There are three different herbs commonly called Ginseng: Asian or Korean ginseng (Panax ginseng), American ginseng (Panax quinquefolius), and Siberian ginseng (Eleutherococcus senticosus). The latter herb is actually not ginseng at all, but the Russian scientists responsible for promoting it believe it functions identically.

Common uses for ginseng are for cognitive disorder (antiaging effect), diabetes and cancer.

Asian ginseng is a perennial herb with a taproot resembling the human body. It grows in northern China, Korea, and Russia; its close relative, Panax quinquefolius, is cultivated in the United States. Because ginseng must be grown for five years before it is harvested, it commands a high price, with top-quality roots easily selling for more than $10,000.

Dried, unprocessed ginseng root is called "white ginseng," and steamed, heat-dried root is called "red ginseng." Chinese herbalists believe each form has its own particular benefits.

Ginseng contains many chemicals, the most important of which are triterpenoids called ginsenosides. Different species of ginseng contain different concentrations of the various classes of ginsenosides.

Therapeutic Uses
Ginseng can elevate blood pressure. It has also been shown to decrease exhaustion (fatigue) by stimulating the central nervous system and by sparing glycogen use in exercising muscles. Ginseng is also well known for its use in the treatment of diabetes. It will decrease blood sugar in diabetic (but not normoglycemic) mice. In non-diabetics, ginseng increases blood cortisol, but it reduces serum cortisol levels in diabetics. In vitro, ginseng has been shown to increase the lifespan of cells (anti-aging effect).

Ginseng can reduce blood cholesterol and triglyceride levels. Regular intake of ginseng may protect against cancer formation; the extract and powder in people was shown more effective than the tea, juice, or fresh sliced ginseng. Ginseng also stimulates the immune system by enhancing white blood cell and antibody functions. It should not be used in high doses during acute infections as it may inhibit some immune functions.

Dosages
Dosage in people varies based upon ginsenoside content. In general, tonic effects are seen when the product contains at least 10 mg of ginsenoside Rg1 to Rb1 of 1:2.

For people, the typical recommended daily dosage of Panax ginseng is 1 to 2 g of raw herb, or 200mg daily of an extract standardized to contain 4–7 percent ginsenosides. Eleutherococcus senticosus is taken at a dosage of 2 to 3 g whole herb or 300 to 400 mg of extract daily. Ordinarily, a two to three week period of using ginseng is recommended, followed by a one to two week 'rest' period. Russian tradition suggests those under 40 should not use ginseng. Finally, because Panax ginseng is so expensive, some products actually contain very little. Adulteration with other herbs and even caffeine is not unusual.

Scientific Evidence
Taken together, the scientific record on ginseng is intriguing but not conclusive. Most studies used injectable ginseng in animals and non-double-blind studies in people. If some of the money spent on animal and non-double-blind studies had been used to fund more double-blind studies in humans, we might know more. At the present it is hard to know whether ginseng is as effective as its mystique would make it seem.

Safety Issues
Ginseng should not be used in pets with hypertension (hyperthyroidism in cats, kidney disease in dogs and cats, cardiomyopathy). Do not use in pets with bleeding or pets with anxiety, hyperactivity or nervousness. Do not use in pets taking hypoglycemic medications without veterinary supervision. Because patients vary in their response to ginseng, because various species of plants exist with various quantities of ginsenosides, and because of variation in quality control among supplements, long-term ingestion should be avoided and veterinary advice sought when using ginseng.

Ginseng may increase levels of digitalis drugs. Siberian ginseng appears to have greater safety due to standardized extracts (typically a 33 percent ethanol extract, standardized to five percent ginsenosides). It is reported to have antioxidant activity, lowers high blood pressure but raises low blood pressure (an adaptogen effect), dilates coronary arteries, and exhibits a mild diuretic effect. Side effects are rare unless high does are used. Follow the guidelines for Panax ginseng.

In people, unconfirmed reports suggest highly excessive doses of ginseng can raise blood pressure, increase heart rate, and possibly cause other significant effects. Whether some of these cases were actually caused by caffeine mixed in with ginseng remains unclear. Ginseng allergy can also occur, as can allergy to any other substance. There is some evidence ginseng can interfere with drug metabolism, specifically drugs processed by an enzyme called "CYP 3A4." There have also been specific reports of ginseng interacting with MAO inhibitor drugs and also digitalis, although again it is not clear whether it was the ginseng or a contaminant that caused the problem. There has also been one report of ginseng reducing the anticoagulant effects of Coumadin.

Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established. Similar precautions are probably warranted in pets.

Shawn Messonnier, DVM

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Shawn Messonnier DVM Past Supporting Member, Oncology Association of Naturopathic Physicians Author, the award-winning The Natural Health Bible for Dogs & Cats, The Natural Vet’s Guide to Preventing and Treating Cancer in Dogs, and Breast Choices for the Best Chances: Your Breasts, Your Life, and How YOU Can Win The Battle!

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