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 market in the United States because of significant adverse effects.
Claims for Ginseng
Ginseng is said to reduce plasma glucose levels; increase high-density lipoprotein (HDL), hemoglobin, and protein levels; and enhance the immune system. Other claims include that it has anticancer, cardiotonic, and estrogenic effects; it acts directly on the endocrine and central nervous systems; enhances physical (including sexual) performance and mental function; and is said to have adaptogenic effects (ie, those that increase energy and resistance to the harmful effects of stress and aging).
Evidence for Ginseng
Studies of ginseng have proposed several benefits, including the following:
Enhancement of immune function (1, 2)
Shortening duration of cold symptoms (3 )
Anticarcinogenic effects (4)
Decreasing blood glucose in patients with diabetes and prediabetes (5)
Improvement of cognitive function (6).
Fatigue (7)
A randomized trial using a combination of Asian and American ginseng reported improvement in blood pressure and glycemic parameters, including hemoglobin A1C, as well as lipids, possibly demonstrating complementary effects of combination treatment (8).
A Cochrane review that included 9 studies (587 participants) suggested that ginseng may improve erectile function when compared to a placebo.(9).
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 may be varying effects, depending on whether the supplement used is American ginseng or Panax ginseng, and sometimes ginseng combinations are used in clinical studies. There is no evidence supporting other health claims for ginseng.
Adverse Effects of Ginseng
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 with Ginseng
Ginseng can interact with antihyperglycemic medications, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, digoxin, estrogens, monoamine oxidase inhibitors, and warfarin.
Ginseng may also increase serum concentrations of certain drugs. For instance, ginseng can increase levels of imatinib and raltegravir, causing liver toxicity. If ginseng is combined with certain antiarrhythmic drugs, such as amiodarone or thioridazine, arrhythmias may occur.
(See also table Some Possible Dietary Supplement–Drug Interactions.)
Довідкові матеріали
1. 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 Res.41(4):435-443, 2016. doi: 10.1016/j.jgr.2016.08.004
2. Ratan ZA, Youn SH, Kwak YS, Han CK, Haidere MF, Kim JK, Min H, Jung YJ, Hosseinzadeh H, Hyun SH, Cho JY. Adaptogenic effects of Panax ginseng on modulation of immune functions. J Ginseng Res. 2021 Jan;45(1):32-40. doi: 10.1016/j.jgr.2020.09.004
3. 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
4. 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
5. Naseri K, Saadati S, Sadeghi A, Asbaghi O, Ghaemi F, Zafarani F, Li HB, Gan RY. The Efficacy of Ginseng (Panax) on Human Prediabetes and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients. 2022 Jun 9;14(12):2401. doi: 10.3390/nu14122401
6. 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
7. 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
8. Jovanovski E, Smircic-Duvnjak L, Komishon A, Au-Yeung FR, Sievenpiper JL, Zurbau A, Jenkins AL, Sung MK, Josse R, Li D, Vuksan V. Effect of coadministration of enriched Korean Red Ginseng (Panax ginseng) and American ginseng (Panax quinquefolius L) on cardiometabolic outcomes in type-2 diabetes: A randomized controlled trial. J Ginseng Res. 2021 Sep;45(5):546-554. doi: 10.1016/j.jgr.2019.11.005
9. Lee HW, Lee MS, Kim TH, et al. Ginseng for erectile dysfunction. Cochrane Database Syst Rev. 4(4):CD012654, 2021. Published 2021 Apr 19. doi:10.1002/14651858.CD012654.pub2
Додаткова інформація
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