panax quinquefolius due to the unambiguous distinction of slightly varying isotypes of ginsenoside compounds.
Ginseng is noted for being an adaptogen, one which can, to a certain extent, be supported with reference to its anticarcinogenic and antioxidant properties. Some animal experiments to determine whether longevity and health were increased in the presence of stress gave negative results.
Many studies have been done with varying results using only ginseng extracts. However, when ginseng is used in combination with other traditional Chinese herbs, the synergistic effects had many more definitive and positive results. For example, Si Jun Zi Tang, a very popular traditional Chinese formula, the main ingredient of which is ginseng, has been shown in multiple studies to have radioprotective effects, preventing a decrease in the hematocrit during radiotherapy.
In research, it has been difficult to either verify or quantify the exact medicinal benefits of ginseng using science, as there are contradictory results from different studies, possibly due to the wide variety and quality of ginseng used in the tests. High-quality studies of the effects of ginseng in the United States are rare. However, many high-quality, double blind, randomized controlled trials have been done in Asian countries, such as China, Taiwan and Japan.
American ginseng (Panax quinquefolius), similar to Panax ginseng in that they both contain the active component ginsenoside, is distinguished in traditional Chinese medicine theory by having a cold property while the property of ginseng is warm. Japanese ginseng, though the same species as ginseng, is thought to have cooling properties similar to American ginseng due to the difference in cultivation environment. (cite M5050) American ginseng has been shown in various studies to have a beneficial effect for diabetes in the regulation of blood sugar levels.
A comparative, randomized and double-blind study at the National Autonomous University of Mexico indicated it may be “a promising dietary supplement” when assessed for an increase in quality of life.
A recent study at the University of Hong Kong has identified ginseng to have anti-inflammatory effects. The study found of the nine ginsenosides they identified, seven could selectively inhibit expression of the inflammatory gene CXCL-10.
P. ginseng appear to inhibit some characteristics associated with cancer in animal models; nevertheless, this effect is unclear in humans. A randomized, double-blind pilot study noted Ginseng appeared to reduce fatigue in cancer patients.
There are references in literature, including authoritative compendia, that show interactions with ginseng. Herbalist Jonathan Treasure of the British National Institute of Medical Herbalists traces the growth of misinformation on an alleged adverse herb-drug interaction between the monoamine oxidase inhibitor phenelzine and Asian ginseng (P. ginseng C.A. Meyer). This originally was mentioned in a 1985 editorial by Shader and Greenblatt in the Journal of Clinical Psychopharmacology. Shader and Greenblatt devoted a couple of lines to the case of a 64-year-old woman who took an undisclosed dose for an undisclosed time of a dietary supplement product called “Natrol High” while concurrently taking phenelzine 60 mg qd. She experienced symptoms of “insomnia, headache, and tremulousness”. Treasure contacted Natrol by e-mail and discovered within ten minutes that there was no P. ginseng in the formula, but instead Eleutherococcus senticosus which was then called by the popular name “Siberian ginseng”, and it was given in a subclinical dosage mixed with a variety of other herbs. The purported interaction effects are well-known side effects of phenelzine alone, which had been given in a high dosage and are not at all suggestive of Eleutherococcus. However, this misinformed article with a misidentified herb has been picked up in literature searches and megastudies, and is now documented by conventional medical authorities, such as Stockley’s, and is repeated in several botanical monographs, e.g. World Health Organization (WHO 1999).
Ginseng and reproductive activity
A 2002 study by the Southern Illinois University School of Medicine (published in the annals of the New York Academy of Sciences) found that in laboratory animals, both Asian and American forms of ginseng enhance libido and copulatory performance. These effects of ginseng may not be due to changes in hormone secretion, but to direct effects of ginseng or its ginsenoside components on the central nervous system and gonadal tissues. In males, ginsenosides can facilitate penile erection. This is consistent with traditional Chinese medicine and Korean medicine medicinal uses of ginseng.
Ginseng is known to contain phytoestrogens. In some studies, ginseng has been demonstrated to have a stimulating effect on the pituitary gland to increase the secretion of gonadotropins. Another study found that in young mice, it speeds up the development of reproductive organs, while in adult male mice, it stimulates the production of sperm, and lengthens the estrus period in female mice.
Use with other medications
Although generally well tolerated, caution is advised when consuming ginseng along with over-the-counter or prescription drugs.
According to a Sports Nutrition FAQ published by UMass Amherst, one of P. ginseng’s most common side effects is the inability to sleep. However, other sources state ginseng causes no sleep difficulties.Other side effects can include nausea, diarrhea, headaches, nose bleeds, high blood pressure, low blood pressure, and breast pain.Ginseng may also lead to induction of mania in depressed patients who mix it with antidepressants.
The common adaptogen ginsengs (P. ginseng and P. quinquefolia) are generally considered to be relatively safe even in large amounts. One of the most common and characteristic symptoms of acute overdose of Panax ginseng is bleeding. Symptoms of mild overdose with Panax ginseng may include dry mouth and lips, excitation, fidgeting, irritability, tremor, palpitations, blurred vision, headache, insomnia, increased body temperature, increased blood pressure, edema, decreased appetite, increased sexual desire, dizziness, itching, eczema, early morning diarrhea, bleeding, and fatigue.
Symptoms of gross overdose with Panax ginseng may include nausea, vomiting, irritability, restlessness, urinary and bowel incontinence, fever, increased blood pressure, increased respiration, decreased sensitivity and reaction to light, decreased heart rate, cyanotic facial complexion, red face, seizures, convulsions, and delirium.
It is possible to treat an overdose with an herbal decoction of 120 grams of gan cao (Radix glycrrhizae). However, patients experiencing any of the above symptoms are advised to discontinue the herbs and seek any necessary symptomatic treatment
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