Posted on June 15 2020
What’s in a name? Rénshēn or “Jen Sheng"—Chinese for “man root”—were the names originally given to ginseng due to its resemblance of a stick figure person with legs. Not ironically, the root also has many known health benefits on the human body. Old cultures thought the closer the root was to resembling a human form, the more potent it would be once consumed.
Anatomical similarities aside, ginseng is one powerful herb. In fact, Swedish botanist Carl Linnaeus later gave it the name Panax—greek for “cure all.” While it may not be a panacea for everything that ails you, ginseng has some pretty potent health-boosting effects.
A Remedy With a History
Before Linnaeus and the western world became aware of ginseng, it already had a long history of use in traditional Chinese medicine. Records dating back to 100 A.D describe the use of ginseng in China, particularly the mountains of Manchuria—where it was often reserved for use only by royalty. The fleshy roots may have also been used for food.1 Before the advent of modern healthcare, the strength-giving properties and regenerative powers of ginseng endeared many cultures to this powerful herbal medicine.
Ancient cultures believed in the medicinal properties of ginseng to treat a cornucopia of diseases and ailments. The Chinese Canon of Medicine even shows reverence to ginseng, stating that, “ginseng strengthens the soul, brightens the eye, opens the heart, expels evil, benefits understanding and if taken for prolonged periods of time will invigorate the body and prolongs one’s life.”1
The belief in ginseng to treat and cure medical conditions was so profound that it was soon being sold for more than its weight in gold.
Chinese emperors began to hoard the stuff, and an industry for this ancient nootropic was born—along with a black market.
Now, ginseng and ginseng supplements are a worldwide sensation. Since its “discovery” in North America in 1716 and now into modern day, ginseng has become popularized and revered by the United States and throughout the western world for many of the same qualities it was loved for in ancient times. Ginseng is marketed in over 35 countries, with yearly sales exceeding $2 billion dollars. A 2002 survey indicated that 4% - 5% of men and women 45 - 64 years old living in the United States have used ginseng.2 It’s popular, and for a good reason.
Types of Ginseng
Due to its high levels of ginsenosides—ginsenosides are the main biologically-active constituents of ginseng (more on these later)—Panax ginseng is the main type of ginseng used for supplementing and in research studies. The Panax variety can include both American ginseng (Panax quinquefolius) and Asian ginseng (Panax notoginseng) or Korean ginseng (Panax ginseng).
In addition to these types, ginseng can come in other forms including Siberian ginseng (eleutherococcus senticosus), Indian ginseng (withania somnifera a.k.a ashwagandha), and Brazilian ginseng (pfaffia paniculata).
Unless stated otherwise, any studies and benefits discussed refer to the Panax varieties of American ginseng and Asian ginseng.
Although referred to as “alternative medicine,” the heroic health effects of ginseng aren’t due to ancient spiritual healing powers.
Instead, we know certain molecular actors are to thank for the benefits of ginseng. Of these, tetracyclic triterpenoid saponins—also known as ginsenosides—are the main active ingredient proposed to explain why ginseng is such a powerful herbal medicine.
What are ginsenosides? Molecularly speaking, they’re steroid-like ring structures with sugars attached to them at various carbon side chains. Over 40 different ginsenosides have been identified and isolated from ginseng root. This large group of active molecules are responsible for the antioxidant, anti-cancer, and anti-inflammatory effects of ginseng.2
Ginsenosides work their molecular magic by acting through signal transduction pathways in the body. Several important processes modulated by ginsenosides include antioxidant signaling, steroid hormones, vascular regulation through the molecule nitric oxide (NO), and neuronal signaling through NMDA and GABA, two super-important neurotransmitters.3
By binding to certain receptors, ginsenosides act as “ligands”—molecular keys that fit into the receptor keyhole and help exert a biological function.
The main receptor targets for ginsenosides seem to be glucocorticoid receptors (GR) and androgen (sex-steroid) receptors.2 Each of these are vitally important in our ability to respond to stress, modulate hormones, and properly grow, recover, and maintain our health.
Protect and Defend
Might the protective effects of ginsenosides be due to the fact that their primary purpose is to defend their host, the ginseng root? Just like a mighty cactus produces spines to prevent certain critters from nibbling it do death, the ginseng root produces ginsenosides as a protective strategy against nature.
Ginsenosides are known to be anti-microbial, anti-fungal, and antifeedant—their bitter taste is a reason that some insects and animals steer clear of eating ginseng. When we consume these compounds, they may impart many of the same host-protective effects for our body.
Health Benefits of Ginseng
With such a long and ancient medical history, ginseng’s use as an herbal supplement has been studied in nearly every medical condition imaginable. No, you can’t get an herbal medicine prescription from your healthcare provider, however, this powerful plant has been shown in clinical trials to benefit many diseases and is available in a variety of herbal supplement forms.
Ginseng and Cardiovascular Disease
One area where the medical potential of ginseng has been vastly explored is within the cardiovascular system.
Specifically, the ginsenosides have powerful anti-inflammatory effects that can prevent oxidative stress and damage to the heart, blood vessels, and circulation. The vascular system may benefit from ginseng, since ginsenosides also increase a protective molecule known as nitric oxide (NO) in the circulation—helping to maintain blood vessel function and blood pressure.4
Indeed, ginseng might help lower blood pressure, but results of clinical trials seem to vary widely on this outcome. A meta-analysis of studies on ginseng supplementation found there was a minor but favorable trend for improved blood pressure for the group consuming ginseng herbal supplements, but the beneficial effect was only seen in individuals with cardiovascular and other types of disease, suggesting that healthy individuals with normal blood pressure may not benefit.5
Nevertheless, ginseng might act on other aspects of the cardiovascular system.
Some benefits of ginseng might partially be due to the fact that it leads to the production and release of nitric oxide (NO), which we need to help dilate our blood vessels.
Studies in patients with reduced coronary blood flow and hypertension have shown that ginseng improves blood circulation (by the anti-clotting mechanism targeted by blood thinners) and lowered arterial stiffness. The wide-ranging actions of ginseng on the cardiovascular system make it apparently beneficial for certain diseases.4
To reduce cardiovascular risk factors like blood pressure, blood vessel dysfunction, and overall heart health, ginseng supplementation seems to have some evidence in those who might be at an increased risk. The good news is, no trials show an adverse effect of supplementation—so it can’t hurt to try.
Depression and Anxiety
Physical, mental, or emotional stress takes a toll on the body. It can lead to a variety of negative health effects, many of which can include changes in mood and outlook on life. In a “fight or flight” world, ginseng may provide some much needed stress relief.
Ginseng may have the potential to boost mood, regulate levels of anxiety, and reduce symptoms of depression.6 It does this through effects on the brain which are known to include neurogenesis (the sprouting of neurons), synaptogenesis (growth of new synapses), neuron growth, and neurotransmitter activity—all of which “protect” the central nervous system.
How you respond to stressful situations (think, road rage) may be improved with ginseng.
In one study, rats were given ginseng and then put in a plus-sized maze (a stressful situation for a small rat) showed fewer anxiety-like behaviors. The anxiety-reducing effects of both types of ginseng used in the study were actually similar to the antidepressant drug Diazepam.7 In mice, red ginseng supplementation for seven days alleviated the psychological fatigue in animals induced by this stressful situation. Ginseng has also been shown to reduce levels of the stress hormone corticosterone.8
Depression can often be associated with stress-like symptoms. In the few studies available, ginseng treatment had been shown to exert antidepressant-like effects in animal models of depression and may improve measures of quality of life and depressive symptoms in postmenopausal women.6 Further research is needed to clarify the extent to which ginseng might be useful as an antidepressant.
Protective effects of ginseng on cancer have been also explored since the root’s discovery in the ancient world. It’s now known that compounds of ginseng can act on several signal pathways involved in the cell cycle, and prevent the unwanted growth and proliferation of cells—a hallmark of cancer development.
Observational studies suggest a benefit (i.e. lower risk) for cancer. It has been shown that ginseng consumption is associated with a 16% lower cancer risk in individuals compared those who don’t consume ginseng,9 and several other studies have shown a relationship between a higher ginseng intake and a reduced risk for cancer.10
The chemoprotective effects are shown to be present for different cancer types, including lung cancer, gastric cancer, liver cancer, and colorectal cancer. So far, most experimental studies have only been conducted in isolated cell cultures or animals, and human trials on ginseng and anti-cancer have yet to be done. For now, all we have are associations, but the data shows that ginseng may have some anti-cancerous properties for people munching it down on the regular.
To stay at your best, avoiding sickness should be a priority. Just consuming vitamin C is probably not your best bet. Ginseng, on the other hand, has shown to have potent effects on boosting the immune system. In particular, our innate immunity—the ability to recognize foreign “invaders” and prevent and eliminate infections—may benefit from ginseng supplementation.
Consuming ginseng has been shown to fortify defense systems by boosting the activity of macrophages, molecules that engulf harmful bacteria present in our cells.
Subjects consuming 100mg of ginseng extract for eight weeks also showed enhanced death of infectious agents in the body, indicating an enhanced ability to fend of certain vicious viruses. In an aging population with reduced immunity, ginseng saponin extract enhanced the function of immune cells called lymphocytes,11 suggesting they had an enhanced ability to respond to bacterial stress.
Along with enhancing the death of “bad” cells, ginseng may also reduce the amount of inflammation present in the body, whether chronic or due to an invading bacteria. Ginseng has been shown to lower the amount of pro-inflammatory cytokines like TNF-alpha, IL-1B, IL-6, IFN-y, IL-12, and IL-18.12 Many of these inflammatory markers are associated with autoimmune diseases.
Whether by enhancing the ability to fend off viruses or boosting our ability to clear them out, ginseng could keep your defense systems robust and keep you out of the doctor's office.
Let’s Talk Sex (Hormones)
Now that we have your attention, let’s look at one of the most historic uses of ginseng.
It’s supposed to act as an aphrodisiac, stimulating “sexual appetite” in anyone consuming it.
Chinese emperor Shen Nung, the “father of Chinese Medicine,” was the first to explore how ginseng might be able to treat erectile dysfunction (ED) in men.
Numerous placebo-controlled studies support a beneficial effect of ginseng supplementation on male ED. Supplemented in doses of 900mg (for eight weeks) and 1,000mg (for 12 weeks) three times per day, ginseng was shown to improve symptoms of ED in over 60% of those in the treatment group. Results of several other studies indicate that ginseng supplementation also improves various markers of sexual function in men with ED,13 increases levels of testosterone, enhances libido and sexual drive,14 and even boosts sperm count and motility.
Ginsenosides are mainly responsible for these improvements by increasing amount of neurotransmitters such as dopamine and GABA, increasing the production of testosterone via increased luteinizing hormone and follicle stimulating hormone, and enhanced nitric oxide (NO) levels in blood vessels, allowing enhanced flow of blood to body parts where it's needed.
Women aren’t excluded from the aphrodisiac-like qualities of ginseng. Post-menopausal women ingesting ginseng capsules (1,000mg) experienced improved sexual function scores and higher arousal levels compared to a placebo group, with no adverse effects reported.15 Another trial in premenopausal women indicated that Korean red ginseng supplementation for eight weeks improved sexual drive and satisfaction however, this was not different than the placebo group, who also increased their function.16
Why the boost? Ginseng appears to have effects on sex-steroid hormone receptors like the estrogen receptor and the androgen receptor. By maintaining healthy levels of receptors and receptor signaling, ginseng can prevent the decline in sex hormones that occur with aging and disease.17
Ginseng might be your next go-to for enhancing cognitive health and performance; it has even been shown to be neuroprotective.
Mice given ginseng compounds showed improvements in learning and memory,18 and just one 500mg dose of a ginseng-containing supplement enhanced long term potentiation (LTP)—a strengthening of synapses related to memory formation.19
Further evidence of brain benefits have been shown in studies where ginseng supplementation improved cognitive performance, reduced mental fatigue, and improved working memory and reaction time.20,21,22,23 Combining ginseng with other cognitive enhancers like caffeine and L-theanine might even have benefits above and beyond ginseng alone.
Through its various anti-inflammatory, antioxidant, and neuroprotective qualities, ginseng may be beneficial as an adjunct therapeutic in various neurodegenerative diseases including Parkinson’s disease, Alzheimer’s disease, Huntington’s disease, and multiple sclerosis.24 Protecting the squishy ball of neurons in our head might be one of the most important and promising benefits of ginseng.
Mental and Physical Performance
We’ve got the health-boosting properties of ginseng down, and there are many. On top of the disease-fighting benefits of this herb, ginseng may also be able to enhance your physical performance, make the most of your exercise routine or training plan, and help you reach your health and fitness goals. At the same time, ginseng can enhance cognitive function, potentially giving you that much needed boost at weekly pub trivia.
There have been very few randomized trials to evaluate the ability of ginseng to improve physical performance and other measures of fitness. In general, a small effect for reducing fatigue had been shown when ginseng was investigated compared to placebo treatments.25
One study noted improved muscular strength and aerobic work or endurance capacity after ginseng supplementation.
Participants given a ginseng extract of 300mg/day for eight weeks improved their aerobic capacity by over 12% as well as their anaerobic capacity, anaerobic power, and leg strength (just as much as exercise training).26 A 30-day regimen of supplementation with 1,350mg/day of Panax notoginseng (PNG) increased time to exhaustion and lowered VO2 and blood pressure during steady state exercise,27 suggesting endurance performance was improved. Pretty remarkable findings for a plant.
Effects on the muscle between your ears have also been promising for ginseng. Studies using ginseng extract supplementation have shown positive improvements in cognitive performance parameters like vitality, alertness, concentration, visual-motor coordination, mental accuracy, reaction times, even better math skills.28,29 Sign me up!
Ginseng’s effect on the brain might be responsible for these improvements—it can improve neuron activity, increase nerve growth factors, enhance levels of neurotransmitters, and enhanced brain blood flow.
Ginseng appears to help everything balance out in the cranium, allowing the brain to receive the nutrients needed for proper function, and clear the mind for thinking and performance.
How to Take Ginseng
Depending on your taste and preferred method, there are many ways to supplement with ginseng. Common forms of consumption include ginseng tea (made from ginseng root), ginseng powder (made from the herb and leaves), ginseng-containing drinks, ginseng seeds, and the most commonly used form, ginseng capsules and powder.
Whichever preparation you use, the effects seem to be similar. Recommended doses tend to fall anywhere from 200mg/day - 400mg/day as a general “preventative” dose, and all the way up to 3,000mg/day of Korean red ginseng to achieve max potency for certain disease states. However, many benefits for health and performance measures have been noted with doses of 400mg daily—especially cognitive benefits. This dose will typically yield about 2% - 3% total active ginsenosides.
Certain nootropic supplements are a great way to consume ginseng along with several other bioactive and beneficial ingredients. Specifically, the combination of caffeine and L-theanine may help provide a calm yet alert feeling to keep you focused and energized all day long.
Is Ginseng Safe?
At the recommended doses and even higher, ginseng appears to be well-tolerated by most and safe for nearly everyone. A review published on the safety of ginseng found a low incidence of adverse effects in over 57 randomized trials.30 Even doses as high as 2,000mg, 4,500mg and all the way up to 6,000mg for several weeks appear to yield few side effects.
When effects are present, they tend to include symptoms like nausea, vomiting, diarrhea, and stomach cramps. And, since ginseng can lower blood sugar levels, hypoglycemia has sometimes been observed.
Uncommon ginseng “overdoses” may lead to bleeding, excitation, fidgeting, headache, increased body temperature, dizziness, and insomnia. As stated before, even high amounts of ginseng are generally well-tolerated and overdosing would require what might be considered a “heroic” dose of ginseng.
Ginseng may have drug interactions of which you should be aware. Some stimulant drugs that speed up the nervous system (caffeine, epinephrine) may cause jitteriness if taken with ginseng. Blood thinners such as Warfarin, immunosuppressants, and Lasix might have decreased effectiveness if taken alongside ginseng. Furthermore, diabetes medications like insulin, if taken with ginseng, may lower blood sugar levels a dangerous amount.
Due to these various interactions, if you’re planning on supplementing with ginseng and are taking any medication, talk to your healthcare professional to ensure safe use and maximal benefit.
While ginseng has been advised against for pregnant women, studies have shown that ginseng is not associated with adverse effects in women who use it during pregnancy.31 However, there is some advice to refrain from use during the first trimester and during lactation. If you’re pregnant and wanting to use ginseng, consult a healthcare professional.