Panax Ginseng (Panax ginseng)
Ginsengs are known as “adaptogens,” meaning they may “increase resistance to physical, chemical, and biological stress and build up general vitality, including the physical and mental capacity for work.” One of the most commonly used and researched of the ginsengs is Panax ginseng, also called Asian or Korean ginseng. Active components include ginsenosides (a type of triterpene saponin), which have been shown to have a variety of beneficial effects, including anti-inflammatory, antioxidant, neuroprotective, and immunomodulatory1. Interest is growing in its utility for neurodegenerative and autoimmune diseases, including MS2,3. Overall, Panax ginseng appears to be well tolerated, although caution is advised about concurrent use with some medications, such as warfarin (Coumadin®), oral hypoglycemic agents, insulin, and phenelzine. Products with a standardized ginsenoside concentration are available1.
An acidic polysaccharide of Panax ginseng called ginsan was evaluated in a controlled study with an EAE animal model of MS. A dose of 200 mcg was found to significantly reduce disease severity and slow progression of the disease by inhibiting autoimmune cells and inflammatory cytokines, as well as promoting the generation of Tregs. Further, clinical benefits were observed4.
In a later study of similar design with the same dose, treatment with ginsan also led to a significant reduction of clinical disease symptoms and relapse rate compared to control. Tissue examination revealed a marked decrease in passage of autoimmune cells and macrophages into the spinal cord, with a lack of demyelination and damage to nerve fibers5.
Panax ginseng has been used traditionally during pregnancy and lactation6. A controlled study conducted on pregnant women carrying poorly growing fetuses found supplementation with 250 mg/day to be of benefit in correcting growth, without adverse effects7. There is some evidence of the potential to cause birth defects upon exposure to ginseng’s active compounds “ginsenosides,” but this occurred in animal embryos with much greater ginsengoside amounts than achievable through normal consumption in humans. In lactation, there are no human studies on the safety of Panax ginseng, only evidence based on three animal studies reporting minimal risk8. It was concluded from a systematic review that due to a lack of extensive research in humans, Panax ginseng should be consumed with caution during pregnancy (especially during the first trimester) and during lactation8,9.
References
1.Kiefer D, Pantuso T. Panax ginseng. Am Fam Physician. Oct 15 2003;68(8):1539-42.
2.Cho IH. Effects of Panax ginseng in Neurodegenerative Diseases. J Ginseng Res. Oct 2012;36(4):342-53. doi:10.5142/jgr.2012.36.4.342
3.Lee JI, Park KS, Cho IH. Panax ginseng: a candidate herbal medicine for autoimmune disease. J Ginseng Res. Jul 2019;43(3):342-348. doi:10.1016/j.jgr.2018.10.002
4.Hwang I, Ahn G, Park E, Ha D, Song JY, Jee Y. An acidic polysaccharide of Panax ginseng ameliorates experimental autoimmune encephalomyelitis and induces regulatory T cells. Immunol Lett. Aug 30 2011;138(2):169-78. doi:10.1016/j.imlet.2011.04.005
5.Bing SJ, Ha D, Hwang I, et al. Protective Effects on Central Nervous System by Acidic Polysaccharide of Panax ginseng in Relapse-Remitting Experimental Autoimmune Encephalomyelitis-Induced SJL/J Mice. Am J Chin Med. 2016;44(6):1099-1110. doi:10.1142/S0192415X16500610
6.Wong HB. Effects of herbs and drugs during pregnancy and lactation. J Singapore Paediatr Soc. Sep-Dec 1979;21(3-4):169-78.
7.Zhang WY, Teng H, Zheng Y. [Ginseng saponin treatment for intrauterine growth retardation]. Zhonghua Yi Xue Za Zhi. Oct 1994;74(10):608-10, 646.
8.Seely D, Dugoua JJ, Perri D, Mills E, Koren G. Safety and efficacy of panax ginseng during pregnancy and lactation. Can J Clin Pharmacol. Winter 2008;15(1):e87-94.
9.Ginseng. Drugs and Lactation Database (LactMed(R)). 2006.