Ginseng root is one of the oldest known herbal medicines. Ginseng has been revered as a revitalising and life-enhancing tonic for over 5000 years. According to legend, ginseng was so prized that Chinese emperors would pay for a ginseng root with its weight in gold.
The Panax ginseng family
The Panax family consists of at least nine different species, including Panax ginseng (Korean ginseng), Panax quinquefolium (American ginseng), Panax japonicus (Japanese ginseng) and Panax notoginseng (sanqi).
The name Panax comes from the Greek word panacea, meaning ‘cure all’. The term ginseng comes from a Chinese word meaning ‘man-like’ as the therapeutic roots are often human-shaped.
Ginseng root has a distinctive warm, sweet and slightly bitter flavour that is reminiscent of peas. American ginseng is preferred by some for its sweeter taste and more gentle action.
Red ginseng versus white ginseng
High quality ginseng roots are collected in the autumn from plants that are five to six years old. Fresh ginseng degrades quickly, so the roots are preserved by air-drying to produce white ginseng (Ginseng Radix Alba), or by first steaming and then drying, to produce red ginseng (Ginseng Radix Rubra).
Steaming generates a new range of modified ginsenosides which are more potent, so red Korean ginseng has a stronger medicinal effect. The red ginseng produced from a plant variety known as Panax ginseng Meyer is the most widely used and studied.
Ginseng plants contain unique substances known as ginsenosides (ginseng saponins or glycosylated steroidal saponins) which were first discovered in 1963. At least 50 different ginsenosides have now been identified in Korean red ginseng which make up three to six percent of the dry weight of the root.
Ginsenosides are found in the leaves, berries and roots of Panax ginseng plants, and are believed to protect against insect, fungal and bacterial attack.
Ginsenosides are divided into two main groups based on their medicinal action:
- Ginsenoside with a stimulating action (eg Rg1, Re, Rf, Rg2) which are mostly derived from the large (main) root.
- Ginsenosides with a relaxing, sedative action (eg Rb1, Rb2, Rc, Rd) which are mostly derived from the small lateral roots.
Korean ginseng provides more of the stimulating ginsenosides, while American ginseng offers more of the relaxing ginsenosides.
Ginseng is an adaptogen
Ginseng is classed as an adaptogenic herb, which means it helps the body adapt to physical or emotional stress and fatigue. Ginseng has a normalising action on many body systems, improving oxygen usage in cells, boosting the production of energy and improving the way cell wastes (such as lactic acid) are processed.
Ginseng is traditionally taken to support the adrenal glands during times of stress. Researchers believe ginsenosides have a direct action on the hypothalamus and pituitary gland in the brain. This effect normalises secretion of adrenocorticotrophic hormone (ACTH) which stimulates adrenal gland function. American ginseng is said to be best for fatigue caused by nervous conditions, anxiety and insomnia, while Korean ginseng is better for fatigue with general weakness and loss of energy.
Ginseng oolong tea
A popular way to obtain the benefits of ginseng is to drink it in the form of ginseng oolong tea.
Oolong, or brown tea, fits somewhere between green and black tea, in that the leaves are only partially fermented and retain much of their green colour.
Ginseng oolong tea is a popular, sweet-tasting and refreshing tea that originated in Taiwan. It’s made by mixing withered green oolong tea leaves with ginseng root powder. The mixture is then rolled to produce green pyramidal shaped pellets.
To brew ginseng oolong tea, it’s best to steep the pellets for no more than 20 seconds – this extracts the sweet flavours while minimising any bitterness. The same leaves are often reused in this way to breat 8 to 10 cups of weak tea in total.
Ginseng health benefits
Traditionally, ginseng is described as restorative tonic that is both stimulating and energising, to improve strength, stamina, alertness and concentration, and to lift anxiety and low mood.
Ginseng and fatigue
Ginseng is a popular tonic to help improve alertness and awareness. Studies involving hospital doctors and nurses suggest that taking ginseng extracts helped them stay awake and perform their night duties better than those not taking it.
The results from 12 clinical trials involving 630 people found that ginseng supplements significantly reduced fatigue by 34% compared with placebo, although there no associated improvements in physical performance.
Ginseng protects against the common cold
Ginseng stimulates the activity of white blood cells against viral and bacterial infections. Some studies have found that taking American ginseng extracts halved the risk of catching a cold during the four-month study period compared with those taking inactive placebo. And when a cold did develop, the severity of symptoms was reduced in those taking ginseng extracts.
The results of five trials, involving 747 people found that American ginseng and Asian ginseng significantly reduced the total number of common colds by 25% compared to placebo and taking ginseng significantly shortened the duration of colds by an extraordinary 6.2 days! Despite this, the researchers concluded there was insufficient evidence to conclude that ginseng reduces the incidence or severity of common colds. They did, however, admit that North American ginseng appeared to be effective in shortening the duration of colds in healthy adults when taken preventively for durations of 8 weeks to 16 weeks.
Ginseng and angina
Ginseng is commonly used in the treatment of ischaemic heart disease and angina (heart pain) in China, with hundreds of randomized controlled trials published in Chinese to show its effectiveness. The results of 18 clinical trials, involving 1,549 people were analysed which showed that prescribed ginseng-based medicines were three times more effective in improving symptoms than nitrates (usual prescribed medical treatment) and were also 61% better at showing improvements in ECG recordings. However, more research is needed to confirm these findings before they are likely to be adopted by western medicine.
Recently, the effects of Panax notoginseng were assessed in patients with unstable angina. In 18 studies, involving 1828 Chinese patients this form of ginseng was found to reduce the risk of cardiovascular events by 65% and reduced the frequency of angina by 48%, as well as alleviating angina symptoms and improving ECG findings.
Ginseng and diabetes
Ginseng is thought to lower blood glucose levels in type 2 diabetes by stimulating the release of insulin from the pancreas and increasing the number of insulin receptors on cells to reduce insulin resistance. The main glucose lowering activity of ginseng appears to derive from five glycans (named panaxans A to E) rather than the ginsenosides.
The results of 16 studies found that ginseng supplements improved fasting glucose in people with type 2 diabetes or metabolic syndrome. There were no improvements in HbA1c, but most trials were of short duration (less than 12 weeks) and included people with a relatively good glycemic control.
If you have diabetes it is important to monitor your glucose levels carefully if you decide to take any supplements, and to check with a doctor or pharmacist for interactions with any drugs you are taking.
Ginseng as an aphrodisiac
Ginseng is traditionally prized as an aphrodisiac, sexual balancer and fertility enhancer. These effects of ginseng are believed to relate to its steroidal compounds that are similar in structure to human sex hormones. Studies in laboratory animals show that ginseng increases libido and copulatory frequency. As well as its effect on nitric oxide to promote blood vessel dilation, ginseng also appears to increase nerve ending sensitivity, lower prolactin secretion (nature’s anti-sex hormone) and promotes the secretion of neurotransmitters in the hypothalamus that are involved in driving sexual behaviour. The only way to know if it will work for you is to try it, as research evidence (in English) into the aphrodisiac properties of ginseng is scant, although it does appear to be effective for treating erectile dysfunction.
Ginseng benefits for men
Ginseng increases levels of nitric oxide (NO) which dilates blood vessels and is essential for normal erectile function and sexual arousal. This action of ginseng is similar in effect to that of l-arginine and anti-impotence drugs such as sildenafil.
The results from 7 trials involving 349 men with erectile dysfunction found evidence that red ginseng was almost two and a half times better than placebo in improving erectile function in studies lasting from 4 to 12 weeks. Around 58% of men experienced an improvement in some aspect of sexual function compared with 20% of those taking placebo.
Korean ginseng berry extracts provide similar ginsenosides as are found in the root, and ginseng berry extracts (350mg per day for 8 weeks) has also been found to significantly improve sexual function in men with erection difficulties. No significant side effects compared with placebo were reported.
The usual dose range is 200 mg – 1,500 mg standardised ginseng extracts per day.
Doses may be divided in two and taken twice daily if you wish.
Select ginseng products standardised to contain at least 4% to 7% ginsenosides, or a known amount such as 30mg ginsenosides per tablet. These will generally be more expensive, but cheap versions may contain very little active ingredient.
Traditionally, ginseng is not usually taken for more than 6 weeks without a break. In the East, ginseng is taken in a two weeks on, two weeks off cycle. Some practitioners recommend taking it in a 6 weeks on, 8 weeks off cycle.
For those who find Korean ginseng too stimulating, try American ginseng which has a more gentle action.
Ginseng side effects
A systematic review of adverse effects and drug interactions with Panax ginseng concluded that single ginseng extracts have a low incidence of side effects at usual therapeutic doses that are similar to those with placebo. Those that have been reported, such as headache, sleep and gastrointestinal disorders are usually mild and transient.
Possible drug interactions were reported between Panax ginseng and warfarin, phenelzine and alcohol.
It is best to avoid taking other stimulants (eg caffeine) while taking ginseng.
NB If you have a health problem, it is important to check with a doctor before deciding whether or not to take any supplements. Always seek medical advice if taking prescribed medicines and check with a pharmacist for potential interactions with any drugs you are taking.