Ginseng: An Herb for All Ailments?

According to herbal folklore, plants that resemble human body parts have healing effects on those parts. And since ginseng’s root resembles a human figure, it’s said to be good for the whole body.

Proponents claim that ginseng acts as an “adaptogen,” boosting the body’s resistance to physical and mental stress, increasing energy, and enhancing general well-being. The herb is said to help prevent or treat everything from colds, diabetes, digestive problems, and menopause symptoms to poor circulation, asthma, memory prob­­lems, and even HIV infection and can­­cer. It’s also touted as an aphrodisiac.

There are several types, including Asian ginseng (Panax ginsengC.A. Meyer, often sold as Korean, Chinese, or Panax ginseng) and American ginseng (Panax quinquefolius). It also comes as red or white ginseng, depending on how it’s processed. Siberian ginseng (Eleutherococcus senticosus) is often said to have the same effects as Panax ginseng, but it is not a true ginseng. It and other similar plants may be used in products as a cheaper substitute.

Ginseng contains many compounds, including more than 40 different ginsenosides, thought to be the plant’s main active ingredients. Studies have shown that ginsenosides have anti-inflammatory, antioxidant, anti-cancer, and immune-modulating properties. They may also relax blood vessels, help protect the nervous system, affect hormones, and improve blood sugar, among other effects.

Still, ginseng’s medicinal effects remain unclear. One problem is its variability. Different types of ginseng have different compounds and biological properties, and different parts of the plant (roots, leaves, stems) also contain varying chemicals. How ginseng is processed affects its biological activity as well. Most studies on ginseng have been small or poorly designed and have used different formulations and doses of ginseng, making them hard to compare. Moreover, it’s difficult to study the many vague claims. How, for instance, do you measure increased “well-being” or  “vitality”?

Some ginseng research  

• Diabetes. Several small but well-designed studies have found that ginseng can help control blood sugar, possibly by increasing insulin production, among other mechanisms. The Natural Standard, which evaluates alternative and complementary therapies, gives ginseng a B rating (good evidence) for its effect on blood sugar in people with type 2 diabetes, but notes that its long-term effectiveness and safety are unclear.

• Immunity. There’s also B-rated evidence that ginseng boosts the immune system, according to the Natural Standard. A small Canadian study a few years ago, for example, found that North American ginseng in­­creased various immune markers in sedentary men who did a short bout of cycling. It’s not clear, however, what practical significance this has.

• Brain health. Though some review articles cite potential benefits on cognition, they note that there is a scarcity of good-quality data. In 2010 the Cochrane Collaboration concluded that there is “no convincing evidence of a cognitive enhancing effect of Panax ginseng” in either healthy people or those with memory problems or dementia. The Natural Standard gives ginseng a C rating (conflicting or unclear evidence) for Alzheimer’s disease.

• Other uses. Some preliminary research suggests that Korean red ginseng may improve erectile dysfunction; other forms may not have this effect. Some athletes use ginseng, but studies have generally found no effect on performance. There’s no convincing evidence ginseng can treat or prevent fatigue, high blood pressure, cancer or any other condition it’s also touted for.

Words to the wise

In a way, it’s hard to evaluate ginseng. How it’s typically studied and used in the West (as a single herb in a purified extract) is not how it’s traditionally used (in its whole form and often in combination with other herbs). Still, we can’t recommend ginseng, since all we have to go on are the studies, which, overall, don’t show clear or conclusive benefits. If you have diabetes you should not use ginseng in place of proven therapies.

In addition, ginseng may interact with anti-clotting medication as well as drugs taken to control blood sugar (such as insulin) and certain antidepressants. It should be used with caution in people with high blood pressure or those taking medications that affect blood pressure. And there can be side effects from long-term use, including anxiety, loss of appetite, and insomnia.

Unless you buy the whole root, which is very expensive, you may not even be getting real ginseng. An analysis by ConsumerLab.com found that several sup­­plements didn’t have the full amount of ginseng listed on the label, and there was also great variability in ginsenosides among the products. Plus, some products were contaminated with lead and pesticides.