Ginseng’s Medicinal Properties and Side Effects
Ginseng is an herb made from the roots of the ginseng plant of the Panax genus, a slow-growing perennial shrub that has been used for over 2,000 years in East Asian and Native American cultures as a youth tonic to treat various conditions. The English word ginseng comes from the Chinese word “ren shen” (pronunciation “jîn-sim”), which literally means “man root” because the roots of the plant resemble outstretched human legs. The Latin name for ginseng is Panax, which in old Greek means “cure-all”. Today, ginseng supplements are used for a number of purposes, including fatigue and stress relief, as an immune system booster and to improve memory and mental acuity in older adults.
Types of Ginseng
There are several different types of ginseng plants from the panax genus. All contain phytochemicals saponins thought to be responsible for the herb’s medicinal properties. Some of the roots contain different concentrations of phytochemicals and thus some ginseng forms may be more or less effective than others at treating particular illnesses.
Furthermore, the level of healthful phytochemicals in each ginseng root depends on crop growing conditions, season when harvested, age of the root and processing method. It takes about 4-6 years for ginseng roots to become mature for harvesting. The roots are then dried and either left whole or further processed into a powdered extract. Some roots may be steamed to produce a more potent red ginseng. Hence, ginseng is available in many forms and products like powders, capsules, teas, tonics, extracts, elixirs, candy, chewing gums and even cigarettes. The root may also be eaten fresh or dried. Certain foods may list ginseng as one of their ingredients.
The most common varieties of ginseng are American ginseng (panax quinquefolius) and Asian ginseng (panax schinseng Nees or panax ginseng C.A. Meyer). American ginseng is considered to be less potent than Asian varieties. Asian ginseng is cultivated in China, Japan, Korea and Vietnam. Each of the Asian countries where ginseng is grown has its own variety of Asian ginseng, plus there is san qui ginseng (panax pseudoginseng) from the Yunnan Province of China, which has allegedly higher concentrations of the phytochemicals than regular Asian ginseng.
In addition, ginseng is classified as red or white, depending on the manufacturing process. White ginseng includes roots that have been dried or made into powder. When the root is dried in the heat or steamed it is called red ginseng, which is said to be slightly more potent than the white variety. Ginseng may also be wild or cultivated, though wild ginseng is extremely rare these days. The wild varieties are believed to be more potent and are therefore more expensive.
Siberian ginseng (eleutherococcus senticosus) is not a true ginseng. It has some but not all of the same saponins present in ginseng of the Panax genus. It is also much cheaper to produce than American or Asian ginseng. Though a distant relative of the Asian and American ginseng, Siberian ginseng is from a different genus. Nonetheless, some manufacturers label it as a true ginseng on their products.
Potential Health Benefits of Ginseng
Ginseng’s purported health benefits are attributed to phytochemicals called saponins, present in the ginseng root. Saponins, which are also found in legumes, alfalfa sprouts, green leafy vegetables, tomatoes and potatoes, are thought to stimulate immune response. The specific kinds of saponins found in the ginseng root are triterpenoid saponin glycosides also known as ginsenosides or panaxosides.
Ginsenosides have similar chemical structure as human steroid hormones. They are believed to stimulate release of hormones in the adrenal glands, such as a stress-fighting and anti-inflammatory agent cortisol and the androgen hormones that form a reproductive hormone estrogen. Ginsenosides may also play a role in protein synthesis and cholesterol production. In addition, saponins called diols and triols may be responsible for ginseng’s purported antihypertensive, sedative but also central nervous system stimulating properties.
Conditions most commonly treated with ginseng include:
- Anal fistula in infants
- Blood pressure problems
- Cancer prevention
- Chronic obstructive pulmonary disease
- Congestive heart failure
- Coronary artery disease
- Erectile dysfunction
- Fatigue relief
- Hepatitis C
- High blood glucose levels
- Immune system weakness
- Improving athletic performance
- Improving mental performance
- Infections including HIV/AIDS and infections of the intestine
- Inflammation of the colon and the lining of the stomach
- Intracranial pressure
- Low white blood cell counts
- Memory loss
- Menopausal symptoms
- Methicillin-resident staphylococcus aureus
- Multi-infarct dementia
- Nerve pain
- Nervous exhaustion
- Rheumatoid arthritis
- Stress relief
- Type 2 diabetes and insulin resistance
- Viral myocarditis
The majority of scientific studies into ginseng’s health benefits have looked at the effects of Asian or American ginseng in treating various conditions. However, there are several different varieties and types of ginseng and different products that contain ginseng. Therefore, the use of one product may not guarantee similar results to those of another product.
The recommended daily dosage varies depending on the type of supplement and type of ginseng. In general, standardized ginseng doses may contain concentrations of 4-7% of ginsenosides. However, even though most manufacturers claim to include standardized concentrations of phytochemicals in their products, there is no guarantee that such claims are accurate.
Potential Risks Associated with Ginseng Consumption
Although products containing ginseng are widely used and accepted in Asia, there has not been enough independent scientific research on the herb’s safety when taken long-term. Prolonged use of ginseng, especially with high dosages, may increase the risk of developing ginseng abuse syndrome, a rare but potentially serious side effect. Patients with this syndrome may experience diarrhea, edema, hypertension, insomnia, nervousness and skin eruptions. Therefore, it is not recommended to take ginseng continuously for long periods of time. To minimize the risk of side effects, consumers are advised to take the herb for three to four weeks followed by a break of one to two weeks.
Ginseng rarely causes serious side effects. However, possible side effects may include appetite loss, anxiety, depression, excitability, insomnia, itching and sore throat. Less common side effects are abnormal menstrual cycles, chest pain, decreased or increased blood pressure, dizziness, fever, headache, heart palpitations, leg swelling, nausea or vomiting and manic episodes in patients with bipolar disorder. Ginseng is not suitable for children and pregnant or breastfeeding women. Also, this herb cannot be recommended for individuals with certain medical conditions, including:
- Bleeding disorders
- Hormonal conditions
- Heart attack/stroke
- Hypoglycemia and diabetes
- Taking ginseng before or shortly after surgical procedures
In addition, ginseng may interact or interfere with certain medications, herbs, supplements and foods, including:
- Anticoagulants (e.g. warfarin)
- Glucose-lowering drugs
- Heart medications
- Hormone therapy including birth control pills, hormone replacement therapy or human growth hormone
- Monoamine oxidase inhibitors (MAOIs)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Opioid painkillers
- Stimulants such as chocolate, decongestants or caffeine
Furthermore, ginseng may also interact with other herbs or dietary supplements, especially those that act to glucose levels such as aloe vera, bitter melon, fish oil and rosemary. Taking ginseng with black cohosh, chamomile, garlic, ginkgo biloba, green tea, licorice root, saw palmetto or vitamin E may increase the risk of bleeding. In addition, ginseng’s purported effects on blood pressure may warrant caution when also taking herbs or supplements that may decrease or increase blood pressure. Therefore, individuals considering ginseng supplements should consult their doctor prior to using the herb.