Ginseng (American) (Panax quinquefolius)
Ginseng is probably the most researched and used medicinal herb in the world. There are 11 different varieties of ginseng, eight species of Panax in all, two of which are considered possessing high medicinal value: Asian Ginseng (Panax ginseng) and American Ginseng (Panax quinquefolius or P. quinquefolius). The genus name, Panax, comes from the Greek word for panacea, or cure-all. American ginseng is a native perennial found in the temperate nutrient-rich forests in North America. American ginseng is considered an adaptogen. Adaptogens are a class of substances that stimulate the body's resistance to physical, environmental, and emotional stressors. Both Native American healers and traditional Chinese medicine (TCM) practitioners have utilized it. It is not to be confused with Panax ginseng as it is a different species with slightly different medicinal properties than Asian or Panax ginseng. Both American and Asian ginseng contain compounds called ginsenosides, so some of their effects may be similar.
American ginseng is thought of as the botanical cousin to Asian ginseng. TCM and Ayurveda consider American ginseng cooling making it better suited for younger, fiery, and overly stimulated (indicating excess heat) individuals. Native Americans used the root of this plant in many medicinal compounds, including a remedy that induces sweating to lower a fever. American ginseng is primarily used for stress, to boost the immune system, for upper airway infections, fatigue, poor mental function, diabetes, and many other conditions. It contains chemicals called ginsenosides, which are shown to affect insulin levels and lower blood sugar.
The bioactive components of American ginseng are ginseng ginsenosides or triterpenoid saponins. Other important chemical constituents of America ginseng include polyacetylenes, sesquiterpenes, polysaccharides, and peptidoglycans, that have also been isolated along with volatile constituents, organic acids, amino acids, sugars, and other constituents. More than 150 ginsenosides have been isolated from different parts of the American ginseng plant so far.
Human studies are limited. Current data suggest that American ginseng may improve glucose control in diabetics and that it is safe for long-term use. It demonstrates a modest effect in reducing number and severity of colds, and enhanced working memory in young and middle-aged healthy adults, and patients with schizophrenia.
Clinical trials have demonstrated that American ginseng can improve cancer-related fatigue. Epidemiological data suggest it may improve survival and quality of life in breast cancer patients.
The saponin glycosides, also known as ginsenosides or panaxosides, are thought responsible for the herb’s biological effects. In lab studies, ginsenosides have both stimulatory and inhibitory CNS effects, can alter cardiovascular tone, enhance humoral and cellular-dependent immunity, and exert anticancer effects. Other lab studies suggest enhanced anticancer activities when combined with antioxidants, synergistic effects with 5-fluorouraci, and protection against oxidative stress in irradiated human lymphocytes.
Related species, such as Panax ginseng, have been the focus of most laboratory and clinical research. Experiments using extracts from these species indicate that ginsenosides stimulate and inhibit the central nervous system. The extracts also stimulate TNF alpha production by alveolar macrophages.
The Rg1 ginsenoside present in American ginseng is associated with improvements in humoral and cell-mediated immune response and increases in T helper cells, T lymphocytes, and NK cells in mice. American ginseng was also shown to lower serum glucose and may affect carbohydrate metabolism.
Several ginsenosides have demonstrated anticancer properties in vitro. Current data suggest that antiproliferative effects of American ginseng are due to compound K, a metabolite of the ginsenoside Rb1, but not Rb1 as previously thought. In a rodent study, the herb significantly attenuated colon carcinogenesis by reducing tumor number and load and was associated with suppression of proinflammatory cytokine activation.
Assinewe VA, et al. Extractable polysaccharides of Panax quinquefolius L. (North American ginseng) root stmulate TNFalpha production by alveolar macrophages. Phytomedicine 2002;9:398-404.
Attele AS, Wu JA, Yuan CS. Ginseng pharmacology: multiple constituents and multiple actions. Biochem Pharmacol 1999;58:1685-93.
Barton DL, Liu H, Dakhil SR, et al. Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: a randomized, double-blind trial, N07C2. J Natl Cancer Inst. 2013 Aug 21;105(16):1230-8.
Chen EY, Hui CL. HT1001, a proprietary North American ginseng extract, improves working memory in schizophrenia: a double-blind, placebo-controlled study. Phytother Res. 2012 Aug;26(8):1166-72.
Chen SE. American ginseng. III. Pharmacokinetics of ginsenosides in the rabbit. Eur J Drug Metab Pharmacokinet 1980;5:161-8.
Cui Yong, et al. Association of ginseng use with survival and quality of life among breast cancer patients. Am J Epidemiol 2006; 163(7):645-53.
Guglielmo M, Di Pede P, Alfieri S, et al. A randomized, double-blind, placebo controlled, phase II study to evaluate the efficacy of ginseng in reducing fatigue in patients treated for head and neck cancer. J Cancer Res Clin Oncol. Oct 2020;146(10):2479-2487.
Lee TK, O’Brien KF, Wang W, et al. Radioprotective effect of American ginseng on human lymphocytes at 90 minutes postirradiation: a study of 40 cases. J Altern Complement Med. 2010 May;16(5):561-7.
Li B, Wang CZ, He TC, et al. Antioxidants potentiate American ginseng-induced killing of colorectal cancer cells. Cancer Letters. 2010;289(1):62-70.
Li B, Zhao J, Wang CZ, et al. Ginsenoside Rh2 induces apoptosis and paraptosis-like cell death in colorectal cancer cells through activation of p53. Cancer Lett. 2011 Feb 28;301(2):185-92.
Li XL, Wang CZ, Sun S, et al. American ginseng berry enhances chemopreventive effect of 5-FU on human colorectal cancer cells. Oncol Rep. 2009 Oct;22(4):943-52.
Mancuso, Cesare, and Rosaria Santangelo. "Panax ginseng and Panax quinquefolius: From pharmacology to toxicology." Food and Chemical Toxicology 107 (2017): 362-372.
Mucalo I, Jovanovski E, Vuksan V, Božikov V, Romić Z, Rahelić D. American Ginseng Extract (Panax quinquefolius L.) Is Safe in Long-Term Use in Type 2 Diabetic Patients. Evid Based Complement Alternat Med. 2014;2014:969168.
Ossoukhova A, Owen L, Savage K, et al. Improved working memory performance following administration of a single dose of American ginseng (Panax quinquefolius L.) to healthy middle-age adults. Hum Psychopharmacol. 2015 Mar;30(2):108-22.
Predy GN, et al. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infectons: a randomized controlled trial. CMAJ 2005;173(9):1043-8.
Sadeghian M, Rahmani S, Zendehdel M, et al. Ginseng and Cancer-Related Fatigue: A Systematic Review of Clinical Trials. Nutr Cancer. 2021;73(8):1270-1281.
Scholey A, Ossoukhova A, Owen L, et al. Effects of American ginseng (Panax quinquefolius) on neurocognitive function: an acute, randomised, double-blind, placebo-controlled, crossover study. Psychopharmacology (Berl). 2010 Oct;212(3):345-56.
Vuksan V, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med 2000;160:1009-13.
Vuksan V, et al. American ginseng (Panax quinquefolius L.) attenuates postprandial glycemia in a time-dependent but not dose-dependent manner in healthy individuals. Am J Clin Nutr 2001;73:753-8.
Vuksan V, et al. American ginseng improves glycemia in individuals with normal glucose tolerance: effect of dose and time escalation. J Am Coll Nutr 2000;6:738-44.
Vuksan V, Xu ZZ, Jovanovski E, et al. Efficacy and safety of American ginseng (Panax quinquefolius L.) extract on glycemic control and cardiovascular risk factors in individuals with type 2 diabetes: a double-blind, randomized, cross-over clinical trial. Eur J Nutr. Apr 2019;58(3):1237-1245.
Wang CZ, Du GJ, Zhang Z, et al. Ginsenoside compound K, not Rb1, possesses potential chemopreventive activities in human colorectal cancer. Int J Oncol. 2012 Jun;40(6):1970-6.
Wang, Yaping, Hyung-Kyoon Choi, Josef A. Brinckmann, Xue Jiang, and Linfang Huang. "Chemical analysis of Panax quinquefolius (North American ginseng): A review." Journal of Chromatography a 1426 (2015): 1-15. https://www.sciencedirect.com/science/article/abs/pii/S0021967315016209
Xie JT, Du GJ, McEntee E, et al. Effects of Triterpenoid Glycosides from Fresh Ginseng Berry on SW480 Human Colorectal Cancer Cell Line. Cancer Res Treat. 2011 Mar;43(1):49-55.
Yu C, Wen XD, Zhang Z, et al. American ginseng attenuates azoxymethane/dextran sodium sulfate-induced colon carcinogenesis in mice. J Ginseng Res. 2015 Jan;39(1):14-21.
Wang CZ, Yu C, Wen XD, et al. American Ginseng Attenuates Colitis Associated Colon Carcinogenesis in Mice: Impact on Gut Microbiota and Metabolomics. Cancer Prev Res (Phila). 2016 Oct;9(10):803-811.