Side Effects and Warnings
Ginseng has been well tolerated by most people in scientific studies when used at recommended doses, and serious side effects appear to be rare.
Based on limited evidence, long-term use may be associated with skin rash or spots, itching, diarrhea, sore throat, loss of appetite, excitability, anxiety, depression, or insomnia. Less common reported side effects include headache, fever, dizziness, chest pain, difficult menstruation, heartburn, heart palpitations, rapid heart rate, leg swelling, nausea/vomiting, or manic episodes in people with bipolar disorder.
Consumption of ginseng may increase or and decrease blood pressure. Caution should be used in those with high or low blood pressure or in those taking drugs for either of these conditions.
There is report of seizures after high consumption of energy drinks containing caffeine, guarana, and herbal supplements, including ginseng.
Based on human research, ginseng may lower blood sugar levels. This effect may be greater in patients with diabetes than in non-diabetics. Use cautiously in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.
There are reports of nosebleeds and vaginal bleeding with ginseng use, although scientific study is limited in this area. There is also evidence in humans of ginseng reducing the effectiveness of the "blood thinning" medication warfarin (Coumadin?). Caution is advised in patients with bleeding disorders or taking drugs that may affect the risk of bleeding or blood clotting. Dosing adjustments may be necessary.
Several cases of severe drops in white blood cell counts were reported in people using a combination product containing ginseng in the 1970s; this may have been due to contamination.
Ginseng may have estrogen-like effects and has been associated with reports of breast tenderness, loss of menstrual periods, vaginal bleeding after menopause, breast enlargement (reported in men), difficulty developing or maintaining an erection, or increased "sexual responsiveness." Avoid use of ginseng in patients with hormone sensitive conditions, such as breast cancer, uterine cancer, or endometriosis.
A severe life-threatening rash known as Stevens-Johnson syndrome occurred in one patient and may have been due to contaminants in a ginseng product. A case report describes liver damage (cholestatic hepatitis) after taking a combination product containing ginseng.
High doses of ginseng have been associated with rare cases of temporary swelling of blood vessels in the brain (cerebral arteritis), abnormal dilation of the pupils of the eye or confusion.
Pregnancy and Breastfeeding
Ginseng has been used traditionally in pregnant and breastfeeding women. Animal studies and early human research suggests that ginseng may be safe, although safety has not been clearly established in humans. Therefore, ginseng use cannot be recommended during pregnancy or breastfeeding. Neonatal death and the development of male characteristics in a developing baby girl after her mother was exposed to ginseng during pregnancy has been reported.
Many tinctures contain high levels of alcohol and should be avoided during pregnancy.
This patient information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Monograph methodology
1. Anderson GD, Rosito G, Mohustsy MA, et al. Drug interaction potential of soy extract and Panax ginseng. J Clin Pharmacol 2003;43(6):643-648.
2. Buettner C, Yeh GY, Phillips RS, et al. Systematic review of the effects of ginseng on cardiovascular risk factors. Ann Pharmacother 2006;40(1):83-95.
3. Cardinal BJ, Engels HJ. Ginseng does not enhance psychological well-being in healthy, young adults: results of a double-blind, placebo-controlled, randomized clinical trial. J Am Diet Assoc 2001;101(6):655-660.
4. Cicero AF, Derosa G, Brillante R, et al. Effects of Siberian ginseng (Eleutherococcus senticosus maxim.) on elderly quality of life: a randomized clinical trial. Arch Gerontol Geriatr Suppl 2004;(9):69-73.
5. Coleman CI, Hebert JH, Reddy P. The effects of Panax ginseng on quality of life. J Clin Pharm Ther 2003;28(1):5-15.
6. de Andrade E, de Mesquita AA, Claro Jde A, de Andrade PM, Ortiz V, Paranhos M, Srougi M. Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction. Asian J Androl 2007;9(2):241-4.
7. Guo R, Pittler MH, Ernst E. Herbal medicines for the treatment of COPD: a systematic review. Eur Respir J 2006;28(2):330-8.
8. Hartley DE, Elsabagh S, File SE. Gincosan (a combination of Ginkgo biloba and Panax ginseng): the effects on mood and cognition of 6 and 12 weeks' treatment in post-menopausal women. Nutr Neurosci 2004;7(5-6):325-333.
9. Hartz AJ, Bentler S, Noyes R, et al. Randomized controlled trial of Siberian ginseng for chronic fatigue. Psychol Med 2004;34(1):51-61.
10. Hong B, Ji YH, Hong JH, et al. A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report. J Urol 2002;168(5):2070-2073.
11. Ito TY, Polan ML, Whipple B, et al. The enhancement of female sexual function with ArginMax, a nutritional supplement, among women differing in menopausal status. J Sex Marital Ther 2006 Oct-Dec;32(5):369-78.
12. Jiang X, Williams KM, Liauw WS, et al. Effect of St John's wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2004;57(5):592-599.
13. Kim JH, Park CY, Lee SJ. Effects of sun ginseng on subjective quality of life in cancer patients: a double-blind, placebo-controlled pilot trial. J Clin Pharm Ther 2006 Aug;31(4):331-4.
14. Rotem C, Kaplan B. Phyto-Female Complex for the relief of hot flushes, night sweats and quality of sleep: randomized, controlled, double-blind pilot study. Gynecol Endocrinol 2007 Feb;23(2):117-22.
15. Shao KD, Zhou YH, Shen YP, et al. Treatment of 37 patients with refractory idiopathic thrombocytopenic purpura by shengxueling. Chin J Integr Med 2007 Mar;13(1):33-6.
START A NEW SEARCH
