Ginseng
Tomomi Kimura
What is Ginseng?
“Low-growing, shade-loving perennial herb of the Aralianceae family” (http://www.bccancer.bc.ca/PPI/UnconventionalTherapies/Ginseng.htm)
Latin name= Panax
The scientific names
Panax Ginseng
Derived from the Greek word for cure-all,
related to the word Panacea.
Types of Ginseng
True Ginseng:
American Ginseng
(Panax Quinquefolium)
Korean, Chinese
or Japanese Ginseng
(Panax Ginseng)
Types of Ginseng
Ginseng Companions and Relatives:
Siberian Ginseng
(Eleutherococcus senticosus)
Dwarf Ginseng
(Panax trifolious)
Fool’s sang or wild sarsaparilla
(Aralia nudicaulis)
History
Ginseng root has been used for over 2000 years
Has traditionally used for treatment of a number of disorders in China and Korea
Crossed to Western by the eighteenth century
US expoted $20.9 million worth of ginseng last year (NYtimes, 2005)
Active Components
Ginsenosides or Panaxosides
Major ginsenosides:
Rg1, Re, Rf, Rb1, Rc, Rg2, Rb2, Rb
Panaxans
Ginsenans
Forms of Ginseng
Root itself ($25~ per root)
Dried root
Teas, capsules, tablets, tinctures, powders.
Dosage
usually provide 100mg to 400mg of dried extract
(equivalent to 0.5g to 2g of ginseng root.)
Marketing Claims
“Heart tonic”
“Energy and mood booster”
“Healthy glucose metabolism formula”
“Helps normalize imbalances in the body’s energy in different disease status”
“Sex drive”
“Immune support”
“Stress management”
“Menopausal control”
Traditional and modern uses
Improving the health of people recovering form illness
Increasing a sense of well-being and stamina, and improving both mental and physical performance.
Traditional and modern uses (cont’d)
Treating erectile dysfunction, hepatitis C, and symptoms related to menopause.
Lowering blood glucose and controlling blood pressure.
Current Research Area
Ginseng vs. Exercise performance
Mood and cognitive function
Cardiovascular disease
Sexual function
Diabetes
Obesity
Cancer
Prevalence of Diabetes
Diabetes is a major health problem
5% of the total population in the US
3% of the population worldwide.
Canadian Diabetes Association
Allocated $6 million to support 123 diabetes research teams across the country last year.
Diabetes vs. Ginseng
Historically used to treat type-2 diabetes.
No. 6th commonly suggested herbal medicine to improve glycemic control by Italian herbalists
Many studies support its antihyperglycemic activity.
Theoretical Basis
Well tolerated by oral intake
Molecular mechanisms of antihyperglycemic reaction are unclear.
Theoretical Basis
Ginsenosides alter blood glucose levels by
stimulating the biosynthesis of insulin by the pancreas
inducing the production of a glucose transporter in the liver
The polysaccharides in ginseng lower blood glucose by
either decreasing the production of glucose by the liver
increasing the use of glucose by tissues
Scientific Evidences
By Vuskan, V. et al & Xie, J. et al.
Study #1
Antidiabetic effects of Panax ginseng berry extract and the identification of an effective component
Diabetics (2002) 51
By Xie, J. et al.
Specific Aim
Evaluate antihyperglycemic and anti-obese effects of Panax ginseng berry extract in obese diabetic mice.
Study Design
In vitro, double blind, placebo controlled.
Antidiabetic effects of Panax ginseng berry extract and the identification of an effective component
Diabetics (2002) 51
By Xie, J. et al.
Subjects
14mice 10-18 weeks of age
Methods
Injection of 150 mg/kg berry extract (n=8)
Monitored by measuring blood glucose and serum insulin levels, and glucose tolerance test for 12 days.
Compared the results with 6 vehicles.
Antidiabetic effects of Panax ginseng berry extract and the identification of an effective component
Diabetics (2002) 51
By Xie, J. et al.
Results
Significantly improved glucose tolerance
Became normoglycemic
– 46% BG glucose tolerance test
Significant reduction in serum insulin levels
Lost significant amount of weight
(-12%BW than day 0)
Ginseng berry extract is effective treatment for obese diabetic mice, and may work for weight loss.
Study #2
Antihyperglycemic effect of the polysaccharides fraction form American ginseng berry extract in ob/ob mice
Phytomedicine (2004) 11
By Xie, J. et al.
Specific Aim
Evaluate antihyperglycemic effects of the polysaccharides fraction from Panax ginseng berry extract in obese diabetic mice.
Study Design
In vitro, double blind, placebo controlled.
Antihyperglycemic effect of the polysaccharides fraction form American ginseng berry extract in ob/ob mice
Phytomedicine (2004) 11
By Xie, J. et al.
Subjects
15 mice 10-15 weeks of age
Methods
Injection of 150 mg/kg polysaccharides fraction from AG to 5 mice
Injection of 50 mg/kg polysaccharides fraction from AG to 5 mice
Monitored by measuring blood glucose and serum insulin levels, and glucose tolerance test for 10 days.
Compared the results with 5 vehicles.
Antihyperglycemic effect of the polysaccharides fraction form American ginseng berry extract in ob/ob mice
Phytomedicine (2004) 11
Results
Significant improvement in glucose tolerance in comparison to the beginning of the study.
Significant change in fasting blood glucose levels on day 5 (-19%) and even more on day 10 (-19% in 50 mg/kg dosage group, -45% in 150 mg/kg group).
Additional observation:
The fasting blood glucose levels stayed lower and returned on day 30.
No significant changes in body weight.
Study #3
Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes.
Diabetes Care (2000) 23
Vuscan, V. et al
Specific Aim
Investigated whether American ginseng (AG) reduce postprandial glycemia in type 2 diabetic individuals and time of American ginseng administration.
Study Design
In vivo, randomized, blind, placebo controlled
Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes.
Diabetes Care (2000) 23
Vuscan, V. et al
Subjects
10 type 2 diabetic patients (6M, 4F) with age 61-65.
Methods
Used 3, 6, 9g of grounded AG root in capsules
Administrated 120, 80, 40min before a 25g oral glucose test.
Measured capillary blood glucose before AG ingestion, 0,15,30,45,60,90, and 120 min from the start of the glucose test.
Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes.
Diabetes Care (2000) 23
Vuscan, V. et al
Results
3, 6, 9g of AG significantly lowered blood glucose at 30, 45, 120 min.
No differences between dosage and the timing of administration.
Study #4
American Ginseng Improves Glycemia in Individuals with Normal Glucose Tolerance: Effect of Dose and Time Escalation
American College of Nutrition (2000) 19
Vuscan, V. et al
Specific Aim
Investigated whether American ginseng (AG) achieve further improvements in glucose tolerance in non-diabetic individuals and effectiveness of timing of AG ingestion
Study Design
In vivo, blind, randomized, placebo controlled
American Ginseng Improves Glycemia in Individuals with Normal Glucose Tolerance: Effect of Dose and Time Escalation
American College of Nutrition (2000) 19
Vuscan, V. et al
Subjects
10 nondiabetic individuals (6M 4F) with age 28-54.
Methods
Used 3, 6, 9g of grounded AG root in capsules
Administrated 120, 80, 40min before a 25g oral glucose test.
Measured capillary blood glucose before AG ingestion, 0,15,30,45,60,90, and 120 min from the start of the glucose test.
American Ginseng Improves Glycemia in Individuals with Normal Glucose Tolerance: Effect of Dose and Time Escalation
American College of Nutrition (2000) 19
Vuscan, V. et al
Results
All AG doses (3, 6, 9g) of AG significantly lowered blood glucose at 30, 45, 60 min.
No relationship between dosage and the timing of administration.
Side Effects
Bleeding disorders
Diarrhea
Edema
Headache
Hypoglycemia
Hyperpyrexia
Menstrual abnormalities
Nausea and vomiting
Nervous excitation
Palpitations
Itchiness
Dizziness
Rose spots
Side Effects (cont’d)
Large doses over an extended period of time
Diarrhea
Estrogenic effect
HTN
Hypertonicity
Decreased libido
Insomnia
Menstruation in menopausal women
Nervousness
Herb-Drug interactions
Hypoglycemic drugs
hypoglycemic effect
Furosemide
Decreased diuretic effect
Digoxin
May increase serum digoxin concentrations
Herb-Drug Interactions (cont’d)
Monoamine oxidase
inhibitors (MAOIs)
Headache, visual hallucination, tremor, manic episodes
Anticoagulants, antiplatelet agents
Decreased effectiveness of warfarin
Estrogens, corticosteroids
Additive drug effects
Herb-Drug Interactions (cont’d)
Drugs that cause gynecomastia
e.g.
Calcium channel blockers
Cardiac glycosides
Methyldopa
Phenothiazines
Spironolactone
Herb contains estrone, estradiol, estriol;
Has additive estrogenic effects

Herb-Nutrition Interactions
Alcohol
May decrease alcohol absorption
Caffeine
Maybe additive stimulant effects
Summary and Recommendations
Many of studies reported ginseng’s benefits in diabetes animals, but there is little comparable research in humans.
More clinical research would be needed to prove ginseng’s benefits in humans
Summary and Recommendations (cont’d)
Seek physicians and use cautiously when taking any other psychiatric, estrogenic or hypoglycemic medication.
Should not be used in combination with warfarin.
Thank you!

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