Ginseng
(Asian, Chinese, Korean (Panax ginseng), American ( P.quinquefolius)

General Description:   A shrub 3-4 feet tall with spiny shoots and grey or brownish bark.  Grows in Asia and is considered the strongest.   American ginseng is milder and less stimulating.  It grows form Canada to Georgia  and takes 6 years to produce a marketable root.

Part Used:  Root and leaves

Uses:   

  improves concentration

  stamina

  combat fatigue, thus improves energy

   stress relief

   improve LDL & HDL levels

   raise and lower BP

         hot flashes

    night sweats

  mood swings

   headaches

    palpitations

              prevent platelet aggregation

              improve immune system

              stress incontinence

Action:  Main components are ginsenosides or panaxosises.  They produce CNS depression or CNS stimulation.  There are complex chemical components in the root, and thus they produce opposing effects.

Dosage: 

100-300 mg/day/divided

Dried roots: - 2-4 grams

Tincture (1:5) - 10-20 ml.

Precaution/Adverse Effects:  Can produce diarrhea, sleep disturbance, headache, hypertension, skin rash, increase bleeding in postmenopausal  women, and can cause a decreased diuretic effect. 

Since ginseng is highly notable for being mislabeled, it is not known whether ginseng itself or its contaminants is the cause for adverse effects.

 Drug Interactions:  Warfarin

                                     Insulin

                                     Phenelzine (MAOIs)

                                     Caffeine        

                              Digitalis toxicity

                                     Guarana 

                                     Hormone therapy

Contraindication:  Do not use concurrently with caffeine, estrogen-dependent malignancies (Breast cancer), menses, acute illness, hypertension,  schizophrenia and  mania.  Pregnancy, lactating, and children. (no studies)

Nursing Considerations:

           Most important is that there are various forms of ginseng.  Depending on the components of ginseng root, the effects will be different.  Also, ginseng is frequently adulterated or mislabeled and varying constitutions of the product has been found.

            Caffeine and ephedrine had sometimes been added, as well as   Phenylbutazone or aminopyrine.

           Warn patients that ginseng and warfarin may both increase or decrease coagulations.  Monitor clotting times routinely.

            Ginseng causes hypoglycemia and diabetics blood sugar levels must be monitored.  

            Over the 400 studies that  have been done on ginseng, some provide unreliable results and have inadequate study design and control.  

            Approximately 6 million American use ginseng regularly.