Latin name: Panax ginseng
Pharmacopoeial name: Ginseng radix
Other names: Asian Ginseng, Chinese Ginseng; Korean Ginseng
About Panax Ginseng
Panax ginseng is one of the most commonly used and highly researched species of ginseng. This species, which is native to China, Korea, and Russia, has been an important herbal remedy in traditional Chinese medicine for thousands of years, where it has been used primarily as a treatment for weakness and fatigue (1)
The main active agents in Panax ginseng are ginsenosides, which are triterpene saponins. The majority of published research on the medicinal activity of Panax ginseng has focused on ginsenosides (2). These are the compounds to which some ginseng products are now standardized.
Ginseng products are popularly referred to as “tonics,”a term that has been replaced by “adaptogens”in much of the alternative medicine literature. The term “adaptogen” denotes an agent that purportedly “increases resistance to physical, chemical, and biological stress and builds up general vitality, including the physical and mental capacity for work.” (3)
Research reviews suggest that extracts of Panax ginseng affect the hypothalamus-pituitary-adrenal axis and the immune system, which could account for many of the documented effects (1,4). Animal models and in vitro studies mentioned in these reviews, indicate that Panax ginseng enhances phagocytosis, natural killer cell activity, and the production of interferon; improves physical and mental performance in mice and rats; causes vasodilation; increases resistance to exogenous stress factors; and affects hypoglycaemic activity.
Panax ginseng is used primarily to improve psychological function, exercise performance, immune function, and conditions associated with diabetes. Traditional Chinese medicine and many current research studies often use products that combine ginseng with other herbal medicines or vitamins (5-8). Because of the use of combination products and the limitations of some studies on ginseng (e.g., poor methodological quality, research focusing on healthy volunteers, small sample size, unstandardized ginseng preparations, varying doses),it is difficult to draw conclusions about some of the clinical effects of ginseng.
Uses of Panax Ginseng
Psychological Function
Trials investigating the effects of Panax ginseng on various psychological parameters have shown positive effects, no effects, or both. In one study of 112 healthy volunteers older than 40 years, the administration of 400 mg per day of a standardized ginseng for eight weeks resulted in better and faster simple reactions and abstract thinking, but no change in concentration, memory, or subjective experience (9). The results of two small studies, each including about 30 young, healthy volunteers who received 200 mg of Panax ginseng extract daily for eight weeks, showed improvement in certain psychomotor functions (i.e., better attention, processing ,and auditory reaction time),social functioning, and mental health (10,11).
A study of 384 postmenopausal women who were randomized to receive placebo or ginseng for 16 weeks showed improvements in three subsets of a Psychological General Well-Being index (12).
In addition, a small study of 20 healthy young volunteers who received a single 400-mg dose of ginseng found improvement in cognitive performance, secondary memory performance, speed of performing memory tasks, and accuracy of attentional tasks .However, another study showed no effect on positive affect, negative affect, or total mood disturbance in 83 young healthy volunteers who took 200 to 400 mg per day of standardised extract for eight weeks (13).
Physical Performance
Most of the clinical studies investigating the value of Panax ginseng in enhancing physical performance have shown no clinical effect (14). One study on the use of 200 mg per day of standardised extract in 19 healthy adult women showed no change in physical work performance, energy metabolic responses, or oxygen uptake (15). Similarly, a study of 31 healthy men who took 200 or 400 mg of the same extract daily for eight weeks found no change in physiologic or psychological responses to submaximal or maximal exercise (16).
In another study,a different product standardized to 7% ginsenosides and administered at 200 mg per day was given to 28 healthy young adults for 21 days (17). No ergogenic effects were demonstrated, including no change in maximal oxygen consumption, exercise time, workload, plasma lactate level, haematocrit, or heart rate.
Immune System
A study of 227 healthy volunteers demonstrated that daily administration of 100 mg of standardised extract for 12 weeks enhanced the efficacy of polyvalent influenza vaccine (18). The patients who received ginseng had a lower incidence of influenza and colds, higher antibody titres, and higher natural killer cell activity levels. Another study in 60 healthy volunteers showed enhanced chemotaxis, phagocytosis, increased total lymphocyte count, and increased numbers of T helper cells in those who received a dosage of 100 mg twice daily for eight weeks (19). In a study of 75 patients with acute exacerbation of chronic bronchitis who were treated with antibiotics or antibiotics plus ginseng, those in the ginseng group showed faster bacterial clearance (20).
Diabetes
The effects of Panax ginseng, given in a dosage of 100 or 200 mg per day for eight weeks, were studied in 36 patients with newly diagnosed non–insulin-dependent diabetes (21) The study showed improved fasting blood glucose levels, elevated mood, and improved psychophysical performance on a numbered diagram test. The 200-mg dose also resulted in improved haemoglobin A1C values.
Additional Uses
In 45 patients with erectile dysfunction, use of ginseng improved erectile function, sexual desire, and intercourse satisfaction (22).
Safety
Panax ginseng generally is well tolerated, and its adverse effects are mild and reversible (23) Associated adverse effects include nausea, diarrhoea, euphoria, insomnia, headaches, hypertension, hypotension, mastalgia, and vaginal bleeding (4,23,24) Panax ginseng may interact with caffeine to cause hypertension, and it may lower blood alcohol concentrations. It also may decrease the effectiveness of warfarin.
Keywords: psychological function, physical performance; immune system; diabetes; erectile dysfunction
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References
References
1. Mahady GB, Gyllenhall C, Fong HH, Farnsworth NR. Nutr Clin Care 2000;3:90-101.
2. World Health Organization. WHO monographs on selected medicinal plants. Geneva: World Health
Organization, 1999.
3. Robbers JE, Tyler VE. Tyler’s Herbs of choice: the therapeutic use of phytomedicinals. New York,
N.Y.: Haworth Herbal Press, 1999
4. Vogler BK, Pittler MH, Ernst E. Eur J Clin Pharmacol 1999;55:567-75.
5. Caso Marasco A, Vargas Ruiz R, Salas Villagomez Drugs Exp Clin Res 1996;22:323-9.
6. Pieralisi G, Ripari P, Vecchiet L. Clin Ther 1991;13:373-82.
7. Kennedy DO, Scholey AB, Wesnes KA. Physiol Behav 2002;75:739-51.
8. Wesnes KA, Ward T, McGinty A, Petrini O. Psychopharmacology 2000;152:353-61.
9. Sorensen H, Sonne J. Curr Ther Res Clin Exp 1996;57:959-68.
10. D’Angelo L, Grimaldi R, Caravaggi M, Marcoli M, Perucca E, Lecchini S, et al. J Ethnopharmacol 1986;16:15-22.
11. Ellis JM, Reddy P. Ann Pharmacother 2002;36:375-9.
12. Wiklund IK, Mattsson LA, Lindgren R, Limoni C. Int J Clin Pharmacol Res 1999;19:89-99.
13. Cardinal BJ, Engels HJ. J Am Diet Assoc 2001; 101:655-60.
14. Bahrke MS, Morgan WR. Sports Med 2000;29:113-33.
15. Engels HJ, Said JM, Wirth JC. Nutr Res [United States] 1996;16:1295-1305.
16. Engels HJ, Wirth JC. J Am Diet Assoc 1997; 97:1110-5.
17. Allen JD, McLung J, Nelson AG, Welsch M. J Am Coll Nutr 1998;17:462-6.
18. Scaglione F, Cattaneo G, Alessandria M, Cogo R. Drugs Exp Clin Res 1996;22:65-72.
19. Scaglione F, Ferrara F, Dugnani S, Falchi M, Santoro G, Fraschini F. Drugs Exp Clin Res 1990;16:537-42.
20. Scaglione F, Weiser K, Alessandria M. Clin Drug Invest [New Zealand] 2001;21:41-5.
21. Sotaniemi EA, Haapakoski E, Rautio A. Diabetes Care 1995;18:1373-5.
22. Hong B, Ji YH, Hong JH, Nam KY, Ahn TY. J Urol 2002;168: 2070-3.
23. Coon JT, Ernst E. Drug Saf 2002;25:323-44.
24. Ernst E. [published erratum appears in Ann Intern Med 2003;138:79]. Ann Intern Med 2002;136:42-53.
