Ginseng: Overview, Benefits, side effects and more

Ginseng Indications

Likely effectiveness

-Boost the immune system.

-Treat erectile dysfunction, treat type 2 diabetes.Ginseng: Overview, Benefits, site effects and more

-Boost memory, improve physical performance, promote general well-being, relieve symptoms of menopause, prevent and treat cancer.

Recognized use

Tone up the body of tired or weakened people, restore physical work capacity and intellectual concentration, help convalescents to regain strength.

Traditional use

Treat diabetes and sexual dysfunction, boost the immune system, preserve the health of ageing people, especially menopausal women.

Dietary supplement of ginseng: the benefits of ginseng

Ginseng is a plant known for its general tonic effect. Moreover, because of this stimulating effect, it is recommended to consume it in the morning. Research shows that ginseng is an ally to help boost the immune system, combat physical and intellectual fatigue, or to help convalescents regain strength.

These are the ginsenosides, the active substances of ginseng, which give it its therapeutic power. Depending on the pain to relieve, the recommended dose of ginseng varies. The advice of your doctor is thus required. If you are pregnant or breastfeeding, consult your doctor.

Ginseng dosage

Standardized extract (4% to 7% ginsenosides). Take 100 mg to 200 mg twice a day.
Physical or intellectual fatigue, convalescence, stimulation of sexual function.

Standardized extract (4% to 7% ginsenosides). Take 200 mg, 1 to 3 times a day.
Tincture (1: 5 – g / ml). Take 5 ml to 10 ml per day.
Dried root. Take 500 mg to 2 g of roots in the form of capsules or as a decoction (boil 1 g to 2 g of roots in 150 ml of water for 10 to 15 minutes). Dosages can be up to 3 g, 3 times a day.
Diabetes

Although several studies indicate that each species of ginseng can help control blood sugar levels, the dosages and types of preparations have varied too much to establish a treatment protocol.

Duration of the different treatments

  • According to Commission E, treatment generally lasts 3 months.
  • In the Russian tradition, on the other hand, it is recommended to take it for 10 to 15 days, then to take a break for 2 weeks before resuming treatment, if necessary.
  • In Traditional Chinese Medicine, there are no time limits for treatment, especially in the case of weakened people who are advised to use it long-term or even chronically.

In addition, the World Health Organization recommends taking ginseng in the morning because of its stimulating effect.

Description of ginseng

The Ginseng is a medicinal plant that enjoys the most renowned in Asia. Chinese doctors consider Asian ginseng ( Panax Ginseng ) as a tonic of Qi, the source of “Vital Energy”.

They attribute to it the property of increasing the strength and volume of ” Blood ” (the concept of “Blood” in TCM is broader than in modern Western medicine – see our section Chinese Medicine 101), to increase the vitality and appetite, to calm the ” Spirit ” and to provide “Wisdom”. It is believed to act on the whole organism in several subtle ways and to contribute globally to health and well-being.

Traditionally, Asian ginseng ( P. ginseng ) is said to be “white” when the root has simply been cleaned and dried. It is said to be “red” or “Korean red ginseng” when the root has been steamed before being dried.

According to practitioners of Traditional Chinese Medicine, Asian ginseng is “hot”, while American ginseng is more “cold”. This means, in short, that the Asian species is stimulating and nourishes Yang energy, while the American species has a calming effect and nourishes Yin. The active molecules known to ginsengs are ginsenosides (from the saponin family). Many ginsenosides have been identified to date and they are present in different proportions in the 2 species.

Almost all of the ginseng in world trade is now grown in the field, under shade houses. Under these conditions, the plant produces a marketable root after 3 to 5 years. China, Korea, the United States and Canada are the main producing countries.

Cultivation in wooded areas, especially in sugar bushes, is being tested in Quebec. In a forest environment, the plant can take 7 years or more to produce a root that has commercial value.

Ginseng history

The generic name Panax comes from the Greek words Pan, which means “everything”, and Akos which means “to heal”. The term ginseng comes from the Chinese words Gin, which means “man”, and Seng which means “essence”.

The Asian ginseng is part of the pharmacopoeia of traditional Chinese medicine (TCM) for at least 2000 years. The North American species ( Panax quinquefolius ) was introduced to China around 1718 after being discovered in the Montreal region by a Jesuit missionary. Chinese herbalists quickly adopted it, emphasizing its great similarity to Asian ginseng while recognizing its specificity.

The Chinese’s marked interest in wild North American ginseng led to a frantic harvest of the plant which threatened its survival. In addition, commercial logging has created an additional threat.

The wild ginseng is now considered a species endangered by the Committee on the Status of Endangered Wildlife in Canada and its collection is prohibited. In the United States, it is either prohibited or tightly controlled in several states. The Asian ginseng wild is a rare plant in Asia.

Little is known about the use that Native Americans made of native ginseng before its near extinction. It seems that one tribe used it to strengthen the health of the elderly while another used it to increase female fertility. Finally, according to a legend, the plant allowed childbirth without pain.

Ginseng Research

In 1947, a prominent Russian researcher by the name of Lazarev formulated the concept of “adaptogen” to describe a type of effect that could be likened to the Chinese concept of “Tonic”. According to Lazarev’s definition, an adaptogenic substance increases, in a general and non-specific way, the resistance of the organism to the various stresses which affect it. While causing a minimum of undesirable effects, and adaptogenic product exerts a non-specific normalizing action on several organs or on many physiological functions.

The concept corresponds well to the different effects of ginseng, observed during clinical studies. For example, it can, depending on the body’s needs, raise or lower body temperature and blood pressure, cause weight loss or gain, stimulate or calm the central nervous system, etc. The known active molecules are ginsenosides (from the saponin family ).

We understand that such a concept, although very interesting, does not fit well in the context of modern medical research and lends itself more or less well to the usual protocols of classic clinical trials. The variation in the quality and content of active ingredients of the different ginsengs used in clinical trials could also explain their contradictory results.

Likely effectiveness Stimulates the immune system. Many tests in different animals indicate that ginseng can boost the immune system. The data are convincing in humans too. In subjects vaccinated against influenza, standardized extracts of Asian ginseng (G115®, 100 mg, twice a day) and American ginseng  (COLD-fX®, 200 mg, twice a day) significantly reduced the risk of getting respiratory infection compared to placebo.

A trial was conducted in Canada with 270 people prone to colds. Taking a standardized extract of American ginseng (COLD-fX®, 400 mg daily for 4 months) was more effective than a placebo in reducing the intensity and duration of symptoms. In addition, only 10% of people in the experimental group had more than one cold, compared to 23% in the placebo group. A smaller trial on the same product gave similar results in vaccinated older adults.

Some researchers wanted to know if Asian ginseng had a stimulating effect on the immune system of athletes

The results have so far been unconvincing. In sedentary men, American ginseng (1,125 mg of standardized extract) also had no effect on immunity, measured after moderate physical exercise.

Possible effectiveness Sexual function. Many medicinal preparations from traditional Chinese medicine and intended for the treatment of various sexual dysfunctions contain ginseng. The authors of a synthesis published in 2008 examined 7 clinical trials with placebo, 6 of which focused on red Asian ginseng. They conclude that red ginseng may be useful in erectile dysfunction, but that the evidence lacks solidity.

In addition, a placebo-controlled trial in Korea has shown promising results in improving sexual function in menopausal women.

Possible effectiveness of Type 2 diabetes. The data is interesting, but not precise enough at the moment. Several trials have been done to check the effect of ginseng on the blood glucose levels of people with and without diabetes.

According to a synthesis published in 2006, the plant had a beneficial effect in most of these studies 14. However, as the authors point out, these data do not allow establishing a treatment protocol. In fact, during these tests, the dosages used, the products used and the effects observed varied greatly.

Uncertain effectiveness Stimulation of cognitive functions. Commission E and the World Health Organization (WHO) recognizes the use of Asian ginseng ( Panax ginseng ) and others to restore the physical work capacity and intellectual concentration.

Although some clinical trials have shown positive results, others have not been conclusive. The whole of the data does not allow us to conclude on the effectiveness of Asian ginseng (no more than American) on memory, in particular, because of the poor methodological quality of the studies and the fact that doses were used and different types of preparations.

Two placebo-controlled trials published in 2010 indicate that taking a single dose of Asian 17 or American 18 ginseng extract had a beneficial effect on short-term memory while inducing a perception of greater calm in participants.

In one of these trials, treatment was continued for 7 days: there was no improvement in these acute effects or any difference in mood or general cognitive performance between the group placebo and the treated group.

In two clinical trials, the effectiveness of a mixture of Asian ginseng and ginkgo Biloba (Gincosan®) was tested to improve memory, with conflicting results.

In terms of Alzheimer’s disease, the authors of a systematic review looked at 2 studies that compared the effects of Asian ginseng as an adjuvant to those of conventional treatment alone. Although treatment with ginseng gave clearly superior results, according to these researchers, the validity of these results is limited by significant methodological flaws.

Uncertain effectiveness Improvement of physical performance. Again, clinical trials have yielded conflicting results. The majority of them, especially the most recent, have been inconclusive. The author of a summary published in 2009 emphasizes that we are still waiting for a test made in the rules of the art to demonstrate the effectiveness of ginseng in athletes wishing to improve their performance.

More recently, a trial on amateur runners was inconclusive during an endurance test in hot and humid conditions: the subjects had taken a single dose of an extract of ginseng.

Uncertain effectiveness of General well-being. The authors of a synthesis published in 2003 looked at 9 trials. Despite certain observed effects, ginseng, alone or in combination with vitamins or minerals, has not given clearly conclusive results in terms of the quality of life of different subjects (healthy people, menopausal people and diabetics).

Uncertain effectiveness Menopause. Ginseng is traditionally used to relieve the symptoms of menopause. The only large trial involved 384 women going through menopause 17. A standardized Asian ginseng extract taken for 16 weeks was not more effective than a placebo in reducing participants’ hot flashes, but it did slightly improve their psychological well-being.

In a preliminary trial of 12 women with severe menopausal symptoms, taking 6 g of Asian red ginseng daily for 1 month reduced participants’ fatigue, insomnia and depression. 18 During these 2 studies, the researchers found that ginseng had no hormonal effect.

Uncertain effectiveness Cancer prevention and treatment. There are only studies conducted in Asia and only one clinical trial with placebo, which does not allow us to conclude that ginseng is effective in preventing or treating cancer.

Case-control studies and epidemiological research in Korea have reported a reduced risk of cancer in people who consume Asian ginseng. As part of a large epidemiological study conducted in China (Shanghai Women’s Health Study), researchers followed for 3 to 4 years a subgroup of 1,455 Chinese women suffering from cancer.

They established 2 interesting correlations: the survival rate was higher in women who took ginseng regularly before cancer was diagnosed, and those who consumed ginseng after being diagnosed had a better quality of life. However, the analysis combined all the preparations and types of ginseng consumed, as well as very variable duration of treatment.

We cannot, therefore, make precise recommendations on the best protocols on the basis of these results. Furthermore, among all the participants in the Shanghai Women’s Health Study (nearly 75,000 women), the consumption of ginseng was not associated with a reduced risk of stomach cancer.

Only one clinical trial with placebo has been published to our knowledge. It involved 643 Chinese patients suffering from chronic atrophic gastritis, an attack on the internal wall of the stomach which can predispose to cancer of this organ.

The treated patients took 1 g of Korean red ginseng extract powder for 3 years and were followed for another 8 years. At the end of this period, only men had benefited from a statistically significant preventive effect against cancer, all organs combined.

Adjuvant treatment. In in vitro and animal studies, several ginsenosides have shown anticancer activity, coupled with low toxicity. This is why researchers are interested in ginseng as an adjuvant treatment for cancer, in particular, to counter the extreme fatigue felt by patients.

In this study, patients who took a dose of 1000 mg or 2000 mg of American ginseng reported having more energy, feeling less tired and having improved their general well-being more, compared to subjects in the group.

Placebo and those who had taken a dose of 750 mg. In a previous placebo-controlled trial of cancer patients, taking 3 g of red ginseng extract improved the participants’ quality of life, especially psychologically.

Recognized use Commission E and the World Health Organization (WHO) recognize the use of Asian ginseng ( Panax Ginseng ) to tone the body of tired or weakened people, restore the capacity for physical work and intellectual concentration and help convalescents to regain strength.

In Traditional Chinese Medicine (TCM), ginseng (for 2,000 years for the Asian and nearly 300 years for the North American) is used in the composition of a multitude of classic preparations. According to TCM, it is a general body tonic.

Precautions

Warning
Self-medication for diabetes can cause serious problems. When starting a treatment that has the effect of changing your blood glucose level, you must monitor your blood sugar very closely. It is also necessary to notify your doctor, so that he can, if necessary, review the dosage of conventional hypoglycemic drugs.

It is important to distinguish between Asian and American species of ginseng because they have specific effects in each (see sections History and Research ). It is advisable to consult a naturopath, a duly certified herbalist or a well-informed health professional in order to choose the relevant species.

Contraindications

Commission E recommends avoiding Asian ginseng ( P. ginseng ) in cases of high blood pressure.
Although it seems that the plant does not exert an estrogenic action, some sources continue to recommend caution to patients who have suffered from hormone-dependent cancer or whose risk of contracting this type of cancer is high.

According to the authors of a recent synthesis, the data are insufficient to conclude that ginseng is safe for pregnant and breastfeeding women. They, therefore, recommend caution.

Side effects

At the recommended dosages, ginseng is essentially devoid of undesirable effects. An analysis of the adverse reaction data found in all of the clinical studies reveals that there were no more adverse effects in the treated subjects than in the control group subjects.

Note that in 1979, a study of 133 subjects taking Asian ginseng reported several adverse effects in 14 people: hypertension, nervousness, irritability, insomnia, diarrhoea, etc. The author named this phenomenon ginseng abuse syndrome (GAS), but his study was discredited for lack of rigour because, among others, the subjects who reported these adverse effects consumed very large amounts of ginseng (up to 15 g per day) and many also ingested a lot of caffeine. No other case of GAS has been reported since.

Interactions with plants or supplements

Ginseng can increase the effect of food, plants or supplements with stimulating properties (coffee, tea, guarana, chocolate, etc.).
Ginseng can increase the effect of plants or supplements with hypoglycemic properties (psyllium, glucomannan, fenugreek, for example).

With medication
It could interact with blood thinners. Two studies published in 2004 and carried out on healthy volunteers taking ginseng and warfarin (Coumadin ® ) came to opposite conclusions, however. During the first, the researchers concluded that there was no interaction, while the second found that taking ginseng reduced the effect of the anticoagulant medication.

Patients taking warfarin or another blood-thinning medication along with ginseng should, therefore, tell their doctor.
Ginseng can interact with hypoglycemic drugs.

Theoretically, ginseng could interact with stimulants of the central nervous system and antidepressants such as monoamine oxidase inhibitors.

On the shelves

Quality of ginseng supplements. From 1995 to 2000, analyzes revealed wide variability in the ginsenoside content of commercially available supplements, especially in Sweden, France, the United States and Ontario.

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