Ginseng is a family of plants. Dietary supplements are derived from American ginseng (Panax quinquefolius) or Asian ginseng. Siberian ginseng is a different genus and does not contain the ingredients believed to be active in the 2 forms used in supplements. Ginseng can be taken as fresh or dried roots, extracts, solutions, capsules, tablets, sodas, and teas or used as cosmetics. Active ingredients in American ginseng are panaxosides (saponin glycosides). Active ingredients in Asian ginseng are ginsenosides (triterpenoid glycosides).
Ginseng products vary considerably in quality because many contain little or no detectable active ingredient. In very few cases, some ginseng products from Asia have been purposefully mixed with mandrake root, which has been used to induce vomiting, or with the drugs phenylbutazone or aminopyrine. These drugs have been removed from the US market because of significant adverse effects.
Ginseng is said to enhance physical (including sexual) and mental performance and to have adaptogenic effects (ie, to increase energy and resistance to the harmful effects of stress and aging). Other claims include reduction in plasma glucose levels; increases in high density lipoprotein (HDL), Hb, and protein levels; stimulation of the immune system; and anticancer, cardiotonic, endocrine, CNS, and estrogenic effects. Some studies have shown that Asian ginseng may lower plasma glucose and have possible beneficial effects on immune function, but there is no evidence for other health claims. Recent Canadian studies show that a polysaccharide extract of P. quinquefolius is useful in helping prevent colds.
Nervousness and excitability may occur but decrease after the first few days. Ability to concentrate may decrease, and plasma glucose may become abnormally low (causing hypoglycemia). Because ginseng has an estrogen-like effect, women who are pregnant or breastfeeding should not take it, nor should children. Occasionally, there are reports of more serious effects, such as asthma attacks, increased BP, palpitations, and, in postmenopausal women, uterine bleeding. To many people, ginseng tastes unpleasant.
Ginseng can interact with antihyperglycemic drugs, aspirin, other NSAIDs, corticosteroids, digoxin, estrogens, monoamine oxidase inhibitors, and warfarin.
Last full review/revision May 2009 by Ara DerMarderosian, PhD
Content last modified February 2012