The herb ginseng, in its various forms, has been used for thousands of years for therapeutic effects in the Orient. There are several different types of ginseng out there but I will be focusing on the uses of Panax Ginseng because it is the most commonly used in studies and in clinical use. In the east, ginseng is considered one of the most highly regarded herbal supplements and has always been a staple in traditional Chinese medicine. It has been used for many different purposes including to improve physical performance, stimulate the immune system, and to prevent and treat various diseases and conditions. This popularity has been spreading rapidly to the west over the past decade and is now being analyzed more closely and subjected to clinical studies to examine its true potential therapeutic qualities. Labeled as a nutritional supplement by the Food and Drug Administration, ginseng is not subject to regulation by the FDA and different brands of ginseng can have different contents and qualities. While a study found that all the ginseng products were labeled with the correct genus of the plant, the concentrations of different products varied greatly. The concentrations of ginseng content must be considering when supplementing with it or creating an accurate scientific study (Hackman et al 2001).
With the hype of ginseng being a panacea and the ease of buying it over the counter, ginseng has incredible sales totaling over $300 million annually and growing. While it is already used as a medicinal treatment in the east, the majority of support for the use of ginseng is actually clinically based with official scientific studies only coming out relatively recently. With the popularity and non-regulation of ginseng, it is important for physicians and anyone in the health/fitness field to know any safety concerns concerning ginseng (Bahrke 2000). As a personal trainer and a sports medicine student, I decided it would be a good idea to dive into the studies regarding ginseng and its many proposed uses to determine if it is in fact a safe and effective supplement.
One of the major proposed uses for ginseng today is to improve physical performance during physical activities. It has been dubbed as an “adaptogen” that allows the body to further tolerate excess stresses placed on it. Russian athletes have been using Siberian ginseng for several decades to boost performance and stamina although the few official studies on this subject are inconclusive to whether this supplementation is helpful or not. Today’s athletes, always trying to find a way to gain an edge, have tried using similar supplementation with Panax ginseng to gain this extra endurance. The few studies out there involving humans have either conflicting or negative conclusions on ginseng supplementation for improving human performance. In various animal studies, however, they have proven that ginseng can in fact help survival against physical and chemical stresses. These animal results seem promising but there is an overall major lack of scientific based evidence for humans supporting the use of ginseng as an ergogenic aid to prevent fatigue, improve physical ability, or prolong performance (Bahrke 2000).
Another major use for ginseng supplementation that shows more promise is its potential use as an antioxidant and immune system aide. With billions of dollars being spent every year on medicine and trips to the doctor, everyone is looking for a cheap, safe, and effective way to boost their immune system. One in vitro experiment suggested that the use of ginseng stimulated cellular immune function by peripheral blood mononuclear cells (PBMC) for normal individuals and patients with either chronic fatigue syndrome or acquired immunodeficiency syndrome (AIDS). The addition of Panax Ginseng led to increased natural killer activity against the herpesvirus 6 infected cells and other damaging cells. The potential for ginseng to play a role in treating the many individuals with chronic fatigue syndrome or AIDS could be incredible because it is a very cheap supplement and has very few side-effects. This study supports the use of Panax ginseng in improving overall immune function in normal patients or those with lower immune systems (Broumand et al 1997).
Since ginseng has been suggested to be a promising tool for the immune system, it would only make sense that it has been considered to play a possible role in the prevention and treatment of various types of physical conditions. One randomized, double blind experiment on 384 post-menopausal women had results that suggested 16 weeks of treatment with ginseng extract significantly reduced symptoms of menopause and increased feelings of well-being (Limoni et al 1999). This is a very large population that could potentially gain benefits from ginseng supplementation instead of expensive traditional treatments and medicinal side-effects. When non-insulin diabetics were treated with for 100-200 mg of ginseng for 8 weeks, they showed a significant improvement in mood, physical activity, psychophysical performance, fasting blood glucose levels, and lowered bodyweight while the placebo group only lowered their weight. This study suggests that 100-200mg of ginseng could be useful as a therapeutic treatment for non-insulin diabetic mellitus patients. With diabetes cases increasing significantly every year, ginseng could play a major role in managing some of the detrimental symptoms of this condition (Haapakoski et al 1995).
Potentially the most important use of ginseng lies in its use as a possible tool in the fight against certain types of cancers. One of the studies I looked at examined the effects of red ginseng (main active ingredients in Panax Ginseng) on various tumors and found that for some tumors it did have strong therapeutic effects and improved overall immune system function (Hongyan et al 1999). Another study I looked at found that subjects that supplemented with ginseng had a significantly lower occurrence of lip, oral cavity and pharynx, larynx, lung, esophagus, stomach, liver, pancreas, ovary, and colorectum cancers. The relative risks of the ginseng users for developing cancer was lower than the relative risk of non-users especially for lung and gastric caners. (Yun et al 2003). Also, smokers were found to have lower concentrations of these antioxidants in their body as well as much higher levels of oxidative damage from the carcinogens in cigarettes. In their study, red ginseng played a role in increasing overall antioxidants in the body as well as helping the body get rid of 8-OHdG and carbonyl compounds causing damage. The implications of this study means that red ginseng, combined with other antioxidants, can play a role in reversing internal damage from smoking and even help prevent some of the types of cancers caused by smoking. This could be good news for the millions of smokers worldwide with damaged lungs and immune systems (Kim et al 1998).
While Panax ginseng seems to have a lot of promise, many more effective scientific studies must be done to truly prove the beneficial effects of it for human use. While supplemental use is still questionable for every population, for some it could have a significant upside and that can be worth the minor risk and low price. I have used it personally and I have noticed minor benefits from it, whether this is from the placebo effect or from actual chemical changes. I feel that it is worth experimenting with safely to determine if it works for you, ideally under the supervision of a physician. After researching the topic, I will keep in mind that the majority of studies stress its importance as an antioxidant and not as an ergogenic aid. Overall it seems that ginseng use is relatively safe and beneficial “….and the potential for doing good seems greater than that for doing harm.” (Ernst 2002)
Bahrke, MS., Morgan, WP. Evaluation of the ergogenic properties of ginseng: An update. Jrl of Sports Medicine. 29(2):113-133, 2000.
Broumand, N., Sahl L., Tilles JG. In vitro effects of Echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Jrl. Immunopharmacology 1997 Jan;35(3):229-35.
Ernst, Edzard. The Risk-Benefit Profile of Commonly Used Herbal Therapies: Ginkgo, St. John’s Wart, Ginseng, Echinacea, Saw Palmetto, and Kava. Annals 2002 137: 1008.
Gillis, CN. Panax Ginseng Pharmacology: A Nitric Oxide Link? Jrl Biochemical Pharmacology 1997 July 1; 54(1):1-8
Haapakoski, E., Rautio, A., Sotaniemi, EA. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care, Vol 18, Issue 10 1373-1375, Copyright © 1995 by American Diabetes Association
Hackman, M., Harkey, MR, Henderson, GL, Gershwin ME, Stern JS. Variability in commercial ginseng products: An analysis of 25 preparations. American Journal of Clinical Nutrition, Vol. 73, No. 6, 1101-1106, June 2001.
Hongyan, L., Lihua, T., Rui, H., Xiaoguang, L, Xiaohong L., Yan, L., Zhaodi, F. Cancer chemopreventitive and therapeutic activities of red ginseng. Jrl Ethmopharmacology 1998 Feb;60(1):71-8.
Kim, HS, Lee, BM, Lee, SK. Inhibition of oxidative DNA Damage, 8-OHdG and carbonyl contents in smokers treated with antioxidants (vitamin E, vitamin C, beta-carotene, and red ginseng). Cancer Lett. 1998 Oct 23;132(1-2):219-27
Limoni, C., Lindgren, R., Mattsson LA, Wiklund, IK. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind placebo-controlled trial. Swedish Alternative Medicine Group. Int. Jrl Clinical Pharmacological Res. 1999;19(3):89-99
Yun, TK. Experimental and epidemiological evidence on non-organ specific cancer
preventative effect of Korean ginseng and identification of active compounds. Mutat Res. 2003 Feb-Mar;523-524:63-74