Ginseng has a plentitude of health benefits. Because of its widespread and long history of use, ginseng is one of the more widely researched forms of alternative and complementary medicine. And though much of the evidence in support of ginseng’s use comes from laboratory-based studies, a fair number of clinical studies involving actual people do exist.
A total of 13 different types of ginseng exist. They all share the same class of active compounds believed to confer ginseng’s medicinal benefits. These compounds are called ginsenosides and constitute part of the ginseng plant’s natural defense system against insects and bacteria/fungi. Dozens of ginsenoside types exist, with each seeming to have different properties, and different effects on one’s health.
There are many ways to make ginseng tea. Generally, one can decide between brewing the actual root versus using a commercially prepared product, such as powdered ginseng or teabags. When using a prepared tea product, one should follow the instructions provided by the manufacturer. If one chooses to use the actual root, there are many factors to consider when choosing roots and preparing the tea.
Ginseng Tea for Health
When people say “ginseng,” they are likely referring to one of three plant species:
- Asian ginseng (Panax ginseng), also called Korean or Chinese ginseng
- American ginseng (Panax quinquefolius) or
- Siberian ginseng or Eleuthero (Eleutherococcus senticosus)
Siberian ginseng, however, is not truly a type of ginseng, but instead represents a separate class of plant with different properties than either Asian or American ginseng. Asian and American ginseng can be considered together because they both contain molecules called ginsenosides that are believed to be the compounds that confer ginseng with its usefulness in various health conditions.
Ginseng has been used for thousands of years, dating back to ancient China, where ginseng was used to improve digestion, strengthen the lungs, and increase energy. It is considered a “yang” herb, which, in Chinese medicine theory, is associated with light, heat, upward motion, and emptying. This is opposed to “yin,” which represents dark, cool, inward motion, and holding.
Another view of ginseng is that it acts as something called an adaptogen. This term was coined by a Russian scientist and physician who began studying ginseng in the 1940’s. Adaptogens are substances that help the body adapt to a variety of stressors, including environmental, physiological, psychological, and emotional. Another characteristic of adaptogens is that they have no side effects, universally treat a multitude of diseases, and restore/maintain balance. This theory conflicts with Chinese traditional medicine, which posits that different substances are helpful in some individuals with certain conditions but either neutral or harmful in others. The existence of adaptogens is more widely accepted in Europe, where many accept ginseng as an adaptogen.
What are ginsenosides?
Ginsenosides are molecules found exclusively in Asian and American ginseng and are the compounds believed to give ginseng its medicinal properties. They belong to a group of compounds called triterpine saponins and are part of the ginseng plant’s natural defense mechanism, acting to protect the plant from insects and bacteria/fungi.
Ginsenosides exert their actions by several mechanisms, which all appear to be mediated by the molecules’ ability to bind to and activate a variety of receptors, including steroid hormone receptors. One type of steroid hormone receptor is that for stress hormone, or glucocorticoids. This can help to explain ginseng’s reported use as an adaptogen and its ability to help one respond to different types of stressors. The wide variety of receptors that ginsenosides can bind to likely explains the wide range of ginseng’s health benefits.
Studies have shown, however, that ginsenosides are poorly absorbed when ginseng is dosed orally, due to sub-optimal concentration and breakdown during the digestive process. This means that it seems unlikely that these active molecules will reach their target organs. Ways to make them more physiologically relevant include having a large quantity/high concentration of ginsenosides and biochemically stabilizing the molecules to decrease degradation in the gastrointestinal tract and improve absorption.
It is also important to note that there are dozens of different types of ginsenosides and that each type binds to a unique collection of receptors, which translates into each ginsenoside having a unique range of targets and benefits. Furthermore, Asian and American ginseng contain different types of ginsenosides in varying concentrations, so one should not expect similar results from all ginseng preparations. This issue is further compounded by ginseng’s status as a nutritional supplement, rather than a drug, since there is no standardization among manufacturers. Even if two ginseng products have the same total amount of ginsenosides, they will likely have different specific health effects because the exact amounts and ratios of different types of ginsenosides vary.
In addition to ginsenosides, ginseng also has a several other biologically active compounds. This includes B vitamins, fatty acids, flavonoids, volatile oil, antioxidants, and anti-inflammatory agents, which likely contribute to its health benefits.
Uses of Ginseng
Ginseng’s medicinal properties have been used for a variety of heath issues:
- Cold/flu prevention and treatment
- Menopausal symptoms
- General strength and stamina
- Sexual dysfunction
- Pain and
- Health maintenance
The majority of studies examining the validity of ginseng’s reported health benefits have either been conducted in animals or been clinical trials involving humans, but were of such low quality that they were deemed unacceptable for generalization to the public. Compared to most other supplements and alternative therapies, a larger collection of well-conducted research studies does exist for ginseng. The most researched, scientifically studied uses for ginseng are protection from colds and flu, diabetes control, mind stimulation, improved general well-being, and enhanced sports performance.
Colds and Flu
Prevention of colds and the flu is one of the most popular uses of ginseng. A well-conducted study in 2005 aimed at studying ginseng’s effects on cold prevention followed more than 300 participants taking 400 mg of American ginseng daily. This study found that participants taking ginseng had fewer colds and also decreased duration and severity of symptoms when a cold did occur. A similar study in 1996 supports Asian ginseng’s efficacy in colds and flu. In addition, Asian ginseng may potentiate the effect of the influenza vaccine. There is also weak evidence that Asian ginseng may provide some benefit in chronic bronchitis.
In general, studies seem to show that American ginseng helps to control blood sugar control, both with fasting and post-prandial (after eating) measurements. However, the evidence is mixed regarding Asian ginseng, as some studies have shown some benefit, while others have observed that Asian ginseng appears to actually worsen blood sugar control. If true, this is likely due to the varying concentrations of different ginsenosides found in American vs. Asian ginger. At this time, due to conflicting evidence, it is not recommended that ginger be used as a component of diabetes treatment.
Studies have shown that both Asian and American ginseng may provide some benefit in mental functioning, though Asian ginseng appears more studied and well-supported. The range of effects includes improvement in memory, attention, concentration, coping ability, abstract thinking, editing tasks, and mental arithmetic. One concern regarding ginseng in this capacity is that there is no consistency in the aspects of mental functioning that ginseng affects; each study varies in term of the precise results seen, which makes it difficult to truly understand ginseng’s effects in this domain.
Several studies have shown a perceived improvement in general well-being attributable to ginseng, as measured by subjective reports of mood, vigor, and psychophysical performance. The degree to which study participants experienced benefit varied largely, from none, to marginal, to significant improvement.
Studies have shown mixed results for ginseng as a performance enhancer, with Asian ginger being the primary type of ginseng examined. Positive studies have shown improved aerobic capacity, physical endurance, and strength, but not in all age groups. A large number of studies, on the other side, have not shown any improvement in sports performance related to ginseng use.
Less Well-studied Uses
Many believe that ginseng is useful in both the prevention and treatment of cancer. And while laboratory studies on both Asian and American ginseng have shown some inhibition of tumor cell growth in isolated cells and tissues, reliable clinical data from humans has not been obtained and laboratory data does not reliably translate into similar results on a clinical level. Another cancer-related use for ginseng that has been well-studied, though, is fatigue related to the disease process itself and/or conventional therapy such as chemotherapy and radiation. Recent studies have shown significant benefit in trials following hundreds of cancer patients, reporting improvements in general and physical energy without side effects. And while these results are encouraging, further data is needed before recommending ginseng for treatment in cancer-related fatigue.
Similarly, anecdotal evidence is plentiful regarding ginseng and erectile dysfunction, but only small clinical studies have been conducted; therefore, more research needs to be done before reaching a definitive conclusion. Similarly, research results for ginseng in treating menopausal symptoms have been inconclusive.
Ginseng is commercially available in a variety of forms. Both Asian and American ginseng are available as liquid extracts in water vs. water/alcohol vs. alcohol, powders, and capsules. Asian ginseng root is additionally available for making a tea or decoction. Using the actual dried root is the most economical method of extracting the useful compounds in ginseng.
Ginseng tea can be brewed by brewing the root slice in water for one hour. As ginseng is a bitter tasting root, potency of the tea correlates with degree of bitterness. One can also add pieces of root to soups and alcoholic beverages to extract the ginsenosides. Alternatively, the root can be chewed directly or ground into a powder.
For Asian ginseng, the typical daily dose is 1-2 grams of raw ginseng or 200 mg of extract containing between 4% and 7% ginsenosides. As stated before, though, ginseng is considered an herbal supplement rather than a drug regulated by the U.S. Food and Drug Administration and is therefore not subject to standardization among different manufacturers of commercial products. Therefore, one must carefully read the specific dosing instructions provided by one’s chosen brand. Ginseng users typically take ginseng in cycles, with two to three weeks on ginseng, followed by one to two ginseng-free weeks.
Reported side effects of ginseng include dry mouth, rapid heart rate, high blood pressure, nausea/vomiting, diarrhea, insomnia, and anxiety. However, these symptoms are seen when ginseng is taken in excessively high amounts. In general, ginseng is considered fairly safe for both short- and long-term use.
Ginseng also has interactions with a number of drugs that may be prescribed by a physician. Given its potential to reduce blood sugar, ginseng should be used cautiously or avoided in those also taking insulin or oral blood sugar reducing agents. This is particularly important because hypoglycemia, or low blood sugar, can be a life-threatening event. Ginseng may also decrease the effects of anticoagulants such as Warfarin or coumadin. Patients on imatinib mesylate, or Gleevec, should know that ginseng may increase the risk of liver damage when taken together. Also, those who take ginseng while on monoamine oxidase inhibitors (MAOIs) should be aware of the possibility of manic-like symptoms (distractibility, uninhibited behavior, racing thoughts, pressured speech, decreased need for sleep).
Given the activity of ginsenosides and their ability to bind hormone receptors, ginseng may have estrogen-like effects. Therefore, those with estrogen-responsive cancer, such as breast cancer, should refrain from ginseng supplementation.
Like many other forms of complementary and alternative medicine, ginseng is not recommended for use in women who are pregnant or breastfeeding, young children, and those with severe liver or kidney disease.
Ginseng has been one of the most popular and commonly used herbal supplements for thousand of years, for a wide range of health conditions. A sizeable body of research is available regarding its efficacy in many of these conditions, with many studies showing significant positive effects. And though ginseng is generally considered safe to consume, it remains important to be aware of side effects and contraindications, as with any supplement, and to inform one’s doctor of all supplements that one is taking.