Pharmacology The main active agents in Panax ginseng areginsenosides, which are triterpene saponins.The majority ofpublished research on themedicinal activity ofPanax ginseng hasfocused on ginsenosides.3These are the com-pounds to which some ginseng products arenow standardized.Research reviews2,4postulate that extracts ofPanax ginseng affect the hypothalamus-pitu-itary-adrenal axis and the immune system,which could account for many ofthe docu-mented effects.Animal models and in vitrostudies mentioned in these reviews2,4indicate that Panax ginseng enhances phagocytosis,natural killer cell activity,and the productionof interferon; improves physical and mentalperformance in mice and rats;causes vasodi-lation; increases resistance to exogenous stressfactors; and affects hypoglycemic activity.Efficacy Panax ginseng is used primarily to improvepsychologic function,exercise performance,immune function,and conditions associatedwith diabetes (Table 1). T raditional Chinesemedicine and many current research studies5-8often use products that combine ginseng withother herbal medicines or vitamins.Because ofthe use ofcombination products and the limi-tations ofsome studies on ginseng (e.g.,poor H
erbal remedies known as“ginseng” are based on theroots ofseveral distinct spe-cies ofplants, mainly Koreanor Asian ginseng (Panax gin-seng), Siberian ginseng (Eleutherococcus sen-ticosus), and American ginseng (Panax quin-quefolius). All ofthese species are in theAraliaceae plant family,but each has its ownspecific effects on the body.Ginseng products are popularly referred to as“tonics, ” a term that has been replaced by“adaptogens” in much ofthe alternative medi-cine literature.The term “adaptogen” connotes an agent that purportedly “increases resistanceto physical,chemical, and biological stress andbuilds up general vitality,including the physicaland mental capacity for work.” 1(p236)Over-the-counter Panax ginseng products include Celes-tial Seasonings Ginseng,Centrum HerbalsGinseng, Korean Ginseng Extract fromNature’s Way,Nature Made’s Chinese RedPanax Ginseng,Pharmaton’s Ginsana,and PhytoPharmica’s Ginseng Phytosome.Panax ginseng is one ofthe most commonlyused and highly researched species ofginseng. This species,which is native to China,Korea, and Russia,has been an important herbalremedy in traditional Chinese medicine forthousands ofyears, where it has been used pri-marily as a treatment for weakness andfatigue. 2The herbal remedies referred to as “ginseng” are derived from the roots of several plants.
One of the most commonly used and researched of the ginsengs is Panax ginseng, also called
Asian or Korean ginseng. The main active components of Panax ginseng are ginsenosides,
which have been shown to have a variety of beneficial effects, including anti-inflammatory,
antioxidant, and anticancer effects. Results of clinical research studies demonstrate that
Panax ginseng may improve psychologic function, immune function, and conditions associ-
ated with diabetes. Overall, Panax ginseng appears to be well tolerated, although caution is
advised about concomitant use with some pharmaceuticals, such as warfarin, oral hypo-
glycemic agents, insulin, and phenelzine. Panax ginseng does not appear to enhance physi-
cal performance. Products with a standardized ginsenoside concentration are available. (Am
Fam Physician 2003;68:1539-42. Copyright© 2003 American Academy of Family Physicians.)
DA VID KIEFER,M.D., and TRACI PANTUSO,B.S.
University ofArizona College ofMedicine, Tucson, Arizona
See page 1461 for
definitions of strength-
of-evidence levels.Downloaded from the American Family Physician Web site at www.aafp.org/afp.Copyright© 2003 American Academy ofFamily Physicians.For the private,noncommercial use ofone individual user ofthe Web site.All other rights reserved.