II. Mechanism
- Different effects seen with each species of Ginseng
- Panax ginseng is most studied
- Commercial products are often a mix of species
- Asian Ginseng (Panax ginseng)
- Siberian Ginseng (Eleutherococcus)
- American Ginseng (Panax quinquefolius)
- Active ingredient: Ginsenosides (triterpene saponins)
- Active at Hypothalamus-Pituitary-Adrenal Axis
- Immune activity (Phagocytosis, Natural Killer Cell)
- Vasodilation
- Hypoglycemic activity
III. Efficacy
- Appears effective in improving psychologic functioning
- Variable effects in studies
- Wiklund (1999) Int J Clin Pharmacol Res 19:89-99 [PubMed]
- Appears effective in improving immune function
- No benefit for physical performance
- Highly valued in Chinese culture
- No standardization of products commercially available
- Folk uses (Described as tonic or adaptogen)
- Strengthen normal body functions
- Improve sexual function
- Assist with resisting stress
- Weight loss or weight gain
IV. Contraindications
V. Adverse Effects
- Lowers Blood Glucose levels (Hypoglycemic effect)
- Occurs in both those with and without Diabetes Mellitus
- Effect may be additive with Oral Hypoglycemics and Insulin
- Possible Platelet inhibitory effect
- Hypertension
- Nausea
- Diarrhea
- Insomnia
- Headaches
VI. Dosing: Doses used in studies
- Panax ginseng extract 200 mg orally daily
VII. Drug Interactions
-
CYP3A4 Inducer (Asian Ginseng)
- May lower affected drug levels and related drug efficacy
-
Warfarin (American Ginseng)
- May lower INR
-
Diabetes Mellitus agents
- See adverse effects above
- Risk of Hypoglycemia
-
Digoxin
- Risk of Digoxin Toxicity by raising Digoxin serum levels
- McRae (1996) CMAJ 155:293-5 [PubMed]
VIII. Precautions
- Discontinue at least 7 days before surgery