Ginseng

Tomomi Kimura

What is Ginseng?
Low-growing, shadeloving perennial herb of
the Aralianceae family
(http://www.bccancer.bc.ca/PPI/UnconventionalTherapies/Ginseng.htm)

Latin name= Panax

The scientific names
Panax Ginseng
Derived from the Greek
word for cure-all,
related to the word
Panacea.

Types of Ginseng
True Ginseng:
American Ginseng
(Panax Quinquefolium)

Korean, Chinese
or Japanese Ginseng
(Panax Ginseng)

Types of Ginseng
Ginseng Companions and Relatives:
Siberian Ginseng
(Eleutherococcus senticosus)
Dwarf Ginseng
(Panax trifolious)
Fool's sang or wild sarsaparilla
(Aralia nudicaulis)

http://www.supertrition.com

http://www.allstarhealth.com

History
Ginseng root has been used for
over 2000 years
Has traditionally used for treatment
of a number of disorders in China
and Korea
Crossed to Western by the
eighteenth century
US expoted $20.9 million worth of
ginseng last year (NYtimes, 2005)

Active Components
Ginsenosides
or Panaxosides
Major ginsenosides:
Rg1, Re, Rf, Rb1, Rc, Rg2, Rb2, Rb

Panaxans
Ginsenans

Forms of Ginseng
Root itself ($25~ per root)
Dried root
Teas, capsules, tablets,
tinctures, powders.

Dosage
usually provide 100mg to
400mg of dried extract
(equivalent to 0.5g to 2g of
ginseng root.)

Marketing Claims
Heart tonic
Energy and mood booster
Healthy glucose metabolism
formula
Helps normalize imbalances in
the bodys energy in different
disease status
Sex drive
Immune support
Stress management
Menopausal control

Traditional and modern uses

Improving the health of people
recovering form illness
Increasing a sense of well-being
and stamina, and improving both
mental and physical performance.

Traditional and modern uses

(contd)

Treating erectile dysfunction,

hepatitis C, and symptoms related
to menopause.
Lowering blood glucose and
controlling blood pressure.

Current Research Area

Ginseng vs. Exercise performance

Mood and cognitive function
Cardiovascular disease
Sexual function
Diabetes
Obesity
Cancer

Prevalence of Diabetes
Diabetes is a major health problem
5% of the total population in the
US
3% of the population worldwide.
Canadian Diabetes Association
Allocated $6 million to support
123 diabetes research teams
across the country last year.

Diabetes vs. Ginseng

Historically used to treat type-2

diabetes.
No. 6th commonly suggested
herbal medicine to improve
glycemic control by Italian
herbalists
Many studies support its
antihyperglycemic activity.

Theoretical Basis

Well tolerated by oral intake

Molecular mechanisms of
antihyperglycemic reaction are
unclear.

Theoretical Basis
Ginsenosides alter blood glucose
levels by
stimulating the biosynthesis of insulin
by the pancreas
inducing the production of a glucose
transporter in the liver

The polysaccharides in ginseng

lower blood glucose by
either decreasing the production of
glucose by the liver
increasing the use of glucose by
tissues

Scientific Evidences
By Vuskan, V. et al & Xie, J. et al.

Study #1
Antidiabetic effects of Panax ginseng berry extract and
the identification of an effective component
Diabetics (2002) 51
By Xie, J. et al.

Specific Aim
Evaluate antihyperglycemic and antiobese effects of Panax ginseng
berry extract in obese diabetic mice.
Study Design
In vitro, double blind, placebo
controlled.

Antidiabetic effects of Panax ginseng berry extract and the

identification of an effective component
Diabetics (2002) 51
By Xie, J. et al.

Subjects
14mice 10-18 weeks of age
Methods
Injection of 150 mg/kg berry extract (n=8)
Monitored by measuring blood glucose
and serum insulin levels, and glucose
tolerance test for 12 days.
Compared the results with 6 vehicles.

Antidiabetic effects of Panax ginseng berry extract and the identification of

an effective component
Diabetics (2002) 51
By Xie, J. et al.

Results
Significantly improved glucose tolerance
Became normoglycemic
- 46% BG glucose tolerance test

Significant reduction in serum insulin levels

Lost significant amount of weight
(-12%BW than day 0)

Ginseng berry extract is effective treatment

for obese diabetic mice, and may work for
weight loss.

Study #2
Antihyperglycemic effect of the polysaccharides fraction
form American ginseng berry extract in ob/ob mice
Phytomedicine (2004) 11
By Xie, J. et al.

Specific Aim
Evaluate antihyperglycemic effects
of the polysaccharides fraction from
Panax ginseng berry extract in
obese diabetic mice.
Study Design
In vitro, double blind, placebo
controlled.

Antihyperglycemic effect of the polysaccharides fraction

form American ginseng berry extract in ob/ob mice
Phytomedicine (2004) 11
By Xie, J. et al.

Subjects
15 mice 10-15 weeks of age
Methods
Injection of 150 mg/kg polysaccharides
fraction from AG to 5 mice
Injection of 50 mg/kg polysaccharides
fraction from AG to 5 mice
Monitored by measuring blood glucose
and serum insulin levels, and glucose
tolerance test for 10 days.
Compared the results with 5 vehicles.

Antihyperglycemic effect of the polysaccharides fraction form American ginseng

berry extract in ob/ob mice
Phytomedicine (2004) 11

Results
Significant improvement in glucose tolerance in
comparison to the beginning of the study.
Significant change in fasting blood glucose levels
on day 5 (-19%) and even more on day 10 (-19%
in 50 mg/kg dosage group, -45% in 150 mg/kg
group).
Additional observation:
The fasting blood glucose levels stayed lower and
returned on day 30.
No significant changes in body weight.

Study #3
Similar postprandial glycemic reductions with escalation of dose
and administration time of American ginseng in type 2
diabetes.
Diabetes Care (2000) 23
Vuscan, V. et al

Specific Aim
Investigated whether American ginseng
(AG) reduce postprandial glycemia in type
2 diabetic individuals and time of
American ginseng administration.
Study Design
In vivo, randomized, blind, placebo
controlled

Similar postprandial glycemic reductions with escalation of dose and

administration time of American ginseng in type 2 diabetes.
Diabetes Care (2000) 23
Vuscan, V. et al

Subjects
10 type 2 diabetic patients (6M, 4F) with age 6165.
Methods
Used 3, 6, 9g of grounded AG root in capsules
Administrated 120, 80, 40min before a 25g oral
glucose test.
Measured capillary blood glucose before AG
ingestion, 0,15,30,45,60,90, and 120 min from
the start of the glucose test.

Similar postprandial glycemic reductions with escalation

of dose and administration time of American ginseng in
type 2 diabetes.
Diabetes Care (2000) 23
Vuscan, V. et al

Results
3, 6, 9g of AG significantly lowered
blood glucose at 30, 45, 120 min.
No differences between dosage and
the timing of administration.

Study #4
American Ginseng Improves Glycemia in Individuals with
Normal Glucose Tolerance: Effect of Dose and Time
Escalation
American College of Nutrition (2000) 19
Vuscan, V. et al

Specific Aim
Investigated whether American ginseng
(AG) achieve further improvements in
glucose tolerance in non-diabetic
individuals and effectiveness of timing of
AG ingestion
Study Design
In vivo, blind, randomized, placebo
controlled

American Ginseng Improves Glycemia in Individuals with Normal

Glucose Tolerance: Effect of Dose and Time Escalation
American College of Nutrition (2000) 19
Vuscan, V. et al

Subjects
10 nondiabetic individuals (6M 4F) with age
28-54.
Methods
Used 3, 6, 9g of grounded AG root in
capsules
Administrated 120, 80, 40min before a 25g
oral glucose test.
Measured capillary blood glucose before
AG ingestion, 0,15,30,45,60,90, and 120
min from the start of the glucose test.

American Ginseng Improves Glycemia in Individuals with

Normal Glucose Tolerance: Effect of Dose and Time
Escalation
American College of Nutrition (2000) 19
Vuscan, V. et al

Results
All AG doses (3, 6, 9g) of AG
significantly lowered blood glucose
at 30, 45, 60 min.
No relationship between dosage and
the timing of administration.

Side Effects

Bleeding disorders
Diarrhea
Edema
Headache
Hypoglycemia
Hyperpyrexia
Menstrual abnormalities
Nausea and vomiting
Nervous excitation
Palpitations
Itchiness
Dizziness
Rose spots

Side Effects (contd)

Large doses over an extended period of time
Diarrhea
Estrogenic effect
HTN
Hypertonicity
Decreased libido
Insomnia
Menstruation in menopausal women
Nervousness

Herb-Drug interactions
Hypoglycemic drugs
hypoglycemic effect

Furosemide
Decreased diuretic effect

Digoxin
May increase serum digoxin
concentrations

Herb-Drug Interactions (contd)

Monoamine oxidase
inhibitors (MAOIs)
Headache, visual hallucination,
tremor, manic episodes

Anticoagulants, antiplatelet agents

Decreased effectiveness of warfarin

Estrogens, corticosteroids
Additive drug effects

Herb-Drug Interactions (contd)

Drugs that cause gynecomastia
e.g.
Calcium channel blockers
Cardiac glycosides
Methyldopa
Phenothiazines
Spironolactone

Herb contains estrone, estradiol,

estriol;
Has additive estrogenic effects

Herb-Nutrition Interactions
Alcohol
May decrease alcohol absorption

Caffeine
Maybe additive stimulant effects

Summary and Recommendations

Many of studies reported
ginsengs benefits in diabetes
animals, but there is little
comparable research in humans.
More clinical research would be
needed to prove ginsengs
benefits in humans

Summary and Recommendations (contd)

Seek physicians and use
cautiously when taking any other
psychiatric, estrogenic or
hypoglycemic medication.
Should not be used in
combination with warfarin.

Thank you!