Panax Ginseng

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What is it?

Panax ginseng is a plant that grows in Korea, northeastern China, and far eastern Siberia. People use the root to make medicine. Do not confuse Panax ginseng with other plants sometimes referred to as ginseng like American ginseng, Blue Cohosh, Canaigre, Codonopsis, Eleuthero, or Panax Notoginseng. These are different plants with different activity.

Panax ginseng is taken by mouth to improve memory and thinking skills, Alzheimer disease, and many other conditions, but there is no good scientific evidence to support these uses.

In manufacturing, Panax ginseng is used to make soaps, cosmetics, and as a flavoring in beverages.

It is effective?
Natural Medicines rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

Possibly Effective for …

  • Memory and thinking skills (cognitive function). Taking Panax ginseng by mouth might improve abstract thinking, mental arithmetic skills, and reaction times in healthy, middle-aged people but not in young adults. Panax ginseng alone does not seem to improve memory. But there is some evidence that a combination of Panax ginseng and ginkgo leaf extract can improve memory in otherwise healthy people between the ages of 38 and 66.
  • Erectile dysfunction (ED). Taking Panax ginseng by mouth seems to improve sexual function in men with ED.
  • Flu (influenza). Taking a specific Panax ginseng by mouth appears to reduce the risk of getting a cold or the flu. But, taking Panax ginseng does not seem to reduce flu symptoms or the length of the illness.
  • Fatigue in people with multiple sclerosis (MS). Taking Panax ginseng daily for 3 months reduces feelings of tiredness and improves quality of life in females with MS.
  • Increasing response to sexual stimuli in healthy people. Taking powdered Korean red ginseng, a specific form of Panax ginseng, seems to improve sexual arousal and satisfaction in postmenopausal women. Also, using a specific product containing Korean red ginseng and other ingredients (ArginMax for Women, Daily Wellness Company) seems to improve sexual desire in women who report sexual problems.

Possibly Ineffective for …

  • Athletic performance. Taking Panax ginseng by mouth for up to 8 weeks does not improve exercise performance.

Insufficient Evidence to Make a Determination for …

  • Hay fever. Early research shows that taking Panax ginseng improves some symptoms of hay fever such as itching and runny nose.
  • Alzheimer disease. Some research shows that taking Panax ginseng root daily for 12 weeks can improve mental performance in people with Alzheimer disease.
  • Breast cancer. Research conducted in China suggests that some people with breast cancer treated with any form of ginseng (American or Panax) have a higher quality of life and lower risk of death. But this might not be due to ginseng. The people in the study were also likely to be treated with the prescription anticancer drug tamoxifen. It is difficult to know how much of the benefit is from ginseng or tamoxifen.
  • Swelling (inflammation) of the main airways in the lung (bronchitis). Taking a specific Panax ginseng extract (G115) by mouth, combined with antibiotics, might be more effective in killing bacteria in the lungs of people with long-term bronchitis than antibiotic treatment alone.
  • Cancer. Research suggests that taking ginseng by mouth might decrease the occurrence of some types of cancer, including stomach cancer, lung cancer, liver cancer, ovarian cancer, and skin cancer. However, other research shows that Panax ginseng doesn’t reduce the risk of getting cancer. But several studies show that Panax ginseng might slow cancer growth and improve quality of life in cancer patients.
  • Tiredness in people with cancer. Early research shows that Panax ginseng can reduce fatigue in some people with cancer.
  • Common cold. There is some evidence that taking a specific Panax ginseng extract (G115) by mouth can decrease the chance of catching a cold.
  • Heart failure and fluid build up in the body (congestive heart failure or CHF). Taking Panax ginseng by mouth daily, without or without conventional medications, seems to improve heart function.
  • A lung disease that makes it harder to breathe (chronic obstructive pulmonary disease or COPD). Taking Panax ginseng by mouth with many other ingredients seems to improve lung function and some symptoms of COPD. But other research suggests that Panax ginseng does not help to prevent COPD exacerbations.
  • Diabetes. Some research shows that taking Panax ginseng by mouth daily can improve blood sugar levels. But not all research agrees.
  • Nerve pain in people with diabetes (diabetic neuropathy). Early research suggests that taking Panax ginseng might reduce nerve sensitivity in people with this condition.
  • Fatigue. Early research shows that Panax ginseng can reduce fatigue in some people with chronic fatigue. But not all research agrees.
  • Fibromyalgia. Research suggests that taking Panax ginseng root extract by mouth daily for 12 weeks does not improve pain, tiredness, sleep quality, anxiety, tender points, or quality of life in people with fibromyalgia.
  • Gallbladder disease. Research suggests that taking Panax ginseng together with medication for 24 weeks does not reduce gallstones.
  • Bad breath. Early research suggests that taking Korean red ginseng, a type of Panax ginseng, daily for 10 weeks might help to improve bad breath.
  • Hangover. Research suggests that drinking a beverage containing Panax ginseng extract within 5 minutes of drinking alcohol and eating a piece of cheese might lower blood alcohol levels and reduce hangover symptoms.
  • Hearing loss. Early research suggests that taking Panax ginseng for 14 days reduces temporary hearing loss caused by loud noise. But it might be less effective than N-acetyl cysteine at preventing temporary hearing loss caused by loud noise.
  • HIV. Early evidence shows that Korean red ginseng, a type of Panax ginseng, might increase immune function. But it doesn’t seem to lower the amount of the HIV virus found in the blood of people with HIV.
  • High blood pressure. Some early research shows that taking Panax ginseng in three divided doses daily for 8 weeks slightly reduces blood pressure in people with high blood pressure. But taking a specific Panax ginseng product (Ginseol K-g1) daily for 8 weeks does not reduce blood pressure in people with mildly high blood pressure.
  • Prediabetes. Early research shows that taking fermented Panax ginseng can reduce post-meal blood sugar levels and increase post-meal insulin levels in people with prediabetes.
  • Symptoms of menopause. Panax ginseng seems to improve some, but not all, symptoms of menopause. Some early research suggests that Panax ginseng might improve quality of life and fatigue, insomnia, and depression. Panax ginseng also seems to reduce cholesterol levels. But most research shows that Panax ginseng doesn’t reduce hot flashes. Also, it does not seem improve memory or concentration.
  • Quality of life. While some research suggests that Panax ginseng might improve quality of life, other research shows no benefit.
  • Stress. Early research in adults who are stressed at work suggests that taking a specific type of Panax ginseng reduces stress and improves attention and memory.
  • Attention deficit-hyperactivity disorder (ADHD).
  • Aging.
  • Anxiety.
  • Anemia.
  • Bleeding disorders.
  • Chronic fatigue syndrome (CFS).
  • Convulsions.
  • Decline in memory and thinking skills in older people that is more than what is normal for their age.
  • Depression.
  • Disorders of pregnancy and childbirth.
  • Dizziness.
  • Fever.
  • Fluid retention.
  • Insomnia.
  • Joint pain.
  • Loss of appetite.
  • Conditions in a man that prevent him from getting a woman pregnant within a year of trying to conceive (male infertility).
  • Early orgasm in men (premature ejaculation).
  • Nerve pain.
  • Stomach inflammation and other digestive problems.
  • Wrinkled skin.
  • Other conditions.

More evidence is needed to rate Panax ginseng for these uses.

How does it work?
Panax ginseng contains many active substances. The substances thought to be most important are called ginsenosides or panaxosides. Ginsenosides is the term coined by Asian researchers, and the term panaxosides was chosen by early Russian researchers.

Panax ginseng is often referred to as a general well-being medication, because it affects many different systems of the body.

Is there concern for the safety of its use?
When taken by mouth: Panax ginseng is LIKELY SAFE when taken for up to 6 months. Panax ginseng is POSSIBLY UNSAFE when taken for more than 6 months. Researchers think it may have some hormone-like effects that could be harmful with long-term use.

The most common side effect is trouble sleeping (insomnia). Less commonly, people experience menstrual problems, breast pain, increased heart rate, high or low blood pressure, headache, loss of appetite, diarrhea, itching, rash, dizziness, mood changes, vaginal bleeding, and other side effects.

Uncommon side effects that have been reported include severe rash, liver damage, and severe allergic reactions.

When applied to the skin: There isn’t enough reliable information to know if Panax ginseng is safe. It might cause side effects such as irritation and burning.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Panax ginseng is POSSIBLY UNSAFE when taking by mouth during pregnancy. One of the chemicals in Panax ginseng has been found to cause birth defects in animals. Do not use Panax ginseng if you are pregnant.

Not enough is known about the safety of Panax ginseng during breast-feeding. Stay on the safe side and avoid use.

Infants and children: Panax ginseng is LIKELY UNSAFE in infants and children. Using Panax ginseng in babies has been linked to poisoning that can be fatal. The safety of Panax ginseng in older children is not known. Until more is known, do not use Panax ginseng even in older children.

“Auto-immune diseases” such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Panax ginseng seems to increase the activity of the immune system. It might make auto-immune diseases worse. Don’t use Panax ginseng if you have any auto-immune condition.

Bleeding conditions: Panax ginseng seems to interfere with blood clotting. Don’t use Panax ginseng if you have a bleeding condition.

Heart conditions: Panax ginseng can affect heart rhythm and blood pressure slightly on the first day it is used. However, there are usually no changes with continued use. Nevertheless, Panax ginseng has not been studied in people with cardiovascular disease. Use Panax ginseng with caution if you have heart disease.

Diabetes: Panax ginseng might lower blood sugar. In people with diabetes who are taking medications to lower blood sugar, adding Panax ginseng might lower blood sugar too much. Monitor your blood sugar closely if you have diabetes and use Panax ginseng.

Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Panax ginseng contains chemicals (ginsenosides) that can act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don’t use Panax ginseng.

Trouble sleeping (insomnia): High doses of Panax ginseng have been linked with insomnia. If you have trouble sleeping, use Panax ginseng with caution.

Organ transplant: Panax ginseng might make the immune system more active. This could interfere with the effectiveness of medications that are given after an organ transplant to reduce the chance that the organ will be rejected. If you have received an organ transplant, don’t use Panax ginseng.

Schizophrenia (a mental disorder): High doses of Panax ginseng have been linked with sleep problems and agitation in people with schizophrenia. Be careful when using Panax ginseng if you have schizophrenia.

Are there any drug interactions?

Alcohol

Interaction Rating=Moderate Be cautious with this combination.

The body breaks down alcohol to get rid of it. Taking Panax ginseng might increase how fast your body gets rid of alcohol.

Caffeine

Interaction Rating=Moderate Be cautious with this combination.

Caffeine can speed up the nervous system. By speeding up the nervous system, caffeine can make you feel jittery and speed up your heartbeat. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with caffeine might cause serious problems including increased heart rate and high blood pressure. Avoid taking caffeine along with Panax ginseng.

Furosemide (Lasix)

Interaction Rating=Moderate Be cautious with this combination.

Some scientists think that Panax ginseng might decrease how well furosemide (Lasix) works. But there isn’t enough information to know if this is a big concern.

Insulin

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might decrease blood sugar. Insulin is also used to decrease blood sugar. Taking Panax ginseng along with insulin might cause your blood sugar to be too low. Monitor your blood sugar closely. The dose of your insulin might need to be changed.

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)

Interaction Rating=Moderate Be cautious with this combination.

Some medications are changed and broken down by the liver. Panax ginseng might decrease how quickly the liver breaks down some medications. Taking Panax ginseng along with some medications that are changed by the liver can increase the effects and side effects of your medication. Before taking Panax ginseng talk to your healthcare provider if you take any medications that are changed by the liver.
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 for depression (MAOIs)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might stimulate the body. Some medications used for depression can also stimulate the body. Taking Panax ginseng with these medications used for depression might cause too much stimulation. This might cause side effects such as anxiousness, headache, restlessness, and insomnia.
Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.

Medications for diabetes (Antidiabetes drugs)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking Panax ginseng along with diabetes medications might cause your blood sugar to go too low. 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 decrease the immune system (Immunosuppressants)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng increases the immune system. By increasing the immune system, Panax ginseng might decrease the effectiveness of medications that decrease the immune system.
Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Interaction Rating=Moderate Be cautious with this combination.

Panax ginseng might slow blood clotting. Taking Panax 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.

Stimulant drugs

Interaction Rating=Moderate Be cautious with this combination.

Stimulant drugs speed up the nervous system. By speeding up the nervous system, stimulant medications can make you feel jittery and speed up your heartbeat. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with Panax ginseng.
Some stimulant drugs include diethylpropion (Tenuate), epinephrine, phentermine (Ionamin), pseudoephedrine (Sudafed), and many others.

Warfarin (Coumadin)

Interaction Rating=Moderate Be cautious with this combination.

Warfarin (Coumadin) is used to slow blood clotting. There is some concern that Panax ginseng might decrease the effectiveness of warfarin (Coumadin). But it’s not clear if this interaction is a big problem. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Are there any interactions with herbs and supplements?
Herbs and supplements that might cause an irregular heartbeat (QT interval-prolonging drugs): Panax ginseng might change the electrical currents in the heart. This can increase the risk of having an irregular heartbeat. Using Panax ginseng with other herbs that can also have this effect might increase the risk for having an irregular heartbeat, which can be dangerous. These other herbs include arsenic, bitter orange, ephedra, grapefruit, iboga, and Sida cordifolia.
Herbs and supplements that might lower blood sugar: Panax ginseng might lower blood sugar. Taking Panax ginseng along with other herbs and supplements that lower blood sugar might make the blood sugar too low. Some of these products include bitter melon, ginger, goat’s rue, fenugreek, kudzu, willow bark, and others.
Herbs and supplements that might slow blood clotting: Using Panax ginseng with other herbs that can slow blood clotting might increase the risk of bleeding in some people. These other herbs include angelica, clove, danshen, ginger, ginkgo, red clover, turmeric, vitamin E, willow, and others.

Are there any interactions with food?
Alcohol (Ethanol): The body breaks down alcohol to get rid of it. Taking Panax ginseng might increase how fast your body gets rid of alcohol.
Caffeine-containing foods: Coffee and tea contain caffeine. Caffeine can speed up the nervous system. By speeding up the nervous system, caffeine can make you feel jittery and speed up your heartbeat. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with caffeine might cause serious problems including increased heart rate and high blood pressure. Avoid taking caffeine along with Panax ginseng.

What dose is used?
The following doses have been studied in scientific research:

BY MOUTH:

  • For memory and thinking skills (cognitive function): 200 to 400 mg of a specific Panax ginseng extract (G115, Pharmaton SA) taken once daily or in two divided doses for up to 12 weeks, or 200 to 960 mg as a single dose, has been used.
  • For erectile dysfunction (ED): 1400 to 2700 mg of Panax ginseng, taken in two or three divided doses per day for up to 12 weeks, has been used.
  • For flu (influenza): 200 mg of Panax ginseng extract (G115) daily, starting 4 weeks before getting a flu shot and continuing for 8 weeks after, has been used. Also, 1 gram of Panax ginseng extract three times daily for 12 weeks has also been used.
  • For fatigue in people with multiple sclerosis (MS): 250 mg of Panax ginseng twice daily for 3 months has been used.
  • For increasing response to sexual stimuli in healthy people: 3 grams of Korean red ginseng, a form of Panax ginseng, daily for 8 weeks has been used. A specific combination product (ArginMax for Women, The Daily Wellness Company), taken daily for 4 weeks, has also been used.

By what other names is the product known?
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, Manchurian 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.

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