Introduction

Ginseng was an herb used in ancient times in China, Korea, Japan, and America. There are two varieties of ginseng - red and white ginseng. Korean ginseng is red and Chinese ginseng is white, with Korean ginseng mainly circulating within Europe. The two most used species are the Asian ginseng, Korean and Chinese, and the American ginseng.¹

In ancient times, ginseng was used to increase energy levels through tonics, as an aphrodisiac and as an antioxidant. It was also used in treating kidney, reproductive, and cardiovascular diseases.¹

Description of ginseng

Species of ginseng

Ginseng refers to the genus Panax. As mentioned earlier, Asian ginseng (Panax ginseng) and American ginseng (Panax quinquefolium) are the two most used species of ginseng. There are around 11 species in the genus Panax, belonging to the family Araliaceae. Here is a list of them:¹

• P. trifolius
• P. notoginseng
• P. quinquefolius
• P. ginseng
• P. pseudoginseng
• P. zingiberensis
• P. stipuleanatus
• P. japonicus
• P. japonicus var. angustifolius
• P. japonicus var. major
• P. japonicus var. bipinnatifidus

Three of these species have had investigations conducted regarding their pharmacological activity – P. ginseng, P. notoginseng, and P. quinquefolius.¹

Speak more on the investigation and why you have mentioned this

Red and white ginseng

White ginseng is obtained through:

• Skinning fresh ginseng
• Sun drying or hot air drying the ginseng without applying steam

After the drying process, white ginseng is separated based on its shape:²

• Curved – obtained by rolling the root into a round shape before drying
• Half curved -obtained by folding the roots upward to condense the length to half
• Straight – obtained by skinning and it maintains the original shape when taken from the field

Red ginseng is not skinned before being steamed or heated. Red ginseng is classified into Chun-sam, Ji-samon, and Yang-sam based on:²

• Rhizome firmness
• Colours
• Proportion of main roots to lateral roots
• Characteristics of body tissues

Chemical composition

Components in ginseng

Ginseng is comprised of 80 – 90% organic substances and approximately 10% of inorganic substances. These include:²

• Ginsenosides/saponins
• Carbohydrates
• Vitamins
• Minerals
• Amino acids
• Fatty acids
• Essential oils

The active components of ginseng are ginsenosides, containing a variety of beneficial effects.

Pharmacological properties and uses

As mentioned above ginsenosides have beneficial effects. There are 7 types of ginsenosides (Rb, Rc, Rd, Re, Rf, Rg, Rh). Here is a list of some pharmacological effects of these ginsenosides²:

• Rb1 – anti-obesity, antidiabetic, neuroprotective
• Rc - prevents the growth of breast cancer cells
• Re – antioxidant, cardioprotective
• Rg1 – neurotropic, suppresses oxidative stress
• Rg2 – neuronal Ach inhibitor
• Rg3 – prevents the growth of prostate cancer cells
• Rh1 – activates estrogen receptor
• Rh2 – prevents the growth of both breast and prostate cancer cells

There are many pharmacological uses of ginseng such as:³

• Antioxidant activity
• Anti-inflammatory activity
• Antimicrobial activity
• Anti-cardiovascular disease activity
• Anti-obesity
• Anti-diabetes effect
• Anti-cancer activity
• Anti- central nervous system disorder effect
• Enhancing energy

Traditional uses in herbal medicine

General health tonic

For thousands of years, ginseng has been used widely throughout East Asia mainly as a general tonic and adaptogen to maintain resistance in the body to adverse factors, improving physical function, general vitality, and anti-aging.⁴

Adaptogenic properties

Adaptogens are active ingredients in plants that impact how the body deals with anxiety, stress, and fatigue. When these plants are consumed they target specific stressors in the body. The goal of adaptogens is to balance the body (homeostasis).⁵

As an adaptogen, P. ginseng helps maintain homeostasis by countering physiological effects brought on by chemical, physical, or biological stressors.⁶

The American ginseng adaptogenic properties are:⁵

• Support to the immune system – which helps reduce inflammation thus relieving pain
• Combats stress
• Boosts nervous system
• Improves fight or flight response

The Asian ginseng helps in relieving both the physical and mental fatigue. It can also improve energy and performance in certain activities.⁵

Cognitive enhancement

Ginseng increases cognitive performance by modulating neurotransmission directly affecting the neurons in the hippocampus.² Within rodents, ginseng has shown to be effective in reducing learning deficits and memory impairment which was due to brain damage or brain ageing. There are very few studies done on humans, however, one study has shown that ginseng had good cognitive improvement effects in Alzheimer’s Disease.⁷

Immune system support

Several studies show that ginseng can influence immune function and fight against illness. Although the human immune system is comprised of a wide variety of cell types, some studies indicate that ginseng or its derivatives can regulate or activate any type of immune cell.⁸

Korean red ginseng mainly stimulates natural killer (NK)cells and macrophages, part of the innate immune system which is the body’s first line of defence against infections and harmful substances. Its secondary property is to act on humoral and cellular immunity, improve immune responses, and increase cells required for acquired immunity.⁹

Aphrodisiac properties

Ginseng is important in traditional Chinese medicine for treating impotence and to increase sexual performance. Studies have shown that ginsenosides improve erections and sexual performance.⁶ It increases serum testosterone and reduces the plasma levels of the hormone prolactin.²

Safety and Side Effects

Toxic or adverse effects

There are a limited number of studies on the toxicity and adverse effects caused by ginseng, but any studies carried out have focused on the impact after misuse or abuse. Examples of these toxic or adverse effects are:^1,3

• Uterine bleeding
• Vaginal bleeding
• Amenorrhea
• Diarrhoea
• Maniac episodes
• Atrial fibrillation with bradycardia
• Long QT syndrome
• Hypertensive crisis
• Acute lobular hepatitis
• CNS hyperactivation – sleeplessness, dizziness, irritability, headache

It is advised that Asian and American ginseng should not be used if pregnant as studies have not been done to ensure safety during pregnancy. . American ginseng interacts with warfarin and should not be used together as there have been reports of warfarin effects decreasing, which can lead to increased risk of clotting. Asian ginseng does not appear to affect warfarin as much as American ginseng, but it is still advised to be careful if using it.^10,11

FAQs

What are the traditional uses of ginseng?

Traditionally, ginseng was used in tonics to increase energy levels, as an antioxidant, and as an aphrodisiac. It was also used in treating kidney, reproductive, and cardiovascular diseases.¹

What is the cultural significance of ginseng?

The traditional belief is that ginseng can heal all parts of the body, and the name Panax means “all healing”.¹²

Who should not take ginseng?

Anyone pregnant is advised to not take ginseng, and anyone on warfarin medication.^10,11 You should speak to your doctor to see if ginseng is suitable for you.

Does ginseng have negative effects?

If used safely then generally there are no adverse effects but using ginseng unsafely can cause effects such as – headaches, menstrual problems, hypertensive crisis, diarrhoea, and dizziness.^1,3

Summary

Ginseng has been used throughout ancient medicinal practices across Korea, China, and America and is renowned for its benefits. The two types are red and white, and Asian and American ginseng are the most used species. Ginseng contains beneficial components such as vitamins, ginsenosides, and minerals that contribute to its pharmacological properties.

The traditional use of ginseng ranges from being used as a general health tonic to treating various ailments of the body. The adaptogenic properties help the body support the immune system, enhance energy levels, and help with coping with stressors.

Ginseng is generally safe to use however, unsafe use of ginseng (abusing or misusing) can cause adverse effects such as dizziness, menstrual problems, headaches, and maniac episodes.

To sum up, ginseng's traditional medicinal background and varied pharmacological characteristics highlight its significance in traditional herbal medicine. Serving as a general health enhancer and possessing adaptogenic, cognitive-enhancing, and immune-strengthening qualities, ginseng presents numerous potential health advantages. Nevertheless, individuals need to approach its usage with caution and seek guidance from healthcare professionals.