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Ginseng, Panax


What is it?

Panax ginseng is a plant. People use the root to make medicine. Do not confuse Panax ginseng with American ginseng, Siberian ginseng, or Panax pseudoginseng. See the separate listings for American ginseng and Siberian ginseng.

Panax ginseng is used for improving thinking, concentration, memory and work efficiency, physical stamina, and athletic endurance.

Some people use Panax ginseng to help them cope with stress and as a general tonic for improving well-being. They sometimes call Panax ginseng an “adaptogen” when it’s used in this way.

Panax ginseng is also used for depression, anxiety, chronic fatigue syndrome (CFS), for boosting the immune system, and for fighting particular infections in a lung disease called cystic fibrosis. These infections are caused by a bacterium named Pseudomonas.

Some people use Panax ginseng to treat breast cancer and prevent ovarian cancer, liver cancer, lung cancer, and skin cancer.

Other uses include treatment of anemia, diabetes, inflammation of the stomach lining (gastritis), fever, hangover, chronic obstructive pulmonary disease (COPD), and asthma.

Panax ginseng is also used for bleeding disorders, loss of appetite, vomiting, intestinal problems, fibromyalgia, sleeping problems (insomnia), nerve pain, joint pain, dizziness, headache, convulsions, disorders of pregnancy and childbirth, hot flashes due to menopause, and to slow the aging process.

Some men use Panax ginseng on the skin of the penis as part of a multi-ingredient product for treating early orgasm (premature ejaculation). Men also use it for erectile dysfunction (ED). There is some evidence that Panax ginseng is effective for these uses.

In manufacturing, Panax ginseng is used to make soaps, cosmetics, and as a flavoring in beverages.

Ginseng has been used as a medicine for over two thousand years. Today, approximately 6 million Americans use it regularly.

Some people consider the age of the ginseng roots important. In 1976, a 400-year-old root of Manchurian ginseng from the mountains of China reportedly sold for $10,000 per ounce.

In Western medicine, Panax ginseng is used as a stimulant to make people more active. But, in contrast, in Traditional Chinese Medicine (TCM), Panax ginseng is used to make people feel calmer. It is also widely used in China for the heart and blood vessels. Higher doses are generally used in TCM than in Western medicine.

Be aware that Panax ginseng products are not always what they claim. The contents of products labeled as containing Panax ginseng can vary greatly. Many contain little or no Panax ginseng.

Panax ginseng interacts with many prescription drugs. See the section below titled “Are there any interactions with medications?” If you take medications, talk to your healthcare provider before taking Panax ginseng.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for GINSENG, PANAX are as follows:

Possibly effective for...

  • Thinking and memory. Taking Panax ginseng by mouth might improve abstract thinking, mental arithmetic skills, and reaction times in healthy, middle-aged people. Panax ginseng alone does not seem to improve memory, but there is some evidence that a combination of Panax ginseng and ginkgo leaf extract can improve memory in otherwise healthy people between the ages of 38 and 66.
  • Diabetes. There is some evidence that Panax ginseng might lower fasting blood sugar in people with type 2 diabetes.
  • Male impotence (erectile dysfunction, ED). Taking Panax ginseng by mouth seems to improve sexual function in men with ED.
  • Chronic obstructive pulmonary disease (COPD). Taking Panax ginseng by mouth seems to improve lung function and improve some symptoms of COPD.
  • Premature ejaculation (reaching orgasm too early) when a cream containing ginseng and other ingredients is applied directly to the skin of the penis.

Possibly ineffective for...

  • Improving athletic performance.
  • Improving mood and sense of well-being.
  • Hot flashes associated with menopause. Taking Panax ginseng by mouth doesn’t seem to help hot flashes but it might improve other menopausal symptoms such as fatigue, insomnia, and depression.

Insufficient evidence to rate effectiveness for...

  • Breast cancer. Some studies conducted in China suggest that some people with breast cancer treated with any form of ginseng (American or Panax) do better and feel better. But this may not be a result of taking the ginseng, because the people in the study were also more likely to be treated with the prescription cancer drug tamoxifen. It is difficult to know how much of the benefit to attribute to ginseng.
  • Infection of the airways in the lung (bronchitis) . Panax ginseng, combined with treatment with antibiotics, might be more effective in killing bacteria that antibiotic treatment alone.
  • Common cold. There is some evidence that taking a specific Panax ginseng extract (G115) by mouth can decrease the chance of catching a cold.
  • Influenza. There is some evidence that taking a specific Panax ginseng extract (G115) by mouth four weeks before a flu shot and continued for eight more weeks can decrease the risk of getting the flu.
  • Cancer (stomach, lung, liver, ovarian, skin) . Population studies suggest that taking ginseng by mouth might decrease the occurrence of cancer, specifically stomach cancer, lung cancer, liver cancer, ovarian cancer, and skin cancer.
  • Depression.
  • Anemia.
  • Fluid retention.
  • Stomach inflammation and other digestive problems.
  • Chronic fatigue syndrome (CFS) .
  • Fibromyalgia.
  • Fever.
  • Other conditions.
More evidence is needed to rate Panax ginseng for these uses.

How does it work?

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Panax ginseng contains many active substances. The substances thought to be most important are called ginsenosides or panaxosides. Ginsenosides is the term coined by Asian researchers, and the term panaxosides was chosen by early Russian researchers.

Panax ginseng is often referred to as a general well-being medication, because it affects many different systems of the body.

Are there safety concerns?

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Panax ginseng is POSSIBLY SAFE when taken by mouth for most adults when used for less than 3 months. It is POSSIBLY UNSAFE when taken long-term. Researchers think it may have some hormone-like effects that could be harmful with prolonged use.

The most common side effect is trouble sleeping (insomnia). Less commonly, people experience menstrual problems, breast pain, increased heart rate, high or low blood pressure, headache, loss of appetite, diarrhea, itching, rash, dizziness, mood changes, vaginal bleeding, and other side effects.

Uncommon side effects that have been reported include severe rash called Stevens-Johnson syndrome, liver damage, and severe allergic reactions.

A cream (SS-Cream) containing Panax ginseng and other ingredients for reaching orgasm too quickly in men (premature ejaculation) seems to be safe when applied to the penis and removed after one hour. It might cause mild pain and irritation or a burning sensation. It is not known if this cream is safe with repeated, long-term use.

Special precautions & warnings:

Pregnancy and breast-feeding: Do not use Panax ginseng if you are pregnant. It is POSSIBLY UNSAFE. One of the chemicals in Panax ginseng has been found to cause birth defects in animals.

Not enough is known about the safety of Panax ginseng during breast-feeding. Stay on the safe side and don’t use it.

Infants and children: Panax ginseng is LIKELY UNSAFE in infants and children. Using Panax ginseng in babies has been linked to poisoning that can be fatal. The safety of Panax ginseng in older children is not known. Until more is known, don’t use Panax ginseng even in older children.

“Auto-immune diseases” such as multiple sclerosis (MS), lupus (systemic lupus erythematosus, SLE), rheumatoid arthritis (RA), or other conditions: Panax ginseng seems to increase the activity of the immune system. It might make auto-immune diseases worse. Don’t use Panax ginseng if you have any auto-immune condition.

Bleeding conditions: Ginseng seems to interfere with blood clotting. Don’t use Panax ginseng if you have a bleeding condition.

Heart conditions: Panax ginseng can affect heart rhythm and blood pressure slightly on the first day it is used. However, there are usually no changes with continued use. Nevertheless, Panax ginseng has not been studied in people with cardiovascular disease. Use Panax ginseng with caution if you have heart disease.

Diabetes: Panax ginseng might lower blood sugar. In people with diabetes who are taking medications to lower blood sugar, adding Panax ginseng might lower it too much. Monitor your blood sugar closely if you have diabetes and use Panax ginseng.

Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Panax ginseng contains chemicals (ginsenosides) that can act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don’t use Panax ginseng.

Trouble sleeping (insomnia): High doses of Panax ginseng have been linked with insomnia. If you have trouble sleeping, use Panax ginseng with caution.

Schizophrenia (a mental disorder): High doses of Panax ginseng have been linked with sleep problems and agitation in people with schizophrenia. Be careful when using Panax ginseng if you have schizophrenia.

Organ transplant: Panax ginseng might make the immune system more active. This could interfere with the effectiveness of medications that are given after an organ transplant to reduce the chance that the organ will be rejected. If you have received an organ transplant, don’t use Panax ginseng.

Are there interactions with medications?

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Moderate

Be cautious with this combination.

Alcohol
The body breaks down alcohol to get rid of it. Taking Panax ginseng might increase how fast your body gets rid of alcohol.

Caffeine
Caffeine can speed up the nervous system. By speeding up the nervous system, caffeine can make you feel jittery and speed up your heartbeat. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with caffeine might cause serious problems, including increased heart rate and high blood pressure. Avoid taking caffeine along with Panax ginseng.

Furosemide (Lasix)
Some scientists think that Panax ginseng might decrease how well furosemide (Lasix) works. But there isn't enough information to know if this is a big concern.

Insulin
Panax ginseng might decrease blood sugar. Insulin is also used to decrease blood sugar. Taking Panax ginseng along with insulin might cause your blood sugar to be too low. Monitor your blood sugar closely. The dose of your insulin might need to be changed.

Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Some medications are changed and broken down by the liver. Panax ginseng might decrease how quickly the liver breaks down some medications. Taking Panax ginseng along with some medications that are changed by the liver can increase the effects and side effects of your medication. Before taking Panax ginseng, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.

Medications for depression (MAOIs)
Panax ginseng might stimulate the body. Some medications used for depression can also stimulate the body. Taking Panax ginseng with these medications used for depression might cause too much stimulation. This might cause side effects such as anxiousness, headache, restlessness, and insomnia.

Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.

Medications for diabetes (Antidiabetes drugs)
Panax ginseng might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking Panax ginseng along with diabetes medications could add to the effects of diabetic medications and lower blood sugar too much. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

Medications that decrease the immune system (Immunosuppressants)
Panax ginseng increases the immune system. By increasing the immune system, Panax ginseng might decrease the effectiveness of medications that decrease the immune system.

Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Panax ginseng might slow blood clotting. Taking Panax ginseng along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, cilostazol (Pletal), clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Stimulant drugs
Stimulant drugs speed up the nervous system. By speeding up the nervous system, stimulant medications can make you feel jittery and speed up your heartbeat. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with Panax ginseng.

Some stimulant drugs include diethylpropion (Tenuate), epinephrine, phentermine (Ionamin), pseudoephedrine (Sudafed), and many others.

Warfarin (Coumadin)
Warfarin (Coumadin) is used to slow blood clotting. There is some concern that Panax ginseng might decrease the effectiveness of warfarin (Coumadin). But it's not clear if this interaction is a big problem. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Are there interactions with herbs and supplements?

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Bitter orange
Taking Panax ginseng along with bitter orange might increase the risk of the type of irregular heart rhythm that can be life-threatening.

Country mallow
Country mallow contains ephedra. Ephedra can make the heart beat irregularly. Taking Panax ginseng along with country mallow might increase the risk of irregular heartbeats that can be life-threatening.

Ephedra
Ephedra can make the heart beat irregularly. Taking Panax ginseng along with ephedra might increase the risk of irregular heart beats that can be life-threatening.

Herbs and supplements that lower blood sugar
Panax ginseng might lower blood sugar. Taking Panax ginseng along with other herbs and supplements that lower blood sugar might make the blood sugar too low. Some of these products include bitter melon, ginger, goat's rue, fenugreek, kudzu, willow bark, and others.

Are there interactions with foods?

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Alcohol
The body breaks down alcohol to get rid of it. Taking Panax ginseng might increase how fast your body gets rid of alcohol.

Coffee, tea
Coffee and tea contain caffeine. Caffeine can speed up the nervous system. By speeding up the nervous system, caffeine can make you feel jittery and speed up your heartbeat. Panax ginseng might also speed up the nervous system. Taking Panax ginseng along with caffeine might cause serious problems including increased heart rate and high blood pressure. Avoid taking caffeine along with Panax ginseng.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • For treating type 2 diabetes: 200 mg daily.
  • For erectile dysfunction: Panax ginseng 900 mg three times daily.
APPLIED TO THE SKIN:
  • For premature ejaculation: a cream (SS-Cream) containing Panax ginseng and other ingredients has been applied to the glans penis one hour before intercourse and washed off before intercourse.

Other names

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Asian Ginseng, Asiatic Ginseng, Chinese Ginseng, Chinese Red Ginseng, Ginseng, Ginseng Asiatique, Ginseng Blanc, Ginseng Blanc de Corée, Ginseng Chinois, Ginseng Coréen, Ginseng Coréen Rouge, Ginseng de Corée, Ginseng Japonais, Ginseng Oriental, Ginseng Panax, Ginseng Radix Alba, Ginseng Root, Ginseng Rouge, Ginseng Sino-coréen, Ginseng Tibétain, Guigai, Hong Shen, Japanese Ginseng, Jen-Shen, Jinsao, Jintsam, Insam, Korean Ginseng, Korean Ginseng Root, Korean Panax, Korean Panax Ginseng, Korean Red Ginseng, Korean White Ginseng, Mandragore de Chine, Ninjin, Ninzin, Oriental Ginseng, Panax Coréen, Panax Ginseng Blanc, Panax schinseng, Racine de Vie, Radix Ginseng Rubra, Red Chinese Ginseng, Red Ginseng, Red Kirin Ginseng, Red Korean Ginseng, Red Panax Ginseng, Ren Shen, Renshen, Renxian, Sang, Seng, Sheng Shai Shen, Tibetan Ginseng, White Ginseng, White Panax Ginseng.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Ginseng, Panax page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/1000.html.

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Page last updated: 01 July 2014