Panax Ginseng

• Panax Ginseng also known as Asian Ginseng is native to China and Korea and has been used in various systems of medicine for many centuries. Asian ginseng is one of several types of true ginseng.
• Treatment claims for Asian ginseng are numerous and include the use of the herb to support overall health and boost the immune system. Traditional and folk uses of ginseng include improving the health of people recovering from illness; increasing a sense of well-being and stamina; improving both mental and physical performance; treating erectile dysfunction, hepatitis C, and symptoms related to menopause; and lowering blood glucose and controlling blood pressure.

• The root of Asian ginseng contains active chemical components called ginsenosides (or panaxosides) that are thought to be responsible for the herb’s claimed medicinal properties. The root is dried and used to make tablets or capsules, extracts, and teas, as well as creams or other preparations for external use.

• Uses
• Cautions
• Interactions
• Other Names
• References

Uses

• Used to increase energy levels and can be found in many energy boosting products.
• Some studies have shown that Asian ginseng may lower blood glucose. Several studies in people have also shown that ginseng may lower blood sugar levels.
• NCCAM supports studies to better understand the use of Asian ginseng. Areas of recent NCCAM-funded research include the herb’s potential role in treating insulin resistance, cancer, and Alzheimer’s disease.
• Some studies have found that ginseng may boost the immune system. There is some evidence that one particular type of American ginseng extract might decrease the number and severity of colds in adults.
• There is some early evidence that ginseng might temporarily — and modestly — improve concentration and learning. In some studies of mental performance, ginseng has been combined with ginkgo.
• Ginseng has also been studied as a way to improve mood and boost endurance as well as treat cancer, heart disease, fatigue, erectile dysfunction, hepatitis C, high blood pressure, menopausal symptoms, and other conditions.

Cautions

• Short-term use of ginseng at recommended doses appears to be safe for most people. Some sources suggest that prolonged use might cause side effects.
• The most common side effects are headaches, sleep problems, and gastrointestinal problems.
• Panax ginseng can cause allergic reactions.
• There have been reports of breast tenderness, menstrual irregularities, and high blood pressure associated with Asian ginseng products, but these products’ components were not analyzed, so effects may have been due to another herb or drug in the product.
• Panax ginseng may lower levels of blood sugar; this effect may be seen more in people with diabetes. Therefore, people with diabetes should use extra caution with Panax ginseng, especially if they are using medicines to lower blood sugar or taking other herbs, such as bitter melon and fenugreek, that are also thought to lower blood sugar.

Interactions

Moderate Interactions:

• Alcohol (Ethanol): Alcohol can cause sedative effects such as sleepiness and drowsiness. Ginseng might also cause sleepiness and drowsiness. Taking large amounts of Siberian ginseng along with alcohol might cause you to become too sedated.

• Digoxin (Lanoxin): Digoxin (Lanoxin) helps the heart beat more strongly. One person had too much digoxin in their system while taking a natural product that might have had Ginseng in it. But it is unclear if Siberian ginseng or other herbs in the supplement were the cause.

• Lithium: Ginseng might have an effect like a “water pill” or diuretic. Taking Ginseng might decrease how well the body gets rid of lithium. This could increase how much lithium is in the body and result in serious side effects. Talk with your healthcare provider before using this product if you are taking lithium. Your lithium dose might need to be changed.

• Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates): Some medications are changed and broken down by the liver. Ginseng might decrease how quickly the liver breaks down these medications. Taking ginseng along with medications that are changed by the liver might increase the effects and side effects of some medications. Before taking ginseng, talk to your healthcare provider if you take any medications that are changed by the liver.

Some of these medications that are changed by the liver include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline (Slo-bid, Theo-Dur, others), zileuton (Zyflo), zolmitriptan (Zomig), and others.

• Medications for diabetes (Antidiabetes drugs): Ginseng might affect blood sugar by lowering blood sugar levels. Diabetes medications are also used to lower blood sugar. Taking ginseng along with diabetes medications might cause your blood sugar to go too low or cause your diabetes medication to be less effective. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

• Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs): Ginseng might slow blood clotting. Taking ginseng along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

• Sedative medications (CNS depressants): Ginseng might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking Ginseng along with sedative medications might cause too much sleepiness.

Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.

Minor Interactions:

• Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates): Some medications are changed and broken down by the liver. Ginseng might decrease how quickly the liver breaks down these medications. Taking ginseng along with medications that are changed by the liver can increase the effects and side effects of your medication. Before taking ginseng, talk to your healthcare provider if you take any medications that are changed by the liver. However, this interaction is not verified with certainty in humans yet.

Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.

• Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates): Some medications are changed and broken down by the liver. Ginseng might decrease how quickly the liver breaks down these medications. Taking ginseng along with medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking ginseng, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.

Herb and Supplement Interaction:

• Herbs and supplements that might lower blood sugar: Ginseng might lower blood sugar. Taking ginseng along with herbs and supplements that might also lower blood sugar might cause your blood sugar to go too low or cause your diabetes medication to be less effective. Some of these products include bitter melon, ginger, goat’s rue, fenugreek, kudzu, gymnema, and others.
• Herbs and supplements that might slow blood clotting: Ginseng might slow blood clotting. Taking ginseng along with herbs or supplements that also slow clotting might increase the chances of bruising and bleeding. Some of these herbs and supplements include angelica, clove, danshen, fish oil, garlic, ginger, Panax ginseng, red clover, turmeric, vitamin E, and others.
• Herbs that might cause sleepiness and drowsiness: Ginseng might act like a sedative. That is, it might cause sleepiness and drowsiness. Taking ginseng along with other herbs that also act like sedatives might increase its effects and side effects. Herbs with sedative effects include calamus, California poppy, catnip, German chamomile, Gotu Kola, hops, Jamaican dogwood, kava, lemon balm, sage, St. John’s wort, sassafras, Chinese skullcap, valerian, wild carrot, wild lettuce, and others.

Other Names

Asian Ginseng, Asiatic Ginseng, Chinese Ginseng, Chinese Red Ginseng, Ginseng, Ginseng Asiatique, Ginseng Blanc, Ginseng Blanc de Corée, Ginseng Chinois, Ginseng Coréen, Ginseng Coréen Rouge, Ginseng de Corée, Ginseng Japonais, Ginseng Oriental, Ginseng Panax, Ginseng Radix Alba, Ginseng Root, Ginseng Rouge, Ginseng Sino-coréen, Ginseng Tibétain, Guigai, Hong Shen, Japanese Ginseng, Jen-Shen, Jinsao, Jintsam, Insam, Korean Ginseng, Korean Ginseng Root, Korean Panax, Korean Panax Ginseng, Korean Red Ginseng, Korean White Ginseng, Mandragore de Chine, Ninjin, Ninzin, Oriental Ginseng, Panax Coréen, Panax Ginseng Blanc, Panax schinseng, Racine de Vie, Radix Ginseng Rubra, Red Chinese Ginseng, Red Ginseng, Red Kirin Ginseng, Red Korean Ginseng, Red Panax Ginseng, Ren Shen, Renshen, Renxian, Sang, Seng, Sheng Shai Shen, Tibetan Ginseng, White Ginseng, White Panax Ginseng.

References

• Source: WEBMD, web article user reviewed by Melinda Ratini, DO, MS on April 14, 2013 www.webmd.com
• Source: Longe, J., ed. The Gale Encyclopedia of Alternative Medicine, second edition, 2004.
• Source: Natural Standard Patient Monograph: “Ginseng.”
• Source: National Center for Complementary and Alternative Medicine web site: “Asian Ginseng.”