The English word ginseng is derived from a Chinese term that literally means “man root” because of its appearance. Ginseng root is usually found in dried form. It is a natural source for energy enhancement, making it a popular ingredient in energy drinks and supplements. Ginseng has been used for centuries in China, and then became popular in the 1800s in the United States. There have been studies to show ginseng can help with cancer prevention and lower diabetes risk but the FDA has not approved those uses. It can be found in capsule, liquid and tablet form.
The medicinal part is the dried root.
Flower and Fruit
The inflorescence is simple or branched with 1 to 3 umbels of 15 to 30 flowers. The flowers are androgynous and have greenish-yellow corollas. The ovary is inferior. The fruit is a pea-sized, globular-to-reniform, scarlet, smooth and glossy drupe, which contains 2 seeds.
Leaves, Stem, and Root
The plant is a perennial, and stands erect from 30 to 80 cm high. It has a smooth, round stem and bears terminal whorls of 3 to 5 palmate leaves. The leaflets are thin, finely serrate, gradually acuminate, 7 to 20 cm long and 2 to 5 cm wide. The rhizome tapers at the ends and is often palmate at the tip, giving it a humanlike form.
Panax ginseng is indigenous to China. It is cultivated in China, Korea, Japan and Russia.
Ginseng root consists of the dried main and lateral root and root hairs of Panax ginseng.
American Ginseng, Chinese Ginseng, Five-fingers, Korean Ginseng, Red Berry, Oriental Ginseng
Actions & Pharmacology
Aglycone (20S)-protopanaxadiol: including ginsenoside Ra1, Ra2, Ra3, Rb1, Rb2, Rb3, notoginsenoside R4, Rs1, Rs2, Rs3, Rs4, malonylginsenoside Rb1, Rc, Rd
Aglycone (20S)-protopanaxytriol: including ginsenoside Re, Rf, Rg1, notoginsenoside R1
Aglycone oleanolic acid: including ginsenoside Ro, chikusetsusasaponin-V Rb1, Rb2, Rc, Rd, Re, Rg1
Water-soluble polysaccharides: panaxane A to U
Polyynes: including falcarinol (panaxynol), falcarintriol (panaxytriol), examples estered with acetic acid or linolenic acid
The anti-inflammatory molecules in Ginseng capable of playing a key role in the inflammation-to-cancer sequence are elucidated in a 2007 Journal of Nutrition review, which among other evidence cites Ginseng's apparent induction of apoptosis and inhibition of cell proliferation and DNA damage. The herb's potent effects on the inflammatory cascade are described, and reference made to Ginseng's long, traditional use in countering cancers of the stomach, liver, pharynx, color, and pancreas (Hofseth, 2007).
The main active component in Ginseng consists of the ginsenosides, a diverse group of steroidal saponins. There are 25 ginsenosides that have been separated and detected based on the sugar unit sequences and aglycone moieties (Attele, 1999; Fuzzati, 1999; Wang, 1999). The ginsenosides demonstrate the ability to target a myriad of tissues, producing a variety of pharmaceutical responses quite different from one another. A single ginsenoside may initiate multiple or opposing actions in the same tissue, thus making the overall pharmacology of Ginseng complex (Attele, 1999). Commonly used to enhance physical and mental well-being, Panax ginseng has long been employed around the world for its adaptogenic qualities. It is primarily indicated in the treatment of fatigue, weakness, and mild depression, though studies also suggest a beneficial effect on serum glucose (Sotaniemi et al, 1995), cholesterol (Li & Zhang, 1988), and the immune system (Scaglione et al, 1996; Yun & Choi, 1990). Other clinical studies of Panax ginseng have examined its use against cancer, immunodepression, hyperlipidemia, for enhancement of cardiovascular status, and alleviating symptoms of climacteric in postmenopausal women. Panax ginseng has been used in China for various cardiac conditions including heart failure. Limited human studies showed positive results in the use of Panax ginseng to decrease blood glucose and hemoglobin A1c in noninsulin dependent diabetics. German Commission E has recommended a general duration of use of Ginseng of up to 3 months.
Ginseng was only slightly more effective than placebo and mostly not as effective as a good night's sleep in improving bodily feelings, mood, and fatigue in 12 fatigued night nurses (Hallstrom et al, 1982). Ginseng administration may have a normalizing effect on the body by increasing its natural resistance to physical, chemical, or biological stress without impairing physiological function. Histamine-like fractions and hormonal content, isolated from the Ginseng root, account for the estrogenic effect (Siegel, 1979).
In vitro, ginsenoside Rg3 displayed inhibitory activity against the human prostate carcinoma LNCaP cell line. Suppression occurred of the biomarker genes for prostate specific antigen, the androgen receptor, and 5 alpha reductase. Proliferating cell nuclear antigen was also suppressed (Liu et al, 2000). A protopanaxadiol component of Ginseng was shown to inhibit proliferation of pulmonary adenocarcinoma cells resistant to cisplatin (Lee, 1999). Ginsenoside-Rs4 and -Rs3 elevates protein levels of p53 and p21WAF1, which are associated with the induction of apoptosis in human hepatoma cells (Kim, 1999). Ginsenoside Rh2 induces apoptotic cell death in the glioma cell line through activation of caspase and production of oxygen species (Kim, 1999).
The antioxidant effects of Ginseng protect against oxidative DNA and protein (globin) damage caused by free radicals (Lee, 1998). Antioxidant activity of the herb also provides a hepatoprotective effect by increasing hepatic gluathione peroxidase activity (Voces, 1999). Antioxidant intervention by Ginseng is exerted by weak radical scavenging activity and stimulation of endothelial nitric oxide synthase in cardiac tissue (Maffei, 1999).
The antiplatelet components consist of panaxynol and ginsenosides Ro, Rg1, and Rg2 in the diethyl ether and 1-butanol fractions of the herb. Panaxynol inhibits the aggregation, release reaction, and thromboxane formation in platelets while ginsenosides Ro, Rg1, and Rg2 suppress the release reaction only (Kuo, 1990; Teng, 1989). Compared with aspirin, ginsenoside Rg2 at concentrations of 0.5 mmol and 1 mmol produced strong inhibition of platelet aggregation induced by arachidonic acid, collagen, and endotoxin. The ginsenoside R0 inhibited thrombin-induced fibrinogen conversion to fibrin at 0.1 to 1 mmol (p less than 0.01) (Matsuda et al, 1986).
Cognitive Function Effects
The loss of nicotinic receptor binding has been associated with age-related cognitive impairments. Nicotinic receptor stimulation of the central nervous system is beneficial for neuroprotection against age-associated cognitive disorders. A non-ginsenoside component of the herb has demonstrated affinity for the nicotinic receptor. This binding of the compound to the receptor results in nicotinic activity (Lewis, 1999). Ginsenoside-Rg2 and -Rg3 block nicotinic acetylcholine and gamma-aminobutyric acid receptors. This results in an inhibitory effect of the acetylcholine-evoked secretion of catecholamines. (Tachikawa, 1999). These different effects of Panax ginseng contribute to the variety of pharmacological effects.
Decrease in Alcohol Levels
The effect of Ginseng in the reduction of blood ethanol levels may be attributed to different mechanisms. Ginseng increases alcohol dehydrogenase and aldehyde dehydrogenase activity at high concentrations due to an augmented induction of the microsomal ethanol oxidizing system. Ginseng enhances blood alcohol clearance in man (Lee, 1987). The ginsenosides also reduce plasma ethanol by a delay in gastric emptying time (Koo, 1999).
Hypolipidemic Cardiac Effects
A 2006 review identified 34 studies and mixed results for Ginseng's effect on lipids, with overall inconsistency in findings despite 5 of 9 trials showing improvement over baseline in one or more lipid parameters. Studies were also inconsistent overall in showing Ginseng's ability to lower blood glucose. Heterogeneity and small study size have hampered meta-analyses. The authors conclude that well-designed, controlled, and randomized trials are needed to confirm the cardioprotective actions of Ginseng (Buettner, 2006). Ginseng saponins activate lipoprotein lipase, an enzyme that reduces chylomicrons and very low-density lipoproteins (VLDL), and results in a decrease of triglycerides and cholesterol (Inoue, 1999). The ginsenosides demonstrate negative chronotropic effects and positive and negative inotropic effects on the heart. The mechanism is thought to be similar to verapamil (Wu & Chen, 1988). The anti-arrhythmic properties of Rg1 consist of prolonged ventricular refractoriness and repolarization, and increased ventricular fibrillation threshold (Wu, 1995).
Ginseng as a whole has shown hemostatic action (Kosuge et al, 1981). The saponin part of Ginseng has no specific action on blood, but individual ginsenosides do. The number of sugars in the ginsenosides, and their sterochemical positions, seems to affect the specific activity (Namba et al, 1974). A study done in vitro and in vivo showed that a methanol extract of P japonicus promoted the activation of the fibrinolytic system (Matsuda et al, 1989).
Monitoring of elderly patients with drug or alcohol-induced chronic hepatotoxicity receiving a Ginseng extract showed an increased bromosulphthalein excretion and improved serum-zinc concentrations, suggesting liver detoxification (Zuin et al, 1987). The preparation also included multivitamins and trace elements. Hepatoprotective effects have been observed for various ginsenosides. Hepatotoxicity was reduced in cultured rat hepatocytes by administration of ginsenosides (Nakagawa et al, 1985; Hikino et al, 1985). Higher doses of various ginsenosides in both series actually produced cytotoxic actions (Tsang et al, 1986). In another study, Ginseng was administered orally to hepatotoxic rats. The Ginseng appeared to inhibit the increase of serum glutamic oxaloacetic transaminase levels, and to prevent the connective tissue increases in the liver (Matsuda et al, 1991).
The hypoglycemic activity of Ginseng has been attributed to both the polysaccharide and the saponin (ginsenoside) fractions. Isolated rat pancreatic islets studies demonstrated in vitro that ginsenosides stimulated insulin release. This release was independent of extracellular calcium. It appeared that the mechanism involved was different from that of glucose (Guodong & Zhongqi, 1987). Other in vivo rat studies, utilizing an extract of Ginseng, found the number of insulin receptors to be increased in bone marrow and reduced numbers of glucocorticoid receptors in rat brain homogenate (Yushu & Yuzhen, 1988). Both of these effects are thought to contribute to the hypoglycemic activity of Ginseng. Ginsenosides R(b1) and R(g1) are reported to decrease islet insulin concentrations to an undetectable level (Waki et al, 1982).
Uncharacterized components and glycans (polysaccharides often called panaxans) contributed to the hypoglycemic activity in both normal and alloxan-induced hyperglycemic mice administered Ginseng intraperitoneally (Waki et al, 1982; Kimura et al, 1981). Various researchers have found that ginsenosides increased lipogenesis and decreased the blood glucose levels in rats (Sekiya et al, 1987). Korean red Ginseng powder has been found to contain adenosine and pyro-glutamic acid in vitro. It is suggested that these substances inhibited epinephrine-induced lipolysis and stimulated insulin-mediated lipogenesis from glucose in fat cells (Takaku et al, 1990).
The saponin fraction of Panax ginseng enhanced sperm motility and progression at the 1-hour and 2-hour mark. Statistically significant results were obtained at both time intervals for sperm motility and at the 1-hour mark for sperm progression (p at least 0.05). Further study to evaluate the clinical significance of these results was suggested by the investigators (Chen et al, 1998).
Ginseng had a preventative effect against cancer in a prospective, cohort, 5-year study of 4,634 subjects over 40 years old. Seventy percent of the group had consumed Ginseng. There was a decreased relative risk (RR) of 0.48 in Ginseng users versus nonusers. The relative risk for fresh Ginseng extract was 0.23. A significant decrease in relative risk of gastric cancer with fresh Ginseng extract intake (RR=0.19) was noted. There was also a significant positive dose-response relationship (Yun, 1996).
A small 2006 clinical trial using Ginseng for menopausal hot flashes failed to find effectiveness for this use, notes a Journal of the American Medical Association review of alternatives to estrogen for the prevention of hot flashes (Tice, 2006).
However, use of Korean red Ginseng in postmenopausal women with climacteric syndrome appeared to alleviate some symptoms including fatigue, insomnia, and depression. Postmenopausal women with climacteric syndrome (n=12) received Ginseng 6 g daily for 30 days. Postmenopausal women without climacteric syndrome (n=8) were used as controls. After 30 days, scores on the Cornell Medical Index and the State-Trait Anxiety Inventory (A-state) were significantly reduced (p<0.001 as compared to before treatment) and were similar to scores recorded in the postmenopausal women without climacteric syndrome. The women treated had a significant decrease in cortisol and cortisol to dehydroepiandrosterone ratio (p<0.05). No adverse effects were noted (Tode et al, 1999).
A double-blind, placebo-controlled, crossover study in 27 healthy young adults (17 male and 10 female undergraduates) showed that Ginseng extract (100 mg) and glucose (25 g glucose in a drink) both enhanced performance on a mental arithmetic test by participants during the late stages of the demanding task. The 10-minute, computerized “cognitive demand battery” involved such elements as counting by serial 3s and 7s, subtractions, and a 5-minute rapid visual information processing task. The Ginseng and glucose supplements also blunted the increase in subjective feelings of mental fatigue. Blood glucose levels were monitored. The findings point to possible gluco-regulatory actions of Ginseng, and an ability to enhance cognitive performance (Reay, 2007).
The same authors demonstrated in a double-blind, placebo-controlled, balanced crossover study on 30 healthy adults that treatment with Panax ginseng extract leads to significant reductions in blood glucose levels. The most notable behavioral effects were associated with 200 mg of ginseng and included significantly improved subtraction task performance and reduced subjective mental fatigue. (Reay et al, 2005).
A randomized, double-blind, placebo-controlled study was conducted to evaluate the effect of Ginseng on cognitive function over an 8-week period. There were 112 healthy volunteers over 40 years of age. The primary outcome was the change in score on each cognitive test, evaluated at baseline, and again at 8 weeks. Oral standardized Ginseng 400 mg daily was significantly better compared to placebo with abstract thinking and a tendency toward faster simple reaction times. There was no difference between the groups with regard to concentration, memory, or subjective experience (Sorenson & Sonne, 1996).
The effect on blood glucose with Ginseng was demonstrated in a double-blind, placebo-controlled study including 36 newly diagnosed Type 2 diabetic patients. Ginseng 200 mg daily improved glycated hemoglobin, serum aminoterminalpropetptide concentration, and physical activity after 8 weeks of therapy. A 100-mg and 200-mg daily dose of Ginseng elevated mood, improved psychophysical performance, and reduced fasting blood glucose and weight (Sotaniemi et al, 1995).
Panax ginseng was found to be an effective alternative to the invasive approaches for treating erectile dysfunction (ED). This was demonstrated in a double-blind, placebo-controlled study of 60 patients with mild or mild-to-moderate ED in which the efficacy of Panax ginseng (1,000 mg, three times daily) and a placebo were compared (deAndrade et al. 2007).
Ginseng at 10 mcg/mL significantly enhanced the in vitro natural killer cell function in healthy subjects and those suffering from chronic fatigue syndrome or AIDS (p<0.01). It also significantly increased the in vitro antibody-dependent cellular cytotoxicity of peripheral blood mononuclear cells (p<0.01). Subjects could not be using medications with immunomodulating effects concomitantly. Blood samples were collected from subjects and treated with Ginseng extract at varying concentrations (See et al, 1997).
The properties of a standardized extract of Ginseng root for inducing a higher immune response in vaccination against influenza were evaluated in 227 volunteers. The multicenter, placebo-controlled, randomized, double-blind, two-arm study was conducted over a 12-week period. Oral standardized Ginseng extract 100 mg daily was given over the entire 12-week period, with anti-influenza polyvalent vaccination given to all volunteers at week 4. There were significantly fewer cases of influenza or the common cold in the Ginseng-treatment group, and significantly higher antibody titers and natural killer cell levels at 8 and 12 weeks in the Ginseng treatment group (Scaglione et al, 1996).
Aerobic exercise performance did not improve following Ginseng supplementation in a 3-week double blind, randomized, placebo-controlled trial with 28 healthy volunteers. Volunteers received 200 mg standardized to 7% Panax ginseng every morning 30 minutes prior to breakfast for 21 days. Exercise performance was measured at baseline and after 21 days via evaluation of heart rate, blood pressure, ventilations and their gas fractions, blood samples, and the Borg rate of perceived exertion self-rating scale following a symptom-limited graded exercise test. Although improvements were seen in peak ventilations and heart rate, and volunteers performed slightly longer after Ginseng supplementation, these parameters did not reach statistical significance (Allen et al, 1998).
Korean red Ginseng improved vascular endothelial dysfunction in patients with hypertension. Forearm blood-flow changes were measured with plethysmography in 7 hypertensive patients treated with Ginseng, 10 hypertensive patients without Ginseng, and 10 control patients. Patients received red Ginseng 300 mg 3 times daily for approximately 24 months. Endothelial function was measured while receiving 3 vasodilating substances including acetylcholine, bradykinin, and sodium nitroprusside. Patients in the Ginseng-treated hypertensive group had forearm blood flows significantly higher with high-dose acetylcholine (p=0.0008) and they were higher with high dose bradykinin (p=0.04) than those of the nontreated hypertensive patients, but not significantly different from the control group. No differences were seen between groups with the administration of nitroprusside. The authors hypothesized that Korean red Ginseng improves vascular endothelial dysfunction in patients with hypertension through increasing synthesis of nitric oxide (Sung et al, 2000).
Indications & Usage
Approved by Commission E:
- Lack of stamina
Ginseng is used internally as a tonic and fortification in times of fatigue and debility; for declining performance, capacity for work, and concentration; and during convalescence.
In Folk medicine, Ginseng is used for loss of appetite, cachexia, anxiety, impotence and sterility, neuralgia, and insomnia.
In Chinese medicine, Ginseng is used for hemoptysis, gastric disturbances, and vomiting.
Ginseng is used for rheumatism and debility.
Precautions & Adverse Reactions
Caution should be taken in patients with cardiovascular disease or diabetes. Panax ginseng has lowered blood glucose in diabetic and nondiabetic patients (Sotaniemi et al, 1995). General adverse effects include insomnia, epistaxis, headache, nervousness, and vomiting. Estrogenic effects have been observed with Ginseng products, though the exact type of Ginseng (i.e., American, Panax, Siberian) was not reported.
Note: Caution should be used when attributing adverse effects to Ginseng use, due to the lack of standardization of Ginseng products and the not uncommon practice of adulterating Ginseng with less expensive materials such as Mandragora officinarum, Rauwolfia serpentina, and Cola species. These adulterants are associated with a plethora of adverse reactions (D'Arcy, 1991). Some formulations have been found to contain aminopyrine and phenylbutazone (Anon, 1980).
Both hypertension and hypotension have been reported in patients taking Ginseng for 10 days (Kim et al, 1995). Fourteen of 133 patients developed edema in a 2-year study. The patients used a number of different Ginseng products and forms. Twenty-two of 133 patients developed hypertension the same study. The patients used a number of different Ginseng products and forms (Siegel, 1979).
Central Nervous System
Fourteen of 133 patients, who averaged a 3-gram daily dose, developed symptoms of Ginseng abuse (characterized by hypertension with nervousness, sleeplessness, skin eruptions, and diarrhea) in a 2-year study (Ryu & Chien, 1995; Bahrke & Morgan, 1994; Keji, 1981). Twenty-six of 133 patients enrolled in the same study developed sleeplessness; 25 developed nervousness. The patients used a number of different products and forms.
Thirty-three of 133 patients involved in a 2-year study developed various skin eruptions. The patients used a number of different products and forms (Siegel, 1979). Skin eruptions are an indicator of Ginseng abuse syndrome (Ryu & Chien, 1995).
Case reports suggest estrogenlike activity of Ginseng (Hopkins et al, 1988; Greenspan, 1983; Punnonen & Lukola, 1980; Palmer et al, 1978). Some authors theorize the saponin content of Ginseng interacts with estrogen receptor proteins in a manner similar to ovarian steroids (Punnonen & Lukola, 1980). A reduction in blood glucose has been shown in nondiabetic patients as well, though these patients have not experienced symptomatic hypoglycemia (Hallstrom et al, 1982). Oral Ginseng and Ginseng face cream have been associated with postmenopausal vaginal bleeding (Greenspan, 1983; Hopkins, 1988).
Forty-seven of 133 patients enrolled in a 2-year study developed morning diarrhea. The patients used a number of different products and forms (Siegel, 1979). Morning diarrhea is an indicator of Ginseng abuse syndrome (Ryu & Chien, 1995). Gastrointestinal complaints were reported in 9 of 227 patients studied by Scaglione et al (1996) and have been reported as a side effect of both Korean Ginseng and Western Ginseng (Kim et al, 1995).
Median total morphological scores of rat embryos exposed to ginsenoside Rb1 at a concentration of 30 mcg/mL were significantly lower (p<0.05) compared to control embryos (35 vs 45). A lower morphological score suggests possible teratogenicity. When the concentration of ginsenoside Rb1 was increased to 50 mcg/mL, median total morphological scores further decreased to 28. Ginsenoside Rb1 is the major ginsenoside in North American Ginseng and is one of more than 20 ginsenosides that have been identified in commercially available Ginseng extracts. The authors suggest that further studies are warranted to further evaluate potential teratogenic effects of other ginsenosides on embryogenesis. Ginseng use during the first trimester of pregnancy should be cautiously considered (Chan et al, 2003).
In one case report, Panax ginseng was suspected to have caused a decrease in INR in a patient previously stabilized on warfarin (Janetsky & Morreale, 1997). Clinical Management: Avoid Ginseng use with anticoagulants if possible. If the patient elects to combine therapy, closely monitor PT/INR.
Ginseng has been shown to have hypoglycemic effects. An interaction between Ginseng and antidiabetic agents has not been reported in the literature to date, but is theoretically possible based on the mechanism of action of Ginseng. Clinical Management: Monitor blood glucose closely in patients taking Ginseng with antidiabetic agents. In patients having difficulty establishing blood glucose control, it is recommended to avoid concomitant use of Ginseng and antidiabetic agents.
Case reports suggest estrogen-like activity of Ginseng (Greenspan, 1983; Punnonen & Lukola, 1980; Palmer et al, 1978). Concomitant use of Ginseng with conjugated estrogens may result in symptoms of estrogen excess or interference. Clinical Management: Since estrogenic effects have been noted with topical and oral estrogen, either dosage form should be treated with the same caution when coadministered with Ginseng. If estrogenic symptoms such as mastalgia and breakthrough menstrual bleeding occur, decrease the Ginseng dosage. Because of the apparent estrogen-like effect, avoid Ginseng in patients with breast cancer, undiagnosed abnormal genital bleeding, active thrombophlebitis or thromboembolic disorders, or if the woman is pregnant.
Concurrent use may result in increased risk of diuretic resistance. Clinical Management: Patients should be advised to discontinue use of Ginseng and germanium-supplemented Ginseng products while taking loop diuretics.
Monoamine Oxidase Inhibitors (MAOIs)
Two case reports suggest that Ginseng when taken with phenelzine may result in insomnia, tremor, headache, agitation, and worsening of depression suggestive of manic-type symptoms (Jones & Runikis, 1987; Shader & Greenblatt, 1985). Clinical Management: Patients should be advised to avoid use of any Ginseng products while taking an MAOI and for several weeks after discontinuation.
Ginseng increased the mean plasma concentration of nifedipine by 53% at 30 minutes in an open trial of 22 healthy subjects. Effects at other time points were not reported (Smith et al, 2001). Clinical Management: Caution is advised if patients take Ginseng with nifedipine.
Panax ginseng significantly accelerated the intestinal clearance of albendazole sulfoxide (the active metabolite of albendazole) when co-administered to rats. The plasma AUC for albendazole sulfoxide was unchanged, as was the intestinal elimination of the inactive metabolite albendazole sulfone (Merino et al, 2003). Clinical Management: Monitor therapeutic efficacy of albendazole.
Asian (Panax) Ginseng provoked digoxinlike immunoreactivity in human serum when digoxin serum concentration was measured by fluorescence polarization immunoassay (FPIA); conversely, false reductions occurred in digoxin concentrations in sera exposed to Ginseng and then measured by the microparticle enzyme immunoassay (MEIA) method (Dasgupta et al, 2003). Similar results occurred in another ex vivo study, where apparent digoxinlike reactivity occurred in digoxin-naive sera (Chow et al, 2003). Ginseng interferes with digoxin immunoassay because of the molecular structural similarity between Panax ginseng and digoxin (Dasgupta et al, 2003; Chow et al, 2003). Clinical Management: The clinician should explore the possibility of a false elevation or depression in digoxin concentration due to ingestion of Asian Ginseng. The following digoxin immunoassay instruments may not be falsely altered in the presence of Panax ginseng: the Enzyme Multiplied Immunoassay (EMIT: Dade Behring); Chemiluminescent assay (CLIA; Bayer Diagnostics); Randox digoxin assay (Randox Laboratories); Beckman digoxin assay (Beckman).
Palpitations, insomnia, pruritus, heart pain, decreased sexual potency, vomiting, hemorrhagic diathesis, headache, and epistaxis have all been reported infrequently. Ingestion of large amounts is said to be fatal (Baranov, 1982). Massive overdosages can bring about Ginseng Abuse Syndrome, which is characterized by hypertension, nervousness, insomnia, hypertonia, edema, morning diarrhea, inability to concentrate, and skin eruptions. It may occur after 1 to 3 weeks of ingestion of 3 g/d of Ginseng root (Ryu & Chien, 1995). Weakness and tremor were seen in one patient upon withdrawal. Large doses may cause insomnia, depression, and nervous disorders (Siegel, 1979). About 10% of volunteers taking Ginseng developed this complex (Anon, 1980a).
Mode of Administration
Comminuted drug infusions, powder and galenic preparations for internal use. Various standardized preparations containing Ginseng root are available.
- Capsules — 50 mg, 100 mg, 150 mg, 200 mg, 250 mg, 404 mg, 405 mg, 410 mg, 424 mg, 470 mg, 500 mg, 505 mg, 520 mg, 535 mg, 560 mg, 648 mg,1000 mg, 1250 mg
- Liquid — 300 mg/mL
- Tablet — 350 mg, 500 mg
To make an infusion, pour boiling water over 3 g comminuted drug and strain after 5 to 10 minutes.
The average daily dosage is 1 to 2 g root. The infusion may be taken 3 to 4 times a day over 3 to 4 weeks.
Cognitive Function — Oral standardized Ginseng 400 mg daily was effective in improving cognitive function (Sorenson, 1996).
Hypoglycemic Effects — Dosage of 100 to 200 mg of oral standardized Ginseng has been effective in Type 2 diabetic patients (Sotaniemi, 1995).
Antiviral — Studies have proven efficacy in addition vaccination with 100 to 200 mg daily of oral standardized Ginseng extract (Scaglione, 1996).
Erectile Dysfunction — Korean Red Ginseng given orally as 600 mg three times daily has been effective (Choi, 1995).
Physical and Psychological Performance Capacity (lack of stamina) — Ginsana given 100 mg twice daily has improved oxygen capacity, reduction of maximum stress frequency, increase in ling function parameters and shortened reaction time to visual stimulants after 11 weeks (Forgo, 1985).
5 drops, 1 tablet, 5 to 10 globules or 1 mL injection solution sc twice weekly.