Pharmacology The main active agents in Panax ginseng are ginsenosides,which are triterpene saponins.The majority of published research on the medicinal activity of Panax ginseng has focused on ginsenosides.3These are the com-pounds to which some ginseng products are now standardized.Research reviews 2,4postulate that extracts of Panax ginseng affect the hypothalamus-pitu-itary-adrenal axis and the immune system,which could account for many of the docu-mented effects.Animal models and in vitro studies mentioned in these reviews 2,4indicate that Panax ginseng enhances phagocytosis,natural killer cell activity,and the production of interferon;improves physical and mental performance in mice and rats;causes vasodi-lation;increases resistance to exogenous stress factors;and affects hypoglycemic activity.Efficacy Panax ginseng is used primarily to improve psychologic function,exercise performance,immune function,and conditions associated with diabetes (T able 1).T raditional Chinese medicine and many current research studies 5-8often use products that combine ginseng with other herbal medicines or vitamins.Because of the use of combination products and the limi-tations of some studies on ginseng (e.g.,poor H
erbal remedies known as “ginseng”are based on the roots of several distinct spe-cies of plants,mainly Korean or Asian ginseng (Panax gin-seng),Siberian ginseng (Eleutherococcus sen-ticosus),and American ginseng (Panax quin-quefolius).All of these species are in the Araliaceae plant family,but each has its own specific effects on the body.Ginseng products are popularly referred to as “tonics,”a term that has been replaced by “adaptogens”in much of the alternative medi-cine literature.The term “adaptogen”connotes an agent that purportedly “increases resistance to physical,chemical,and biological stress and builds up general vitality,including the physical and mental capacity for work.”1(p236)Over-the-counter Panax ginseng products include Celes-tial Seasonings Ginseng,Centrum Herbals Ginseng,Korean Ginseng Extract from Nature’s Way,Nature M ade’s Chinese Red Panax Ginseng,Pharmaton’s Ginsana,and PhytoPharmica’s Ginseng Phytosome.Panax ginseng is one of the most commonly used and highly researched species of ginseng.This species,which is native to China,Korea,and Russia,has been an important herbal remedy in traditional Chinese medicine for thousands of years,where it has been used pri-marily as a treatment for weakness and fatigue.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 of Arizona College of Medicine,Tucson,Arizona
See page 1461 for
definitions of strength-
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