Ginseng

Aka: Ginseng, Panax ginseng

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II. Mechanism

  1. Different effects seen with each species of Ginseng
  2. Panax ginseng is most studied
  3. Commercial products are often a mix of species
    1. Asian Ginseng (Panax ginseng)
    2. Siberian Ginseng (Eleutherococcus)
    3. American Ginseng (Panax quinquefolius)
  4. Active ingredient: Ginsenosides (triterpene saponins)
    1. Active at Hypothalamus-Pituitary-Adrenal Axis
    2. Immune activity (Phagocytosis, Natural Killer Cell)
    3. Vasodilation
    4. Hypoglycemic activity

III. Efficacy

  1. Appears effective in improving psychologic functioning
    1. Variable effects in studies
    2. Wiklund (1999) Int J Clin Pharmacol Res 19:89-99 [PubMed]
  2. Appears effective in improving immune function
    1. Scaglione (1996) Drugs Exp Clin Res 22:65-72 [PubMed]
  3. No benefit for physical performance
    1. Bahrke (2000) Sports Med 29:113-33 [PubMed]
  4. Highly valued in Chinese culture
  5. No standardization of products commercially available
  6. Folk uses (Described as tonic or adaptogen)
    1. Strengthen normal body functions
    2. Improve sexual function
    3. Assist with resisting stress
    4. Weight loss or weight gain

IV. Contraindications

  1. Hypertension
  2. Asthma
  3. Bleeding Disorder

V. Adverse Effects

  1. Lowers Blood Glucose levels (Hypoglycemic effect)
    1. Occurs in both those with and without Diabetes Mellitus
    2. Effect may be additive with Oral Hypoglycemics and Insulin
  2. Possible Platelet inhibitory effect
  3. Hypertension
  4. Nausea
  5. Diarrhea
  6. Insomnia
  7. Headaches

VI. Dosing: Doses used in studies

  1. Panax ginseng extract 200 mg orally daily

VII. Drug Interactions

  1. CYP3A4 Inducer (Asian Ginseng)
    1. May lower affected drug levels and related drug efficacy
  2. Warfarin (American Ginseng)
    1. May lower INR
  3. Diabetes Mellitus agents
    1. See adverse effects above
    2. Risk of Hypoglycemia
  4. Digoxin
    1. Risk of Digoxin Toxicity by raising Digoxin serum levels
    2. McRae (1996) CMAJ 155:293-5 [PubMed]

VIII. Precautions

  1. Discontinue at least 7 days before surgery

IX. References

  1. Ang-Lee (2001) JAMA 286:208-16 [PubMed]
  2. Cupp (1999) Am Fam Physician 59(5):1239-44 [PubMed]
  3. Kiefer (2003) Am Fam Physician 68:1539-42 [PubMed]
  4. Shaughnessy (1997) Fam Practice Recert 19(10):53-6 [PubMed]

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Related Studies

Ontology: Ginseng Preparation (C1119918)

Definition (NCI) The aromatic root of the perennial herb Panax quinquefolius, native to eastern North America. American ginseng, used in Chinese traditional medicine and available as a nutritional supplement, is classified as an adaptogenic herb with multiple effects, many of which are regulatory in nature. It contains a complex mixture of saponin glycosides, also known as ginsenosides or panaxosides. Although the mechanism of action is unclear, this agent is reported to enhance the immune system and reduce fatigue.
Definition (NCI_NCI-GLOSS) An herb with a root that has been used in some cultures to treat certain medical problems. It may have anticancer effects.
Definition (PDQ) The aromatic root of perennial herbs of the Panax genus used in Chinese traditional medicine. Ginseng is classified as an adaptogenic herb with multiple effects, many of them regulatory in nature. It contains a complex mixture of saponins, ginsenosides and panaxosides, and is available as a nutritional supplement. Although the mechanism of action is unclear, Ginseng is reported to enhance the immune system and reduce fatigue. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=269063&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=269063&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C26651" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
SnomedCT 329511000, 412395006
English ginseng, Panax ginseng, GINSENG, ginseng (medication), Panax quinquifolius, American ginseng, extract ginseng, Ginseng Root, American Ginseng, AMERICAN GINSENG, american ginseng, Ginseng, ginseng extract, Ginseng Preparation, Ginseng product, Ginseng product (product), Ginseng product (substance), Ginseng extract (substance), Ginseng extract, ninjin, jen shen, panax ginseng, renshen, shinseng, GINSENG EXTRACT
Spanish ginseng (producto), ginseng, producto (producto), ginseng, ginseng, producto, extracto de ginseng (sustancia), extracto de ginseng
Derived from the NIH UMLS (Unified Medical Language System)

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