Monograph: Ginseng, American

Date: 2023-01-27

NHPID name

Panax quinquefolius ( Germplasm Resources Information Network Taxonomy )

Proper name(s)

Panax quinquefolius ( USDA 2005 )

Common name(s)

• American ginseng ( Unavailable )
• Occidental ginseng ( Unavailable )
• Sang ( Unavailable )
• Shang ( Unavailable )
• Xi yang shen ( Unavailable )

Source material

Panax quinquefolius - Root (Unavailable) Panax quinquefolius is an endangered plant in the wild; thus only the roots from cultivated plants are acceptable source material (EC 2009). See Specifications for further details.

Route Of administration

Oral

Dosage form(s)

• The acceptable pharmaceutical dosage forms include, but are not limited to capsules, chewables (e.g. gummies, tablets), liquids, powders, strips or tablets.
• This monograph is not intended to include foods or food-like dosage forms such as bars, chewing gums or beverages.

Use(s) or purpose(s)

Statement(s) to the effect of:

• Used in Traditional Chinese Medicine (TCM) for deficiency of qi and yin, internal heat, cough, bloody phlegm, fire in the deficiency syndrome, dysphoria and tiredness, dry and thirsty mouth and throat.  (PPRC 2015)
• Used in Herbal Medicine as supportive therapy for the promotion of healthy glucose levels.  (PPRC 2015, Dascalu et al. 2007, Vuksan et al. 2000a, Vuksan et al. 2000b, Vuksan et al. 2000c)
• (Traditionally) used in Herbal Medicine to help relieve restlessness and/or nervousness (calmative).  (Bartram 1998, Ellingwood 1998[1919])
• Traditionally used in Herbal Medicine to help relieve nervous dyspepsia / to help digestion in cases of nervousness and/or stress.  (Bartram 1998, Felter and Lloyd 1983[1898], Wren 1956)
• Used in Herbal Medicine as an adaptogen to help maintain a healthy immune system.  (Upton 2012, Godfrey et al. 2010, Assinewe 2001, Bartram 1998)

Dose(s)

Adults:

Glucose levels; Mild sedative; Nervousness; Immune System TCM

Duration of use

No statement is required

Risk information

Statement(s) to the effect of:

Caution(s) and Warning(s):

• Consult a health care practitioner/health care provider/health care professional/ doctor/ physician prior to use if you are taking blood thinners or digoxin.  (Brinker 2010, Dasgupta et al. 2007, Elmer et al. 2007, Yuan et al. 2004)
• Consult a health care practitioner/health care provider/health care professional/ doctor/ physician prior to use if you have diabetes.  (Brinker 2010, Dascalu et al. 2007, Vuksan et al. 2000a, Vuksan et al. 2000b, Vuksan et al. 2000c)

Contraindication(s): No statement is required Known Adverse Reaction(s): No statement is required

Non-medicinal ingredients

Must be chosen from the current Natural health products ingredients database and must meet the limitations outlined in the database.

Specifications

• The finished product specifications must be established in accordance with the requirements described in the NHPD Quality of natural health products guide.
• The medicinal ingredient must comply with the requirements outlined in the Natural health products ingredient database (NHPID).
• Proof of sale or permit must be available for possession of the cultivated Panax quinquefolius because the wildlife species is endangered: (i) Panax quinquefolius is protected under the federal Species at Risk Act (SARA). Under section 32(2) of this Act, no person shall possess, collect, buy, sell or trade an individual of a wildlife species that is listed as an extirpated species, an endangered species or a threatened species, or any part or derivative of such an individual (JC 2015), (ii) Panax quinquefolius is protected by the Quebec Act Respecting Threatened or Vulnerable Species. Under this Act, it is prohibited to possess, trade, or harm this species, or to disturb its habitat (EC 2015).
• The medicinal ingredient may comply with the specifications outlined in the American Ginseng, Powdered American Ginseng monographs published in the U.S. Pharmacopoeia (USP 38).

References cited

• Assinewe VA. Phytochemical variation and immunopharmacology of Panax quinquefolius L. (American Ginseng) [Doctoral dissertation]. Ottawa (ON): University of Ottawa;2001
• Bartram T. Bartram's Encyclopedia of Herbal Medicine: The Definitive Guide to the Herbal Treatments of Diseases. New York (NY): Marlowe & Company; 1998.
• Bensky D, Gamble A. Chinese Herbal Medicine: Materia Medica. Revised Edition. Seattle (WA): Eastland Press, Incorporated; 1993.
• Brinker F. Online Updates and Additions to Herb Contraindications and Drug Interactions, 3rd edition. Sandy (OR): Eclectic Medical Publications; 2010. [Accessed 2015 June 4]. Available from: http://www.eclecticherb.com/emp/updatesHCDI.html
• Dascalu A, Sievenpiper JL, Jenkins AL, Stavro MP, Leiter LA, Arnason JT, Vuksan V.Five batches representative of Ontario-grown American ginseng root produce comparable reductions of postprandial glycemia in healthy individuals. Canadian Journal of Physiology and Pharmacology 2007. 85(9):856-864.
• Dasgupta A, Kang E, Olsen M, Actor JK, Datta P. Interference of Asian, American, and Indian (Ashwagandha) ginseng in serum digoxin measurements by a fluorescence polarization immunoassay can be minimized by using a new enzyme-linked chemiluminescent immunosorbent or turbidimetric assay. Archives of Pathology & Laboratory Medicine 2007. 131(4):619-621.
• EC 2015: Environment Canada. Species at Risk Act Public Registry. Gatineau (QC): Environment Canada. [Accessed 2015 June 4]. Available from: http://www.sararegistry.gc.ca/comments/default_e.cfm
• Ellingwood F. American Materia Medica, Therapeutics and Pharmacognosy. Sandy (OR): Eclectic Medical Publications; 1998 [Reprint of 1919 original].
• Elmer GW, Lafferty WE, Tyree PT, Lind BK. 2007. Potential interactions between complementary/alternative products and conventional medicines in a Medicare population. The Annals of Pharmacotherapy 41(10):1617-1624.
• Felter HW, Lloyd JU. King's American Dispensatory, Volume 1, 18th edition. Sandy (OR): Eclectic Medical Publications; 1983 [Reprint of 1898 original].
• Godfrey A, Saunders PR, Barlow K, Gilbert C, Gowan M, Smith F. Principles and Practices of Naturopathic Botanical Medicine. Volume 1: Botanical Medicine Monographs. Toronto (ON): CCNM Press; 2010.
• Hoffmann D. 2003. Medical Herbalism: The Science and Practice of Herbal Medicine. Rochester (VT): Healing Arts Press.
• JC 2015: Department of Justice Canada. Species at Risk Act. Ottawa (ON): Department of Justice Canada. [Accessed 2015 June 4]. Available from :http://laws-lois.justice.gc.ca/eng/acts/S-15.3/index.html.
• King ML, Adler SR, Murphy LL. 2006. Extraction-dependent effects of American ginseng (Panax quinquefolium) on human breast cancer cell proliferation and estrogen receptor activation. Integrative Cancer Therapies 5(3):236-243.
• Lust J. The Herb Book. New York (NY): Bantam Books Incorporated, published by arrangement with Benedict Lust Publications; 1974.
• McGuffin M, Kartesz JT, Leung AY, Tucker AO, editors. 2000. Herbs of Commerce, 2nd edition. Austin(TX): American Herbal Products Association.
• PPRC: Pharmacopoeia of the People's Republic of China, Volume 1, English edition 2015. Beijing (CN): The State Pharmacopoeia Commission of the People's Republic of China.
• Upton R, editor. American Herbal Pharmacopoeia and Therapeutic Compendium: American ginseng Root (Panax quinquefolius L.) - Standards of Analysis, Quality Control, and Therapeutics. Santa Cruz (CA): American Herbal Pharmacopoeia; 2012.
• USDA 2005: United States Department of Agriculture, Agricultural Research Service, National Genetic Resources Program. Germplasm Resources Information Network (GRIN) [Online database]. 2005. Panax quinquefolius. Beltsville (MD): National Germplasm Resources Laboratory. [Accessed 2015 June 4]. Available from: http://www.ars-grin.gov/cgi-bin/npgs/html/tax_search.pl.
• USP 38: United States Pharmacopeia and the National Formulary (USP 38 - NF 33). Rockville (MD): The United States Pharmacopeial Convention; 2015.
• Vuksan V, Stavro MP, Sievenpiper JL, Beljan-Zdravkovic U, Leiter LA, Josse RG, Xu Z. 2000b. Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes. Diabetes Care 23(9):1221-1226.
• Vuksan V, Stavro MP, Sievenpiper JL, Koo VY, Wong E, Beljan-Zdravkovic U, Francis T, Jenkins AL, Leiter LA, Josse RG, Xu Z. 2000c. American ginseng improves glycemia in individuals with normal glucose tolerance: effect of dose and time escalation. Journal of the American College of Nutrition 19(6):738-744.
• Vuksan V, Xu Z, Jenkins AL, Belgan U, Sievenpiper JL, Leiter LA, Josse RG, Stavro MP. 2000a. American ginseng (Panax quinquefolium L.) improves long-term glycemic control in type 2 diabetes: double-blind placebo controlled crossover trial. Diabetes 49 (Suppl.1):A95.
• Wren RC. Potter's Cyclopedia of Botanical Drugs and Preparations. London (UK): Potter and Clark; 1956.
• Yuan CS, Wei G, Dey L, Karrison T, Nahlik L, Maleckar S, Kasza K, Ang-Lee M, Moss J. 2004. American ginseng reduces warfarin's effect in healthy patients. Annals of internal medicine 141(1):23-27.

References reviewed

• Adams LL, Gatchel RJ. 2000. Complementary and alternative medicine: applications and implications for cognitive functioning in elderly populations. Alternative therapies in health and medicine 7(2):52-61.
• Adimoelja A. 2000. Phytochemicals and the breakthrough of traditional herbs in the management of sexual dysfunctions. International Journal of Andrology 23(Suppl 2):82-84.
• Allen JD, McLung J, Nelson AG, Welsch M. 1998. Ginseng supplementation does not enhance healthy young adults' peak aerobic exercise performance. Journal of the American College of Nutrition 17(5):462-466
• Anderson GD, Rosito G, Mohustsy MA, Elmer GW. 2003. Drug interaction potential of soy extract and Panax ginseng. The Journal of Clinical Pharmacology 43(6):643-648.
• Ang-Lee MK, Moss J, Yuan C-S. 2001. Herbal medicines and perioperative care. The Journal of the American Medical Association 286(2):208-216.
• Attele AS, Wu JA, Yuan CS. 1999. Ginseng pharmacology: multiple constituents and multiple actions. Biochemical Pharmacology 58(11):1685-1693.
• Attele AS, Zhou Y-P, Xie J-T, Wu JA, Zhang L, Dey L, Pugh W, Rue PA, Polonsky KS, Yuan C-S. 2002. Antidiabetic effects of Panax ginseng berry extract and the identification of an effective component. Diabetes 51:1851-1858.
• Awang DV. 1991. Maternal use of ginseng and neonatal androgenization. The Journal of the American Medical Association 266(3):363.
• Bahrke MS, Morgan WP. 1994. Evaluation of the ergogenic properties of ginseng. Sports Medicine 18(4):229-248
• Bao H Y, Zhang J, Yeo SJ, Myung CS, Kim HM, Kim JM, Park JH, Cho J, Kang JS. 2005. Memory enhancing and neuroprotective effects of selected ginsenosides. Archives of Pharmacal Research 28(3):335-342.
• Barnes J, Anderson LA, Philipson JD. 2007. Herbal Medicines, 3rd edition. London (GB): Pharmaceutical Press.
• Barton DL, Soori GS, Bauer BA, Sloan JA, Johnson PA, Figueras C, Duane S, Mattar B, Liu H, Atherton PJ, Christensen B, Loprinzi CL. Pilot study of Panax quinquefolius (American ginseng) to improve cancer-related fatigue: a randomized, double-blind, dose-finding evaluation: NCCTG trial N03CA. Support Care in Cancer 2010;18(2):179-187.
• BHP 1983: British Herbal Pharmacopoeia. Cowling (GB): British Herbal Medical Association; 1983.
• BHP 1996: British Herbal Pharmacopoeia. Bournemouth (UK): British Herbal Medical Association; 1996.
• Biondo PD, Goruk S, Ruth MR, O'Connell E, Field CJ. 2008. Effect of CVT-E002 (COLD-fX) versus a ginsenoside extract on systemic and gut-associated immune function. International Immunopharmacology 8(8):1134-42.
• Biondo PD, Robbins SJ, Walsh JD, McCargar LJ, Harber VJ, Field CJ. 2008. A randomized controlled crossover trial of the effect of ginseng consumption on the immune response to moderate exercise in healthy sedentary men. Applied Physiology, Nutrition, and Metabolism 33(5): 966-975.
• Block KI, Mead MN. 2003. Immune system effects of echinacea, ginseng, and astragalus: a review. Integrative Cancer Therapies 2(3):247-267.
• Blumenthal M, Busse W, Goldberg A, Gruenwald J, Hall T, Riggins C, Rister R, editors. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin (TX): American Botanical Council; 1998.
• Blumenthal M, Goldberg A, Brinckmann J, editors. Herbal Medicine: Expanded Commission E Monographs. Boston (MA): Integrative Medicine Communications; 2000.
• BP 2003: British Pharmacopoeia Commission. British Pharmacopoeia. London ( UK ): Her Majesty's Stationary Office; 2003.
• BP 2015: British Pharmacopoeia 2015, Volume II. London (GB): The Stationary Office.
• Bradley PR, editor. 1992. British Herbal Compendium: A Handbook of Scientific Information on Widely Used Plant Drugs, Volume 1. Bournemouth (GB): British Herbal Medicine Association.
• Bradley PR, editor. British Herbal Compendium: A Handbook of Scientific Information on Widely Used Plant Drugs, Volume 2. Bournemouth (UK): British Herbal Medicine Association; 2006.
• Briggs CJ, Briggs GL. 1998. Herbal products in depression therapy. Canadian Pharmacists Journal/Revue Des Pharmaciens Du Canada November:40-44.
• Bucci LR. 2000. Selected herbs and human exercise performance. The American Journal of Clinical Nutrition 72(Suppl 2):624S-636S
• Capital Health. 2003. Professional Reference Guide: Herbal - Drug Interactions. Canada.: Mediscript Communications Inc.
• Carai MAM, Agabio R, Bombardelli E, Bourov I, Gessa GL, Lobina C, Morazzoni P, Pani M, Reali R, Vacca G, Colombo G. 2000. Potential use of medicinal plants in the treatment of alcoholism. Fitoterapia 71:S38-S42.
• Cardinal BJ, Engels HJ. 2001. Ginseng does not enhance psychological well-being in healthy, young adults: results of a double-blind, placebo-controlled, randomized clinical trial. Journal of the American Dietetic Association 101(6):655-660
• Caso Marasco A, Vargas Ruiz R, Salas Villagomez A, Begoña Infante C. 1996. Double-blind study of a multivitamin complex supplemented with ginseng extract. Drugs Under Experimental and Clinical Research 22(6):323-329.
• Chan LY, Chiu PY, Lau TK. 2003. An in-vitro study of ginsenoside Rb(1)-induced teratogenicity using a whole rat embryo culture model. Human Reproduction 18:2166-2168.
• Chang Kiu Moon , Kyl Soon Sim, Soo Hwan Lee, Kwang Sik Park, Yeo Pyo Yun, Bae-Jin Ha and Chong-Chul Lee. 1983. Antitumor activity of some phytobased polysaccharides and their effects on the immune function. Pharmaceutical Society of Korea 6(2):123-131
• Chen F, Eckman EA, Eckman CB. 2006. Reductions in levels of the Alzheimer's amyloid beta peptide after oral administration of ginsenosides. The FASEB journal: official publication of the Federation of American Societies for Experimental Biology 20(8):1269-1271.
• Coleman CI, Hebert JH, Reddy P. 2003. The effects of Panax ginseng on quality of life. Journal of Clinical Pharmacy and Therapeutics 28(1):5-15
• Cui Y, Shu XO, Gao Y, Wen W, Ruan ZX, Jin F, Zheng W. 2004. Use of complementary and alternative medicine by Chinese women with breast cancer. Breast Cancer Research and Treatment 85:263-270.
• Cui Y, Shu XO, Gao YT, Cai H, Tao MH, Zheng W. 2006. Association of ginseng use with survival and quality of life among breast cancer patients. American Journal of Epidemiology 163(7):645-653.
• Diamond WJ. The Clinical Practice of Complementary, Alternative, and Western Medicine. Boca Raton (FL): CRC Press LLC; 2001.
• Duda RB, Taback B, Kessel B, Dooley DD, Yang H, Marchiori J, Slomovic BM, Alvarez JG. 1996. pS2 expression induced by American ginseng in MCF-7 breast cancer cells. Annals of Surgical Oncology 3(6):515-520.
• Duda RB, Zhong Y, Navas V, Li MZ, Toy BR, Alavarez JG. 1999. American ginseng and breast cancer therapeutic agents synergistically inhibit MCF-7 breast cancer cell growth. Journal of Surgical Oncology 72(4):230-239.
• Elam JL, Carpenter JS, Shu XO, Boyapati S, Friedmann-Gilchrist J. 2006. Methodological issues in the investigation of ginseng as an intervention for fatigue. Clinical nurse specialist CNS 20(4):183-189.
• Ellis JM, Reddy P. 2002. Effects of Panax ginseng on quality of life. The Annals of Pharmacotherapy 36(3):375-379
• Engels HJ, Fahlman MM, Wirth JC. 2003. Effects of ginseng on secretory IgA, performance, and recovery from interval exercise. Medicine & Science in Sports & Exercise 35(4):690-696
• Engels HJ, Kolokouri I, Cieslak TJ, Wirth JC. 2001. Effects of ginseng supplementation on supramaximal exercise performance and short-term recovery. Journal of Strength and Conditioning Research 15(3):290-295
• Ernst E, Cassileth BR. 1999. How useful are unconventional cancer treatments? European Journal of Cancer 35(11):1608-1613.
• Ernst E. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Annals of Internal Medicine 2002;136(1):42-53.
• ESCOP 2003: ESCOP Monographs: The Scientific Foundation for Herbal Medicinal Products, 2nd edition. Exeter (UK): European Scientific Cooperative on Phytotherapy and Thieme; 2003.
• Findeis MA. 2000. Approaches to discovery and characterization of inhibitors of amyloid-beta-peptide polymerization. Biochimica et Biophysica Acta 1502:76-84.
• Fugh-Berman A, Ernst E. 2001. Herb-drug interactions: Review and assessment of report reliability. British Journal of Clinical Pharmacology 52(5):587-595
• Fugh-Berman A. 2000. Herb-drug interactions. Lancet 355:134-138
• Gaffney B, Hügel H, Rich P. The effects of Eleutherococcus senticosus and Panax ginseng on steroidal hormone indices of stress and lymphocyte subset numbers in endurance athletes. Life Sciences. 2001;70(4):431-442.
• Gray SL, Lackey BR, Tate PL, Riley MB, Camper ND. 2004. Mycotoxins in root extracts of American and Asian ginseng bind estrogen receptors alpha and beta. Experimental Biology and Medicine 229(6):560-568.
• Greenblatt DJ, von Moltke LL. 2006. Interaction of warfarin with drugs, natural substances, and foods. Journal of Clinical Pharmacology 45(2):127-132.
• Greenspan EM. 1983. Ginseng and vaginal bleeding. Journal of the American Medical Association 249(15):2018 (Letter).
• Gross D, Shenkman Z, Bleiberg B, Dayan M, Gittelson M, Efrat R. 2002. Ginseng improves pulmonary functions and exercise capacity in patients with COPD. Monaldi Archives for Chest Disease 57(5-6):242-246
• Gurley BJ, Gardner SF, Hubbard MA, Williams DK, Gentry WB, Cui Y, Ang CY. 2002. Cytochrome P450 phenotypic ratios for predicting herb-drug interactions in humans. Clinical pharmacology and therapeutics 72(3):276-287.
• Gurley BJ, Gardner SF, Hubbard MA, Williams DK, Gentry WB, Cui Y, Ang CY. 2005. Clinical assessment of effects of botanical supplementation on cytochrome P450 phenotypes in the elderly: St John's wort, garlic oil, Panax ginseng and Ginkgo biloba. Drugs & Aging 22(6):525-539
• Guyton KZ, Kensler TW. 2002. Prevention of liver cancer. Current Oncology Reports 4(6):464-70. Review
• Gyllenhaal C, Merritt SL, Peterson SD, Block KI, Gochenour T. 2000. Efficacy and safety of herbal stimulants and sedatives in sleep disorders. Sleep Medicine Reviews 4(2):229-251
• Han KH, Choe SC, Kim HS, Sohn DW, Nam KY, Oh BH, Lee MM, Park YB, Choi YsS, Seo JD, Lee YW. Effect of red ginseng on blood pressure in patients with essential hypertension and white coat hypertension. The American Journal of Chinese Medicine 1998;26(2):199-209.
• Harkey MR, Henderson GL, Gershwin ME, Stern JS, Hackman RM. Variability in commercial ginseng products: an analysis of 25 preparations. American Journal of Clinical Nutrition 2001;73:1101-1106.
• Hartley DE, Elsabagh S, File SE. 2004. 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. Nutritional Neuroscience 7(5-6):325-333
• Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. American Journal of Health-System Pharmacy 2000;57(13):1221-1227.
• Hofseth LJ, Wargovich MJ. 2007. Inflammation, cancer, and targets of ginseng. Journal of Nutrition 137(1 Suppl):183S-185S
• Hong B, Ji YH, Hong JH, Nam KY, Ahn TY. 2002. A double-blind crossover study evaluating the efficacy of Korean red ginseng in patients with erectile dysfunction: a prelimary report. The Journal of Urology 168(5):2070-2073
• Hu C, Kitts D. 2001 Free Radical Scavenging Capacity as Related to Antioxidant Activity and Ginsenoside Composition of Asian and North American Ginseng Extracts. Journal of the American Oil Chemists' Society 78(3):249
• Hu SY. 1976. The genus Panax (ginseng) in Chinese medicine. Economic Botany 30:14
• Integrated Taxonomic Information System (IT IS) on-line database. Panax quinquefolius . [Accessed 2015 June 4]. Available from: http://www.itis.gov/servlet/SingleRpt/SingleRpt?search_topic=TSN&search_value=29399.
• Izzo AA, Ernst E. 2001. Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs 61(15):2163-2175.
• Janetzki K, Morreale AP. 1997. Probable interaction between warfarin and ginseng. American Journal of Health-System Pharmacy 54(6):692-693
• Jellin JM. Natural Medicines Comprehensive Database: American ginseng. Stockton (CA): Therapeutic Research Faculty; 1995-2015. [Accessed 2015June 4]. Available from: http://naturaldatabase.therapeuticresearch.com/nd/Search.aspx?cs=CEPDA&s=ND&pt=100&sh=1&id=967.
• Ji ZN, Dong TT, Ye WC, Choi RC, Lo CK, Tsim KW. 2006. Ginsenoside Re attenuate beta-amyloid and serum-free induced neurotoxicity in PC12 cells. Journal of Ethnopharmacology 107:48-52
• Jiang X, Williams KM, Liauw WS, Ammit AJ, Roufogalis BD, Duke CC, Day RO, McLachlan AJ. 2004. Effect of St John's wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. British Journal of Clinical Pharmacology 57(5):592-599.
• Jin Y, Kotakadi VS, Ying L, Hofseth AB, Cui X, Wood PA, Windust A, Matesic LE, Pena EA, Chiuzan C, Singh NP, Nagarkatti M, Nagarkatti PS, Wargovich MJ, Hofseth LJ. 2008. American ginseng suppresses inflammation and DNA damage associated with mouse colitis. Carcinogenesis 29(12):2351-2359.
• Kabalak AA, Soyal OB, Urfalioglu A, Saracoglu F, Gogus N. 2004. Menometrorrhagia and tachyarrhythmia after using oral and topical ginseng. J Womens Health (Larchmt ) 13(7):830-833
• Kaneko H, Nakanishi K, Kuwashima K, Ikeda K. 2000. Effects of the long-term administration of red ginseng on working stress and changes of physiological parameters of workers. A study at a care hospital for the aged (ROUJIN BYOUIN). Therapeutic Research 21(5):1451-1463. [abstract]
• Kang KS, Yamabe N, Kim HY, Okamoto T, Sei Y, Yokozawa T. 2007. Increase in the free radical scavenging activities of American ginseng by heat processing and its safety evaluation. Journal of Ethnopharmacology 113(2):225-232
• Kawahara M, Kuroda Y. 2000. Molecular mechanism of neurodegeneration induced by Alzheimer's beta-amyloid protein: channel formation and disruption of calcium homeostasis. Brain Research Bulletin 53:389-397
• Kelly GS. 1999. Nutritional and botanical interventions to assist with the adaptation to stress. Alternative Medicine Review: A Journal of Clinical Therapeutic 4(4):249-265
• Kennedy D, Scholey A, Wesnes KA. 2000. Dose-dependent enhancement of cognitive performance in young volunteers by a single doses of ginseng. International Journal of Neuropsychopharmacology 3(Suppl 1):S365
• Kennedy DO, Haskell CF, Wesnes KA, Scholey AB. 2004. Improved cognitive performance in human volunteers following administration of guarana (Paullinia cupana) extract: comparison and interaction with Panax ginseng. Pharmacology, Biochemistry and Behavior 79(3):401-411
• Kennedy DO, Scholey AB, Drewery L, Marsh VR, Moore B, Ashton H. 2003. Electroencephalograph effects of single doses of Ginkgo biloba and Panax ginseng in healthy young volunteers. Pharmacology, Biochemistry and Behavior 75(3):701-709
• Kennedy DO, Scholey AB, Wesnes KA. 2001. Differential, dose dependent changes in cognitive performance following acute administration of a Ginkgo biloba/Panax ginseng combination to healthy young volunteers. Nutritional neuroscience 4(5):399-412
• Kennedy DO, Scholey AB, Wesnes KA. 2001. Dose dependent changes in cognitive performance and mood following acute administration of Ginseng to healthy young volunteers. Nutritional Neuroscience 4(4):295-310
• Kennedy DO, Scholey AB, Wesnes KA. 2002. Modulation of cognition and mood following administration of single doses of Ginkgo biloba, ginseng, and a ginkgo/ginseng combination to healthy young adults. Physiology & Behavior 75(5):739-751
• Kennedy DO, Scholey AB. 2003. Ginseng: potential for the enhancement of cognitive performance and mood. Pharmacology, Biochemistry and Behavior 75(3):687-700
• Kiefer D, Pantuso T. 2003. Panax ginseng. American Family Physician 68(8):1539-1542
• Kim C, Choi H, Kim CC, Kim JK, Kim MS. 1976. Influence of ginseng on mating behavior of male rats. The American Journal of Chinese Medicine 4(2):163-168
• Kim JH, Park CY, Lee SJ. 2006. Effects of sun ginseng on subjective quality of life in cancer patients: a double-blind, placebo-controlled pilot trial. Journal of Clinical Pharmacy and Therapeutics 31(4):331-334
• Kitts DD, Wijewickreme AN, Hu C. 2000. Antioxidant properties of a North American ginseng extract. Molecular and Cellular Biochemistry 203(1-2):1-10
• Ko SR, Choi KJ, Uchida K, Suzuki Y. 2003. Enzymatic preparation of ginsenosides Rg2, Rh1, and F1 from protopanaxatriol-type ginseng saponin mixture. Planta Medica 69:285-286
• Kulaputana O, Thanakomsirichot S, Anomasiri W. 2007. Ginseng supplementation does not change lactate threshold and physical performances in physically active Thai men. Journal of the Medical Association of Thailand 90(6):1172-1179
• Lee BM, Lee SK, Kim HS. 1998. Inhibition of oxidative DNA damage, 8-OHdG, and carbonyl contents in smokers treated with antioxidants (vitamin E, vitamin C, beta-carotene and red ginseng). Cancer letters 132(1-2):219-227
• Li N, Liu B, Dluzen DE, Jin Y. 2007. Protective effects of ginsenoside Rg2 against glutamate-induced neurotoxicity in PC12 cells. Journal of Ethnopharmacology 111(3):458-463
• Lieberman HR. 2001. The effects of ginseng, ephedrine, and caffeine on cognitive performance, mood and energy. Nutrition Reviews 59(4):91-102
• Liu J, Burdette JE, Xu H, Gu C, van Breenmen RB, Bhat KP, Booth N, Constantinou AI, Pezzuto JM, Fong HH, Farnsworth NR, Bolton JL. 2001. Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. Journal of Agricultural and Food Chemistry 49(5):2472-2479
• Liu ZH, Hu HT, Feng GF, Zhao ZY, Mao NY. 2005. Protective effects of gastrodin on the cellular model of Alzheimer's disease induced by Abeta25-35. Sichuan Da Xue Xue Bao Yi Xue Ban 36(4):537-540
• Low Dog T. 2005. Menopause: a review of botanical dietary supplements. American Journal of Medicine 19:118 Suppl 12B:98-108
• López MV, Cuadrado MP, Ruiz-Poveda OM, Del Fresno AM, Accame ME. 2007. Neuroprotective effect of individual ginsenosides on astrocytes primary culture. Biochimica et Biophysica Acta 1770(9):1308-1316
• Mahady GB, Parrot J, Lee C, Yun GS, Dan A. 2003. Botanical dietary supplement use in peri- and postmenopausal women. Menopause 10(1):65-72
• Mantle D, Lennard TWJ, Pickering AT. 2000. Therapeutic applications of medicinal plants in the treatment of breast cancer: a review of their pharmacology, efficacy and tolerability. Adverse Drug Reaction Toxicology Review 19(3):2223-2240
• Mantle D, Pickering AT, Perry AK. 2000. Medicinal plant extracts for the treatment of dementia: a review of their pharmacology, efficacy, and tolerability. CNS Drugs 13:201-213
• McElhaney JE, Goel V, Toane B, Hooten J, Shan JJ. 2006. Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo controlled trial. Journal of Alternative and Complementary Medicine 12(2):153-157
• McElhaney JE, Gravenstein S, Cole SK, Davidson E, O'neill D, Petitjean S, Rumble B, Shan JJ. 2004. A placebo-controlled trial of a proprietary extract of North American ginseng (CVT-E002) to prevent acute respiratory illness in institutionalized older adults. Journal of the American Geriatrics Society 52(1):13-19 and the erratum in 52(5):857
• Miller LG. 1998. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Archives of Internal Medicine 158(20):2200-2211.
• Mills E, Dugoua J, Perri D, Koren G. Herbal Medicines in Pregnancy and Lactation: An Evidence-Based Approach. London (UK): Taylor and Francis Medical; 2006.
• Mills S, Bone K. 2000. Principles and Practice of Phytotherapy. Toronto (ON): Churchill Livingstone.
• Mills S, Bone K. 2005. The Essential Guide to Herbal Safety. St. Louis (MO): Elsevier Churchill Livingstone.
• Mitra SK, Chakraborti A, Bhattacharya SK. 1996. Neuropharmacological studies on Panax ginseng. Indian Journal of Experimental Biology 34:41-47
• Mkrtchyan A, Panosyan V, Panossian A, Wikman G, Wagner H. 2005. A phase I clinical study of Andrographis paniculata fixed combination Kan Jang versus ginseng and valerian on the semen quality of healthy male subjects. Phytomedicine 12(6-7):403-409
• Moerman DE . 1998. Native American Ethnobotany. Portland (OR): Timber Press.
• Morris AC, Jacobs I, Klugerman A, McLellan TM. 1994. No ergogenic effect of ginseng extract ingestion. Medicine & Science in Sports & Exercise 26(5)(Suppl.):S6
• Morris AC, Jacobs I, McLellan TM, Klugerman A, Wang LC, Zamecnik J. 1996. No ergogenic effect of ginseng ingestion. International journal of sport nutrition 6(3):263-271
• Murphy LL, Cadena RS, Chávez D, Ferraro JS. 1998. Effect of American ginseng (Panax quinquefolium) on male copulatory behavior in the rat. Physiology Behavior 64(4):445-450
• Murphy LL, Lee TJ. 2002. Ginseng, sex behavior, and nitric oxide. Annals of the New York Academy of Sciences 962:372-377
• NCCAM 2005: National Center for Complementary and Alternative Medicine. 2005. Herbs at a glance: Asian Ginseng. Bethesda (MD): National Center for Complementary and Alternative Medicine, National Institutes of Health. [Accessed 2015 June 4]. Available from: http://nccam.nih.gov/health/asianginseng/
• Nocerino E, Amato M, Izzo AA. 2000. The aphrodisiac and adaptogenic properties of ginseng. Fitoterapia 71(Suppl 1):S1-S5
• O'Hara M, Kiefer D, Farrell K, Kemper K. 1998. A review of 12 commonly used medicinal herbs. Archives of Family Medicine 7(6):523-536
• Odani T, Tanizawa H, Takino Y. 1983. Studies on the absorption, distribution, excretion and metabolism of ginseng saponins. III. The absorption, distribution and excretion of ginsenoside Rb1 in the rat. Chemical & Pharmaceutical Bulletin 31:1059-1066
• Ohya T, Usui Y, Okamoto K, Inoue Y, Arii S, Iwai T. 2004. Management for fistula-in-ano with Ginseng and Tang-kuei Ten Combination. Pediatrics International 46(1):72-76
• Ott BR, Owens NJ. 1998. Complementary and alternative medicines for Alzheimer's disease. Journal of Geriatric Psychiatry and Neurology 2:163-173
• Predy GN, Goel V, Lovlin RE, Basu TK. 2006. Immune Modulating Effects of Daily Supplementation of COLD-fX (a Proprietary Extract of North American Ginseng) in Healthy Adults. Journal of Clinical Biochemistry and Nutrition 39:162-167
• Predy GN, Goel V, Lovlin RE, Donner A, Stitt L, Basu TK. 2005. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. Canadian Medical Association 173(9):1043-1048
• Reay JL, Kennedy DO, Scholey AB. 2006. Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained 'mentally demanding' tasks. Journal of Psychopharmacology 20(6):771-781
• Reay JL, Kennedy DO, Scholey AB. 2006. The glycaemic effects of single doses of Panax ginseng in young healthy volunteers. British Journal of Nutrition 96(4):639-642
• Rudakewich M, Ba F, Benishin CG. 2001. Neurotrophic and neuroprotective actions of ginsenosides Rb(1) and Rg(1). Planta Medica 67(6):533-537
• Scaglione F, Cattaneo G, Alessandria M, Cogo R. 1996. Efficacy and safety of the standardized ginseng extract G115 for potentiating vaccination against common cold and/or influenza syndrome. Drugs Under Experimental and Clinical Research 22(2):65-72
• Scaglione F, Weiser K, Alessandria M. 2001. Effects of the standardised ginseng extract G115 in patients with chronic bronchitis. Clinical Drug Investigation 21(1):41-45
• Scholey AB, Kennedy DO. 2002. Acute, dose-dependent cognitive effects of Ginkgo biloba, Panax ginseng and their combination in healthy young volunteers: differential interactions with cognitive demand. Human Psychopharmacology 17(1):35-44
• Schott N, Konietzny S, Raschka C. 2006. Red ginseng enhances the effectiveness of strength training in elderly: A randomized placebo-controlled double-blind trial. Schweizerische Zeitschrift fur GanzheitsMedizin 18(7-8):376-383
• Seida JK, Durec T, Kuhle S. North American (Panax quinquefolius) and Asian Ginseng (Panax ginseng) Preparations for Prevention of the Common Cold in Healthy Adults: A Systematic Review. Evidence-based complementary and alternative medicine 2011.
• Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. 2003. Null and opposing effects of asian ginseng (Panax ginseng C.A Meyer) on acute glycemia: results of two acute dose escalation studies. Journal of the American College of Nutrition 22(6):524-532
• Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. 2003. Variable effects of American ginseng: a batch of American ginseng (Panax quinquefolius L.) with a depressed ginsenoside profile does not affect postprandial glycemia. European Journal of Clinical Nutrition 57(2):243-248
• Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. 2004. Decreasing, null and increasing effects of eight popular types of ginseng on acute postprandial glycemic indices in healthy humans: the role of ginsenosides. Journal of the American College of Nutrition 23(3):248-258
• Sievenpiper JL, Sung MK, Buono MD, Seung-Lee K, Nam KY, Arnason JT, Leiter LA, Vuksan V. 2006. Korean red ginseng rootlets decrease acute postprandial glycemia: results from sequential preparation- and dose-finding studies. Journal of the American College of Nutrition 25(2):100-107
• Sinclaire S. 2000. Male infertility: nutritional and environmental considerations. Alternative Medicine Review: A Journal of Clinical Therapeutic 5(1):28-38
• Sotaniemi EA, Haapakoski E, Rautio A. 1995. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care 18(10):1373-1375
• Stavro PM, Woo M, Heim TF, Leiter LA, Vuksan V. 2005. North American ginseng exerts a neutral effect on blood pressure in individuals with hypertension. Hypertension 46(2):406-11
• Stavro PM, Woo M, Leiter LA, Heim TF, Sievenpiper JL, Vuksan V. 2006. Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 47(4):791-796
• Sun XB, Matsumoto T, Yamada H. 1994. Purification of immune complexes clearance enhancing polysaccharide from the leaves of Panax ginseng , and its biological activities. Phytomedicine 1:225-231
• Sun Y, Zhu H, Zhu Y, Feng J, Chen Z, Li G, Zhang X, Zhang Z, Tang J, Shi M, Hao X, Han H. 2006. A randomized, prospective, multi-centre clinical trial of NP regimen (vinorelbine + cisplatin) plus Gensing Rg3 in the treatment of advanced non-small cell lung cancer patients. Chinese Journal of Lung Cancer 9(3):254-258
• Sung J, Han K-H, Zo J-H, Park H-J, Kim C-H, Oh B-H. 2000. Effects of red ginseng upon vascular endothelial function in patients with essential hypertension. American Journal of Chinese Medicine 28(2):205-216
• Sünram-Lea SI, Birchall RJ, Wesnes KA, Petrini O. 2005. The effect of acute administration of 400 mg of Panax ginseng on cognitive performance and mood in healthy young volunteers. Current Topics in Nutraceutical Research 3(1):65-74
• Takahashi M, Tokuyama S. 1998. Pharmacological and physiological effects of ginseng on actions induced by opioids and psychostimulants. Methods & Findings in Experimental & Clinical Pharmacology 20(1):77-84
• Tawab MA, Bahr U, Karas M, Wurglics M, Schubert-Zsilavecz M. 2003. Degeneration of ginsenosides in humans after oral administration. Drug Metabolism and Disposition 31:1065-1071
• Tilgner S. Herbal Medicine from the Heart of the Earth. Creswell (OR): Wise Acre Press; 1999.
• Tode T, Kikuchi Y, Hirata J, Kita T, Nakata H, Nagata I. 1999. Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes. International Journal of Gynecology & Obstetrics 67(3):169-174
• Tohda C, Hashimoto I, Kuboyama T, Komatsu K. 2006. Metabolite 1 of protopanaxadiol-type saponins, an axonal regenerative factor, stimulates teneurin-2 linked by PI3-kinase cascade. Neuropsychopharmacology 31(6):1158-1164
• Tohda C, Kuboyama T, Komatsu K. 2005. Search for natural products related to regeneration of the neuronal network. Neurosignals 14(1-2):34-45
• Tohda C, Matsumoto N, Zou K, Meselhy MR, Komatsu K. 2004. Abeta(25-35)-induced memory impairment, axonal atrophy, and synaptic loss are ameliorated by M1, a metabolite of protopanaxadiol-type saponins. Neuropsychopharmacology 29:860-868
• Tohda C, Matsumoto N, Zou K, Meselhy RM, Komatsu K. 2002. Axonal and dendritic extension by protopanaxadiol-type saponins from ginseng drugs in SK-N-SH cells. Japanese Journal of Pharmacology 90:254-262
• Vaes LP, Chyka PA. 2000 Interactions of warfarin with garlic, ginger, ginkgo, or ginseng: nature of the evidence. The Annals of Pharmacotherapy 34(12):1478-1482
• Vogel VJ. 1970. American Indian Medicine. Norman (OK): The University of Oklahoma Press
• Vogler BK, Pittler MH, Ernst E. 1999. The efficacy of ginseng. A systematic review of randomized clinical trials. European Journal of Clinical Pharmacology 55(8):567-575
• Vohra S, Johnston BC, Laycock KL, Midodzi WK, Dhunnoo I, Harris E, Baydala L. 2008. Safety and tolerability of North American ginseng extract in the treatment of pediatric upper respiratory tract infection: a phase II randomized, controlled trial of 2 dosing schedules. Pediatrics 122(2):e402-e410
• Vuksan V, Sievenpiper JL, Wong J, Xu Z, Beljan-Zdravkovic U, Arnason JT, Assinewe V, Stavro MP, Jenkins AL, Leiter LA, Francis T. 2001. American ginseng (Panax quinquefolius L.) attenuates postprandial glycemia in a time-dependent but not dose-dependent manner in healthy individuals. The American Journal of Clinical Nutrition 73(4):753-758
• Vuksan V, Sung MK, Sievenpiper JL, Stavro PM, Jenkins AL, Buono MD, Lee KS, Leiter LA, Nam KY, Arnason JT, Choi M, Naeem A. 2008. Korean red ginseng (Panax ginseng) improves glucose and insulin regulation in well-controlled, type 2 diabetes: results of a randomized, double-blind, placebo-controlled study of efficacy and safety. Nutrition, Metabolism & Cardiovascular Diseases 18(1):46-56
• Wang CZ, Aung HH, Zhang B, Sun S, Li XL, He H, Xie JT, He TC, Du W, Yuan CS. 2008. Chemopreventive effects of heat-processed Panax quinquefolius root on human breast cancer cells. Anticancer Research 28(5A):2545-51
• Wang CZ, Mehendale SR, Yuan C-S. 2007. Commonly used antioxidant botanicals: active constituents and their potential role in cardiovascular illness. The American Journal of Chinese Medicine 35(4):543-558
• Wang M, Guilbert LJ, Li J, Wu Y, Pang P, Basu TK, Shan JJ. 2004. A proprietary extract from North American ginseng (Panax quinquefolium) enhances IL-2 and IFN-gamma productions in murine spleen cells induced by Con-A. International Immunopharmacology 4(2):311-315
• Wang M, Guilbert LJ, Ling L, Li J, Wu Y, Xu S, Pang P, Shan JJ. 2001. Immunomodulating activity of CVT-E002, a proprietary extract from North American ginseng (Panax quinquefolium). Journal of Pharmacy and Pharmacology 53(11):1515-23
• Wargovich MJ. 2001. Colon cancer chemoprevention with ginseng and other botanicals. Journal of Korean Medical Science 16 Suppl:S81-S86
• Washida D, Kitanaka S. 2003. Determination of polyacetylenes and ginsenosides in Panax species using high performance liquid chromatography. Chemical & pharmaceutical bulletin 51(11):1314-1317
• Weiss RF. 1998. Herbal Medicine. Gothenburg (SE), Beaconsfield (UK): AB Arcanum, Beaconsfield Publishers Ltd
• Wen J. 2001. Species diversity, nomenclature, phylogeny, biogeography, and classification of the ginseng genus (Panax L., Araliaceae). In: Punja, ZK, editor. Utilization of biotechnological, genetic and cultural approaches for North American and Asian ginseng improvement. Proceedings of the International Ginseng Workshop 2001, 69.
• WHO 1999: World Health Organization. WHO Monographs on Selected Medicinal Plants, Volume 1. Geneva (CH): World Health Organization; 1999.
• WHO 2007: World Health Organization (WHO) Monographs on Selected Medicinal Plants, Volume 3. Geneva (CHE): World Health Organization.
• Wichtl M, editor. Herbal Drugs and Phytopharmaceuticals: A Handbook for Practice on a Scientific Basis, 3rd edition. Stuttgart (D): Medpharm GmbH Scientific Publishers; 2004.
• Wiklund I, Karlberg J, Lund B. 1994. A double-blind comparison of the effect on quality of life of a combination of vital substances including standardized ginseng G115 and placebo. Current Therapeutic Research 55:32-42
• Wiklund IK, Mattsson LA, Lindgren R, Limoni C. 1999. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. International Journal of Clinical Pharmacology Research 19(3):89-99
• Williamson EM, Evans FJ, Wren RC. Potter's New Cyclopaedia of Botanical Drugs and Preparations. Saffron Walden (GB): C.W. Daniel Company Limited; 1988.
• Williamson EM. Potter's Herbal Cyclopaedia: The Authoritative Reference work on Plants with a Known Medical Use. Saffron Walden (UK): The C.W. Daniel Company Limited; 2003.
• Wittkowsky AK. 2005. A systematic review and inventory of supplement effects on warfarin and other anticoagulants. Thrombosis Research 117(1-2):81-86; discussion 113-115.
• Wren RC. 1907. Potter's Cyclopedia of Botanical Drugs and Preparations. London (GB): Potter and Clark.
• Xie JT, Mehendale SR, Wang A, Han AH, Wu JA, Osinski J, Yuan CS. 2004. American ginseng leaf: ginsenoside analysis and hypoglycemic activity. Pharmacology Research 49(2):113-117
• Youdim KA, Joseph JA. 2001. A possible emerging role of phytochemicals in improving age-related neurological dysfunctions: a multiplicity of effects. Free Radical Biology and Medicine 30(6):583-594
• Youl Kang H, Hwan Kim S, Jun Lee W, Byrne HK. 2002. Effects of ginseng ingestion on growth hormone, testosterone, cortisol, and insulin-like growth factor 1 responses to acute resistance exercise. Journal of strength and conditioning research / National Strength & Conditioning Association 16(2):179-183
• Younus J, Collins A, Wang X, Saunders M, Manuel J, Freake C, Defen P. 2003. A double-blind placebo controlled pilot study to evaluate the effect of ginseng on fatigue and quality of life in adult chemo-naive cancer patients. Proceedings of the American Society of Clinical Oncology 733
• Yun TK, Choi SY, Yun HY. 2001. Epidemiological study on cancer prevention by ginseng: are all kinds of cancers preventable by ginseng? Journal of Korean Medical Science 16 Suppl:S19-S27
• Yun TK, Choi SY. 1995. Preventive effect of ginseng intake against various human cancers: A case-control study on 1987 pairs. Cancer Epidemiology, Biomarkers & Prevention 4:401-408
• Zhao Y, Chen Z, Ma X. 1991. The preservation capacity of water and fertility of soilless cultivation substrate for Panax quinquefolium L. Zhongguo Zhong Yao Za Zhi 16(2):76-79, 125-126
• Zhong Z, Qu Z, Wang N, Wang J, Xie Z, Zhang F, Zhang W, Lu Z. 2005. Protective effects of Panax notoginseng saponins against pathological lesion of cholinergic neuron in rat model with Alzheimer' s disease. Zhong Yao Cai 28(2):119-122
• Zhong ZG, Qu ZQ, Wang NP, Zhang FF, Zhang WY, Lu UP. 2005. Effects of the Panax notoginseng saponins on the level of synaptophysin protein in brain in rat model with lesion of Meynert. Zhongguo Zhong Yao Za Zhi 30(12):913-915
• Ziemba AW, Chmura J, Kaciuba-Uscilko H, Nazar K, Wisnik P, Gawronski W. 1999. Ginseng treatment improves psychomotor performance at rest and during graded exercise in young athletes. International Journal of Sport Nutrition 9(4):371-377