Ginseng

Nutrient group: plant extracts & active ingredients

Sources and physiological effects

Dietary sources
Ginseng is originally native to North Korea, Northeast China and Southeast Siberia. The plant has been used for thousands of years in traditional Chinese medicine and in many asian countries. Besides Chinese ginseng (Panax ginseng), American ginseng (Panax quinquefolius) is one of the most common species. Phytotherapy primarly makes use of root extracts. Ginseng is mainly used in food production in Korea, where it is constantly finding more creative uses. The most common products include soups, teas, syrups, spirits, sweets, biscuits, ginseng wine and candied ginseng roots.
Physiological effects
Nervous system	Ginsenosides increase stress tolerance by regulating the hypothalamus-pituitary adrenal axis
Immune system	Support of lymphocyte proliferation
Glucose metabolism	Antidiabetic effects by supporting insulin regulation and protecting pancreatic cells

Detailed information

Ginseng increases stress tolerance

Extracts from the ginseng root (Panax ginseng) are used in traditional Chinese medicine for a variety of indications. The ginsenosides have a broad effect profile, which is particularly evident in the modulating effects on the immune system, the endocrine system and the central nervous system. Through their corticomimetic and adaptogenic effects, ginsenosides increase tolerance to psychological and physical stress (1). This is done through various mechanisms. In stress situations, ginsenosides can maintain the homeostasis of metabolic regulation (2), cortisol and testosterone levels (3) and lymphocyte proliferation and mitigate the consequences of stress-induced oxidative stress (4). Improving physical stress tolerance can improve psychophysical performance in physical or psychological stress situations and reduce the incidence of stress-induced secondary diseases.

Red Ginseng root has adaptogenic properties

Ginseng has a stimulating effect on different organ systems (1) induced by influences on the hypothalamus-pituitary adrenal axis through corticomimetic and adaptogenic effects. This could also explain the effects of ginseng on sexual functions (5). The use of ginseng is discussed as an alternative treatment for erectile dysfunction (6). The direct effect of ginseng on sperm quality (7) and an indirect effect through improved stress tolerance, which reduces the proven negative influence of stress on sperm quality (8), makes ginseng root an adjuvant instrument in the treatment of fertility disorders in men.

Ginseng for blood glucose control

Red ginseng root extract also has well documented antidiabetic effects. In clinical trials, ginseng supplementation showed an improvement in plasma glucose and plasma insulin regulation (9). The various ginsenosides can also prevent cytokine-induced apoptosis of pancreatic beta cells, making ginseng particularly suitable as an adjuvant therapy for diabetes mellitus type 1 (10).

Ginseng and sports

A small study of 10 track and field athletes showed that Panax ginseng had an effect on delayed-onset muscle soreness (DOMS) by increasing muscle excitation and reducing perceived exertion while speeding muscle recovery (11).

Indications

Effect	Indication	Dosage
Physiological effects at a low intake	Complementary therapy for improvement of sexual function, especially for stress induced disorders	100 – 300 mg/d
	To improve mood parameters and cognitive abilities	100 – 300 mg/d
	To increase sperm quality and quantity	100 – 300 mg/d
	To improve stress tolerance and adaptation to stressors and to strengthen physiological resistance to physical and psychological stress	100 – 300 mg/d
	For the prevention and therapy of stress-induced symptoms such as nervousness, chronic exhaustion, sleeping disorders, digestive problems and psychosomatic symptoms	100 – 300 mg/d
	For adjuvant therapeutic use in burn-out syndrome, hypertension, cardiovascular diseases and weakened immune response	100 – 300 mg/d
	For lowering and regulating elevated blood sugar levels in diabetes mellitus disorders	100 – 300 mg/d

Administration

General mode of administration
When	Ginseng should be taken before or between meals. Notes: The recommended period of supplementation is at least 3 months.
Side effects
No side effects are known to date.
Contraindications
No contraindications are known to date.

Interactions

Drug interactions
None	No interactions are known to date.
Nutrient interactions
None	No interactions are known to date.

References

1) Wagner, H., Wiesenauer, M. 2003. Phytotherapie. Phytopharmaka und pflanzliche Homöopathika.
2) Wang, X. et al. 207. Metabolic regulatory network alterations in response to acute cold stress and ginsenoside intervention. J Proteome Res. 6(9):3449-55
3) Gaffney, B. T. et al. 2001. The effects of Eleutherococcus senticosus and Panax ginseng on steroidal hormone indices of stress and lymphocyte subset numbers in endurance athletes.Life Sci. 70(4):431-42.
4) Hwang, H. J. et al. 2007. Combined effects of swim training and ginseng supplementation on exercise performance time, ROS, lymphocyte proliferation, and DNA damage following exhaustive exercise stress. Int J Vitam Nutr Res. 77(4):289-96.
5) Nocerino, E. etal. 2000. The aphrodisiac and adaptogenic properties of ginseng. Fitoterapia. 71 Suppl 1:S1-5
6) Hong, B. et al. 2002. A double-blind crossover study evaluating the efficacy of Korean red ginseng in patients with erectile dysfunction. A preliminary report. J Urol. 168(5):2070-3
7) Mkrtchychan, A. et al. 2005. A phase I clinical study of andrographis paniculata fixed combination versus ginseng and valerian on the semen quality of healthy male subjects. Phytomedicine. 12(6-7):403-9
8) Eskiocak, S. et al. 2005. Glutathione and free sulphydryl content of seminal plasma in healthy medical students during and after exam stress. Hum Reprod. 20(9):2595-600.
9) Vuksan, V. et al. 2006. Korean red ginseng (panax ginseng) improves glucose and insulin regulation in well controlled type 2 diabetes: results of a randomized, double-blind, placebo-controlled study of efficacy and safety. Nutr Metab Cardiovasc Dis.
10) Kim, H. Y., Kim, K. 2007. Protective effect of ginseng on cytokine-induced apoptosis in pancreatic beta cells. J Food Chem.
11) Gislaine, C.-S. et al. Panax ginseng Supplementation Increases Muscle Recruitment, Attenuates Perceived Effort, and Accelerates Muscle Force Recovery After an Eccentric-Based Exercise in Athletes. J Strength Cond Res. 36(4):991-997.

References Interactions
Stargrove, M. B. et al. Herb, Nutrient and Drug Interactions: Clinical Implications and Therapeutic Strategies, 1. Auflage. St. Louis, Missouri: Elsevier Health Sciences, 2008.
Gröber, U. Mikronährstoffe: Metabolic Tuning –Prävention –Therapie, 3. Auflage. Stuttgart: WVG Wissenschaftliche Verlagsgesellschaft Stuttgart, 2011.
Gröber, U. Arzneimittel und Mikronährstoffe: Medikationsorientierte Supplementierung, 3. aktualisierte und erweiterte Auflage. Stuttgart: WVG Wissenschaftliche Verlagsgesellschaft Stuttgart, 2014.