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Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidence
Grade*

Heart conditions

Ginseng appears to have antioxidant effects that may benefit patients with heart disorders. Some studies suggest that ginseng also reduces oxidation of low-density lipoprotein (LDL or "bad") cholesterol and brain tissue. Better studies are needed to make a firm recommendation.

B

High blood sugar/glucose intolerance

Several studies suggest ginseng may lower blood sugar levels in patients with type 2 diabetes before and after meals. These results are promising, especially because ginseng does not seem to lower blood sugar to dangerous levels. Future research should focus on the long-term effects of ginseng in managing blood sugar levels.

B

Immune system enhancement

Several studies report that ginseng may boost the immune system, improve the effectiveness of antibiotics in people with acute bronchitis, and enhance the body's response to flu vaccines. Additional studies are needed before a clear conclusion can be reached.

B

Type 2 diabetes (adult-onset)

Several human studies report that ginseng may lower blood sugar levels in patients with type 2 diabetes. Long-term effects are not clear, and it is not known what doses are safe or effective. People with diabetes should seek the care of a qualified healthcare practitioner and should not use ginseng instead of more proven therapies. Effects of ginseng in type 1 diabetes ("insulin dependent") are not well studied.

B

Aplastic anemia

Weak studies suggest that ginseng in combination with other herbs may improve cell activity, immune function, and red and white blood cell counts in patients with aplastic anemia. Other studies have found decreases in blood cell counts. High-quality studies of ginseng alone are needed.

C

Attention deficit hyperactivity disorder (ADHD)

Early small studies suggest that Korean ginseng may help treat attention deficit hyperactivity disorder in children. However, there is currently not enough evidence to support this use of ginseng.

C

Birth outcomes (anoxemic encephalopathy)

There is currently not enough evidence to support the use of ginseng for this condition. High-quality studies are needed to understand this relationship.

C

Bronchodilator

Limited research suggests that ginseng has positive effects on breathing. Further studies are needed in this area.

C

Cancer chemotherapy

Early studies suggest that ginseng injections may help patients undergoing chemotherapy for various types of cancer. Ginseng may improve body weight, quality of life, and the immune response. Although this evidence is promising, the effect of ginseng alone is not clear. More research using ginseng alone is needed.

C

Cancer prevention

A few studies report that ginseng taken by mouth may lower the risk of developing some cancers, especially if ginseng powder or extract is used. Study results are controversial, and more research is needed before a clear conclusion can be reached.

C

Cardiovascular risk reduction

Current evidence does not support the use of ginseng to reduce the risk of heart disease. Some evidence suggests that ginseng may improve blood pressure, blood sugar levels, and cholesterol. High-quality studies are needed.

C

Chronic hepatitis B

Early studies show that ginseng may improve some aspects of liver function but not others. More research is needed in this area.

C

Chronic obstructive pulmonary disease (COPD)

Ginseng was reported to improve lung function and exercise capacity in patients with COPD. Further research is needed to confirm these results.

C

Congestive heart failure

Based on limited research, it is unclear if ginseng improves congestive heart failure. High-quality studies looking at the effect of ginseng alone are needed.

C

Coronary artery disease

Several studies from China report that ginseng in combination with various other herbs may reduce symptoms of coronary artery disease. Without further evidence on the effects of ginseng specifically, a firm conclusion cannot be reached.

C

Dementia

Early small studies report that Fuyuan mixture, an herbal combination that contains ginseng, may improve symptoms of multi-infarct dementia. The effects of ginseng alone are not clear, and no firm conclusion can be drawn.

C

Diabetic complications (kidney damage)

Early evidence suggests that a form of ginseng not commonly available in the United States may improve kidney damage in patients with diabetes. Some research suggests that Panax notoginseng may be as effective as the prescription drug Ticlid?. However, more research is needed.

C

Erectile dysfunction

Early studies suggest that ginseng may help treat erectile dysfunction. Additional high-quality studies are needed.

C

Exercise performance

Athletes commonly use ginseng as a potential way to improve stamina. However, it remains unclear if ginseng taken by mouth significantly affects exercise performance. Many studies have been published in this area, with mixed results. Better studies are necessary before a clear conclusion can be reached.

C

Fatigue

A few studies using ginseng extract G115? (with or without multivitamins) report improvements in patients with fatigue of various causes. However, these results are early, and studies have not been high quality.

C

Fistula (anal)

Early evidence in infants with peri-anal abscesses or anal fistulas suggests that GTTC (Ginseng and Tang-kuei Ten Combination) may speed up recovery. Further research is needed to confirm these results.

C

Heart damage (cardiac bypass complications)

Early studies suggest that ginseng may have a positive effect on complications of cardiac bypass surgery, including decreasing damage to the lining of the digestive tract. Well-designed studies are needed before a strong recommendation can be made.

C

High blood pressure

Early research suggests that ginseng may lower blood pressure (systolic and diastolic). It is not clear what doses may be safe or effective. Well-conducted studies are needed to confirm these early results.

C

High cholesterol

Several low-quality studies have examined the effects of Panax ginseng on cholesterol levels. Results are mixed. More studies are needed to understand the effects of ginseng on cholesterol levels.

C

Idiopathic thrombocytopenic purpura (refractory)

Combination herbal products containing ginseng may help treat refractory idiopathic thrombocytopenic purpura, a blood disorder that does not respond well to treatment. Studies that use ginseng alone are needed.

C

Intracranial pressure (ICP)

Early research reports that Xuesaitong injection (XSTI), a preparation of Panax notoginseng , may help decrease pressure inside the skull and benefit coma patients. Further study is needed to confirm these results.

C

Kidney dysfunction (hemorrhagic fever with renal syndrome)

A combination of herbs that included ginseng was not better than treatment with a conventional medicine plus traditional Chinese medicine. More research is needed in this area because the effects of ginseng alone are unknown.

C

Liver protection

Early studies suggest that ginseng may have protective effects on the liver. Additional human study is warranted in this area.

C

Lung conditions

Several studies have looked at the effects of ginseng in a variety of lung conditions. Early results are promising, but many studies have used combination products, making it difficult to evaluate the effect of ginseng. More research using ginseng alone is needed in this area.

C

Male infertility

Early evidence suggests that ginseng may improve male fertility by increasing the number and movement of sperm. Further studies are needed to determine what dose may be safe and effective.

C

Menopausal symptoms

Based on limited research, it is unclear if ginseng may help treat menopausal symptoms. Some studies report improvements in depression and sense of well-being, without changes in hormone levels.

C

Mental performance

Several studies report that ginseng may modestly improve thinking or learning. Benefits have been seen both in healthy young people and in older ill patients. Effects have also been reported with a combination of ginseng and Ginkgo biloba . However, some mixed results have also been reported. Therefore, even though most available evidence supports this use of ginseng, better research is needed before a strong recommendation can be made.

C

Methicillin-resistant Staphylococcus aureus (MRSA)

In patients treated with Hochu-ekki-to, which contains ginseng and several other herbs, urinary MRSA has been reported to decrease after 10 weeks. Further study of ginseng alone is necessary in order to draw firm conclusions.

C

Mood and cognition in post-menopausal women

A review of several studies suggested that ginseng may improve mood and anxiety in postmenopausal women. Additional studies are needed before a firm conclusion may be drawn.

C

Neurological disorders

Early studies suggest that ginseng may have beneficial effects on neurological disorders. High-quality studies are needed in this area.

C

Postoperative recovery (breast cancer)

Early studies have tested the effect of a combination product containing ginseng on recovery after surgery among breast cancer patients. Results suggest no benefits in cell counts, but a slightly faster recovery of the iron-carrying component of red blood cells (called hemoglobin). Studies using ginseng alone are needed.

C

Pregnancy problems (intrauterine growth retardation)

Early studies have found that components of Panax ginseng might be useful in treating intrauterine growth retardation. Larger, well-designed studies are needed in this area.

C

Premature ejaculation

Early studies suggest that applying an herbal combination containing Panax ginseng on the penis may help treat premature ejaculation. However, because ginseng was tested with other herbs, its individual effects are unclear.

C

Quality of life

There is early evidence that Panax ginseng or Korean ginseng may help improve quality of life in both healthy and ill patients, although effects may not be long-lasting unless ginseng is taken continually. More research is needed in this area before a firm conclusion can be reached.

C

Radiation therapy side effects

Early studies suggest that ginseng may improve fatigue and measures of well-being among patients receiving radiation therapy. However, there is not enough evidence to recommend the use of Panax ginseng or Korean ginseng for this use.

C

Respiratory infections

Ginseng (CVT-E002) may be safe, well tolerated, and potentially effective for preventing acute respiratory illnesses caused by the flu or the respiratory syncytial virus. More study is needed in this area.

C

Sexual arousal (in women)

Early studies suggest that a product containing Panax ginseng , L-arginine, Ginkgo biloba , damiana, and multivitamin/minerals may improve sexual function in menopausal women and women with decreased sex drives. Studies with Panax ginseng alone are needed before strong recommendations can be made.

C

Viral myocarditis

Poorly described research in patients treated with Shenmai and Shengmai injection (a ginseng preparation) report that there may be some improvement in heart function. More studies are needed before a clear conclusion can be drawn.

C

Well-being

Several studies have examined the effects of ginseng (with or without multivitamins) on overall well-being in healthy and ill patients, for up to 12 weeks. Most studies are not high quality, and results are mixed. It remains unclear if ginseng is beneficial for well-being in any patient.

C

Key to grades

A   Strong scientific evidence for this use
B   Good scientific evidence for this use
C   Unclear scientific evidence for this use
D   Fair scientific evidence against this use (it may not work)
F   Strong scientific evidence against this use (it likely does not work)

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acrocyanosis (circulatory insufficiency of the extremities), adaptogen, adrenal tonic, aerobic fitness, aggression, aging, AIDS/HIV, air pollution protection, alcoholism, allergy, altitude (mountain) sickness, Alzheimer's disease, amnesia, antibacterial, antidepressant, antifungal, anti-infective, anti-inflammatory, antioxidant, antipsychotic, antitumor, anxiety, appetite stimulant, asthma, atherosclerosis, autoimmune disorders, bile flow stimulant, bleeding disorders, breast cancer, breast enlargement, breathing difficulty, burns, cancer, cardiomyopathy, central nervous system diseases, chronic cough, chronic fatigue syndrome, colitis, convulsions, demulcent, diabetic nerve pain, dialysis, digestive complaints, diuretic (water pill), dizziness, dysentery, dyspnea (shortness of breath), earache, female infertility, fetal development, fever, fibromyalgia, frequent urination, gastritis, gastrointestinal motility, gynecology-related disorders, hair tonic, hangovers, head injury (severe intractable), headaches, heart attack, hemolytic anemia, herpes, hoarse voice, improved memory and thinking after menopause, improvement of blood supply, improving resistance to disease, inflammation (systemic inflammatory reaction syndrome), influenza, insomnia, irritability, ischemia-reperfusion injury prevention, ischemic injury (brain), ischemic stroke, jaundice, Kaposi's sarcoma, kidney disease, learning, leukemia, liver diseases, long-term debility, longevity, low back pain, lumbar disc herniation, lung cancer, lung conditions, lymphoma (Burkitt's and Hodgkin's lymphoma), malaise, malignant tumors, migraine, mood enhancement, morphine tolerance, multiple myeloma, muscle weakness, nausea, neuralgia (pain due to nerve damage or inflammation), neurasthenia, neuroblastoma, neurodegenerative diseases, neuroprotective, organ dysfunction (multiple organ failure), organ prolapse, ovulation disorders, oxygen absorption, pain relief, palpitations, Parkinson's disease, physical work capacity, pneumonia, postherpetic neuralgia, prostate cancer, Pseudomonas infection in cystic fibrosis, psycho-asthenia, pulmonary edema, qi-deficiency and blood-stasis syndrome in heart disease (Eastern medicine), rehabilitation, rheumatism, salivary stimulant, scar healing (acne), sciatica, sedative, sexual symptoms, skin care, skin irritation (mucus membranes), spleen disorders, stimulant, stomach cancer, stomach ulcers, stomach upset, stress, strokes, sweating, tonic, toxicity, tuberculosis, upper respiratory tract infection, vein clots, vitality, vomiting, weight loss, wound healing, wrinkle prevention.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old)

Many different doses are used traditionally. Practitioners sometimes recommended that after using ginseng continuously for 2-3 weeks, people should take a break for 1-2 weeks. Long-term dosing should not exceed 1 gram of dry root daily.

Capsules containing 100-200 milligrams of a standardized ginseng extract (4% ginsenosides) have been taken by mouth once or twice daily for up to 12 weeks. 0.5-2 grams of dry ginseng root, taken daily by mouth in divided doses, has also been used. E . senticosus dry extract at a dose of 300 milligrams daily was used for eight weeks to improve quality of life in elderly patients. A ginseng root extract has been studied in athletes for 28 days at a dose of 400 milligrams daily. Higher doses are sometimes given in studies or under the supervision of a qualified healthcare provider. A decoction of 1-2 grams added to 150 milliliters of water, has been taken by mouth daily. A 1:1 (grams per milliliter) fluid extract has been taken as 1-2 milliliters by mouth daily. 5-10 milliliters (about 1-2 teaspoons) of a 1:5 (grams per milliliter) tincture has been taken by mouth daily.

Panax ginseng tea may be made by soaking about 3,000 milligrams (3 grams) of chopped fresh root or 1,500 milligrams (1.5 grams) of dried root powder in about 5 ounces of boiling water for 5-15 minutes and then straining the tea. Some sources suggest consuming ginseng tea via the above method 3-4 times daily for 3-4 weeks.

When applied on the skin, 0.20 grams of SS-cream containing ginseng has been used to treat premature ejaculation.

Children (under 18 years old)

There is not enough scientific information available to recommend the safe use of ginseng in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

People with known allergies to Panax species and/or plants in the Araliaceae family should avoid ginseng. Signs of allergy may include rash, itching, or shortness of breath. Inhalation of ginseng root dust has been associated with immediate and late-onset asthma.

Side Effects and Warnings

Ginseng has been well tolerated by most people in scientific studies when used at recommended doses, and serious side effects appear to be rare.

Based on limited evidence, long-term use may be associated with skin rash or spots, itching, diarrhea, sore throat, loss of appetite, excitability, anxiety, depression, or insomnia. Less common reported side effects include headache, fever, dizziness, chest pain, difficult menstruation, heartburn, heart palpitations, rapid heart rate, leg swelling, nausea/vomiting, or manic episodes in people with bipolar disorder.

Consumption of ginseng may increase or and decrease blood pressure. Caution should be used in those with high or low blood pressure or in those taking drugs for either of these conditions.

There is report of seizures after high consumption of energy drinks containing caffeine, guarana, and herbal supplements, including ginseng.

Based on human research, ginseng may lower blood sugar levels. This effect may be greater in patients with diabetes than in non-diabetics. Use cautiously in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.

There are reports of nosebleeds and vaginal bleeding with ginseng use, although scientific study is limited in this area. There is also evidence in humans of ginseng reducing the effectiveness of the "blood thinning" medication warfarin (Coumadin?). Caution is advised in patients with bleeding disorders or taking drugs that may affect the risk of bleeding or blood clotting. Dosing adjustments may be necessary.

Several cases of severe drops in white blood cell counts were reported in people using a combination product containing ginseng in the 1970s; this may have been due to contamination.

Ginseng may have estrogen-like effects and has been associated with reports of breast tenderness, loss of menstrual periods, vaginal bleeding after menopause, breast enlargement (reported in men), difficulty developing or maintaining an erection, or increased "sexual responsiveness." Avoid use of ginseng in patients with hormone sensitive conditions, such as breast cancer, uterine cancer, or endometriosis.

A severe life-threatening rash known as Stevens-Johnson syndrome occurred in one patient and may have been due to contaminants in a ginseng product. A case report describes liver damage (cholestatic hepatitis) after taking a combination product containing ginseng.

High doses of ginseng have been associated with rare cases of temporary swelling of blood vessels in the brain (cerebral arteritis), abnormal dilation of the pupils of the eye or confusion.

Pregnancy and Breastfeeding

Ginseng has been used traditionally in pregnant and breastfeeding women. Animal studies and early human research suggests that ginseng may be safe, although safety has not been clearly established in humans. Therefore, ginseng use cannot be recommended during pregnancy or breastfeeding. Neonatal death and the development of male characteristics in a developing baby girl after her mother was exposed to ginseng during pregnancy has been reported.

Many tinctures contain high levels of alcohol and should be avoided during pregnancy.

Methodology

This patient information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Selected references

  1. Anderson GD, Rosito G, Mohustsy MA, et al. Drug interaction potential of soy extract and Panax ginseng. J Clin Pharmacol 2003;43(6):643-648.
  2. Buettner C, Yeh GY, Phillips RS, et al. Systematic review of the effects of ginseng on cardiovascular risk factors. Ann Pharmacother 2006;40(1):83-95.
  3. Cardinal BJ, Engels HJ. Ginseng does not enhance psychological well-being in healthy, young adults: results of a double-blind, placebo-controlled, randomized clinical trial. J Am Diet Assoc 2001;101(6):655-660.
  4. Cicero AF, Derosa G, Brillante R, et al. Effects of Siberian ginseng (Eleutherococcus senticosus maxim.) on elderly quality of life: a randomized clinical trial. Arch Gerontol Geriatr Suppl 2004;(9):69-73.
  5. Coleman CI, Hebert JH, Reddy P. The effects of Panax ginseng on quality of life. J Clin Pharm Ther 2003;28(1):5-15.
  6. de Andrade E, de Mesquita AA, Claro Jde A, de Andrade PM, Ortiz V, Paranhos M, Srougi M. Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction. Asian J Androl 2007;9(2):241-4.
  7. Guo R, Pittler MH, Ernst E. Herbal medicines for the treatment of COPD: a systematic review. Eur Respir J 2006;28(2):330-8.
  8. Hartley DE, Elsabagh S, File SE. Gincosan (a combination of Ginkgo biloba and Panax ginseng): the effects on mood and cognition of 6 and 12 weeks' treatment in post-menopausal women. Nutr Neurosci 2004;7(5-6):325-333.
  9. Hartz AJ, Bentler S, Noyes R, et al. Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychol Med 2004;34(1):51-61.
  10. Hong B, Ji YH, Hong JH, et al. A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report. J Urol 2002;168(5):2070-2073.
  11. Ito TY, Polan ML, Whipple B, et al. The enhancement of female sexual function with ArginMax, a nutritional supplement, among women differing in menopausal status. J Sex Marital Ther 2006 Oct-Dec;32(5):369-78.
  12. Jiang X, Williams KM, Liauw WS, et al. Effect of St John's wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2004;57(5):592-599.
  13. Kim JH, Park CY, Lee SJ. Effects of sun ginseng on subjective quality of life in cancer patients: a double-blind, placebo-controlled pilot trial. J Clin Pharm Ther 2006 Aug;31(4):331-4.
  14. Rotem C, Kaplan B. Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study. Gynecol Endocrinol 2007 Feb;23(2):117-22.
  15. Shao KD, Zhou YH, Shen YP, et al. Treatment of 37 patients with refractory idiopathic thrombocytopenic purpura by shengxueling. Chin J Integr Med 2007 Mar;13(1):33-6.