Ginseng refers lo a group of adaptogenic herbs from the plant family Araliacae. Commonly, the term ginseng refers to “true” ginseng (Panax ginseng C.A. Meyer), as well as to a related plant called Siberian ginseng (Eleutherococcus seniicosus, or eleuthero for short). Medicinal preparations are made from the roots of the plants. Panax ginseng has been used in Traditional Chinese Medicine (TCM) for thousands of years as a tonic indicated for its beneficial effects on the central nervous system, protection from stress, antifatigue action, enhancement of sexual function, and acceleration of metabolism.

Siberian ginseng did not come into the picture as a botanical remedy until the twentieth century. Found in the northern regions of the former Soviet Union, the roots of Eleutherococcus seniicosus were sought out as a cheaper substitute for the expensive Oriental ginsengs. Soviet researchers found Siberian ginseng to be an excellent tonic to enhance athletic performance as well as to strengthen the body during times of stress.

Several other “ginsengs” are used as adaptogenic tonics throughout the world; among them are Panax quinquefolium (or Panax fjuijiquefoiius, also known as American ginseng, with a rich history of use by Native Americans) and ashwagandha, sometimes called Indian ginseng (not a true ginseng but with a long history of medicinal use by ayurvedic healers in India).

American ginseng is the most similar to the true Panax ginseng and is highly prized in the Orient, where it is thought to provide a “cooler” invigoration than the native Panax ginseng (considered “warming” by traditional Chinese healers).

In general, the various ginseng supplements available in the U.S. market are claimed to increase energy levels, relieve stress, enhance athletic performance, enhance immune system function, control blood sugar, improve mental function, and promote general well-being. In most of these functions, ginseng, whether Siberian, Panax ginseng, or one of the other varieties, is often termed an adaptogen a therapeutic and restorative tonic generally thought to produce a “balancing” effect on the body. The properties typically attributed to adaptogens are a nonspecific increase in resistance to a wide range of stressors (including physical, chemical, and biological factors) as well as a “normalizing” action irrespective of the direction of the pathological changes. In general, an adaptogen can be thought of as a substance that helps the body adapt to stress.

Among the many herbs promoted as energy boosters, Asian ginseng is by far the most popular. Although the term ginseng actually encompasses a family of roots, Panax ginseng, the type grown in China, Korea, and Japan, is die type generally known for its energetic and antistress properties. In TCM, Panax-ginseng is used as a tonic properties. In general terms, an adaptogen is a substance that boosts energy and aids in combatting stress and remaining calm. The research on ginseng’s benefits as a tonic and energy booster is equivocal. Some studies have shown benefits in increasing energy levels in fatigued sub jects (Vogler et al., 1999; Wang et al., 1983), but most studies on ginseng as an aid to athletic performance have shown no effect (Bahrke and Morgan, 2000). The differences among study findings may have been the result of many commercially available ginseng supplements actually containing little or no ginseng at all; many researchers often take it for granted that a given product selected off the shelf for study will actually contain what it claims (not always a good assumption). The clearest indication that a supplement contains something other than real ginseng is the price; ginseng root is a very expensive ingredient, and “bargain” ginseng products may not contain real ginseng, enough ginseng, or the active saponin compounds that are thought to deliver ginseng’s antifatigue and adaptogenic effects.

Siberian ginseng (eleuthero), is not truly ginseng (it is a shrub, rather than a root) but it is a close enough cousin (same botanical family but different genus) to deliver some of die same energetic benefits. Eleuthero is used in popular sports supplements. The Siberian form of ginseng is generally a less expensive alternative to true Asian or Panax ginseng, though it may have more of a stimulator;’ effect rather than an adaptogenic effect (not necessarily a bad thing if you just need a boost). Often promoted as an auhletic performance enhancer, eleuthero may also possess mild-to-moderate benefits in promoting recover}’ following intense exercise, perhaps the result of an enhanced deliver}’ of oxygen to recovering muscles.

Ashwagandha is an herb from India that is sometimes called Indian ginseng, not because it is pan of the ginseng family but to suggest energy-promoting and stress-reducing benefits similar to those attributed to the more well-known Asian and Siberian ginsengs. Although there has been very little human research done on ashwagandha, herbalists and natural medicine practitioners often recommend the herb to combat stress and fatigue, and it does appear to be particularly suited as a relaxant following stressful events.

Although the scientific evidence for the benefits of ginseng and its mechanisms of action can be considered inconclusive, the adaptogenic role of the various ginseng strains have proven beneficial for many thousands of years and may therefore prove valuable as normalizing substances during stressful conditions.

The active components in Panax ginseng and American ginseng are thought to be a family of triterpenoid saponins that are collectively referred to as ginsenosides. In general, most of the top-quality ginseng products, whether whole root or extract, are standardized for ginsenoside content. The active components in Siberian ginseng are considered to be a group of related compounds called eleutlierosides. It has been theorized that ginseng’s action in the body is the result of its interaction within the hypothalamic-pituitary axis to balance secretion of adrenal corticotropic hormone (ACTH). ACTH has the ability to bind directly to brain cells and can affect a variety of stress-related processes in the body. These behaviors might include motivation, vitality, performance, and arousal.

In a widely cited, though poorly conducted, study of student nurses on night duty, 1,200 mg/day of Panax ginseng appeared to improve general indices of stress and mood disturbances (Coleman et al,, 2003). Levels of free fatty acids, testosterone, and blood sugar, which were all elevated by night work, were significantly reduced to the levels observed under day work. In another study, 2,700 mg/day of Panax quinquefoUus was able to reduce blood sugar levels and insulin requirements in a group of diabetic subjects following 3 months of supplementation (Vuksan et al., 2000). One study of the effects of 200 mg/day of Panax ginseng extract for 12 weeks showed improvements over baseline values of mental performance: attention, mental processing, logical deduction, and both motor function and reaction time (Kennedy and Scholey, 2003).

Over a period of several decades, German and Soviet researchers have studied the effects of ginseng extract, typically standardized to 4% ginsenosides, on the performance of athletes. One study compared 200 mg/day of eleuthero versus a placebo in 14 highly trained male athletes (Dowling et al., 1996). The ginseng group showed an increase in maximum oxygen uptake compared with the placebo group as well as a statistically significant improvement in recovery time and lower serum lactate values. Other studies in various groups of young athletes have shown ginseng extract to provide statistically significant improvements in performance measures, such as forced vital capacity and maximum breathing capacity, compared with the placebo groups (Pieralisi et al., 1991; Ziemba et al., 1999).

In a double-blind, placebo-controlled, crossover study (8 weeks on treatment, 2 weeks of washout, and 8 weeks on treatment), 45 patients were given 900 mg of ginseng 3 times a day. Mean International Index of Erectile Function scores were significantly higher in patients treated with the ginseng than those who received a placebo. The authors concluded that ginseng may be an effective alternative for treating male erectile dysfunction (Hong et al., 2002).

An open study consisting of 36 children ranging from 3 to 17 years old were given a combination product containing Panax quinquefolium (200 mg) and Ginkgo ttloba extract (50 mg) to be taken twice daily for 4 weeks. At the beginning of the study, after 2 weeks, and then at week 4, parents completed the Conners’ Parent Rating Scale. After 4 weeks of treatment, the proportion of subjects exhibiting improvements ranged from 44% for the social problems attribute to 74% for the Conners’ attention-deficit/ hyp era ctivity disorder (ADHD) index and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-JV) hyperactive-impulsive attribute. The authors concluded that the combination treatment may improve symptoms of ADHD and that further research on the combination should be done (Lyon et al., 2001).

Unfortunately, the scientific evidence for ginseng is far from definitive. For every study showing a positive benefit in terms of energy levels and/ or physical or mental performance, there is at least one other study showing no benefits (Bahrke and Morgan, 2000). Part of the discrepancy in results from well-controlled studies may have to do with differences among the ginseng extracts used in various studies (nonstandardized extracts with unknown quantities of active components).

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