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Ginseng

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Ginseng, Panax ginseng

  • 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
  • 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
  • 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
  • Dosing
  • Doses used in studies
  1. Panax ginseng extract 200 mg orally daily
  • 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]
  • Precautions
  1. Discontinue at least 7 days before surgery