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Ginseng is an herbal plant that has been used for thousands of years in Eastern medicine. It can improve fatigue, performance, fertility, cognition, and even potentially prevent and fight cancer. It has antioxidant and anti-inflammatory effects. Read on to learn about how this ancient plant can improve your health.

What is Ginseng?

Ginseng is an herbal plant found in North America and eastern Asia. There are many different types of ginseng, such as American ginseng (Panax quinquefolius), Red ginseng (Panax ginseng), Indian ginseng (Withania somnifera), and Siberian ginseng (Eleutherococcus senticosus). American ginseng is a very popular varietal [R, R].

American ginseng is known for its stimulant properties and is used in traditional Chinese medicine. Native Americans have used it to relieve headaches and to treat fever and indigestion. It can boost mood, immunity, and cognition. Studies have also suggested that ginseng may protect against cancer.

Common Types of Ginseng

American Ginseng

American ginseng (Panax quinquefolius) is commonly used in traditional Chinese medicine and is used for relaxation and to combat fatigue. It is also thought to regulate hormones, relieve stress, and stimulate the immune system [R].

Asian Ginseng

Asian ginseng, also called red or Korean ginseng (Panax ginseng), is sometimes considered the opposite of American ginseng. It is thought to stimulate the nervous system and enhance cognitive performance and shows promise in treating neurodegenerative diseases, cancer, and stroke [R].

Siberian Ginseng

Siberian ginseng (Eleutherococcus senticosus) can help with fatigue and boost the immune system, much like Asian ginseng. However, Siberian ginseng is not a true ginseng [R].

Active Constituents of Ginseng

The main active components of American ginseng are ginsenosides. Over thirty ginsenosides have been isolated, which can be classified into several groups [R]:

  • Protopanaxadiol-type (PPD), including Rb1, Rc, Rb2, Rd, Rg3, and Rh2 ginsenosides
  • Ginsenosides protopanaxatriol-type (PPT), including Rg1, Re, Rg2, and Rh1 ginsenosides
  • Oleanolic acid-type, such as Ro ginsenoside

How Ginseng Interacts with the Body

Following ingestion, ginseng is chemically transformed through contact with stomach acids, gut flora, and enzymes, increasing its bio-availability and reactivity [R].

Health Benefits of Ginseng

1) Sexual Performance and Male Fertility

Ginseng is considered a tonic or adaptogenic that enhances physical performance (including sexual) and promotes vitality [R].

A meta-analysis of 7 RCTs with 349 participants total found that Korean red ginseng was effective in treating erectile dysfunction. However, the total sample sizes and the qualities of the studies were too low to draw definitive conclusions. Thus more rigorous studies are necessary [R].

A study on Korean red ginseng (1,000 mg, 3x/day) found that there was a significant improvement in male sexual performance (penetration and maintenance), with no change in testosterone levels. The study concluded that Korean red ginseng can be an effective alternative treatment of erectile dysfunction (DB-RCT on 60 men with mild erectile dysfunction) [R].

Patients with erectile dysfunction who took Korean red ginseng (900 mg, 3x/day for 8 weeks on, 2 weeks off, and then another 8 weeks on) experienced a boost in sexual performance (penetration and maintenance). 60% of the patients had improved erections, making ginseng an effective treatment for erectile dysfunction (DB-RCT with 45 patients). In another study, Korean red ginseng had the same efficacy rate, compared to 30% improvement for the placebo group and 30% for the tradozone group (study with 90 patients) [R, R].

Similarly, Korean ginseng (1000 mg, 2x/day for 8 weeks) improved erectile function in ED patients (DB-RCT of 86 patients) [R].

Panax ginseng extract supplementation increased both sperm count and sperm motility in men with fertility issues. It also increased total and free testosterone, DHT (dihydrotestosterone), FSH (follicle stimulating hormone), and LH (luteinizing hormone) but lowered prolactin (PRL) levels (66 patients with fertility issues and 20 healthy controls) [R].

Mechanism of Action:

Several components of ginseng, maca, ginkgo, arginine, and yohimbine, all appear to help sexual function by promoting the production of nitric oxide, which improves blood flow to and in the penis [R].

2) Anti-Inflammatory and Antioxidant Effects

Korean red ginseng (3 or 6 g/day for 8 weeks) increased superoxide dismutase (SOD) activity, with the higher dose also increasing glutathione peroxidase and catalase activity. Both doses also decreased oxidized LDL cholesterol levels (DB-RCT with 57 subjects) [R].

3 g/day red ginseng increased superoxide dismutase activity (an antioxidant) but not glutathione peroxidase (another antioxidant). It also did not affect levels of 8-hydroxydeoxyguanosine (marker of oxidative stress) or fasting glucose, fasting insulin, and insulin resistance (DB-RCT with 71 postmenopausal women) [R].

In a DB-RCT with 82 participants, ginseng extract (1 or 2 g/day for 4 weeks) had several antioxidant effects, such as decreased levels of markers of oxidative stress (ROS (reactive oxygen species) and malondialdehyde (MDA)). 2 g of ginseng enhanced glutathione reductase activity and total glutathione content. However, supplementation did not change total antioxidant capacity, catalase, superoxide dismutase (SOD), and peroxidase activities [R].

Korean red ginseng extract (20 g/day) reduced exercise-induced inflammatory response and creatine kinase activity compared to the group taking Agastachis herba (Korean mint) (DB-RCT of 18 males) [R].

Korean red ginseng supplementation (60 mg/kg/day for 1 year) post-chemotherapy treatment reduced inflammatory cytokines more quickly than the control. However, there was no difference between ginseng and the control group for the other factors measured (lymphocytes and immunoglobulins) (controlled trial with 30 children) [R].

Animal Studies:

  • Ginseng extract prevented inflammation and protected cells from pneumococcal bacteria infection in mice [R].
  • Ginsenosides from Korean Red Ginseng reduced inflammation by suppressing the tumor necrosis factor, IL-6, IRF-3, and AP-1 pathways in a study with mice [R].

Cellular Studies:

  • Ginseng exhibited antioxidant and anti-inflammatory properties [R, R, R].
  • Ginseng protected against cellular oxidative stress caused by hydrogen peroxide in adult retinal cells [R].
  • Ginseng increased the growth of wound-healing cells, or fibroblasts, and increased collagen synthesis in human dermal cells [R].
  • Ginseng protected against chromatin damage in sperm, which leads to reproductive fitness [R].
  • Pectinase-treated ginseng reduced hydrogen peroxide-induced oxidative stress in rat sperm [R].

3) Alzheimer’s Symptoms

Alzheimer’s patients randomized to receive either 4.5 or 9 g/day of Korean red ginseng for 24 weeks experienced improvements in cognitive function that continued to the 2-year follow-up (randomized, open-label study with 61 participants) [R].

In a similar study, treatment with Korean red ginseng (9 g/day for 12 weeks) improved some symptoms of Alzheimer’s (RCT with 61 patients). However, the lower dose (4.5 g/day) did not significantly improve symptoms [R].

Similarly, Alzheimer’s patients taking 4.5 g/day for 24 weeks of heat-processed ginseng had improvements in cognitive function and behavioral symptoms. Lower dosages (1.5 and 3 g/day) improved some Alzheimer’s symptoms as well (RCT with 40 patients) [R].

4) Heart Health

Heart attack patients given red ginseng (3 g/day for 8 months) following heart surgery had increased circulating angiogenic cell (cells that make new blood vessels) action and reduced inflammation levels. These data indicate improved blood flow (RCT with 50 patients) [R].

Korean red ginseng (3 g) treatment improved the stiffness of arteries (as measured by radial augmentation index) but did not change blood pressure (DB-crossover of 17 healthy individuals) [R].

Supplementation with 3 g/day of red ginseng for 12 weeks decreased total and LDL cholesterol levels as well as arterial (carotid intima-media) thickness in postmenopausal women (DB-RCT with 72 subjects) [R].

However, when high blood pressure patients taking blood pressure medication were given Korean red ginseng (3 g/day for 3 months), they did not experience an improvement in arterial stiffness (as measured by blood pressure) (DB-RCT with 80 participants) [R].

Similarly, Korean red ginseng (4.5 g/day for 12 weeks) did not affect blood pressure, lipid profile, oxidized LDL, or artery stiffness (or fasting blood sugar levels) in people with metabolic syndrome (DB-RCT of 48 subjects) [R].

5) Diabetes, Blood Sugar, and Insulin

A review of 16 RCT’s determined that ginseng slightly improved fasting blood glucose of both diabetics and non-diabetics but stated more studies are needed. There is also a lack of standardization in studies examining these effects and it’s possible that different ginseng types have different or opposing effects, which have currently not been parsed out [R, R].

American ginseng (3, 6, or 9 g) given to non-diabetes improved sugar clearance from the blood (glucose tolerance). In another study with healthy individuals, Korean red ginseng (3 g from the body of the ginseng) improved post-meal sugar levels (RCT with 13 participants). A ginseng supplement (200 or 400 mg G115) also improved glucose levels in healthy adults (DB-crossover of 30 participants) [R, R, R].

Non-insulin dependent diabetes patients given 100 or 200 mg of ginseng had lower fasting blood sugar levels and body weight. The 200 mg treatment improved HbA1c (hemoglobin A1c). Interestingly, the placebo also reduced body weight (DB-RCT with 36 patients) [R].

Fermented red ginseng supplementation (2.7 g/day for 4 weeks) lowered blood glucose levels and increased insulin levels following meals in people with impaired fasting glucose or type 2 diabetes. However, ginseng did not change fasting glucose, insulin, or lipid levels (DB-RCT of 42 subjects) [R].

However, overweight and obese subjects with either impaired glucose tolerance or type 2 diabetes given Korean red ginseng extract (3-8 g/day) or ginsenoside Re (250-500 mg/day) for 30 days did not have improved insulin sensitivity or beta cell function (the cells that make insulin) (RCT of 15 participants) [R].

Similarly, Korean red ginseng (4.5 g/day for 12 weeks) did not affect fasting blood sugar levels (or blood pressure, lipid profile, oxidized LDL, or artery stiffness) in people with metabolic syndrome (DB-RCT of 48 subjects) [R].

A review of two DB-RCTs determined that consistent ginseng consumption had no effect on blood sugar control in healthy individuals (as measured by HbA1c levels, fasting insulin levels, fasting blood sugar levels, and response following meals) [R].

6) Brain Function and Well-Being

Panax ginseng supplementation (200 mg/day for 8 weeks) boosted mental health and social functioning after 4 weeks. However, at 8 weeks, the results were not significantly different from the control group. More ginseng users (58%) thought they were receiving the active treatment compared to the placebo group (17%), which may bias the results (DB-RCT of 30 people) [R].

200 mg of G115, a ginseng supplement boosted performance on a math task while also helping with mental fatigue (DB-crossover of 27 healthy adults) [R].

Ginseng supplementation slightly reduced feelings of depression and improved well-being in postmenopausal women (DB-RCT of 384 subjects) [R].

Non-insulin dependent diabetics given 100 or 200 mg of ginseng experienced an enhanced mood (DB-RCT with 36 patients) [R].

Subjects taking 200 mg of G115, a ginseng supplement, experienced improvement in a mental task with less mental fatigue. Interestingly, subjects who took the higher dose (400 mg) did not experience this effect (DB-crossover trial of 30 healthy adults) [R].

Another study had mixed results. Subjects taking 200 mg of G115 had a slower response on a mental task but 400 mg improved mood and performance on a mental task (DB-crossover trial of 30 subjects) [R].

However, G115 supplementation (200 or 400 mg) didn’t affect mood or the experience of feeling/emotion (psychological affect) in healthy young adults (DB-RCT with 83 adults) [R].

7) Fatigue

Enzyme-modified ginseng extract treatment decreased fatigue severity in healthy adults [R].

Ginseng (800 mg/day for 29 days) improved fatigue, well-being, and overall quality of life in patients with cancer-related fatigue (prospective, open-label study with 30 patients) [R].

Similarly, 2 g/day of ginseng for 8 weeks improved cancer-related fatigue (DB-RCT with 364 participants) [R].

Patients with chronic fatigue were given 1 or 2 g/day of ginseng extract for 4 weeks, with the higher dose improving fatigue. This effect might be due, in part, to ginseng’s antioxidant properties (DB-RCT with 90 subjects) [R].

A meta-analysis of 4 RCT’s with a total of 429 participants found that although ginseng seemed to reduce fatigue, more clinical data needs to be collected [R].

A ginsenoside treatment reduced aminotransferase and creatinine levels, indicators of adverse chemotherapy side effects, in mice [R].

8) Immune Function

People who took 100 mg of a ginseng extract, G115, for 12 weeks along with their flu vaccine were significantly less likely to get a cold or the flu. The ginseng group also had higher levels of immune response (natural killer cell activity) (DB-RCT with 227 volunteers) [R].

Patients with stage III gastric cancer taking red ginseng powder during their chemotherapy treatment had a higher 5-year disease-free survival and overall survival rate (study with 42 patients) [R].

However, a review study stated that more studies need to be conducted on the effect of ginseng on immune function [R].

9) Menopausal Symptoms

Some menopausal women experience various sexual symptoms such as impaired sexual function. Sexual arousal was improved after Korean red ginseng extracts (3 g/day) supplementation. However, the treatment caused 2 cases of vaginal bleeding (DB-crossover of 32 subjects) [R].

Supplementation with 3 g/day of red ginseng for 12 weeks improved menopause symptoms (DB-RCT with 72 postmenopausal women) [R].

Although ginseng supplementation slightly reduced feelings of depression and improved well-being in postmenopausal women, it did not affect menopause symptoms (DB-RCT of 384 subjects) [R].

10) ADHD and Learning

Korean red ginseng (2 g/day) reduced the inattention and hyperactivity scores for children with ADHD symptoms (DB-RCT with 70 children) [R].

Ginseng treatment increased the learning performance for impaired rats and may improve spatial cognitive impairment [R].

11) Anti-Cancer Effects

A meta-analysis on 9 studies (5 cohort, 3 case-control, and 1 RCT) found that ginseng consumption was related with a decreased risk of developing cancer and that this effect was not specific to a particular organ or set of organs [R].

An observational study found consumption of certain types of ginseng (fresh ginseng extract, white ginseng extract, white ginseng powder, and red ginseng) but not others (fresh ginseng slices or juice and white ginseng tea) was associated with decreased risk of certain cancers (lip, oral cavity, pharynx, esophageal cancer, stomach, colorectal cancer, liver cancer, pancreatic, laryngeal, lung cancer, and ovarian) but not others (breast, uterine cervix, urinary bladder, and thyroid) [R].

Red ginseng extract (1 g/week for 3 years) reduced the risk of developing non-organ-specific cancer, but only in the male subjects (DB-RCT of 643 patients with chronic gastritis) [R].

Animal Studies:

  • In mice, panaxydol, a compound found in ginseng, increased cancer cell death [R].
  • Ginseng root extract reduced the number of skin tumors in mice compared to mice not treated with ginseng [R].

Cellular Studies:

  • Ginsenoside Rg5 increased cancer cell death in breast cancer cells [R].
  • Ginseng extract increased cancer cell death and metastasis in lung cancer cells [R, R].
  • Ginseng berry extract and increased cell death and prevented cell growth in liver cancer cells [R].
  • Ginsenoside compound K prevented certain enzymes (CYP2C9 and CYP3A4) from working properly in liver cells [R].
  • A type of sugar (oligosaccharide) derived from ginseng has anti-cancer effects in skin cancer cells by increasing macrophage function [R].
  • Microwave processed ginseng prevented cancer cells from further growth and increased cell death in prostate cancer cells [R].

12) Weight Loss

Ginseng therapy was associated with increased psychological performance and mood, and decreased body weight and fasting blood glucose in patients with newly diagnosed non-insulin-dependent diabetes [R].

However, in another study, ginseng (100 or 200 mg/day for 8 weeks) did not affect body weight because both the treatment groups and the placebo group lost weight (DB-RCT with 36 patients) [R].

In older obese mice, fermented red ginseng improved insulin sensitivity relative to reduced body weight [R].

Ginseng reduced triglyceride and free fatty acids levels. It also prevented adipose inflammation, insulin resistance, and hepatic steatosis in premenopausal mice [R].

Chinese ginseng-fed mice had decreased fat cell production and had reduced body fat mass gain, improved glucose tolerance and insulin sensitivity in obese mice [R].

Animal and Cellular Studies

The following studies were conducted only on animal models and/or on cell lines.

13) Brain Inflammation

In animals, Panax ginseng reduced symptoms of autoimmune brain inflammation (by suppressing pro-inflammatory genes IFNG, IL-17A, and TNF) [R].

American ginseng protects the brain against brain inflammation, mitochondrial dysfunction, oxidative stress, and HPA axis activation in sleep-deprived animals [R].

Ginseng may improve motor function recovery after a spinal cord injury by reducing inflammation in mice [R].

14) Stress Response

Ginseng treatment helps with physical performance and increases resistance to stress and aging by affecting the hypothalamic-pituitary-adrenal axis, which increases elevated plasma corticotropin and corticosteroid levels [R].

15) Alcohol Toxicity

Ginseng and seabuckthorn increased enzymes (ADH and ALDH) that break down alcohol in mice with acute alcohol intoxication. This helps lessens the effects in the brain against acute alcohol intoxication [R].

Side Effects and Drug Interactions

As a stimulant, ginseng may cause nervousness and/or sleeplessness, as well as high blood pressure, anxiety, vomiting, and diarrhea in high doses.

Symptoms of excessive ginseng use include mastalgia (breast pain), skin reactions, and vaginal bleeding [R].

Ginseng may interact with ACE inhibitors, calcium channel blockers, blood thinners, stimulants, MAOIs, and morphine.

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5 COMMENTS

  • VAL YOUNG

    Hi. Thanks for the valuable info in this article. It was a well written one. I learned some things about the herb ginseng that I didn’t know. I appreciate that!

    I would like to point out something regarding how ginseng is used in TCM, albeit my explanation is a simplistic one. Ginseng is typically combined with other herbs in various formulas – this is to deal with either enhancement of certain properties of the herb that are used in the formula to address a certain pattern of diagnosis or to reduce any unwanted side effects of the herb (think counterbalance). This is roughly how most all TCM herbal formulas are made. Ginseng is an amazing herb, but like everything, too much of a good thing is not always good.

    I also want to bring to you attention that you stated “ginger” in the article when it seems you intended to say “ginseng”. Here is the sentence: “Following absorption into the blood stream the GINGER constituents are dispersed throughout the body where they interact either directly with metabolites or through genetic components such as the gene ACE (Angiotensin I converting enzyme).” I retyped the word “ginger” in all caps. Thanks in advance for making the appropriate correction(s).

    Again, it was a great article!

  • Kelly Spinks

    Sorry Mr Hung.iam 63 years old and it only takes me a nice 4 hour walk in the woods to find enough Seng to last me till the next year.Dont know how much organic you could want?

  • Carol Willis

    Panax ginseng can also provoke or aggravate herpes and shingles, even if taken with a TCM “kidney yin” tonifier for balance. Panax ginseng is an extremely hot-temperature herb, can aggravate all Ayurvedic pitta-type conditions.

  • Hung P Tran

    Ginseng is grown in the ground for up to 6 years which means it is absorbing years worth of pesticides, herbicides, fungicides…Organic Ginseng is almost impossible to find. Not worth it.

    1. Ken

      Ginseng is highly susceptible to plant pests. Growers have no choice but to apply pesticides or risk losing entire crops.

      Instead of so many animal and in vitro results, which may or may not be found in people, it would more useful for readers to learn the outcomes of well controlled clinical trials, not all of which have shown that ginseng has significant benefits.

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