Many other health claims are made for herbal
mixtures that contain ginseng. These claims are
extremely difficult to evaluate because of the number
of variables, including the strength of the mixture, the
effects of the different herbs, and potential interac-
tions among other herbs. Until much more is known
about the chemical properties and active ingredients of
common medicinal herbs, it is almost impossible to
evaluate these mixtures in a way that satisfies the
demands of conventional medicine.Precautions
Ginseng is generally safe and causes few side
effects when taken at recommended doses. The gener-
ally recommended dose is 100–200 mg of standardized
ginseng extract containing 4% ginsenosides once or
twice daily. The safety of ginseng in children and
pregnant and breastfeeding women has not been
studied. Pregnant and breastfeeding women should
be aware that some tinctures of ginseng contain high
levels of alcohol. Some herbalists recommend that
individuals take ginseng for 2–3 weeks and then take
a break of 1–2 weeks before beginning the herb again.
Independent laboratory analyses have repeatedly
found that many products labeled as ginseng contain
little or none of the herb. True ginseng is expensive,
and unscrupulous manufacturers often substitute low-
cost herbs for ginseng. Another problem is that some
ginseng products have been found to be contaminated
with pesticides and other chemicals that can cause
serious side effects.Interactions
Ginseng appears to interact with blood-thinning
and anti-coagulant medicines such as warfarin (Cou-
madin), clopidogrel (Plavix), aspirin, and nonsteroidal
anti-inflammatory drugs (e.g. Advil, Motrin). Individ-
uals taking these drugs should not begin taking gin-
seng without consulting their health care provider.
Because ginseng lowers blood sugar levels, indi-
viduals who are taking insulin or other medications
that also lower blood sugar, and those with type 2
diabetes, should be monitored for low blood sugar if
they begin taking ginseng. Adjustments are needed in
their other medications.
Ginseng may also interact with monoamine-oxi-
dase (MAO) inhibitors used to treat certain kinds of
depression and mental illness. Examples of MAOs
include isocarboxazid (Marplan), phenelzine (Nardil)
and tranylcypromine (Parnate). Individuals taking
MAOs with ginseng may develop headache, tremors,
increased anxiety, restlessness, sleeplessness, and mania.Preliminary evidence suggests that ginseng may
interact with certain blood pressure and heart medi-
cations. The herb may also interfere with the way the
liver processes other drugs and herbs. Before begin-
ning to take a supplement containing ginseng, individ-
uals should review their current medications with their
health care provider to determine any possible
interactions.Complications
Serious side effects of ginseng are rare. The most
common side effects are increased restlessness, insom-
nia, nausea, diarrhea, and rash. Allergic reactions are
possible, but uncommon. Some of the more serious
side effects reported are thought to be the result of
contamiNation with pesticides, heavy metals, or other
chemicals rather than a side effect caused by ginseng.Parental concernsParents should be aware that the safe dose of
many herbal supplements has not been establsihed
for children. Accidental overdose may occur if chil-
dren are give adult herbal supplements.Resources
BOOKS
Court, William E.Ginseng: The Genus Panax.Australia:
Harwood Academic, 2000.
Johanssen, Kristin.Ginseng Dreams: The Secret World of
America’s Most Valuable Plant.Lexington, KY: Uni-
versity Press of Kentucky, 2006.
PDR for Herbal Medicines,3rd ed. Montvale, NJ: Thomp-
son Healthcare, 2004.
Pierce, Andrea.The American Pharmaceutical Association
Practical Guide to Natural Medicines.New York: Wil-
liam Morrow, 1999.
Taylor, David.Ginseng, the Divine Root: The Curious His-
tory of the Plant That Captivated the World.Chapel
Hill, NC: Algonquin Books of Chapel Hill, 2006.
Wildman, Robert E. C., ed.Handbook of Nutraceuticals and
Functional Foods,2nd ed. Boca Raton, FL: CRC/Taylor
&Francis, 2007.
PERIODICALS
Kaneko, Hitoshi and Kozo Nakanish. ‘‘Proof of the Mys-
terious Efficacy of Ginseng: Basic and Clinical Trials:
Clinical Effects of Medical Ginseng, Korean Red Gin-
seng: Specifically, Its Anti-stress Action for Prevention
of Disease.’’Journal of Pharmacological Sciences 95
(2004):158–62.
Kiefer, David and Traci Pantuso. ‘‘Panax Ginseng.’’Amer-
ican Family Physician68 (October 15, 2003):1539–42.
Also available at<http://www.aafp.org/afp/20031015/
1539.html>Ginseng