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Ginseng

By

Laura Shane-McWhorter

, PharmD, University of Utah College of Pharmacy

Last full review/revision Jul 2020| Content last modified Jul 2020
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Ginseng is a family of plants. Dietary supplements are derived from American ginseng (Panax quinquefolius) or Asian ginseng (Panax ginseng). Siberian ginseng (Eleutherococcus senticosus) is a different genus and does not contain the ingredients believed to be active in the 2 forms used in supplements.

Ginseng can be taken as fresh or dried roots, extracts, solutions, capsules, tablets, sodas, and teas or used as cosmetics. Active ingredients in American ginseng are panaxosides (saponin glycosides). Active ingredients in Asian ginseng are ginsenosides (triterpenoid glycosides).

Many ginseng products contain little or no detectable active ingredient. In very few cases, some ginseng products from Asia have been purposefully mixed with mandrake root, which has been used to induce vomiting, or with the drugs phenylbutazone or aminopyrine. These drugs have been removed from the US market because of significant adverse effects.

Claims

Ginseng is said to enhance physical (including sexual) and mental performance and to have adaptogenic effects (ie, to increase energy and resistance to the harmful effects of stress and aging). Other claims include reduction in plasma glucose levels; increases in high-density lipoprotein (HDL), hemoglobin, and protein levels; stimulation of the immune system; and anticancer, cardiotonic, endocrine, central nervous system, and estrogenic effects. Another claim is possible beneficial effects on immune function.

Evidence

Studies of ginseng have shown varying effects and limitations and include the following:

  • Enhancement of immune function via modulation of inflammatory cytokines (1)

  • Anticarcinogenic effects (2)

  • Decreases in blood glucose (3)

  • Improvement of cognitive function (4)

  • Fatigue (5)

A systematic review of 5 studies (747 subjects) found no evidence that ginseng decreased the incidence or severity of colds, but ginseng did shorten cold duration (6).

A 2010 Cochrane review of 9 randomized, double-blind, placebo-controlled trials evaluated the efficacy and adverse effects of ginseng supplementation taken to improve cognitive function in healthy participants (8 trials) and those with age-associated memory impairment (1 trial) (4). The analysis found no serious adverse events with ginseng supplementation, but there was no convincing evidence for enhanced cognitive function in healthy participants or people with diagnosed dementia. A longitudinal Korean study found that ginseng intake > 5 years may benefit cognition in community-dwelling older adults (7).

Larger trials are needed to evaluate the effectiveness of ginseng. Also, further evaluation of the compounds found in the supplements is necessary to determine the components responsible for the observed beneficial effects. There is no evidence supporting other health claims for ginseng.

Adverse effects

Nervousness and excitability may occur but decrease after the first few days. Ability to concentrate may decrease, and plasma glucose may become abnormally low (causing hypoglycemia). Because ginseng has an estrogen-like effect, women who are pregnant or breastfeeding should not take it, nor should children. Occasionally, there are reports of more serious effects, such as asthma attacks, increased blood pressure, palpitations, and, in postmenopausal women, uterine bleeding. To many people, ginseng tastes unpleasant.

Drug interactions

Ginseng can interact with antihyperglycemic drugs, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, digoxin, estrogens, monoamine oxidase inhibitors, and warfarin.

Ginseng references

  • Kim JH, Yi Y-S, Kim M-Y, et al: Role of ginsenosides, the main active components of Panax ginseng, in inflammatory responses and diseases. J Ginseng Res41(4):435-443, 2016. doi: 10.1016/j.jgr.2016.08.004.

  • Yun TK, Zheng S, Choi SY, et al: Non-organ-specific preventive effect of long-term administration of Korean red ginseng extract on incidence of human cancers. J Med Food 13(3):489-494, 2010. doi: 10.1089/jmf.2009.1275.

  • Shishtar E, Sievenpiper JL, Djedovic V, et al: The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials. PLoS One 9(9):e107391, 2014. doi: 10.1371/journal.pone.0107391.

  • Geng J, Dong J, Ni H, et al: Ginseng for cognition. Cochrane Database Syst Rev (12):CD007769, 2010. doi: 10.1002/14651858.CD007769.pub2.

  • Arring NM, Millstine D, Marks LA, et al: Ginseng as a treatment for fatigue: a systematic review. J Altern Complement Med 24(7):624-633, 2018. doi: 10.1089/acm.2017.0361.

  • Seida JK, Durec T, Kuhle S: North American (Panax quinquefolius) and Asian ginseng (Panax ginseng) preparations for prevention of the common cold in healthy adults: a systematic review. Evid Based Complement Alternat Med 2011:282151, 2011. doi: 10.1093/ecam/nep068. 

  • Lho SK, Kim TH, Kwak KP, et al: Effects of lifetime cumulative ginseng intake on cognitive function in late life. Alzheimers Res Ther 10(1):50, 2018. doi: 10.1186/s13195-018-0380-0.

More Information

The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

Click here for Patient Education
NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version

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