Contraindications and Precautions
Korean ginseng is generally contraindicated in acute infections with fever, and in persons who are very hot, tense and overly stimulated. Overuse may result in headache, insomnia and palpitation. Ginseng should not be taken concurrently with other stimulants including caffeine and should be discontinued 1 week before major surgery. Use in hypertension should be supervised however it may prove beneficial for this indication.
Ginseng is traditionally used in Korea as a tonic during pregnancy. The Commission E does not list any restrictions. However, due to the potential teratogenicity of some compounds (ginsenoside Rb1) observed under experimental conditions, ginseng should be used cautiously during the first trimester of pregnancy.
Practice Points / Patient Counselling
Ginseng is traditionally used for deficiency of Qi (energy/life force) manifested by shallow respiration, shortness of breath, cold limbs, profuse sweating and a weak pulse (such as may occur from severe blood loss). Ginseng is also used for wheezing, lethargy, lack of appetite, abdominal distention and chronic diarrhea. Ginseng may also be used for palpitations with anxiety, insomnia, forgetfulness and restlessness associated with low energy and anaemia. Scientific evidence There is some scientific evidence for the beneficial effects of ginseng for the following conditions. In practice, it is mostly used as a supportive treatment and combined with other herbs to treat a specific condition.
• Prevention and supportive treatment of cancer.
• Chronic immune deficiency.
• Menopausal symptoms.
• Erectile dysfunction.
• Chronic respiratory disease.
• Enhancement of psychomotor activity, memory and concentration.
• Adaptogenic effects in any chronic condition and for the elderly and infirm.
• Type 1 diabetes.
• Cardiovascular disease (the effects on hypertension remain to be fully investigated).
• Quality of life (equivocal scientific support).
Commission E recommends ginseng as a tonic for invigoration and fortification in times of fatigue, debility and convalescence, or declining capacity for work and concentration. The World Health Organization suggests that ginseng can be used as a prophylactive and restorative agent for enhancement of mental and physical capacities, in cases of weakness, exhaustion, tiredness and loss of concentration and during convalescence.
Answers to Patients’ Frequently Asked Questions
What will this herb do for me?
Ginseng is a safe herb used to support the body during times of prolonged stress or chronic disease and to restore mental and physical functioning during the rehabilitative process. Numerous studies have identified a range of pharmacological activites that suggest it may be useful in the treatment of many conditions.
When will it start to work?
In practice, it generally appears that ginseng has a quick onset of action with the condition continuing to improve with long-term use; however, this will vary depending on the individual and the indication.
Are there any safety issues?
Ginseng may interact with warfarin and other blood thinning drugs and should not be used with these medications unless under medical supervision. Avoid use in children or in hypertension unless under supervision. Use with caution in pregnancy.