Korean ginseng: Practice Points – Patient Counselling. FAQ

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. Pregnancy Use 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. In a two-generation rat study, a ginseng extract fed at doses as high as 1 5 mg/kg/day did not produce adverse effects on reproductive performance, including embryo development and lactation. Practice Points / Patient Counselling TRADITIONAL USE 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 Read more […]

Korean ginseng: Adverse Reactions. Significant Interactions

Adverse Reactions Ginseng abuse syndrome (hypertension, nervousness, insomnia, morning diarrhea, inability to concentrate and skin reactions) has been reported and there has been a report of a 28-year-old woman who had a severe headache after ingesting a large quantity of ethanol-extracted ginseng. Cerebral angiograms showed ‘beading’ appearance in the anterior and posterior cerebral and superior cerebellar arteries, consistent with cerebral arteritis. High doses (1 5 g/day) have been associated with confusion, depression and depersonalisation in four patients. However, the majority of the scientific data suggest that ginseng is rarely associated with adverse events or drug interactions. A systematic review found that the most commonly experienced adverse events are headache, sleep and gastrointestinal disorders. Data from clinical trials suggest that the incidence of adverse events with ginseng mono-preparations is similar to that of placebo. Any documented effects are usually mild and transient. Combined preparations are more often associated with adverse events, but causal attribution is usually not possible. A case of suspected ginseng allergy has recently been reported in the scientific literature. The case Read more […]

Korean ginseng: Other Uses. Dosage

Other Uses GASTROPROTECTION DURING HEART SURGERY In a trial of 24 children undergoing heart surgery for congenital heart defects, 12 children received 1.35 mg/kg ginsenoside compound or placebo intravenously before and throughout the course of cardiopulmonary bypass surgery. Ginseng administration resulted in attenuation of gastrointestinal injury and inflammation. RESPIRA TORY DISEASE Ginseng extract (G115) has been shown significantly (P < 0.05) to improve pulmonary function test, maximum voluntary ventilation, maximum inspiratory pressure and maximal oxygen consumption (VO2max) in a study of 92 patients suffering moderately severe chronic obstructive pulmonary disease (n = 49, G115 100 mg twice daily for 3 months). HEUCOBACTER PYLORI Helicobacter pylori can provoke gastric inflammation, ulceration and DNA damage, resulting in an increased risk of carcinogenesis. As preliminary evidence suggests that Panax ginseng inhibits the growth of Helicobacter pylori and can inhibit adhesion it may be useful as a gastroprotective agent against Helicobacter pylori-associated gastric mucosal cell damage. HIV INFECTION Long-term intake of Korean ginseng slows the depletion of CD4+ T cells and may delay disease progression Read more […]

Korean ginseng: Clinical Use

In the scientific arena, ginseng and the various ginsenosides are used in many forms and administered via various routes. This review will focus primarily on those methods commonly used in clinical practice. CANCER PREVENTION The various anticancer actions of Panax ginseng, as demonstrated in animal and in vitro trials, support its use as an agent to prevent the development and progression of cancer. A 5-year prospective study of 4634 patients over 40 years of age found that ginseng reduced the relative risk of cancer by nearly 50%. A retrospective study of 905 case-controlled pairs taking ginseng showed that ginseng intake reduced the risk of cancer by 44% (odds ratio equal to 0.56). The powdered and extract forms of ginseng were more effective than fresh sliced ginseng, juice or tea. The preventative effect was highly significant (P < 0.001). There was a significant decline in cancer occurrence with increasing ginseng intake (P < 0.05). Epidemiological studies in Korea strongly suggest that cultivated Korean ginseng is a non-organ-specific human cancer preventative agent. In case-control studies, odds ratios of cancer of lip, oral cavity and pharynx, larynx, lung, oesophagus, stomach, liver, pancreas, Read more […]

Korean ginseng: Other Actions

PREVENTION OF DAMAGE FROM TOXINS Ginseng extract has been shown to be beneficial in the prevention and treatment of testicular damage induced by environmental pollutants. Dioxin is one of the most potent toxic environmental pollutants. Exposure to dioxin either in adulthood or during late fetal and early postnatal development causes a variety of adverse effects on the male reproductive system. The chemical decreases spermatogenesis and the ability to conceive and carry a pregnancy to full term. Pretreatment with 100 or 200 mg/kg ginseng aqueous extract intraperitoneally for 28 days prevented toxic effects of dioxin in guinea pigs. There was no loss in body weight, testicular weight or damage to spermatogenesis. In guinea pigs Panax ginseng also improves the survival and quality of sperm exposed dioxin. PROMOTING HAEMOPOIESIS Ginseng is traditionally used to treat anaemia. The total saponin fraction, and specifically Rg1 and Rb1, have been shown to promote haemopoiesis by stimulating proliferation of human granulocyte-macrophage progenitors. ANTIOXIDANT In vitro studies did not find various extracts of ginseng to be particularly potent antioxidants against several different free radicals. However, animal models Read more […]

Korean ginseng: Main Actions

Clinical note — Adaptogens Adaptogens are innocuous agents, non-specifically increasing resistance against physical, chemical or biological factors (stressors), having a normalising effect independent of the nature of the pathological state (original definition of adaptogen by Brekhman & Dardymov 1969). Adaptogens are natural bioregulators, which increase the ability of the organism to adapt to environmental factors and to avoid damage from such factor (revised definition by Panossian et al 1999). (Refer to the Siberian ginseng post for more information about adaptogens and allostasis.) ADAPTOGEN The pharmacological effects of ginseng are many and varied, contributing to its reputation as a potent adaptogen. The adrenal gland and the pituitary gland are both known to have an effect on the body’s ability to respond to stress and alter work capacity, and ginseng is thought to profoundly influence the hypothalamic-pituitary-adrenal axis. The active metabolites of protopanaxadiol and protopanaxatriol saponins reduce acetylcholine-induced catecholamine secretion in animal models and this may help to explain the purported antistress effects of ginseng. Ginseng has been shown in numerous animal experiments Read more […]

Korean ginseng: Background

Historical Note Gin refers to man and seng to essence in Chinese, whereas Panaxis derived from the Greek word pan (all) and akos (cure), referring to its use as a cure-all. Ginseng is a perennial herb native to Korea and China and has been used as a herbal remedy in eastern Asia for thousands of years. It is considered to be the most potent Qi or energy tonic in TCM. Modern indications include low vitality, poor immunity, cancer, cardiovascular disease and enhancement of physical performance and sexual function. However, a recent systematic review of RCT found that the efficacy of ginseng root extract could not be established beyond doubt for any of these indications. Common Name Korean ginseng Other Names Ren shen (Mandarin), red ginseng, white ginseng Botanical Name / Family Panax ginseng C.A. Meyer (family Araliaceae) It should be differentiated from Panax aquifolium (American ginseng), Panax notoginseng (Tien chi, pseudoginseng), Eleutherococcus senticosis (Siberian ginseng) and other ginsengs. Plant Part Used Main and lateral roots. The smaller root hairs are considered an inferior source. There are two types of preparations produced from ginseng: white ginseng, which is prepared by drying the raw herb, Read more […]

Selenium: Practice Points – Patient Counselling. FAQ

Selenium is a trace element that is essential for health. • Low selenium states have been associated with a variety of conditions, such as cardiovascular disease, cancer, asthma, atopy, male subfertility, rheumatoid arthritis, depression and anxiety and compromised immune function. • Studies have identified selenium deficiency in a significant number of people with the HIV infection and suggested a link between selenium levels and mortality rate. • It is also involved in the detoxification of some heavy metals and xenobiotics. • Selenium-enriched yeast is the safest way to supplement the diet, but other forms are also used. Answers to Patients’ Frequently Asked Questions What will this supplement do for me? Selenium supplementation may reduce the risk of developing certain cancers and heart disease and help to improve a range of conditions such as rheumatoid arthritis, asthma, autoimmune thyroiditis, male subfertility, depression and anxiety. When will it start to work? If a protective effect is to occur with selenium against cancer or cardiovascular disease, the effect appears to develop slowly over several years’ consistent intake. Are there any safety issues? High intakes Read more […]

Selenium: Adverse Reactions. Interactions. Pregnancy Use.

Toxicity Long-term ingestion of excessive levels of selenium (> 1000 µg/day) may produce fatigue, depression, arthritis, hair or fingernail loss, garlicky breath or body odour and gastrointestinal disorders or irritability. Adverse Reactions Nausea, vomiting, nail changes, irritability and fatigue have been reported. The organic form of selenium found in high-selenium yeast is often preferred because it is less toxic. The National Health and Medical Research Council of Australia states that selenium intake should not exceed 600 µg/day. Significant Interactions CISPLATIN Selenium may reduce associated nephrotoxicity, myeloid suppression and weight loss, according to in vitro and in vivo tests — beneficial interaction. HEAVY METALS (E.G. MERCURY, LEAD, ARSENIC, SILVER AND CADMIUM) Selenium reduces toxicity of heavy metals such as mercury, lead, arsenic, silver and cadmium by forming inert complexes — beneficial interaction. Contraindications and Precautions Sensitivity to selenium. Pregnancy Use Considered safe in usual dietary doses; safety at higher levels is unknown.

Selenium: Clinical Use. Dosage

DEFICIENCY STATES: PREVENTION AND TREATMENT Traditionally, selenium supplementation has been used to treat deficiency or prevent deficiency in conditions such as malabsorption syndromes. CANCER: PREVENTION AND POSSIBLE ADJUNCT TO TREATMENT Selenium supplementation is used to reduce total cancer incidence and mortality. Chemoprevention Collectively, geographical studies, epidemiological data, laboratory bioassays, studies in over 12 different animal models and human intervention trials generally support a protective role for selenium against the development of cancer. Populations who live in low selenium environments and have low selenium intakes tend to have higher cancer mortality rates. However, the results from epidemiological studies have been less consistent and show the effect is strongest in males. Total cancer incidence and mortality The Nutritional Prevention of Cancer Trial was a large multicentre, double-blind, randomised, placebo-controlled trial conducted with 1312 patients with a history of basal cell or squamous cell carcinomas of the skin, which investigated the effects of 200 µg selenium daily (as 500 mg brewer’s yeast) as a cancer protective agent. Selenium supplementation in this population Read more […]