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Ginseng: Fact Versus Myth

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Ginseng: Fact Versus Myth FEATURE Ginseng: Fact Versus Myth WILLIAM HAMILTON, Pharm.D. Assistant Professor, Creighton University School of Pharmacy and Allied Health Professions, Omaha, NE WILLIAM KIRCHAIN, Pharm.D. Associate Professor, Philadelphia College of Pharmacy, Philadelphia, PA erbalists claim that preparations of ginseng improve overall physical and mental performance, regulate brain function and raise resistance to stress.1 Known as atale-kule to the Cherokee, it Hwas used for headaches, premenstrual syndrome and other menstrual-associated complaints.2 Traditional Chinese textbooks describe near-mythical qualities such as restoring balance to one’s life force, increasing longevity, improving memory, stopping convulsions, and increasing happiness.3 Ginseng is one of the Few herbs carry the history and Eleutherococcus senticosus on vari- most frequently used ous physiologic measurements therapeutic promise of ginseng. failed to support either supple- herbs reported in a study ment as a reliable aid to athletic of customers visiting Is the promise fulfilled? performance.15-18 health food stores.4 Improved Erectile Function: blood pressure, anti-stress activity, and COMMON NAMES American ginseng has shown positive better athletic performance. Ginseng is effects on male copulatory behavior in Panax ginseng C. A. Meyer [Fam. also believed to protect the liver, male rats.19 Reproductive performance Araliaceae] is also referred to as reduce radiation effects, improve blood was studied in two generations of rats 3,5 Korean ginseng or Chinese ginseng. sugar in diabetics, and help to prevent using ginseng extract G115. Results Used extensively in Asia, it is the cancer. revealed no significant differences in subject of numerous historical anec- Improved Concentration and Anti- physiologic or reproductive parame- dotes and subjective publications.6 stress Activity: Studies have shown ters in two generations.20 In a separate Another major species is Panax quin- mixed results with respect to memory study, Korean red ginseng (Panax quefolius L., commonly referred to as and anti-stress responses in rats. ginseng) was compared to placebo and American ginseng. A third variety— Ginseng standardized extract (G115) trazodone. Choi HK, et al.,21 noted Siberian ginseng—is not a species of and American ginseng produce modest increased “penile rigidity and girth, Panax. The preferred name is eleuthero positive improvements in standardized libido and patient satisfaction (p < (Eleutherococcus senticosus Maxim.)6 10,11 0.05)” in a group of 90 men. Ginseng American and Korean ginseng contain tests of memory in animal models. has been shown to enhance the conver- a complex mixture of triterpenoid In a double-blind study evaluating 22 saponins classified into panaxosides, quality-of-life parameters, a multivita- sion of L-arginine to nitrous oxide. ginsenosides and chikusetsusaponins.7 min product was compared to a Cardiovascular Protection: Ginsenoside RB-1 must be hydrolyzed multivitamin with ginseng extract American ginseng has an inhibitory by intestinal bacteria to be absorbed.8 G115. The 12-week study involved 501 effect on low density lipoprotein oxida- outpatients. Results, assessed by a tion in hyperlipidemic-prone rats.23 In REPORTED USES standardized questionnaire, indicated an animal model, Panax ginseng Herbalists classify ginseng as an that ginseng was effective in improv- enhanced release of nitric oxide from “adaptogen,” a term with no allopathic ing quality of life.12 endothelial cells, which appeared equivalent. These are substances that Improved Athletic Performance: partially responsible for its cardiopro- “enhance endurance for physical and Most claims of improved athletic tective effects.24 An extract of ginseng mental work and increase nonspecific performance are not supported by root has been shown to inhibit high- resistance to stress…in physiologically scientific evidence.13 Ginseng is threshold, voltage-dependent calcium 9 adverse habitats.” promoted for “accelerating the restora- channels.25 When added to a cardio- Claims for ginseng include tive processes after intensive activity plegic solution, ginsenosides were improved concentration, increased and increasing the body’s resistance to claimed to have protective effects in a stamina, improved erectile function, unfavorable external influences.”14 human trial of 30 mitral valvular surgi- cardiovascular protection, decreased Investigations of Panax ginseng and cal patients.26 A study of 45 patients 10 COMMUNICATION JULY/AUGUST 2000 with class IV congestive heart failure to benefit in this study included female with a multivitamin was found effec- compared red ginseng alone and in breast, uterine cervix, urinary bladder tive for developing resistance to combination with digoxin to digoxin and thyroid gland. In Korea, stomach physical stress.9 A small, double-blind, alone. A synergistic benefit was cancer is the most frequently reported controlled study of geriatric inpatients suggested for the treatment of conges- neoplasm. There appears to be a correla- found no identifiable effect of ginseng tive heart failure with ginseng in tion with people who have the highest in length of hospital stay or in the combination with digoxin.27 Another consumption of broiled meats and fish, functional outcomes measured.41 study of red ginseng on blood pressure especially salted and fermented prod- Another double-blind study investi- in 26 subjects showed decreased ucts. Ginseng, mung bean pancake, tofu gated the effect of ginseng extract G115 systolic blood pressure (p = 0.03) and a spinach, cabbage and sesame oil appear added to a multivitamin in 501 outpa- trend to lowering diastolic blood pres- to decrease this risk.36 tients under environmental stress. sure (p = 0.17).28 Reduced Effect from Radiation: They found a significant increase in the quality-of-life index.12 Liver Protection: One animal study Eleuthero has shown protection 37 suggests a possible liver-protective against the effects of radiation in rats. Immunity: A study of 20 young effect with ginseng. Ginseng signifi- Improved Blood Sugar in Thai males on the effects of prolonged cantly decreased AST and ALT levels Diabetics: Sotaniemi, Haapakoski, and administration of standardized ginseng in dexamethasone-treated rats.29 A Rautio38 generated interest in the extract on peripheral blood leukocytes preparation containing a standardized impact of ginseng on type 2 diabetes and lymphocyte subsets. Two equal ginseng extract, trace elements and mellitus. In an 8-week, double-blind, groups, one supplemented with vitamins was compared to placebo in placebo-controlled study of 36 newly ginseng and one taking placebo, were 24 elderly outpatients with toxin- diagnosed patients, ginseng (100 or 200 used. The treatment group received induced (alcohol and drugs) chronic mg) reduced fasting blood glucose and two capsules daily of standardized liver disease. No significant difference body weight, and improved ginseng extract 150 mg per capsule for in these parameters was observed.30 psychophysical performance. 8 weeks. No significant differences were seen in total and differential Cancer Preventative: An leukocyte counts or lymphocyte animal model evaluating the subpopulations between the two ability of red ginseng to protect subject groups.42 In Milan, Italy, a against a papilloma induced by two-arm, randomized, placebo- 7,12-dimethylbenz[alpha]anthracene controlled, double-blind showed a significant benefit.31 investigation looked at whether Ginseng showed inhibition of some ginseng supplementation increased lung metastasis. It was not effective the protective effect of influenza in preventing the invasion of vaccination. Volunteers (227) 32 melanoma and fibrosarcoma cells. received daily oral capsule doses of Ginsenoside Rh2 inhibits the growth either placebo or 100 mg of a stan- of B16 melanoma cells. Oral but not dardized ginseng extract for a period intraperitoneal treatment with Rh2 of 12 weeks, within which they resulted in induction of apoptotic received an anti-influenza polyvalent cells in the tumor, in addition to vaccination at week 4. There were 42 augmenting natural killer activity in cases of influenza or common cold in spleen cells from tumor-bearing the placebo group, versus 15 cases in nude mice.33 American ginseng root the ginseng group. The difference extract has been evaluated in breast Adaptogen-Anti-aging: Traditional was highly significant (p = 0.001). cancer cell lines. Results indicate an anti-aging products are being studied Antibody titers and natural killer cell exhibition of estrogen-like effects on extensively in China. Chen and Li39 activities were twice as high in the certain estrogen receptor-positive reviewed 386 traditional effective anti- ginseng group versus placebo (p = breast cancer cells. This induction of aging medications. Ginseng heads that 0.0001). Insomnia was reported to be a pS2 expression appears to promote a list, but the authors of the review clas- common adverse event.43 34 protective role against breast cancer. sify the results of most studies as Polymorphonuclear leukocyte chemi- A Korean study compared the preliminary and suggest further inves- luminescence increased in a rat cancer risk to the reported intake of tigations. One animal study in mice model.44 A comparison of wild and ginseng. A decreased risk of some investigated four different ginseng cultured Panax ginseng measured pan T types of cancer was associated with infusions for up to 96 days. The cells, helper T cells, and cytotoxic T groups ingesting fresh
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