Walk into an American convenience store these days, and you might find ginseng on the shelf—dark little vials of extract with bright labels selling for 99 cents a bottle. Whether the bottles contain more sugar than ginseng is a decision for the discriminating consumer to make, but ginseng’s presence on a quick-stop shelf is a sign of its growing popularity in the United States: sales of ginseng products totaled $10.8 million in this country in 1992, the latest year for which figures are available.
In China, where ginseng has been considered one of life’s necessities for millennia, millions of Chinese reach for the herb daily, believing that it will slow aging, enhance sexual prowess, and prevent disease. The strength of Chinese cultural belief in ginseng, however, is matched by the strength of Western skepticism. Different cultural perspectives and a relative scarcity of good, repeatable controlled studies of ginseng’s effects on the human body make it difficult for some Westerners to believe in its therapeutic value. So, who’s right?
The answer isn’t simple, but a summary of what is known about the herb, its history, and its performance in scientific studies may help you decide whether to reach for ginseng every day, use it only on occasion, or opt for something else.
The True Ginsengs
Ginsengs have been classified into two groups: true ginsengs and, for lack of a better term, the others. The others, including Eleutherococcus senticosus, are outside the scope of this article.
In Traditional Chinese Medicine (TCM), true ginsengs are considered the most valuable and potent for lengthening life and promoting vitality. Botanists and herbalists know them as members of the genus Panax in the ginseng family (Araliaceae).
The generic name Panax is derived from the Greek pan, “all”, and akos, “cure”; however, the Chinese rarely use the herb alone to “cure” anything. Instead, it is an ingredient of hundreds of therapeutic herbal formulas. TCM practitioners use it to restore deficient qi (vital energy) and regulate body systems. In TCM, that makes ginseng a superior medicine because it is thought that the primary purpose of the healing arts is to restore balance and strength so that the body can heal itself.
The best-known of the true ginsengs are Asian or Oriental ginseng (P. ginseng), which is available in red and white forms, and American ginseng (P. quinquefolius).
• White ginseng is the peeled and dried root of Asian ginseng. In TCM, the fresh root is considered “cooler” than red ginseng and useful for people who need a little energy boost. It is almost always used in combination with other herbs to help a person withstand the effects of stronger herbs. The best white ginseng is actually a very pale yellow.
• Ginseng root turns red and hard when the fresh root is slowly steamed, then dried. It is suspected that steaming alters constituents known as ginsenosides and makes red ginseng more stimulating than the white form. In TCM, red ginseng is frequently given to people aged forty and older who have “collapsed qi”, as shown by low energy, withdrawal, lackluster appearance, and low sex drive.
• Native Americans have used American ginseng for centuries to treat fevers, colic, convulsions, dysentery, and headaches. The Chinese consider it a better tonic than Asian ginseng for supporting the adrenal glands, regulating metabolism, and increasing fluids. They view it as even more cooling than Asian ginseng and thus appropriate for younger, hotter, stressed individuals. Unfortunately, high market prices—as much as $600 a pound—and irresponsible harvesters have helped bring wild American ginseng to the brink of extinction in much of its range (for more information about this environmental concern, see page 37).
Health Claims and Human Studies
Centuries ago, people thought that the ginseng root resembled a human and that this was a hint of its medicinal value. Because the root resembled man, they believed it could be used to treat man (a concept known as the Doctrine of Signatures). This belief led healers initially to use ginseng as a panacea, or cure-all, and many still view it as such.
From a Western standpoint, however, little evidence exists to support ginseng’s effectiveness. Chemical analysis has shown that ginseng contains many vitamins, minerals, and—unique to plants in the genus Panax—steroidlike compounds called ginsenosides. As many as eleven major ginsenosides and about nineteen minor ones may occur in a single species. The amount of a given ginsenoside varies not only from species to species, but also with growing and manufacturing conditions.
Of the many scientific studies on ginseng’s effects, most performed and published in China, 95 percent have involved animals or animal or human cell cultures; few have involved humans or were designed with controls to ensure consistent testing methodology. Modern Chinese researchers are aware that more well-designed studies are needed before Westerners as a whole will accept ginseng as a valuable remedy or preventive, but here are some of the results to date.
Athletic performance: Ginseng appears to improve both physical and mental performance under stress. In 1982, researchers at the University of Munich found that fourteen healthy male athletes training at least ten hours a week and receiving a standardized ginseng extract twice daily increased their maximum oxygen uptake, whereas athletes receiving a placebo did not. Those in the ginseng group also had a faster recovery period and lower incidence of muscle fatigue than those taking the placebo. Two earlier studies, each nine weeks long and involving twenty and thirty volunteers, had similar outcomes. The athletes’ enhanced performance and metabolic efficiency persisted for three weeks after the ginseng administration stopped.
In 1981, a double-blind study of 120 men and women aged thirty to sixty indicated the age-specific benefits of ginseng. Participants aged forty to sixty who took two capsules daily of a standardized ginseng extract for twelve weeks showed an increased ability to perform visual and acoustic reaction tests; their lung function also improved. In the younger group, ginseng had no such effects.
In a 1991 double-blind, randomized, crossover study of fifty healthy male sports teachers between the ages of twenty-one and forty-seven, half received a ginseng preparation and half were given a placebo for six weeks; the groups then switched medications for six weeks. At a given workload, total oxygen consumption, carbon dioxide production, and blood lactate levels were lower in the ginseng group, suggesting that those participants used energy more efficiently and had greater endurance.
Mental sharpness: Results of studies conducted in the past fifteen years vary. In a 1982 study, forty-five patients suffering from a lack of blood flow to the brain received either a pharmaceutical drug called Hydergin, a standardized ginseng extract, or a placebo. Those who took the ginseng extract showed 34 percent improvement in blood flow compared with 58 percent for those taking Hydergin and 0.7 percent for those taking the placebo.
In 1980, a thirty-day, double-blind study of thirty-eight dental students who received as many as fourteen doses of either red ginseng root, American ginseng, or a placebo showed that ginseng did not significantly improve mathematical performance, proofreading error detection, or mood. But in a 1978 double-blind study involving thirty-two wireless operators and telegraphists ages twenty to twenty-three, those taking ginseng made fewer mistakes than those in the placebo group. And in 1980, a double-blind study involving sixty volunteers aged twenty-two to eighty found that commercial ginseng preparations improved reaction time, two-hand coordination, and physical fitness.
Increasing longevity: Ginseng has a longstanding reputation for prolonging life and fighting senility, and animal tests showing it increases production of various hormones and helps nerves regenerate may lend support to this claim. Clinical studies have not confirmed that ginseng prolongs life directly, though it may increase longevity indirectly through disease prevention.
Disease prevention: In a 1990 double-blind study, European researchers gave sixty volunteers either 100 mg of an aqueous ginseng extract, 100 mg of standardized ginseng extract, or a lactose capsule (a common ingredient in placebos) twice daily for eight weeks. Those who took the standardized ginseng extract showed increased counts of immune cells (including T helper cells) compared to those who received either the aqueous ginseng or the placebo.
Heart disease and cancer: Ginseng is commonly used throughout China to treat heart disease and cancer, but few controlled clinical studies exist to determine whether ginseng can really fight these diseases. One uncontrolled human study performed in 1995 in China showed that red ginseng is effective in treating congestive heart failure, and a 1994 study showed that patients recovering from open-heart surgery who took ginsenosides recovered faster and had less tissue damage than patients who did not take the ginsenosides.
In 1995, researchers performed statistical analyses on 1,987 pairs of human volunteers to determine whether ginseng might prevent cancer. Participants in one group had been diagnosed with various types of cancer, while those in the other group were healthy. The researchers determined that ginseng users had lower risks of lip, oral pharyngeal, esophageal, stomach, colorectal, liver, pancreatic, laryngeal, lung, and ovarian cancers.
Cancer treatment: In China, herbs are commonly used to supplement chemo- and radiation therapy. In 1994, researchers conducted a study of this practice, focusing on twelve patients’ use of ginseng leaf and the root of astragalus (Astragalus membranaceus) in conjunction with vincristine, cyclophosphamide, and other conventional chemotherapy agents. They reported that the survival rates of patients taking ginseng and astragalus increased “considerably”, with ten of the twelve patients gaining more than three to seventeen years of survival than those not using the herbal medicine. The treatments were given for more than two years.
Sexual performance: Whether ginseng has an effect on human sex hormones is not clear. Experiments have shown that ginseng can affect the sexual function and speed sexual maturity of mice and rabbits by stimulating specific glands to increase sex-hormone secretion. How this translates to human use is unknown, but the herb’s reputation as an aphrodisiac continues to pique the interest of researchers.
Taking a ginseng supplement or tea in moderation is safe for many people, but it is not appropriate for:
• people with high blood pressure (ginseng has been shown to increase blood pressure in some people);
• those with emotional or psychological imbalances, headaches, heart palpitations, insomnia, asthma, inflammation, or infections associated with high fever (ginseng may make these conditions worse);
• pregnant women (ginseng may raise estrogen levels);
• infants or young children.
If you have a serious condition or symptoms of any condition persist more than ten days, consult a qualified health-care provider. If ginseng is right for you, use the information at right as a guide for taking it.
Choosing Ginseng Products
Adapted from The Ginsengs, by Christopher Hobbs (Botanica Press, 1996). Hobbs, a fourth-generation herbalist and botanist, is a member of the Herbs for Health Editorial Advisory Board. He practices acupuncture and phytotherapy in Santa Cruz, California.