Ginseng (Renshen) is a perennial herb with a long history of use in treating diseases and enhancing health, often referred to as the “king of herbs.” It is generally divided into Asian ginseng (Ren Shen) and American ginseng (Xi Yang Shen). This article will explore the Asian ginseng that grows in East Asia.
Ginseng can be classified into more than ten types based on its origin, cultivation methods, and processing techniques, each with different properties, meridian affinities, and effects. The main active components include polysaccharides, saponins, polypeptides, and fatty acids, which are believed to have potential effects such as immune modulation, anti-fatigue, anti-aging, anti-diabetes, and anti-cancer.
Based on origin: Changbai Mountain ginseng, Korean ginseng.
Based on cultivation methods: wild mountain ginseng (naturally grown), garden ginseng (artificially cultivated).
Based on processing methods: fresh ginseng, white ginseng, red ginseng, sun-dried ginseng.
Korean ginseng (Gao Li Shen) is a well-known medicinal material both domestically and internationally, famous for its health benefits and anti-aging properties. It can be used in dietary therapy or made into various health supplements, with an astonishing variety. There are many legends about the origin of the name ginseng; one story suggests that hunters who encountered heavy snow survived by consuming ginseng, which resembles a human form, hence the name “ren shen” (人参), meaning “human root.”
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1. Ginseng Benefits Erectile Dysfunction
Erectile dysfunction (ED) is a common male sexual dysfunction defined as the persistent inability to obtain or maintain an erection sufficient for satisfactory sexual performance (prevalence approximately 19.2%), significantly affecting the quality of life of men.
Erection is primarily a vascular event, attributed to the release of neurotransmitters and nitric oxide (NO) from the corpus cavernosum, allowing blood to flow into the penis and maintain the erection. Therefore, any disease that may cause endothelial dysfunction can interfere with vascular dilation and impede erection.
A systematic review of literature (including 9 randomized controlled trials with a total of 587 men with mild to moderate ED) indicated that ginseng (primarily using Korean red ginseng) had a slight positive effect on erectile function or sexual satisfaction compared to placebo (assessed using IIEF-5 or IIEF-15 tools).
Additionally, ginseng also improved self-reported sexual ability in men.
*Conclusion: For mild to moderate erectile dysfunction, ginseng may provide positive assistance, but due to the low quality of existing evidence, further research is needed for validation.
2. Ginseng Benefits Liver Function
Chronic liver disease is one of the common diseases and is rapidly becoming an increasing burden on healthcare systems.
Due to the liver’s significant functional reserve, most patients with chronic liver disease are diagnosed only in the late stages of the disease.
When the liver can no longer maintain internal balance and begins to lose compensation, patients may experience ascites, variceal bleeding, spontaneous bacterial peritonitis, hepatic encephalopathy, or jaundice.
A systematic review and meta-analysis (including 14 randomized controlled trials with 992 participants) indicated that ginseng supplementation did not significantly help levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and albumin (ALB).
Additionally, subgroup analysis showed that in unhealthy individuals, when the daily supplementation of ginseng was ≥3 g, bilirubin levels significantly increased.
*Conclusion: Based on current evidence, supplementation with ginseng preparations has not shown significant benefits for populations with relatively normal liver function, and due to the heterogeneity among studies, further research is needed to confirm its effects on liver disease patients.
3. Ginseng Benefits Male Infertility
In recent decades, the quality of human semen has been declining, which may lead to an increase in male infertility, with an estimated 48.5 million couples worldwide affected by infertility.
In addition to intrinsic factors (genetic or congenital diseases), semen quality can also be influenced by external lifestyle factors, including diet, physical activity, environmental pollutants, endocrine disruptors, exposure to electromagnetic fields, and occupational characteristics.
A systematic review of literature (including 5 studies) indicated that among these studies, one randomized controlled trial reported that Korean red ginseng improved semen quality in infertile men, while other studies found no such effect (regardless of whether the subjects were healthy or infertile).
*Conclusion: To date, there is no clear evidence that ginseng improves semen quality, and due to small sample sizes and risk of bias, further high-quality research is needed for validation.
4. Ginseng Enhances Cognition (for Mild Cognitive Impairment)
Mild cognitive impairment (MCI) is considered an intermediate state between normal cognitive aging and early dementia.
Individuals diagnosed with MCI may remain stable or return to normal (approximately 14.4% to 55.6% of patients), but they may also progress to dementia.
It is estimated that 40% to 60% of MCI patients aged 58 and older have potential Alzheimer’s disease pathological features.
A randomized, double-blind, placebo-controlled clinical trial (lasting 6 months with 90 MCI volunteers) indicated that oral ginseng powder capsules (daily dose of 3g) helped improve immediate recall and 20-minute delayed recall test scores.
*Conclusion: For mild cognitive impairment, the use of ginseng has a positive effect on cognitive improvement, but due to small sample sizes, further large-scale studies are needed for validation.
5. Ginseng Reduces Inflammatory Markers (C-Reactive Protein)
C-reactive protein (CRP) is a homogenous acute-phase inflammatory protein and a highly sensitive plasma protein first discovered in 1930 by Tillet and Francis in the serum of patients with pneumonia.
CRP significantly increases in inflammatory conditions such as rheumatoid arthritis, cancer, certain cardiovascular diseases, and infections, sometimes increasing 1000-fold at the site of infection or inflammation.
Additionally, many factors can alter baseline levels of CRP, including age, sex, smoking status, weight, blood lipid levels, and blood pressure.
A systematic review and meta-analysis (including 7 randomized placebo-controlled trials with 420 participants) indicated that overall, ginseng supplementation did not significantly help reduce CRP levels.
However, subgroup analysis showed that when baseline CRP levels were greater than 3 mg/dl, ginseng could significantly reduce serum CRP levels.
*Conclusion: For patients with elevated serum CRP levels, ginseng supplementation may have a positive effect on reducing values.
6. Ginseng Lowers Blood Lipids
Cholesterol, triglycerides, and high-density lipoprotein are important components of human blood lipids.
Cholesterol is an unsaturated alcohol in the steroid family, essential for the normal function of all animal cells and a precursor for various important substances, such as adrenal and sex steroid hormones and bile acids.
Triglycerides are a type of glycerol fatty acid ester and are the main lipid component of dietary fats and fat stores in animals.
A systematic review and meta-analysis (including 10 randomized controlled clinical trials related to metabolic syndrome) indicated that compared to placebo, oral ginseng extract has a lowering effect on total cholesterol and low-density lipoprotein cholesterol, with no significant effect on high-density lipoprotein cholesterol and triglycerides.
*Conclusion: For individuals with metabolic syndrome, oral ginseng extract may have a positive effect on improving certain blood lipid indicators, but due to the heterogeneity of the included studies, further high-quality research is needed for confirmation.
7. Ginseng Benefits Diabetes
Diabetes has seen a multiple increase in the number of cases over the past 30 years, primarily due to obesity, stress, overeating, and lack of exercise.
Symptoms of hyperglycemia include polyuria, polydipsia, weight loss, sometimes accompanied by polyphagia and blurred vision.
A systematic review and meta-analysis (including 8 studies) indicated that for patients with type 2 diabetes or impaired glucose tolerance, ginseng intake helps improve blood glucose control (related indicators include: fasting blood glucose, postprandial insulin, insulin resistance), with the most significant effects observed in subjects not receiving medication or insulin treatment.
The underlying mechanisms may involve the regulation of insulin secretion, glucose metabolism absorption, inflammatory pathways, and activation of the AMPK pathway.
*Conclusion: Ginseng intake is beneficial for blood glucose regulation, but due to potential biases and heterogeneity, further clinical research is needed for confirmation.
8. Ginseng Benefits Ischemic Heart Disease – Angina Pectoris
Angina pectoris is triggered by plaque rupture, coronary artery spasm, thrombosis, and oxygen supply-demand imbalance, characterized by a feeling of pressure, tightness, and difficulty breathing in the sternum, most commonly occurring during physical activity or emotional fluctuations.
A literature meta-analysis (including 18 randomized controlled trials with 1549 angina patients) indicated that compared to nitrate medications, using ginseng-based prescriptions produced better symptom and electrocardiogram improvement effects.
*Conclusion: For the treatment of angina pectoris, ginseng-based therapies can produce more significant symptom improvement effects than nitrate medications.
9. Ginseng Prevents Acute Respiratory Diseases (Common Cold)?
Acute respiratory diseases are self-limiting viral infections characterized by symptoms such as fever, chills, malaise, and dry cough, with rhinovirus and coronaviruses (50%-70%) being the most common, followed by influenza viruses (20%-35%) and adenoviruses (5%-10%).
According to disease burden surveys, acute respiratory diseases have the highest incidence and mortality rates among children under five in developing countries, influenced by factors such as age, sex, nutritional status, breastfeeding (type and duration), socioeconomic level, overcrowding, indoor pollution, and passive smoking.
A randomized, double-blind, placebo-controlled trial (lasting 12 weeks with 100 healthy adults) indicated that oral Korean red ginseng extract significantly reduced the frequency of acute respiratory infections and helped reduce the duration and severity of symptoms (though the latter two did not reach statistical significance).
*Conclusion: Korean red ginseng extract may have preventive effects against acute respiratory-related diseases, but due to the study’s scale, further large-scale research is needed for confirmation.
10. Ginseng Reduces Cancer Incidence?
The occurrence of cancer is usually caused by multiple factors, influenced by internal factors (genetic mutations, hormonal and immune conditions) and environmental/external factors (tobacco, diet, radiation, and infectious diseases).
According to statistics from the United States, the probability of being diagnosed with cancer in a lifetime is 43% for men and 38% for women, a remarkably high incidence rate.
A literature meta-analysis (including 9 studies with 7,436 cancer cases and 334,544 participants) indicated that overall, the population consuming ginseng had a 16% lower risk of developing cancer compared to non-users.
Subgroup analysis also found that for specific types of cancer, such as colorectal cancer, lung cancer, gastric cancer, and liver cancer, the risk reduction rates were 23%, 19%, 17%, and 23%, respectively.
The underlying mechanisms involve ginseng regulating cell cycles, inducing apoptosis, inhibiting angiogenesis, and invasion through various cellular signaling pathways.
*Conclusion: Ginseng intake has effects on reducing cancer incidence, but due to the heterogeneity of the included studies, further large-scale clinical trials are needed for verification.
11. Ginseng Reduces Fatigue and Enhances Physical Performance?
Fatigue is a physiological state characterized by a lack of energy and motivation, usually triggered by physical activity, emotional stress, boredom, lack of sleep, or related medical conditions.
A literature meta-analysis (including 12 randomized controlled trials with 630 participants) indicated that taking ginseng-related supplements significantly improved fatigue levels, but did not enhance physical performance.
*Conclusion: Due to the insufficient number of studies and sample sizes, there is currently no adequate evidence to confirm that ginseng has anti-fatigue and physical performance-enhancing effects, requiring further large-scale studies for validation.
12. Ginseng Benefits Women’s Menopausal Disorders?
Women’s menopause, also known as the transition period to menopause, typically refers to the period from irregular menstrual cycles to the cessation of menstruation, occurring around the ages of 40 to 50.
During menopause, due to dramatic fluctuations in estrogen, symptoms such as emotional changes, hot flashes, insomnia, vaginal dryness, decreased libido, and cognitive impairment often accompany.
A systematic review of literature (including 10 randomized controlled trials) indicated that for menopausal women, the use of ginseng has effects on improving sexual function, sexual arousal, and hot flash scores (but no improvement in hot flash frequency, hormone levels, or endometrial thickness).
*Conclusion: Due to the unknown risk of bias and small sample sizes in the included studies, the effects of ginseng on improving menopausal disorders in women are limited and require more rigorous experiments for validation.
13. Ginseng Benefits Alzheimer’s Disease?
Alzheimer’s disease is a progressive neurodegenerative disease first discovered over a century ago by German psychiatrist Alois Alzheimer, accounting for 75% of all dementia cases, with a prevalence of 3.9% among those over 60, equating to 5 million new cases globally each year.
As the disease progresses, Alzheimer’s often leads to various functional disabilities requiring specialized care, making it one of the diseases with the highest coexistence of disability (11.2%), surpassing stroke, musculoskeletal diseases, and cardiovascular diseases.
A literature review and meta-analysis (including 4 randomized controlled trials with a total of 259 participants) indicated that due to inconsistent results, the effectiveness of ginseng in Alzheimer’s disease remains inconclusive.
*Conclusion: Due to small sample sizes, poor methodological quality, and lack of placebo control, the effects of ginseng on improving Alzheimer’s disease are questionable and require confirmation.
Ginseng has been used in countries such as China, Japan, and Korea for thousands of years and is considered a safe natural supplement for short-term use. However, reported potential side effects or adverse reactions include: insomnia, hypoglycemia, loss of appetite, diarrhea, itching, rapid heartbeat, elevated or lowered blood pressure, headache, dizziness, rash, breast pain, mood changes, vaginal bleeding, allergies, etc., especially with excessive doses or prolonged use.
Safety Precautions (9 Cautions for Use)
1. Pregnant women, breastfeeding mothers, infants, and individuals with poor liver or kidney function should avoid use (due to unknown safety).
2. Individuals with autoimmune diseases should avoid use (such as multiple sclerosis, systemic lupus erythematosus, rheumatoid arthritis), as ginseng may stimulate the immune system, worsening the condition.
3. May have anticoagulant effects; therefore, individuals with bleeding disorders or those taking related anticoagulants should avoid use, as it may increase the risk of bruising and bleeding.
4. May produce weak estrogenic effects; individuals with hormone-sensitive conditions, such as uterine cancer, breast cancer, endometriosis, or uterine fibroids, should avoid use, as it may worsen symptoms.
5. May have blood sugar-lowering effects; individuals with diabetes or those taking hypoglycemic medications should be cautious, as it may lead to hypoglycemia.
6. Individuals who have undergone organ transplants and are taking related anti-rejection medications should avoid use, as it may affect the efficacy of the medications.
7. Do not use with coffee, as it may accelerate side effects such as palpitations, sweating, arrhythmias, and anxiety.
8. Individuals taking antihypertensive medications, those in the acute phase of coronary heart disease or stroke, and those with unstable hypertension (systolic blood pressure above 140 mmHg) should avoid use.
9. Individuals with bipolar disorder or those taking monoamine oxidase inhibitors (MAOIs) should avoid use, as it may cause headaches or manic symptoms.
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