Ginseng - The magic root

What is ginseng?

Not only in traditional Chinese medicine (TCM), but also in European medicine, the ginseng root has been used for centuries to treat and prevent various ailments. The various types of ginseng all belong to the genus Panax, which in turn is part of the Aralia family (Araliaceae).

The name Panax for the genus ginseng comes from Latin or Greek and means something like panacea. Panacea was an all-healing goddess and daughter of Aesculapius in Greek mythology. The name Ginseng, however, has its origin in Chinese and means 'human root'. This is mainly due to the shape of the ginseng root, which resembles an abstract representation of a person.

When speaking of ginseng, Panax ginseng, Asian or Korean ginseng, is usually spoken of. American ginseng, Japanese ginseng or Chinese ginseng all belong to the genus Panax. Around 13 Panax species are called ginseng.

In its wild form, Korean ginseng hardly ever occurs. Numerous other types of ginseng are now on the red list of plant species that are threatened with extinction. However, ginseng has been cultivated and processed as a medicinal plant for around 800 years.

The cultivation of the ginseng plants is extremely complex. For example, the forest plant prefers shady areas. The root can only be harvested after four to six years. For a period of 10 to 15 years, no further ginseng cultivation is possible in the same area. A ginseng harvest in a field is therefore only possible every 14 to 21 years.

Ginseng botany

The different Panax types are similar in appearance. The perennial and herbaceous plants have simple stems that are scaled at the bottom. There are three to five leaves on each branch. The petioles in their entirety are reminiscent of a human hand.

Since the ginseng grows rather herbaceous, it only grows to heights of 30 to 60 centimeters. Each plant forms umbel-shaped inflorescences with up to 50 small flowers. These are whitish-green in color and develop into red drupes when ripe.

The rootstock of ginseng plants consists of one or two bundles of roots. The cylindrical or spindle-shaped roots only grow about a centimeter a year.

Types of ginseng

White Korean ginseng is the best known Panax species. It has been used as a medicinal plant for many centuries. However, other types of ginseng can also be used for medicinal purposes.

Red ginseng or white ginseng?

Both white and red ginseng roots are commercially available. However, this color difference is not due to the type of ginseng but is due to the processing of the root. Ginseng roots, which are dried in one piece or cut, turn white and are therefore called white ginseng. However, if the root is treated with steam before it is dried, it turns red, which is why it is called red ginseng.

Korean ginseng

Korean ginseng (Panax ginseng) is also known as Asian ginseng. The plant is native to mountain and forest areas in Korea and China, but also in Siberia. Korean ginseng feels particularly comfortable in mixed and deciduous forests. Due to the global trade with the ginseng roots, the Washington Convention on International Trade in Endangered Species of Wild Fauna and Flora now lists Korean ginseng as a plant in need of protection.

Chinese ginseng

The Chinese ginseng (Panax pseudoginseng) belongs to the genus Panax just like Panax ginseng. The plant from the Araliaceae family grows in China and Japan. Panax pseudoginseng and Panax ginseng are similar in their ingredients, but in contrast to Korean ginseng, Chinese is not one of the so-called adaptogens. Adaptogenic plants contain biologically active plant substances that can support the body in coping with stress.

American ginseng

Panax quinquefolius, the American ginseng, is cultivated mainly in North America but also in China and South Korea. Although it comes from Korean ginseng, it has lost part of its original ingredients due to the changed growing conditions. Korean ginseng contains around 30 different ginsenosides, while the American version only contains half.

Japanese ginseng

The Japanese ginseng root, like the root of the Korean ginseng, is used for medicinal purposes. Panax japonicum has a pharmacological effect, which differs from that of Korean ginseng. All four varieties of Japanese ginseng are used as medicinal plants:

• Panax japonicus var. Angustifolius
• Panax japonicus var. Bipinnatifidus
• Panax japonicus var. Japonicus
• Panax japonicus var. Major

Ginseng - Types of foreign species

Various plants are called ginseng, although they are not classified as Panax. These include, for example, Siberian ginseng (Eleutherococcus senticosus), Indian ginseng (also known as Ashwagandha (Withania somnifera) and Brazilian ginseng (Pfaffia paniculata). Although they have the same name, the plants have little to do with each other. They differ very clearly in their ingredients and thus also in their effects.

Ingredients of ginseng

The ginseng root contains various active ingredients:

Ginsenosides

The main active ingredients of the ginseng root are the so-called triterpene saponins. These belong to the group of soaps (saponins). Saponins are glycosidic plant substances that, when dissolved in water, form a durable foam similar to soap when shaken. They have an emulsifying effect on oils and can stabilize suspensions.

Ginsenosides are saponin compounds that only occur in ginseng. More than 20 different ginsenosides are known to date.

The ginsenosides are responsible for a large part of the effects of the ginseng. The secondary plant substances are said to have a concentration and attention-promoting effect. The ginsenosides from the ginseng root are also said to strengthen the natural resistance to stress and stimulate the production of neurotransmitters.

According to the European Pharmacopoeia, the dried ginseng root must contain at least 0.4 percent ginsenoside Rg1 and Rb1. The proportion of ginsenosides depends on the one hand on the type of ginseng and on the other hand on the age of the plant. The active ingredients concentrate mainly in the outer root layers. The hair roots contain significantly more ginsenosides than the main and minor roots. However, the minor roots are not used because they contain more ginsenosides, but they have a different composition.

Essential oils and more

In addition to the soap substances, the ginseng root also contains essential oils. These volatile mixtures belong to the secondary plant substances and have different effects depending on the composition. Peptidoglycans and polyacetylenes are also active ingredients in ginseng.

The discovery as a medicinal plant

In Chinese and Korean medicine, ginseng has been used as a medicinal plant for more than two millennia. As early as 11 BC, the Koreans started cultivating ginseng in order to use the root for the manufacture of medicine. The 'root of life', as the ginseng is called in Asia, is said to bring body, mind and soul into harmony.

For a long time, ginseng was considered a particularly valuable commodity and was therefore reserved for kings, emperors and very wealthy people. The ginseng root was considered so valuable that its export was even punished with death.

Nevertheless, the medicinal plant came to Europe in 1610 through Dutch sailors. However, the root with its healing properties was still very unknown here and was therefore not valued as much as it should have been. Only around 200 years later did Europeans recognize the benefits of ginseng and from then on used it to increase well-being.

In the 20th century, scientific research increasingly focused on the ginseng root. Gradually, more ingredients and mechanisms of action became known. Ginseng is rated positively in Commission E's monograph today. Commission E is an independent and scientific expert commission for herbal medicinal products and part of the Federal Institute for Drugs and Medical Devices (BfArM) in Germany.

Ginseng effect

According to Commission E's monograph, ginseng is particularly suitable as a general tonic. The root can be used to strengthen and reinforce tiredness and weakness. Dietary supplements with ginseng can also be helpful in the event of reduced performance and impaired concentration.

Ginseng also shows an immunomodulatory effect. The dried root of ginseng can help prevent stress-related infectious diseases such as colds and protect against the real flu (influenza).

The ginseng can also have a positive effect on the mood and brain activity. The root stimulates the production and distribution of the 5-HTP substance. 5-HTP is the precursor of the happiness hormone serotonin. Ginseng can also increase the concentration of the neurotransmitter dopamine in the blood. This messenger not only controls mood, but is also responsible for the driving force.

Ginseng is also known as a natural means of increasing potency. The legendary emperor Shennong, who lived more than 5000 years ago, mentioned ginseng as a potent medicinal plant in his three-part book on medicinal plants and herbs.

Ginseng against tiredness and fatigue

Tiredness and fatigue are common symptoms that can have different causes. The complaints often hide a lack of sleep, but infectious diseases, stress or autoimmune diseases can also be associated with increased fatigue. Ginseng has long been known in Asia as an exhaustion tonic.

Ginseng and chronic fatigue

The power of the ginseng root becomes clear when you look at a few studies on fatigue syndrome. Typical symptoms of chronic fatigue syndrome are absolute fatigue as well as absolute tiredness and exhaustion. Fatigue occurs, for example, in cancer patients.

A study by Barton et al. examined the influence of a standardized ginseng preparation from the Wisconsin ginseng with a three percent ginsenoside content. After 8 weeks, 30 percent of cancer patients showed signs of fatigue improvement of 30 percent and more.

Yennurajalingam et al. reported similarly positive results in her study on the connection between fatigue in cancer patients and the intake of high-dose Panax ginseng. The patients received 800 mg Panax ginseng daily. There was a significantly positive influence of ginseng intake on the symptoms of fatigue and on the general quality of life.

Chronic fatigue in multiple sclerosis

Taking a food supplement with ginseng can have a positive effect not only on cancer patients, but also on people with multiple sclerosis. Weakness and a pronounced tiredness are among the most common symptoms of chronic inflammatory disease of the nervous system. Similar to the studies on cancer fatigue, the researchers were able to improve symptoms in people with multiple sclerosis by taking ginseng supplements.

However, choosing the right type of ginseng plays a crucial role in its success. In her study from 2011, for example, Kim et al. was unable to alleviate the tiredness of her subjects with an extract from the American ginseng. Korean ginseng appears to be better here.

Blood pressure and ginseng

Hypertension is still the number one widespread disease. Every third to every second German between the ages of 35 and 64 suffers from arterial hypertension. The common illness can have very serious consequences. Chronic high blood pressure hardly causes any symptoms, but it increases the risk of cardiovascular diseases. To prevent life-threatening complications such as heart attack or stroke, blood pressure must therefore be regulated quickly.

Causes of high blood pressure

High blood pressure comes in two forms: Primary and secondary. Secondary hypertension is the result of an underlying illness or occurs as a result of various detectable factors. Causes of a secondary hypertension are:

• Kidney diseases
• Disorders of the hormonal balance such as an overactive thyroid or Cushing's syndrome
• Vascular diseases
• Tumors
• Psychiatric disorders such as social phobias or panic disorders

The primary hypertension arises with no apparent cause. More than 80 percent of all hypertensive patients have a primary hypertension.

High blood pressure due to endothelial dysfunction

Scientists suspect that many primary hypertension disorders are based on an endothelial dysfunction. This is a malfunction of the vascular endothelium. The endothelium is a thin layer that lines the inside of the blood vessels. This layer influences the narrowing and dilation of the vessels as well as the permeability of the vessels and also partially prevents the accumulation of platelets. As a result, the endothelium indirectly affects blood pressure.

Ginseng and the vascular endothelium

The ingredients of the ginseng root have a positive effect on the function of the vascular endothelium in hypertensive patients. This effect is presumably based, among other things, on an increased release of nitrogen monoxide (NO) from the endothelial cells and the associated relaxation of the vessels.

Ginseng also shows other positive effects on the function of the heart and blood vessels and blood pressure. The ginsenosides not only have antioxidant properties, they also influence the release of blood pressure regulating messenger substances and have a positive effect on blood lipid levels.

Ginseng and diabetes

Diabetes mellitus is shown by high blood sugar levels. While type 1 diabetes is usually caused by an absolute lack of the hormone insulin in childhood or adolescence, type 2 diabetes only occurs later. There is no absolute, but rather a relative insulin deficiency here. The reason for this is insulin resistance. This means that the body cells do not respond properly to the insulin and the sugar remains in the blood despite the insulin release.

Type 2 diabetes - Dangerous consequences

The increased blood sugar levels initially do not cause any symptoms, so that diabetes often remains undetected for a long time. In the long term, the sugar in the blood damages the small and large blood vessels in the body. The dreaded complications of diabetes include:

• Heart attack
• Stroke
• Nerve damage
• Damage to the retina up to blindness
• Kidney weakness or renal failure

Ginseng lowers fasting blood sugar and postprandial sugar

To prevent the after-effects, the blood sugar has to be lowered. The ginseng root can be helpful here. Various studies have shown that ginseng can significantly lower fasting blood sugar and postprandial sugar, so the blood sugar after eating.

After taking ginseng, the insulin level in the blood increases. Sen et al. study from 2013 reveals one possible reason for this. In the pre-clinical study, the researchers were able to stimulate the regeneration of ß cells in the pancreas by taking a ginseng root extract.

The β cells are the insulin-producing cells in the Langerhans islands of the pancreas. In both type 1 and type 2 diabetes mellitus, the function of the ß cells is severely impaired. Type 1 and type 2 diabetics could both benefit from taking ginseng supplements.

Improvement of the insulin sensitivity

Ginseng not only leads to an increased insulin release and production, it can also improve insulin sensitivity. Insulin sensitivity is the sensitivity of the body's cells to the hormone insulin. The more sensitive the cells are to the insulin, the better they can absorb glucose from the blood.

Ginseng can also lower blood sugar by activating AMP kinase (AMPK). The enzyme stimulates the glucose transport in the muscle and reduces the production of glucose in the liver. Part of the effect of metformin, a well-known diabetes medication, is also mediated by the enzyme AMPK.

Preventing diabetes consequences with ginseng

Heart and vascular diseases as well as the diabetic retinopathy (eye disease) are extremely feared as a consequence of diabetes. In animal studies, the intake of ginseng has proven to be a promising measure for the prevention of this damage. This way, ginseng improved the cardiac activity and the elasticity of the blood vessels in the test animals with diabetes. Further clinical studies on the prophylactic role of ginseng would be desirable to further establish ginseng in diabetic therapy.

Liver disease and ginseng

The liver is a remarkable organ. As the largest gland in the human body, it is the central metabolic organ and takes on many important tasks. It produces vital proteins, utilizes the components from food, produces bile and serves to excrete and utilize poison, medication and metabolic end products.

Not only alcohol, but also medication, sugar and fatty foods can damage the liver and impair its function. Fatty liver, cirrhosis of the liver, hepatitis or congestive liver are liver diseases that can lead to a decrease in the liver function. Complaints appear rather late. This includes:

• Fatigue
• Feeling of pressure in the right upper abdomen
• Weight loss
• Yellow discoloration of the skin
• Nausea and vomiting
• Itchiness

Ginseng for liver health

Ginseng plays a role in the regulation of liver functions and in the (accompanying) treatment of liver diseases such as hepatitis, liver cirrhosis or liver cancer.

Ginseng extract can protect the liver cells from liver-damaging substances such as alcohol or medication. The ginsenosides can also offer protection against hepatotoxins such as the aflatoxins (fungal toxins), cadmium chloride or benzpyrene, which is formed, for example, when barbecuing.

Ginseng promotes the regeneration of the liver

Ginseng also appears to promote liver regeneration after surgery. Animal experiments showed a positive influence on the ability of the liver to regenerate after a partial removal of the organ. The researchers were able to demonstrate a growth in liver cells after the administration of ginseng. The liver increased in weight as a result.

Scientists also achieved promising results in the treatment of acute graft-versus-host disease. This systemic disease occurs in up to 60 percent of all patients after a blood stem cell or bone marrow transplant, but also after a liver transplant. In 2011, Xu et al. managed to cure an acute graft-versus-host disease after liver transplantation using red Korean ginseng.

Ginseng and fatty liver

A fatty liver is caused by excessive alcohol consumption or by overeating. The 'good' HDL cholesterol can be increased with the help of ginseng. However, the level of LDL cholesterol and triglycerides in the liver drops. This is how ginseng protects the liver from becoming fatty.

Ginseng against liver cancer

Liver cancer is often the result of liver cirrhosis but it can also result from mold products in food, as well as from disorders in iron metabolism or certain chemical substances. Chronic hepatitis B or C virus infections are also common causes of cancer.

Abdel-Wahhab et al. were able to lower the virus titer in the blood in their study from 2011 in patients with chronic hepatitis C using Korean ginseng. The study also showed a significant improvement in liver function in cirrhosis.

Additional studies suggest that ginseng can also play a role in preventing liver cancer. For example, people who regularly take preparations from the ginseng root are less likely to develop liver cancer.

Ginseng - The effect mechanism

Scientists suspect that ginseng can have a positive effect on liver health in a number of ways. On the one hand, the ginsenosides act as antioxidants and protect the cells of the body from harmful free radicals. On the other hand, ginseng has an anti-inflammatory effect because it can suppress the production of inflammation-promoting chemokines and cytokines.

Immune system and ginseng

In Far Eastern medicine, ginseng is considered to be an immune-boosting tonic. The medicinal plant has also been able to demonstrate its positive effect on the immune system in various scientific studies. In this way, ginseng can support the various cells of the immune system in their fight against the pathogen and thereby increase resistance to various microbes.

Among other things, ginseng has a positive effect on the activity of the so-called macrophages. These phagocytes belong to the white blood cells, are part of the innate immune system and are used to eliminate microorganisms. Ginseng also stimulates the activity of natural killer cells (NK cells) and thus helps protect against pathogens.

Ginseng against bacterial infections

Inside the body, bacteria find optimal conditions for reproduction and growth. They use the so-called Glykokalix, a layer on the outer surface of the cells, as an anchorage and remain on their host cells. Ginseng polysaccharides can prevent this bacterial adhesion to the body cells.

The medicinal plant appears to have a very broad spectrum of antibacterial activity. Various scientific studies report successes with Helicobacter pylori, Staphylococcus aureus or Escherichia coli.

The antiviral effects of ginseng

Ginseng doesn't only act against bacteria, but also against viruses in the body. So the medicinal plant can positively influence the course of the disease of the real flu (influenza). Ginseng extract can stimulate the production of antibodies such as IgG or IgA and thus strengthen the immune system. Ginseng also stimulates the release of interleukins. IL-4 and IL-5 are among the key signaling substances in the immune reactions.

Ginseng and HIV

To improve the immune response, ginseng preparations are also used in the treatment of HIV patients. In their 2017 study, scientists Young-Keol and Jung-Eun found a significant correlation between the intake of Panax ginseng and the number of CD4+ cells in HIV patients.

CD4 cells are cells of the immune system that carry a special surface receptor. They are often referred to as T helper cells. The number of CD4+ cells in the blood is an important marker of the course of the disease. The fewer cells there are, the more pronounced the infection.

By taking ginseng, the researchers were able to significantly improve the CD4 + values in their test subjects and also extend the average survival time of the patients. Especially in combination with an anti-retroviral therapy, ginseng can be used to treat HIV patients with good results.

Ginseng as an immunomodulator

However, an increase in immune defense is not always desired. An excessive immune and inflammatory reaction, such as allergies or autoimmune diseases can permanently damage body structures. Taking ginseng can be helpful here too. Ginseng is therefore not just an immune booster, but also an immune modulator.

The medicinal plant can alleviate the symptoms of an asthma attack due to the hyper-reactive bronchial system. Ginseng also reduces the inflammatory process in acute arthritides (arthritis).

People with atopic eczema can also benefit from the immunomodulating effect of ginseng. Atopic eczema, also called neurodermatitis, is a chronic, non-contagious skin disease. Korean ginseng is anti-inflammatory and antioxidant in the keratinocytes of the skin and can thus relieve the unpleasant skin complaints.

Ginseng and arteriosclerosis

The medicinal plant has a positive effect on the fat metabolism in the human body and can thus make a decisive contribution to vascular health. Ginseng regulates the activity of the hormone leptin. Researchers suspect that the leptin that is increasingly produced in overweight people is not only involved in the development of arteriosclerosis, but is also (co-) responsible for the arteriosclerosis complications of a myocardial infarction and stroke.

Ginseng also affects the lipid levels. The medicinal plant can't just lower cholesterol levels in the blood, but also counteract what is known as hypertriglyceridemia. The increased blood lipid levels significantly increase the risk of arteriosclerosis and the associated complications. However, it should be noted that the majority of the studies are based on animal models. Further clinical studies could confirm the prophylactic value of ginseng with regard to arteriosclerosis.

Ginseng and potency

An erectile dysfunction occurs when a man no longer has an erection in more than two thirds of all cases or can't maintain an erection. This makes intercourse impossible. Erectile dysfunction, which occasionally occurs, is actually not in need of treatment. Erectile dysfunction only occurs if the erectile dysfunction persists for at least six months.

While erectile dysfunction in older men mainly has a physical cause, erectile dysfunction in younger people often has a psychological cause. Regardless of the cause, the men suffer from the limitation of their sexuality. Erectile dysfunction often affects the partnership.

Ginseng against erectile dysfunction

For several thousand years, people in Asia have used ginseng root as a sexual enhancer. Ginseng is mentioned as a potent medicinal plant in the 3000-year-old Chinese pharmacopoeia of the Chinese emperor Shennong.

In their 2006 study, Choi et al. was able to achieve good results in people with erectile dysfunction with the administration of ginseng. The test subjects reported an increased libido and better penis stiffness. In 60 percent of the study participants, sex life improved significantly by taking ginseng.

De Andrade et al. came to a similar conclusion in a placebo-controlled double-blind study with 60 subjects. Half of the study participants received a placebo preparation, the other half received 1000 mg of Korean ginseng three times a day. In the ginseng group, patients reported an improved penile stiffness and easier penetration. They could also keep their erection for longer. In contrast, there were no improvements in the placebo group.

A meta-study, in which the researchers considered the results of 20 studies on ginseng in erectile dysfunction, confirmed the positive influence of ginseng on male potency. Accordingly, ginseng can also be helpful in the case of a psychogenic erectile dysfunction.

Menopause and ginseng

Menopause refers to the years before and after the last menstrual period. The so-called climacteric usually begins at the age of 40. The sex hormones decrease and fertility decreases.

Menopause is not a disease, but a completely normal biological process. Nevertheless, many women with menopause suffer from complaints due to the changes in the hormonal balance. This includes:

• Hot flashes
• Sweating
• Night sweats
• Vaginal dryness
• Sleep disorders
• Mood swings
• Nervousness
• Weight gain

Ginseng during menopause

The medicinal plant can alleviate the symptoms that can occur during the menopause and thus make life easier for women in this phase of change. The ginseng seems to have a very broad effect.

Taking ginseng during menopause not only improves the general well-being, it also counteracts mood swings, depressed moods and unpleasant hot flashes. Ginseng also has a positive effect on sexuality. The study participants reported, among other things, increased sexual arousal.

Ginseng, menopause and heart health

The changed hormone levels in the menopause increase the risk of certain diseases in women. In addition to diabetes and osteoporosis, this also includes cardiovascular diseases. Ginseng can be useful to protect against cardiovascular diseases after menopause.

Adding three grams of ginseng with a standardized ginsenoside content of 60 mg leads to lower cholesterol levels in menopausal women. The Kim et al. study also showed a decrease in intima-media-thickness in the vascular wall of the carotid artery. A thickened vascular wall is considered a risk factor for cardiovascular events such as a heart attack or stroke.

Concentration and performance with ginseng

The concentration is an important prerequisite for efficient and effective work. If you want to increase your concentration and performance, you can use ginseng preparations.

Taking ginseng in particular can improve working memory. This allows the short-term storage and processing of information. Without a functioning working memory, we can neither read nor write.

In particular, people who engage in mentally demanding activities more often can benefit from taking ginseng and improve their cognitive performance.

Ginseng in Alzheimer's

In the dementia disease Alzheimer's, mental performance is severely restricted. Patients are very forgetful, have difficulties coping with their everyday lives and problems expressing themselves linguistically. You lose your orientation and have difficulties concentrating.

Panax ginseng can improve the cognitive performance of patients with Alzheimer's. In a study by Lee et al. Alzheimer's patients received 4.5 g of ginseng daily. Their cognitive performance was determined at the beginning of the study using the mini-mental-state-examination (MMSE) and the Alzheimer's disease assessment scale (ADAS), two quantitative measurement tools. During the twelve-week intake, the ginseng subjects achieved significantly better results here. After discontinuing the ginseng preparation, the mental state worsened again.

Heo et al. came to similar results in their 2012 study. The cognitive performance of Alzheimer's patients improved significantly by taking ginseng here as well.

Ginseng dosage and application

The German Pharmacopoeia (DAB) recommends an average daily dose of one to two grams of ginseng per day. Depending on the desired effect, the medicinal plant can be dosed very differently. Doctors in Traditional Chinese Medicine often recommend eight grams of ginseng a day to their patients. Doses of 800 mg to two grams per day are also used in the treatment of cancer-related Fatique.

To prevent illnesses and to alleviate minor complaints, the intake of 200 to 400 mg per day is recommended. For the treatment of erectile dysfunction, however, the dose should be increased to up to three grams per day.

These dosage recommendations always depend on the type of ginseng and the ginsenoside content.

Ginseng side effects

Basically, ginseng is well tolerated. Side effects are rare when taking high doses. Possible side effects include:

• Insomnia
• Unrest
• Nausea
• Vomit
• Diarrhea
• Stomach cramps

A study also reported about hypoglycaemia, also called low blood sugar, in type 2 diabetics. Since ginseng is used by diabetics to reduce blood sugar, it is probably not an undesirable side effect, but rather the result of too high a dosage.

Ginseng interactions

So far, there are only a few studies that investigate the interaction of ginseng with drugs and other substances. However, the existing data currently do not indicate any interactions. As a precautionary measure, taking ginseng while taking medication should be discussed with your doctor.