Ginseng supplement benefit and side effects, review
Siberian, Korean, and American root, what are the differences in
benefits and adverse reactions, how safe is this herbal root and its extracts?
Ray Sahelian, M.D.
March 1, 2014
The root of the ginseng plant has been used in China, Japan, and Korea for many centuries as a benefit in psychiatric and neurological conditions, and for enhancing vitality. There are several varieties sold over the counter: Asian (Panax ginseng), American (Panax quinquefolius), and Siberian (Eleutherococcus Chinensis) are the most common. Technically Siberian does not belong in the same genus as Asian or American and does not contain the same ingredients. As a rule, Asian ginseng is more stimulating and raises body temperature while American is less heating and stimulating. Hundreds of ginseng products are available over the counter with different dosages and combinations. You may notice a slightly or moderately different effect from these various formulations.
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Supplement Facts: Serving Size: 1 Capsule
Amount Per Serving:
Panax Ginseng Root 400 mg each pill
Suggested Use: One ginseng capsule in the morning a few times a week or as recommended by your health care professional. I prefer it not be taken daily for prolonged periods. As a general rule, you may consider taking a capsule every other day with a week off each month. This is a rough guideline that you can adapt to your own unique needs.
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Ginseng is a legendary tonifier first written about in the Sui Dynasty of China ( 580 - 601 A.D. ). In traditional Chinese herbalism it is rarely used alone, but rather is combined with herbs considered to assist and augment its tonifying actions. This classic formula that has been in continued use since 1078 A.D. This dynamic combination is designed to support energy levels.
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Benefit as sexual enhancer
Ginseng supplements have been touted as a sex stimulant for countless generations. It has compounds that benefit nitric oxide production which helps dilate blood vessels. This may partially account for the improvement in erectile dysfunction. It is a good sex herb but in my opinion there are better ones such as horny goat weed, tribulus terrestris, tongkat ali, muira puama, catuaba, mucuna pruriens, yohimbe, and others.
Sexual enhancement, erectile dysfunction, impotence
Int J Impot Res. 2013. Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study. In all, 119 men with mild-to-moderate ED participated in a multicenter, randomized, double-blind, parallel, placebo-controlled clinical study. They were administered 4 tablets of either standardized Korean ginseng berry (SKGB, 350 mg ginseng berry extract per tablet), or placebo, daily, for 8 weeks. Administration improved all domains of sexual function. It can be used as an alternative medicine to improve sexual life in men with sexual dysfunction.
Korean red ginseng, a herb considered an aphrodisiac in some Asian countries, seems to be an effective treatment for erectile dysfunction. In some Asian cultures, ginseng has been used traditionally to boost sex enjoyment and sexual stamina, but the effectiveness of the herbal remedy has been evaluated in only a handful of studies, so a team at the University of Ulsan and the Korea Ginseng and Tobacco Research Institute in Seoul evaluated Korean red ginseng in 45 men with erectile dysfunction. The men were randomly assigned to take either 900 milligrams of ginseng or an inactive placebo pill three times a day. Eight weeks into the study, the men were taken off the treatment for 2 weeks, after which they switched treatments for the next 8 weeks. Scores for erectile function, sexual desire and satisfaction during intercourse were higher when the men were taking ginseng than when they were on the placebo. The men reported being better able to achieve and maintain an erection while taking ginseng than when on the placebo. While they were taking ginseng, 60% of men said that their erections improved compared to 20% while taking placebo. The herb did not have a significant effect on testosterone levels. Despite the apparent improvements, the researchers did not detect any improvement in blood flow to the penis while men were taking ginseng. In addition, most men who said that their erectile function improved did not experience more frequent ejaculations or more satisfaction with their orgasms. 2002 The Journal of Urology.
Study of the efficacy of Korean Red Ginseng in the
treatment of erectile dysfunction.
A double-blind crossover study evaluating the efficacy
of korean red ginseng in patients with erectile dysfunction: a preliminary
J Urol. 2002.
We investigated the efficacy of Korean red ginseng for erectile dysfunction. A total of 45 patients with clinically diagnosed erectile dysfunction were enrolled in a double-blind, placebo controlled, crossover study (8 weeks on treatment, 2 weeks of washout and 8 weeks on treatment) in which the effects of Korean red ginseng and a vehicle placebo were compared using multiple variables. The ginseng dose was 900 mg. 3 times daily. Mean International Index of Erectile Function scores were significantly higher in patients treated with Korean red ginseng than in those who received placebo. Scores on penetration and maintenance were significantly higher in the ginseng than in the placebo group. In response to the global efficacy question 60% of the patients answered that Korean red ginseng improved erection. Our data show that Korean red ginseng can be an effective alternative for treating male erectile dysfunction.
Ginseng, sex behavior, and nitric oxide.
Ann N Y Acad Sci. 2002.
Both Asian and American forms of ginseng enhance libido and copulatory performance. These effects may not be due to changes in hormone secretion, but to direct effects, or its ginsenoside components, on the central nervous system and gonadal tissues. There is good evidence that ginsenosides can facilitate penile erection by directly inducing the vasodilatation and relaxation of penile corpus cavernosum. The effects on the corpus cavernosum appear to be mediated by the release and/or modification of release of nitric oxide from endothelial cells and perivascular nerves. Animal studies lend growing support for the use of ginseng in the treatment of sexual dysfunction and provide increasing evidence for a role of nitric oxide in the mechanism of ginsenoside action.
Spermatogenesis. July 1 2013. Ginseng and male reproductive function. Ginseng is often referred to as the King of all herbs, and is found to be a promising agent to improve general well-being. Ginseng has also been reputed as an aphrodisiac, and is used to treat sexual dysfunction as well as to enhance sexual behavior in traditional Chinese medical practices. Data from animal studies have shown a positive correlation among ginseng, libido, and copulatory performances, and these effects have been confirmed in case-control studies in human. In addition, ginseng is found to improve the sperm quality and count of healthy individuals as well as patients with treatment-related infertility. These actions are mostly attributed to ginsenosides, the major pharmacological active components of ginseng. This review compiles the current knowledge about the multifaceted effects of ginseng on male reproductive function, and also focuses on its mechanisms of action that may represent novel therapeutic strategies for the treatment of male reproductive diseases or disorders.
Benefits - laboratory and human studies
Lets examine some of the studies done with ginseng to find out in what conditions this root herb is of benefit or not helpful.
Pharmacogn Mag. 2013. Sterols isolated from seeds of Panax ginseng and their antiinflammatory activities.
performance - no significant benefit
Ginseng supplementation does not change lactate threshold and physical performances in physically active Thai men.
J Med Assoc Thai. 2007.
Ginseng has been one of the most popular herbs said to improve human exercise performance. The purpose of the present study was to investigate the effect of ginseng supplementation on lactate threshold in physically active young men. Sixty men from the Naval Medical Corps, Royal Thai Navy, aged 17- 22 years old, were randomized into either the ginseng or placebo group. The ginseng group took 3 grams of 100% ginseng orally, while the placebo group took an equal amount of lactose powder each day, for 8 weeks. Daily administration of 3 g of ginseng for an 8-week period did not improve lactate threshold nor did it affect physical performances. Therefore, ginseng supplementation did not exert an ergogenic property on aerobic fitness enhancement in well-fit individuals.
Association of Ginseng Use with Survival and Quality of Life among Breast Cancer Patients.
Am J Epidemiol. 2006. Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN.
The authors evaluated the associations of ginseng use as a complementary therapy with survival and quality of life in a cohort of 1,455 breast cancer patients who were recruited to the Shanghai Breast Cancer Study in Shanghai, China. Approximately 27% of study participants were regular ginseng users before cancer diagnosis. Compared with patients who never used ginseng, regular users had a significantly reduced risk of death. Ginseng use after cancer diagnosis, particularly current use, was positively associated with quality of life scores, with the strongest effect in the psychological and social well-being domains.
J Natl Cancer Inst. August, 2013. Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. Data support the benefit 2000 mg daily, on CRF over an 8-week period. There were no discernible toxicities associated with the treatment. Studies to increase knowledge to guide the role of ginseng to improve CRF are needed.
Most people have had family members or friends or coworkers who have had treatment for cancer in the form of chemotherapy and/or radiation. Perhaps you, yourself, have had such treatment. During and after such chemotherapy most patients feel tired or sluggish. Many survivors attempt different regimens to combat and reverse this condition. In a recent trial, investigators divided 364 people with cancer-related fatigue into two groups. People in one group took 2,000 milligrams of ginseng daily for eight weeks; those in the other group took placebo capsules. After eight weeks, the ginseng group reported a significant improvement compared to the placebo group. Journal of the National Cancer Institute, online July 13, 2013.
Cholesterol, and blood lipids
The administration of several grams of ginseng daily increases the ability of the body to maintain its antioxidant status. Furthermore, lipid levels such as LDL cholesterol are lowered.
Effects of Panax ginseng extract on lipid metabolism in humans.
Pharmacol Res. 2003.
The purpose of this study was to examine the effects on lipid metabolism in humans by measuring cholesterol, malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT). Serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and plasma MDA levels were decreased by administration of ginseng extract for 8 weeks (6 g per day), however, high density lipoprotein (HDL) was increased. Those results suggest that lipid lowering effect of ginseng is associated with a decrease in TC, TG, LDL, MDA levels and an increase in HDL. These findings support scientific claims that ginseng has lipid lowering potential. Administration of ginseng extract increased SOD and CAT activities while decreased MDA level indicating that antioxidant potential of PGE might induce hypolipidemic effect as one of action mechanism.
Various tests of mental performance were carried out in a group of sixteen healthy male volunteers given a standardized preparation of Asian ginseng (100 mg twice a day for twelve weeks of a product called G 115). A similar group was given identical placebo capsules under double-blind conditions. A favorable effect of ginseng was observed in attention, mental arithmetic, logical deduction, and auditory reaction time.
Researchers at the Cognitive Drug Research Ltd., Beech Hill, Reading, in the United Kingdom evaluated the effects of a Ginkgo biloba / ginseng combination on cognitive function. The study lasted ninety days and was performed in a double blind, placebo-controlled manner with sixty-four healthy volunteers (aged 40 to 65 years) who had mild fatigue and low mood. The treatment was well tolerated by all volunteers. There were improvements noted in memory and overall cognitive functioning.
Ginseng root saponin at a dose of 50 mg three times a day was given for two months to 358 middle and old age individuals. The results showed that the herb improved memory and immunity.
Certain active substances in ginseng appear to combat degenerative brain disease in rats. The various commercial preparations are generally made from the roots of one of several plant species, including Panax ginseng and Panax quinquefolius. A whole-root preparation of American ginseng was not beneficial in helping degeneration in the brains of rats. But a partially purified extract of some of the herb's active chemicals, known as ginsenosides, did. The study focused on brain damage that, in rats, mimics the degenerative process seen in Huntington's disease, an inherited disorder of the central nervous system that progressively impairs movement and mental function. But the findings suggest that certain ginseng components have potential for treating other degenerative conditions, such as Parkinson's. The partial purification of American ginseng boosted the concentration of three ginsenosides known as Rb1, Rb3 and Rd. Animals that were given the extract before receiving a brain-cell-damaging toxin called 3-NP showed less movement impairment than animals that received 3-NP alone, and none died. Annals of Neurology, May 2005.
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Lung disease, COPD
Ginseng improves pulmonary functions and exercise capacity in patients with COPD.
Arch Chest Disease. 2002.
The purpose of this study was to evaluate the effects of ginseng extract (G115) on Pulmonary Function Tests (PFTs), Maximum Voluntary Ventilation (MVV), Maximum Inspiratory Pressure (MIP) and Maximal Oxygen Consumption (VO2max) in patients with moderately-severe Chronic Obstructive Pulmonary Disease (COPD). Ninety-two adults were randomly divided into the experimental (Ginseng 100 mg bid for three months) and placebo-control groups. Ginseng extract 100 mg bid for three months, but not placebo, improved PFTs, MVV, MIP and VO2 max in patients with moderately-severe COPD with no side effects.
Combination with prescription drugs
Ginseng may interact with a number of prescription medications, for instance warfarin or Coumadin.
Brief communication: American ginseng reduces warfarin's effect in healthy patients: a randomized, controlled Trial.
Ann Intern Medicine. 2004.
People using prescription medication often concurrently take herbal supplements. In a case report, the anticoagulant effect of warfarin decreased after patients consumed ginseng. To evaluate the interactions between American ginseng and warfarin. In this 4-week study, 20 patients received warfarin for 3 days during weeks 1 and 4. Beginning in week 2, patients were assigned to receive either American ginseng or placebo. International normalized ratio (INR) and plasma warfarin level. The peak INR statistically significantly decreased after 2 weeks of ginseng administration compared with placebo. American ginseng reduces warfarin's anticoagulant effect. When prescribing warfarin, physicians should ask patients about ginseng use..
Can I take Korean ginseng with hypertension
There are dozens of different hypertension drugs. We have not seen any research regarding its combination with such medications, so we can't say. Chances are low dosages would not have much of an influence but we suggest you avoid high dose ginseng supplements if you are taking blood pressure medications.
Can I take ginseng with cholesterol medication such
as a statin drug?
There are many different cholesterol drugs. We have not seen any research regarding its combination with various such cholesterol lowering medications, so we can't say.
Why is it that panax ginseng is contraindicated in hypertension, when it is also a known vasodilator due to its tendency to increase nitric oxide production? This is really confusing me. I have done a lot of internet searching, but cannot find the answer to this question. I did find some sites which stated that Korean Ginseng might be useful in treating hypertension, but in general, the consensus is that ginseng is a stimulant and should not be used by hypertensive patients. How can it be both a vasodilator and a vasoconstrictor at the same time? (I'm assuming that the stimulant aspect of ginseng involves vasoconstriction and that that is the mechanism in causing hypertension.
This is a good question. We are not sure completely but we will take an educated guess. Each herb, including ginseng, has many, many components. Some of these substances may cause dilation of blood vessels, but other chemicals in ginseng may stimulate heart tissue to beat faster and stronger thus increasing blood pressure. Various forms may act in different ways, and also the way the ginseng is made into powder, and various extract forms determines the final constituents. So, different preparations may have a different effect.
Quality of life
The aim of this study was to compare the quality-of-life parameters in subjects receiving multivitamins plus ginseng with those found in subjects receiving multivitamins alone (Caso Marasco 1996). The study was randomized and double-blind, and it involved 625 patients of both sexes divided into two groups taking one capsule per day for twelve weeks. Group A received vitamins, minerals, trace elements and ginseng extract while group B received vitamins, minerals and trace elements only. By the end of the study, both the group-A and the group-B tested positively on a questionnaire evaluating quality of life, but Group A had a higher score.
Constituents, what's in it?
The roots of Asian and American ginseng contain several saponins named ginsenosides that are believed to contribute to the adaptogenic properties. They are used in traditional Chinese medicine to improve stamina and combat fatigue and stress. Saponins are interesting natural compounds found in many plants, herbs, roots, and beans. Saponins have potential in the prevention and treatment of diseases of the heart and circulatory system. For instance, they inhibit the formation of lipid peroxides (fat oxidation) in cardiac muscle or in the liver, they influence the function of enzymes contained in them, they decrease blood coagulation, cholesterol, and sugar levels in blood, and they stimulate the immune system. Some saponins may even have anti-tumor properties.
Availability of ginseng supplements
Countless varieties and dosages of ginseng are available. One option is to buy a ginseng product that has a standardized extract of 3 to 7 percent ginsenosides but some products are as high as 90 percent ginsenosides. Use 100 mg of this extract in the morning a few times a week. You may require 500 to 2,000 mg of he dried ginseng root to feel the effects. Its best to cycle the use of ginseng. For instance, you can take ginseng for two or three weeks and then take off a few weeks.
Ginseng side effects, safety,
High dosages of ginseng can cause overstimulation, restlessness, rapid heart beat, anxiety, headache, and insomnia. Just with any medication or supplement, the right dosage can be quite helpful while an excessive amount can lead to unpleasant adverse effects. Discuss with your doctor before using a ginseng product if you have a heart condition, are taking blood pressure pills, hormone medications, anti-depressants, or have a serious health condition.
Insomnia is a common side effect from ginseng overuse, particularly Asian ginsengespecially when its combined in high doses with other herbs or nutrients that cause alertness. Althea, a 38 year-old owner of a garden shop in Maui, says, "I took ginseng that was recommended by a Chinese physician for fatigue. I took it for two weeks. I felt really better emotionally, mellow, and with increased energy. Then I started to have increased sleep problems and insomnia. I went three days being so mentally and physically overstimulated that I hardly got any sleep. I imagine this is what being on "speed" must feel like. I stopped taking the ginseng and within two days I slowly returned to my normal state."
This story confirms my recommendations that dosages of nutrients and herbs have to be constantly evaluated since they can build up in the system.
Patients being treated with the blood-thinning drug Coumadin (warfarin) should probably avoid using ginseng, since ginseng seems to reduce the drug's effects. Ginseng use for two weeks was tied to a significant reduction in the INR, meaning that the blood was now less thin and more prone to clotting.
Ginseng should be used cautiously in those with heart disease. Keep the dosage low in order to prevent heart racing or high blood pressure.
Will a multi vitamin supplement taken along with panax ginseng make you shaky?
Several years ago I tried it and it made my shaky.
Yes, too much ginseng can cause side effects including nervousness and anxiety.
Mechanisms of action
The roots of Chinese and American ginseng contain several saponins named ginsenosides. These are interesting natural compounds found in many plants, herbs, roots, and beans. They are used in traditional Chinese medicine to improve stamina and combat fatigue and stress. They inhibit the formation of lipid peroxides (fat oxidation) in cardiac muscle and in the liver, influence the function of enzymes, decrease blood coagulation, cholesterol, and sugar levels in the blood, and stimulate the immune system. Some saponins may even have anti-tumor properties. Both the Asian and American forms of ginseng enhance libido and copulatory performance. These effects of ginseng may not be due to changes in hormone secretion, but to the direct effects of ginseng, or its ginsenoside components, on the central nervous system and gonadal tissues. There is good evidence that ginsenosides can facilitate penile erection by directly inducing the vasodilatation and relaxation of penile corpus cavernosa. Moreover, the effects of ginseng on the corpus cavernosa appear to be mediated by the release of nitric oxide from endothelial cells and from nerves that surround the vessels. Treatment with American ginseng also affects the central nervous system and has been shown to significantly alter the activity of hypothalamic catecholamines, such as dopamine and norephinephrine, involved in the facilitation of copulatory behavior and hormone secretion. According to recent findings,
that ginseng treatment decreases prolactin secretion,
which also suggests a direct effect of ginseng at the level of the pituitary
gland. High levels of prolactin inhibit libido. Studies sometimes have provided
contradictory results, perhaps because the ginsenoside content of ginseng root
or root extracts can differ depending on the species, method of extraction,
subsequent treatment, or even the season of collection.
Review and summary
Many people who take ginseng find this herb to be a good overall energizer and cognitive enhancer. Due to the tremendous variety of ginseng products sold, it is difficult to give definite dosage recommendations. You could certainly try a few ginseng products to see which one(s) give you a positive effect. In practical and simple terms, Asian ginseng raises body temperature and is more stimulating while American ginseng is more calming. The effects of Siberian ginseng fall somewhere between these two.
Dr. Sahelian's experience
The sexual effects from ginseng are subtle but definitely present. I have tried Asian ginseng on numerous occasions. Most of my trials have been with root powder at a dosage ranging from 500 to 1,000 mg. I notice an enhancement in alertness, motivation, focus, and mood, along with a mild sexual stimulation. The effects seem to improve on subsequent days of use. I find high doses to cause anxiety and interfere with sleep. Use a dose that does not cause you insomnia.
Q. I noticed in a product that one of the ingredients is a 30% ginsenoside. I would like to ask if you have such a ginsenoside or eleutheroside extract. I've taken eleuthero and American ginseng, which has wonderful effects on my physical and mental energy, but it also gives anxiety and insomnia. I thought if I could try a ginseng extract with a higher content of the main beneficial ingredients, maybe the side effects wouldn't be so bad. I've seen the concentrations of ginsenoside in ginseng as high as 80%.
A. There is no guarantee that higher concentration ginseng extracts will cause fewer side effects.
Q. I regularly take ginseng tablets, and the particular
brand I take I find has definitely been helpful. When I take ginseng I am more
mentally motivated, I work better, I am more motivated to workout, etc. When I
stop taking it for a little more than a week to two weeks -when a bottle is
finished- I start to feel very "run down", fatigued, and "not myself". Once I
restart ginseng I'm back to my old self again. (25 year old male by the way).
Now I don't mind taking ginseng on a regular basis as I see that as a part of my
wellness program, but I've been wondering whether the fact that there's such a
great difference when I take the ginseng, if it means that there's actually some
kind of nutritional or physiological shortfall in my body that the ginseng is
somehow "making up" for? In other words, I see ginseng as a "bonus" in terms of
my nutrition plan, not as a "regular" like vitamins, minerals, etc. So for the
ginseng to bring me up to "normal", does that indicate that there's actually a
deficiency of some sort in the "regular" stuff that the ginseng is making up
for? I hope I've stated the question adequately.
A. There are many causes of fatigue, and relying on herbs such as ginseng for long term daily use in not the best option. The fact that ginseng improves energy does not mean the body is deficient in the substances found in ginseng. An amphetamine pill can also increase energy, but that does not mean the body is short on amphetamines. Ginseng can be used for brief periods of time, but see the page on energy on the website for more information to a comprehensive approach.
Q. Is the benefit of ginseng korean red tea as good
as the benefit from Siberian ginseng root?
A. It is very difficult to compare the benefit of Korean root ginseng to other types of ginseng since so much depends on the dose use, the frequency, the particular person using it, and interactions with other supplements and drugs.
Q. Last year my Psychiatrist suggested fish oil for
bipolar disorder and I have been taking twelve fish oil 1200mg softgels a day
for almost a year and have felt great! Recently my friend asked me to try
Tunguska Blast an immune boosting energy drink that contains ginseng and several
other herbs. I was manic the whole time I drank the Tunguska Blast. Once I
stopped drinking it I felt like I woke up from a dream. I wasn't sure if the
herbs in the drink could've caused the manic episode and yesterday I told my
Psychiatrist's NP about the episode and she offered me Depakote. I don't smoke,
I eat healthy, exercise daily, take fish oil, multi-vitamins, and do all that I
can to reduce stress so I do not want to take a medication that has side effects
and cause harm my organs. When I saw on your site that ginseng could aggravate
bipolar disorder and induce mania I believe that is exactly what happened to me.
I am going to try to continue on the fish oil and avoid ginseng! Thank you for
A. A search on the internet reveals Tunguska Blast has the following herbs: Eleutherococcus Senticosus which is sometimes called Siberian Ginseng' Schizandra Chinensis, Aralia Mandchurica, Crataegus Oxyacantha, Inonotus Obliquus, Viburnum Sargenti. Glycyrrhiza Uralensis, Rhaponticum Carthamoides, Rhodiola Rosea, and Sorbus Aucuparia. I am not familiar with some of these herbs, but I do know that at least three of them, rhodiola, schizandra, and eleuthero have stimulating properties. Often it is a matter of dosage or amount. You do not mention how much of the drink you had, but perhaps a fraction of the amount you drank may have been fine for you. Nevertheless, this shows that herbs have potential side effects and are potent and should be used with caution.
Q. I am taking 200 mg of SAM-e supplement per day.
Can I use American ginseng extract while taking SAMe? If so what would be the
dosage of each?
A. Both cause alertness, more energy, increased heart rate, and could cause insomnia in high dosages. It is best to take each one separately since adverse reactions could become worse by adding a SAM-e pill.