Ginseng is generally considered safe for nonpregnant
healthy adults; however, at sufficient doses, ginseng may
elevate blood pressure and cause insomnia, palpitations,
nervousness, and tremor in susceptible individuals.
These effects are increased if caffeine or other stimulants
are taken concurrently. Both Panax and Siberian
ginsengs should definitely be avoided in any patient
with poorly controlled hypertension. Dizziness,
headache, diarrhea, and nausea have also been reported.
A controversial ginseng abuse syndrome consisting
of tremor, elevated blood pressure, insomnia,
and anxiety may also occur.
Diabetic patients have had hypoglycemia on ginseng,
so sugars must be monitored, and insulin or other hypoglycemic
medication dosages may have to be reduced.
The use of ginseng with anticoagulants (e.g., warfarin) and
antiplatelet drugs is to be avoided because of the theoretical
risk of increased bleeding. Also, coadministration of
ginseng with digoxin and MAOIs should be avoided.
Despite the long popularity of ginseng and its evident
mild stimulatory effect, there is less conclusive evidence
for its clinical effectiveness than for many of the other
herbs discussed in this chapter. In regard to improving
cognitive function, most studies have failed to prove a
consistent benefit. A recent investigation of ginseng’s
effect on physical stamina found that an 8-week course
of therapy failed to improve aerobic work capacity.
Ginseng has been studied as a diabetic agent, with reduced
hemoglobin A1c levels and improved glucose
control being documented in a small trial. Although
there is some intriguing work with ginseng as a cancer
preventive, there is not enough evidence to suggest its
clinical use at this time.
Ginseng can refer to either white or red ginseng, and herbal preparations varyaccording to the type. In European herbal medicine, ginseng is powdered into300 mg/capsule, with 2–3 capsule/day dosage (Lust 2014). For ginseng in dryextract, 15 ml of oral liquid is given once daily. Each 15 ml of oral liquid contains140 mg of dry extract (Kapoor 2000). American ginseng is also listed as an ingredientin some soft drinks, and its oil and extracts are used in soap and cosmetics(Gupta et al. 2004). There is a little evidence in terms of clinical research to supportginseng treating breast cancer (Shin et al. 2000). However, research conducted inChina suggests that patients treated with any form of ginseng maintained betterpsychological condition. Thus, it might be more appropriate to say it has benefits interms of supporting and minimising damage from the cancer drug tamoxifen intreatment (Cui et al. 2006).
ginseng extract (Panax sp.) is considered tonic and nourishing because of its vitamin and hormone content. It seems to aid in diminishing wrinkles and helps dry skin. It is also said to promote skin elasticity, perhaps by stimulating sterol and protein production. other claims include skin rejuvenating, oxygenating, and stimulating properties. Folkloric remedies cite use for boils, bruises, sores, and swellings. This root’s active components are called ginsenosides and these are said to be responsible for revitalizing and reactivating epidermal cells. other important constituents include saponins, mucin, and vitamin B. The extract comes from the root. ginseng has been associated with many allergic skin reactions.
Major components are named the ginsenosides. The chemical constituents of ginseng are called ginsenosides or panaxosides. A total of 12 of these have been isolated but are present in such small quantities that purification is difficult. Sterols, flavonoids, proteins, and vitamins (B1, B2, B12, pantothenic acid, niacin, and biotin) are also components with pharmacological activity. The chemistry of ginseng gives a good example of how different compounds in one herb can have opposing pharmacological effects. Ginsenoside Rb-1 acts as a CNS depressant, anticonvulsant, analgesic, and antipsychotic, prevents stress ulcers, and accelerates glycolysis and nuclear RNA synthesis. Ginsenoside Rg-1 stimulates the CNS, combats fatigue, is hypertensive, and aggravates stress ulcers. Additionally, ginsenosides Rg and Rg-1 enhance cardiac performance, whereas Rb depresses that function. Some of the other ginsenosides display antiarrhythmic activity similar to that of the calcium channel blocker verapamil and amiodarone. Ginseng is popularly believed to enhance concentration, stamina, alertness, and the ability to do work. Longer-term use in elderly patients is claimed to enhance “well-being.”.
Panax ginseng describes the root from two species of
plants, Asian ginseng (Panax ginseng) and American ginseng
(Panax quinquefolius), popularly used for improving
stamina and providing a sense of well-being. The
terms red and white ginseng refer to how the root is
processed, not the species of origin. Red ginseng roots are
steam-cured prior to drying, while white ginseng is
bleached and dried. Panax ginsengs contain triterpenoid
saponins called ginsenosides (also called panaxosides), of
which up to 18 types are recognized as having differing
and sometimes opposing pharmacological properties.
Siberian ginseng (Eleutherococcus senticosus)
should not be confused with Panax ginseng.Although it
belongs to the same plant family (Araliaceae), it is a
much larger, more abundant, and consequently less expensive
plant. Like Panax ginseng, however, it is used as
a tonic and adaptogen, a nonmedical term meaning that
it helps the body adapt to stress in a variety of ways.
Siberian ginseng does contain saponins (eleutherosides)
but no ginsenosides. To date, in spite of its popularity,
there is little conclusive evidence of clinical efficacy.
Ginseng is now found throughout the world. Panax quinquefolius is native to North America; Panax ginseng is native to the Far East.
Mechanism of action
Ginsenosides are thought to be the active principles in
Panax ginseng root. The various subtypes can have opposing
pharmacological actions: Rg1 stimulates the central
nervous system (CNS) and elevates blood pressure,
while Rb1 does just the opposite. Somehow these multiple
ginsenoside constituents are thought to act in concert
to provide increased stamina. In addition, these
compounds have antiplatelet aggregation effects and
antioxidant properties, and they may stimulate the immune