Ginseng (American)

Purported Benefits, Side Effects & More
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Ginseng (American)

Purported Benefits, Side Effects & More
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Ginseng (American)

Common Names

  • Xi yang shen
  • Western ginseng
  • Five-fingers

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For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.

What is it?

American ginseng is an herb used in traditional Chinese medicine. It also comes as capsules, pills, powder, and tablets.

What are the potential uses and benefits?

American ginseng is used to:

  • Improve your strength
  • Boost your immune system
  • Treat the common cold
  • Improve your memory
  • Treat diabetes
  • Reduce fatigue (feeling weaker than usual) due to cancer

American ginseng also has other uses that haven’t been studied by doctors to see if they work. 

Talk with your healthcare providers before taking American ginseng supplements. They can interact with some medications and affect how they work. For more information, read the “What else do I need to know?” section below.

What are the side effects?

There aren’t any reports of side effects from taking American ginseng

What else do I need to know?
  • Talk with your healthcare provider if you’re taking blood thinners such as warfarin (Coumadin®, Jantoven®). American ginseng may increase your risk of bleeding.
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For Healthcare Professionals

Scientific Name
Panax quinquefolius
Clinical Summary

A popular herb often confused with Asian or Panax ginseng, American ginseng has unique medicinal properties. It is frequently used in Chinese medicine to nourish “Yin” (1). American ginseng is also used in supplemental form to improve athletic performance, strength, and stamina, and to treat diabetes and cancer. Saponin glycosides, also known as ginsenosides or panaxosides, are thought responsible for its biological effects. In lab studies, ginsenosides have both stimulatory and inhibitory CNS effects (4), can alter cardiovascular tone, enhance humoral and cellular-dependent immunity, and exert anticancer effects (15) (16) (28). Other preclinical studies suggest enhanced anticancer activities when combined with antioxidants (14), synergistic effects with 5-fluorouracil (17), and protection against oxidative stress in irradiated human lymphocytes (18).

Studies in humans are limited. Current data suggest that American ginseng may help improve glucose control in diabetics (2) (6) (29) (30) and that it is safe for long-term use (25). It has a modest effect in reducing number and severity of colds (12), and may enhance working memory (21) (24) (27).

Findings from clinical trials on whether American ginseng can improve cancer-related fatigue are mixed (23) (31) (32), although a large multisite trial suggests benefit (23), and a systematic review/meta analysis reported efficacy of ginseng-containing formulas in reducing fatigue, but not ginseng alone (33). Epidemiological data suggest it may improve survival and quality of life in breast cancer patients (13), but more studies are needed.

Purported Uses and Benefits
  • Improve strength
  • Immunostimulation
  • Common cold
  • Improve memory
  • Diabetes
  • Cancer-related fatigue
Mechanism of Action

Ginsenosides are thought responsible for American ginseng’s activity, although the exact mechanism of action is unknown. Related species, such as Panax ginseng, have been the focus of most laboratory and clinical research. Experiments using extracts from these species indicate that ginsenosides stimulate and inhibit the central nervous system (4). The extracts also stimulate TNF alpha production by alveolar macrophages (10).

The Rg1 ginsenoside present in American ginseng is associated with improvements in humoral and cell-mediated immune response and increases in T helper cells, T lymphocytes, and NK cells in mice (5). American ginseng was also shown to lower serum glucose and may affect carbohydrate metabolism (2) (6).

Several ginsenosides have demonstrated anticancer properties in vitro (3). Current data suggest that antiproliferative effects of American ginseng are due to compound K, a metabolite of the ginsenoside Rb1, but not Rb1 as previously thought (22). In a rodent study, the herb significantly attenuated colon carcinogenesis by reducing tumor number and load, and was associated with suppression of proinflammatory cytokine activation (26).

Contraindications

Breast cancer patients should use this product with caution as American ginseng may stimulate the growth of breast cancer cells (9).

Herb-Drug Interactions

Warfarin: American ginseng has been shown to antagonize warfarin’s effects in humans (11).
CYP3A4 substrates: Lab studies suggest certain ginsenosides can induce CYP3A4 and may affect the metabolism of drugs that are substrates of this enzyme (19) (20). Clinical relevance has yet to be determined.

Herb Lab Interactions

Reductions in PT, PTT, and INR and blood glucose may occur (8) (11).

Dosage (OneMSK Only)
References
  1. Huang KC. The Pharmacology of Chinese Herbs, 2nd ed. New York: CRC Press; 1999.
  2. Vuksan V, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med 2000;160:1009-13.
  3. Shin HR, et al. The cancer-preventive potential of Panax ginseng: a review of human and experimental evidence. Cancer Causes Control 2000;11:565-76.
  4. Attele AS, Wu JA, Yuan CS. Ginseng pharmacology: multiple constituents and multiple actions. Biochem Pharmacol 1999;58:1685-93.
  5. Chen SE. American ginseng. III. Pharmacokinetics of ginsenosides in the rabbit. Eur J Drug Metab Pharmacokinet 1980;5:161-8.
  6. Vuksan V, et al. American ginseng (Panax quinquefolius L.) attenuates postprandial glycemia in a time-dependent but not dose-dependent manner in healthy individuals. Am J Clin Nutr 2001;73:753-8.
  7. Brinker F. Herb Contraindications and Drug Interactions, 3rd ed. Sandy (OR): Eclectic Medical Publications; 2001.
  8. Vuksan V, et al. American ginseng improves glycemia in individuals with normal glucose tolerance: effect of dose and time escalation. J Am Coll Nutr 2000;6:738-44.
  9. Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause 2002;9:145-50.
  10. Assinewe VA, et al. Extractable polysaccharides of Panax quinquefolius L. (North American ginseng) root stmulate TNFalpha production by alveolar macrophages. Phytomedicine 2002;9:398-404.
  11. Yuan CS, et al. Brief Communication: American Ginseng reduces Warfarin’s effect in healthy patients. Ann Intern Med 2004;141:23-27.
  12. Predy GN, et al. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infectons: a randomized controlled trial. CMAJ 2005;173(9):1043-8.
  13. Cui Yong, et al. Association of ginseng use with survival and quality of life among breast cancer patients. Am J Epidemiol 2006; 163(7):645-53.
  14. Li B, Wang CZ, He TC, et al. Antioxidants potentiate American ginseng-induced killing of colorectal cancer cells. Cancer Letters. 2010;289(1):62-70.
  15. Li B, Zhao J, Wang CZ, et al. Ginsenoside Rh2 induces apoptosis and paraptosis-like cell death in colorectal cancer cells through activation of p53. Cancer Lett. 2011 Feb 28;301(2):185-92.
  16. Xie JT, Du GJ, McEntee E, et al. Effects of Triterpenoid Glycosides from Fresh Ginseng Berry on SW480 Human Colorectal Cancer Cell Line. Cancer Res Treat. 2011 Mar;43(1):49-55.
  17. Li XL, Wang CZ, Sun S, et al. American ginseng berry enhances chemopreventive effect of 5-FU on human colorectal cancer cells. Oncol Rep. 2009 Oct;22(4):943-52.
  18. Lee TK, O’Brien KF, Wang W, et al. Radioprotective effect of American ginseng on human lymphocytes at 90 minutes postirradiation: a study of 40 cases. J Altern Complement Med. 2010 May;16(5):561-7.
  19. Hao M, Ba Q, Yin J, et al. Deglycosylated ginsenosides are more potent inducers of CYP1A1, CYP1A2 and CYP3A4 expression in HepG2 cells than glycosylated ginsenosides. Drug Metab Pharmacokinet. 2011;26(2):201-5.
  20. Hao M, Zhao Y, Chen P, et al. Structure-activity relationship and substrate-dependent phenomena in effects of ginsenosides on activities of drug-metabolizing P450 enzymes. PLoS One. 2008 Jul 16;3(7):e2697.
  21. Scholey A, Ossoukhova A, Owen L, et al. Effects of American ginseng (Panax quinquefolius) on neurocognitive function: an acute, randomised, double-blind, placebo-controlled, crossover study. Psychopharmacology (Berl). 2010 Oct;212(3):345-56.
  22. Wang CZ, Du GJ, Zhang Z, et al. Ginsenoside compound K, not Rb1, possesses potential chemopreventive activities in human colorectal cancer. Int J Oncol. 2012 Jun;40(6):1970-6.
  23. Barton DL, Liu H, Dakhil SR, et al. Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. J Natl Cancer Inst. 2013 Aug 21;105(16):1230-8.
  24. Chen EY, Hui CL. HT1001, a proprietary North American ginseng extract, improves working memory in schizophrenia: a double-blind, placebo-controlled study. Phytother Res. 2012 Aug;26(8):1166-72.
  25. Mucalo I, Jovanovski E, Vuksan V, Božikov V, Romić Z, Rahelić D. American Ginseng Extract (Panax quinquefolius L.) Is Safe in Long-Term Use in Type 2 Diabetic Patients. Evid Based Complement Alternat Med. 2014;2014:969168.
  26. Yu C, Wen XD, Zhang Z, et al. American ginseng attenuates azoxymethane/dextran sodium sulfate-induced colon carcinogenesis in mice. J Ginseng Res. 2015 Jan;39(1):14-21.
  27. Ossoukhova A, Owen L, Savage K, et al. Improved working memory performance following administration of a single dose of American ginseng (Panax quinquefolius L.) to healthy middle-age adults. Hum Psychopharmacol. 2015 Mar;30(2):108-22.
  28. Wang CZ, Yu C, Wen XD, et al. American Ginseng Attenuates Colitis Associated Colon Carcinogenesis in Mice: Impact on Gut Microbiota and Metabolomics. Cancer Prev Res (Phila). 2016 Oct;9(10):803-811.
  29. Jenkins AL, Morgan LM, Bishop J, et al. Co-administration of a konjac-based fibre blend and American ginseng (Panax quinquefolius L.) on glycaemic control and serum lipids in type 2 diabetes: a randomized controlled, cross-over clinical trial. Eur J Nutr. Sep 2018;57(6):2217-2225.
  30. Vuksan V, Xu ZZ, Jovanovski E, et al. Efficacy and safety of American ginseng (Panax quinquefolius L.) extract on glycemic control and cardiovascular risk factors in individuals with type 2 diabetes: a double-blind, randomized, cross-over clinical trial. Eur J Nutr. Apr 2019;58(3):1237-1245.
  31. Guglielmo M, Di Pede P, Alfieri S, et al. A randomized, double-blind, placebo controlled, phase II study to evaluate the efficacy of ginseng in reducing fatigue in patients treated for head and neck cancer. J Cancer Res Clin Oncol. Oct 2020;146(10):2479-2487.
  32. Sadeghian M, Rahmani S, Zendehdel M, et al. Ginseng and Cancer-Related Fatigue: A Systematic Review of Clinical Trials. Nutr Cancer. 2021;73(8):1270-1281.
  33. Li X, Yang M, Zhang YL, et al. Ginseng and Ginseng Herbal Formulas for Symptomatic Management of Fatigue: A Systematic Review and Meta-Analysis.
    J Integr Complement Med. 2023 Feb 1. doi: 10.1089/jicm.2022.0532. Online ahead of print.
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