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Quick guide to Red Ginseng

Scientific Name: Panax Ginseng

Other Names: Asian Ginseng, Chinese Ginseng, Ginseng, Panax, Guigai, Japanese Ginseng, Korean Ginseng, Ninjin, Oriental Ginseng, Panax schinseng, Red Ginseng, Seng

Who is this for?

NOTE: Panax ginseng is different from American ginseng and Eleuthero (formerly Siberian ginseng). They are not interchangeable.

Panax ginseng is related to, but not identical with American ginseng. Panax ginseng is native to Asia, while American ginseng originated on the North American continent. The two plants have somewhat different chemical compositions, the most notable differences are that Panax ginseng has higher levels of a ginsenoside known as Rg1 and lower levels of ginsenoside Rb1.

Panax ginseng is best known as an “adaptogen” — a substance that may help individuals cope with physical and emotional stress. As a part of traditional Chinese medicine for thousands of years, Panax ginseng has been used to treat almost every ailment from anxiety to cancer. Currently, it is used extensively in Oriental countries to treat several illnesses, including heart conditions, and for an overall health enhancer.

In western herbal medicine, Panax ginseng’s regulating effects on the immune system have been studied for potential effectiveness in preventing colds, flu, and some forms of cancer. In clinical studies, Panax ginseng has been shown to lower blood levels of both sugar and cholesterol, therefore it may help treat type 2 diabetes and high cholesterol. Its other potential uses are not as well defined, however. In separate studies of laboratory animals and humans, Panax ginseng had a relaxing effect on muscles in the lungs. The resulting airway expansion may help relieve asthma symptoms and other lung conditions that result from constricted airways. In other studies, a combination of Panax ginseng and gingko is believed to boost memory and thinking processes. Early results from laboratory study may show that chemicals in Panax ginseng promote the growth of blood vessels, which could be valuable in treating extensive injuries. All of these possible effects are under more extensive study.

Panax ginseng may be taken by mouth or applied topically, directly to the penis to treat erectile dysfunction in men. One large study revealed that taking Panax ginseng orally improved male fertility by increasing sperm count, quality, and movement. Although the exact reasons that Panax ginseng may enhance male fertility are not completely known, it is believed that chemicals in Panax ginseng may activate the body system that increases production of certain hormones. Whether Panax ginseng increases testosterone levels in the blood is uncertain, however. Nevertheless, due to proposed hormonal activation, Panax ginseng is frequently added to sports drinks or supplements as a way to enhance athletic performance, even though no evidence supports this use.

Through the same activation of hormone production, chemicals in Panax ginseng are thought to exert an effect similar to the female hormone, estrogen. In some laboratory studies, Panax ginseng accelerated the growth of breast cancer cells, perhaps by activating estrogen receptors. Other laboratory and animal studies suggest that Panax ginseng may increase blood levels of substances that the body converts into estrogen. Results of a recent chemical analysis show that some of Panax ginseng’s possible estrogenic effects may be due to a fungus that frequently contaminates Panax ginseng roots. Much more research is needed to understand more clearly Panax ginseng’s possible hormonal effects.

When should I be careful taking it?

An intoxication-like syndrome has been seen in a few newborn babies who were given Panax ginseng or whose mothers took it while pregnant or breast-feeding. One documented case of an infant's death which was attributed to Panax ginseng intoxication has been reported. Small children and babies should not be given Panax ginseng; pregnant and breast-feeding women should also avoid taking it.

Women with hormone-dependent conditions such as endometriosis, uterine fibroids, and cancers of the breast, ovaries, or uterus should not take Panax ginseng due to its possible estrogenic effects. Men with prostate cancer should also avoid taking Panax ginseng.

In clinical studies of both humans and animals, Panax ginseng has slowed the rate and decreased the force of heartbeats. It has also reduced blood pressure in some cases. All of these effects may worsen some heart conditions. Individuals with any kind of heart disease should not take Panax ginseng without supervision from a healthcare professional.

Precautions

Individuals with diabetes should avoid taking large amounts of Panax ginseng because it can lower blood sugar levels, potentially resulting in hypoglycemia (blood sugar that is too low). Indications that blood sugar may be too low include shakiness, sweating, confusion, distorted speech, and loss of muscle control. If not corrected, low blood sugar can lead to unconsciousness and even death.

Taking Panax ginseng by mouth may cause or worsen insomnia.

What side effects should I watch for?

Note:Most side effects from Panax ginseng have been reported in individuals who took high doses or who took Panax ginseng continually for long periods of time.

Major Side Effects

Infants given Panax ginseng may develop a condition, resembling alcohol intoxication that has lead to at least one reported death of a newborn.

Rarely, taking Panax ginseng by mouth has been associated with non-infectious hepatitis.

In other rare reports, Panax ginseng may have caused inflammation of blood vessels in the brain – a condition that could result in headaches or strokes.

One case has been reported of an individual who developed anaphylaxis-like symptoms shortly after ingesting a small amount of Panax ginseng syrup. Anaphylaxis is a potentially life-threatening allergic reaction that may involve the development of a rash or hives, a sudden fall in blood pressure, swelling of the mouth and throat, or unconsciousness.

Less Severe Side Effects

Other side effects associated with taking Panax ginseng are generally mild and temporary. They usually diminish after a few days and they may include:

  • Blood pressure changes
  • Breast pain
  • Diarrhea
  • Dizziness
  • Headache
  • Heart rate changes
  • Insomnia
  • Itching
  • Loss of appetite
  • Mood changes
  • Nervousness

A few individuals have experienced itchy rashes after taking or applying Panax ginseng preparations or touching Panax ginseng plants. In very rare cases, Panax ginseng may have caused a very serious skin reaction called Stevens-Johnson Syndrome. A doctor should be contacted right away if a high fever, swollen eyelids, blisters in the mouth, or red marks on the skin develop while Panax ginseng is taken.

What interactions should I watch for?

Prescription Drugs

In studies, Panax ginseng has been shown to increase the time blood needs to clot. When it is taken with antiplatelet or anticoagulant drugs, the effect of the drug may be increased, possibly resulting in uncontrolled bleeding.

  • Antiplatelet agents include Plavix and Ticlid
  • Anticoagulants include heparin and warfarin

Some drugs used for asthma, heart problems, or other reasons can affect heart rhythm. Because Panax ginseng can change the force and rate of heart beats, it can increase the risk of side effects from drugs such as:

  • theophylline and related drugs for asthma
  • albuterol
  • clonidine
  • Viagra

Panax ginseng may interfere with insulin and oral drugs for diabetes, such as:

  • Actos
  • Amaryl
  • Avandia
  • glipizide (Glucotrol XL)
  • glyburide (Glynase)
  • Glyset
  • metformin (Glucophage)
  • Prandin
  • Precose

Panax ginseng is believed to affect levels of neurotransmitters, chemicals that carry messages from nerve cells to other cells. Antipsychotic drugs used to treat mental disorders such as schizophrenia also alter the levels of neurotransmitters. If Panax ginseng and antipsychotic drugs are taken at the same time, the effectiveness of the drug may be changed, so it is best to avoid using Panax ginseng while taking drugs such as:

  • chlorpromazine (Thorazine)
  • fluphenazine (Prolixin)
  • olanzapine (Zyprexa)
  • prochlorperazine (Compazine)
  • quetiapine (Seroquel)
  • risperidone (Risperdal)

Because it is broken down by certain enzymes in the liver, Panax ginseng may possibly interfere with the use of prescription drugs that are processed by the same enzymes. Some of these drugs are:

  • Allergy drugs such as Allegra
  • Antifungal drugs such as ketoconazole (Nizoral) and Sporanox
  • Cancer drugs such as etoposide, paclitaxel, vinblastine, or vincristine
  • Drugs for high cholesterol such as lovastatin
  • Oral contraceptives

In reported cases, the risk of side effects such as headache, insomnia, and shakiness increased when Panax ginseng was taken with antidepressants known as MAO inhibitors. Drugs in this class include:

  • isocarboxazid (Marplan)
  • phenelzine (Nardil)
  • selegiline (Eldepryl)
  • tranylcypromine (Parnate)

Because it is a non-specific central nervous system stimulant, Panax ginseng may increase the effects and the side effects of prescription drugs that also stimulate the central nervous system. Used mainly to treat attention-deficit hyperactivity disorder, narcolepsy, and obesity; stimulant drugs can raise heart rate and blood pressure. They include:

  • amphetamine salts (Adderall)
  • dextroamphetamine (Dexedrine)
  • methylphenidate (Concerta, Methlyn, Ritalin)
  • phentermine (Adipex-P, Ionamin)

Non-prescription Drugs

Panax ginseng can affect the ability of blood to clot after an injury. Aspirin can also delay clotting, so Panax ginseng should not be taken orally at the same time as aspirin.

Stimulants may be included in non-prescription drugs that are used for increasing energy, losing weight, raising mental alertness, or treating colds or asthma. If Panax ginseng is taken by mouth at the same time as one of these products is being used, the central nervous system may be overstimulated, possibly resulting in insomnia, irritability, and increased blood pressure. If you are not sure whether the non-prescription drugs you take contain stimulants, ask your doctor or pharmacist before you take Panax ginseng.

Herbal Products

Theoretically, if Panax ginseng is used with other herbs that affect blood clotting, bleeding may occur. Some of the most common herbal products that might inhibit blood clotting are:

  • Danshen
  • Devil's Claw
  • Eleuthero
  • Garlic
  • Ginger (in high amounts)
  • Ginkgo
  • Horse Chestnut
  • Papain
  • Red Clover
  • Saw Palmetto

If Panax ginseng is taken at the same time as other herbs that also affect the heart, potentially dangerous changes in heart function may result. Some herbal products with heart effects are:

  • European Mistletoe
  • Ginger (in large doses)
  • Hawthorn
  • Motherwort
  • Pleurisy Root
  • Squill

Because Panax ginseng may decrease blood sugar levels, taking it with other blood sugar-lowering herbal products may result in hypoglycemia - blood sugar that is too low. Herbals that may reduce blood sugar include:

  • Fenugreek
  • Ginger (in high amounts)
  • Kudzu

Certain herbal products are stimulants that may result in side effects if they are taken with Panax ginseng. These herbal products include ephedra (which has been withdrawn from the market), guarana, and mate. Taken together with Panax ginseng, any one of these herbals may cause insomnia, irritability, nervousness, and other side effects.

Foods

Caffeine increases the central nervous system stimulation effect of Panax ginseng. The combination may cause excessive nervousness and irritability, along with other signs of over-stimulation. Caffeinated beverages such as coffee, soft drinks, and tea should not be consumed when taking Panax ginseng.

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals.

Should I take it?

Panax ginseng is native to the northern parts of China, Korea, and Siberia. While closely related to American ginseng, Panax ginseng contains different chemical substances. It looks similar to American ginseng, with mature plants having three to seven short stems each containing five leaves. One tall central stem bears a cluster of tiny yellow flowers followed by small red berries. Panax ginseng plants generally are larger than American ginseng plants, their roots may be bigger in diameter, and the roots have a sweetish smell. Typically, fresh roots of Panax ginseng are a slightly darker tan color, as opposed to a yellow or cream color for the roots of American ginseng. Unlike the quicker-growing American ginseng, though, cultivated Panax ginseng roots are not large enough to harvest until the plants are at least 7 years old. Wild Panax ginseng grows even more slowly. Thought to be more effective than cultivated roots, authenticated extremely old wild Panax ginseng roots are extremely expensive.

The name “red ginseng” refers to a method of preserving Panax ginseng by steaming it under pressure. Processing by steam is thought to increase the amounts of some active components of Panax ginseng.

In Oriental countries, Panax ginseng is used to flavor drinks and foods, it is an ingredient in some soft drinks and chewing gum, and it is included in vitamin tablets. Powdered Panax ginseng may be added to cooked foods or coffee. In cosmetics, Panax ginseng is used as a scent and a coloring agent.

Dosage and Administration

Panax ginseng is available in a number of different oral dosage forms that include capsules, dried root powder, fresh root, liquid extracts, and teas. Many Panax ginseng products are standardized to contain 7% of the active ingredients known as ginsenosides. Standardization by the manufacturer should assure the same amount of active ingredient in every batch of the commercial preparation. The U.S. Food and Drug Administration does not require standardization of herbal products, so not every Panax ginseng product sold in the United States may contain the same active ingredients. Additionally, the amounts of active chemicals in Panax ginseng vary greatly according to how the plants are grown, harvested, processed, and stored. Panax ginseng products may be extended with other types of ginseng that are less expensive to produce.

For improving or maintaining general health, a commonly recommended daily dose of oral Panax ginseng is 500 mg to 3000 mg (0.5 gram to 3 grams) of fresh root or 200 mg to 600 mg as dried root powder in capsules. Doses for other conditions differ widely depending on the type of product being used and the condition being treated. If Panax ginseng is used, the directions on the package that is purchased should be followed.

Panax ginseng tea may be made by soaking about 3000 mg (3 grams) of chopped fresh root or 1500 mg (1.5 grams) of dried root powder in about 5 ounces of boiling water for 10 to 15 minutes and then straining out the solid particles. Panax ginseng tea may have a strong taste, so it is often sweetened, flavored, or added to other herbals before drinking.

Many sources recommend that the use of Panax ginseng be interrupted for 2 or 3 weeks after oral Panax ginseng is used continuously for up to 3 months.

Summary

Taken most commonly as an adaptogen to help the body resist stress, Panax ginseng has been studied for improving memory, treating asthma, and enhancing immune function. It may also help to reduce levels of blood sugar and blood cholesterol. Either orally or topically, it may treat erectile dysfunction and it may also help to relieve some types of male infertility. Possible estrogenic effects need further investigation.

Risks

Individuals who have heart conditions or cancers of the breast, ovaries, prostate, or uterus should not take Panax ginseng. Pregnant women, infants, and young children should also avoid taking it. Individuals who have diabetes or insomnia should be careful if they decide to take Panax ginseng.

Side Effects

Rarely, newborn babies who are given Panax ginseng have developed an intoxication-like condition. In adults, rare cases of hepatitis or inflamed blood vessels in the brain have been attributed to taking it. One case of possible severe allergy to Panax ginseng resulted in breathing problems, low blood pressure, and sudden rash. More often, Panax ginseng is associated with milder and temporary side effects such as diarrhea, heart rate changes, insomnia, and nervousness.

Interactions

Panax ginseng may interfere with many prescription drugs, non-prescription products, and herbals, including:

  • albuterol
  • caffeine
  • Central nervous system stimulants
  • Drugs and herbals that affect blood clotting
  • Drugs and herbals used for the treatment of diabetes
  • Drugs used to treat schizophrenia
  • MAO inhibitors
  • theophylline and related drugs for asthma
  • Viagra

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(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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