Panax ginseng: what is it for and what are its properties

Index

  • Description of the plant: habitat, hints of botany and preparation
  • Ginsenosides
  • Phytotherapeutic uses
  • Side effects
  • Conclusion

Questions and answers

Description of the plant: habitat, hints of botany and preparation

Panax ginseng CAMey. (known as Asian or Korean ginseng ) is one of the best-known herbaceous perennial plants of traditional Chinese medicine , whose uses in the herbal field date back to over 2000 years ago .
Traditionally it is used as a tonic agent , able to improve physical and mental capacity of resistance to fatigue . Before continuing with the description of this millenary plant, it should be emphasized that today the term “ginseng” brings together several herbal preparations , made with plants belonging to both species and different genera.
In addition to ginseng Korean (Panax ginseng CAMey.), there are American ginseng (Panax quinquefolium L.), ginseng sanchi (Panax notoginseng (Burkill) FHChen), Himalayan ginseng (Panax pseudoginseng Wall.) and Siberian ginseng (Eleutherococcus senticos. & Maxim.) Maxim.), Without disturbing the use of the different synonyms.

Even Asian ginseng is also known as:

  • Panax schin-seng var. coraiensis T. Nees;
  • Panax quinquefolius var. ginseng (CAMey.) Regel & Maack;
  • Panax chin-seng Nees;
  • Panax verus Oken;
  • Aralia ginseng (CAMey.) Baill .;
  • Aralia quinquefolia var. ginseng (CAMey.) auct.

Only the use of the correct botanical name makes it possible to identify the species and correlate the biological properties associated with it. Returning to Korean ginseng, the name “Panax” derives from the Greek, from the fusion of the two terms ” pan ” ( all ) and ” akeia ” ( cure ), intended as a “panacea, remedy for all ills”. While “ginseng” derives from the Chinese word ” rensheng “, the meaning of which, “little man”, refers to the typical anthropomorphic structure of the root.

The part of the plant used in the phytotherapeutic field consists of the roots , fusiform formations of a straw yellow color, divided into secondary roots, anticipated by a small rhizome which constitutes the “head” of the drug. In order to be considered a valid phytotherapeutic product, the roots must be at least 4-6 years old at the time of harvest.

These can be sold and consumed fresh , or undergo treatments that change their appearance and content in active ingredients. The dried root treated with sulfur dioxide, both whole and chopped, even without secondary roots (beards), represents the so-called ” white ginseng ” (also called ginseng radix alba); the fresh root treated with steam (90 ° -100 ° C, for 2-3 hours) and subsequently dried constitutes the so-called “ red ginseng ” (also called ginseng radix rubra ), with a reddish-brown color. Asian ginseng has spontaneous origins in the mountainous areas of China , Nepal and Korea , however the wild form is very rare; in fact, today’s ginseng production derives almost entirely from crops.

Ginsenosides

The properties of Asian ginseng are to be attributed to some molecules , with hormone-like structure, called ginsenosides (also known as panaxosides). These molecules belong to the group of triterpene saponins and, based on their structure, can be classified into two main categories: protopanaxadiol derivatives (e.g. Rb1, Rb2, Rc, Rd) and protopanaxatriol derivatives (e.g. Rg1, Re, Rf, Rg2, Rh1).

Their nomenclature expresses the retention factor, calculated by thin layer chromatography(TLC), and expresses their degree of polarity. As the letter of the alphabet progresses, polarity decreases, a characteristic directly related to their degree of glycosylation (number of bound carbohydrates ).

In white ginseng the ginsenosides make up 2-3% of the dry weight , while in red ginseng the concentration drops to 1%. Not only the quantity, but also the type of ginsenosides changes in the two preparations. Compounds such as malonylginsenosides (eg mRb1 and mRb2) are found only in white ginseng, because they are unstable to heat treatment, while Rh1 is the most abundant variant in red ginseng. L’
ginsenosides analysis allows to discriminate between the various ginseng species , allowing to recognize the starting sources and discover any adulterations. According to the European Pharmacopoeia, the dried drug must have a minimum content of ginsenosides of 0.4%, of which Rg1 (≥ 0.2%) and Rb1 (≥0.1%). In the intestine, these molecules are metabolized by the intestinal microflora; from these processes a molecule called M1 (or compound-K) is obtained, considered the most pharmacologically active metabolite. For the sake of completeness, it is important to underline that there are other molecules within the phytocomplex that can influence its activity, such as flavonoids and polysaccharides., called panaxani.

Phytotherapeutic uses

Korean ginseng is included in the Italian ministerial list for use in plant-based supplements as a tonic-adaptogen , antioxidant and for the metabolism of carbohydrates . In addition to these indications, various other activities have been described in the literature, listed below.

Adaptogenic activity

With ” adaptogens ” are described substances capable of increasing the resistance to stress , in a non-specific way, whose activity aims to restore the physiological balance of the organism.

The adaptogenic action of Korean ginseng is attributable to the action of ginsenosides, several human studies have suggested that these molecules involve the activity of the hypothalamus-pituitary-adrenal axis . In particular, ginseng is able to stimulate the release of adrenocorticotropic hormone from the adenohypophysis , which in turn stimulates the adrenal glands to produce corticosteroids .
Among them, cortisol reaches several target organs and induces effects such asgluconeogenesis and lipolysis, as well as vasopressor effects. A recent systematic review recognized ginseng as having positive effects on fatigue syndrome in people with chronic diseases .

Immunomodulating activity

Several studies conducted on animal models and cell cultures have shown that Korean ginseng extract, in particular its polysaccharide component , is able to induce an immunomodulatory effect , stimulating the activity of lymphocytes and macrophages and favoring the acquired immune response.
Some ginsenosides are also capable of stimulating the growth of T lymphocytes and Natural Killer (NK) cells . Human studies, albeit in limited numbers, have all confirmed the immunostimulating effect, improving overall the number of lymphocytes, NK cells and antibodies, also favoring phagocytic activity.. In some studies, groups of patients treated with ginseng had a lower frequency of flu or cold symptoms , however from the studies it is not clear whether the strengthening of the immune defenses always translates into greater protection from different diseases. In any case, the data are interesting and deserve to be deepened.

Cognitive performance

The improvement in memory and cognitive abilities attributed to ginseng appears to involve the synthesis and release of acetylcholine , accompanied by a decrease in serotonin levels . Ginseng extracts can inhibit the reuptake of various neurotransmitters, and they can also antagonize the effects of stress by reducing dopamine receptors . Three clinical studies conducted on humans have shown positive effects on the enhancement of cognitive functions , while two other studies have shown no differences in resistance to physical stress or in the feeling of well-being.. Further studies are required to confirm these activities.

Cardiovascular effects

Ginseng appears to transiently stimulate the cardiovascular system , but the effects are complex and still unclear. Some ginsenosides have hypertensive activity, while others have hypotensive activity. Furthermore, some of these molecules have antiarrhythmic properties , while others act as antiplatelet agents , probably through the inhibition of thromboxane A2. Finally, some ginsenosides promote the release of nitric oxide , promoting a vasodilatory action .

In summary, we know that there are several properties associated with individual ginsenosides, often considered positive, but the intake of ginseng, as a mixture of these components, leads toconflicting results due to the interaction of all these components. Therefore, new studies with titrated products are needed to arrive at more precise conclusions.

Effects on metabolism on diabetes

Ginsenosides have been attributed a hypoglycemic function . Studies conducted on isolated pancreatic cells show that different ginsenosides induce the release of insulin, while in animal models they involve the increase of insulin receptors, in different target organs. Other animal model studies report a decrease in blood cholesterol and triglyceride levels , accompanied by an increase in high density lipoprotein (HDL). An old clinical study confirmed the reduction in blood glucose levels, while no changes in plasma cholesterol levels were observed .

A recent meta-analysis confirmed that ginseng consumptionimproves blood glucose and insulin parameters both in fasting and post-prandial; moreover, after more than three months, effects on glycated hemoglobin levels were also observed.

Sports performance and antioxidant activity

The improving effects at a sporting level can be traced back to an increase in performance , or to the reduction of damage caused by exercise, for example through antioxidant- type mechanisms . Some studies have evaluated the effect of ginseng on the sports performance of professional athletes, through the analysis of parameters such as oxygen uptake, plasma lactate levels and heart rhythm.

In the first studies carried out, the drug appeared to show improvements in anaerobic tests, probably due to better neuro-motor and circulatory coordination. Also in this case the effect was attributed to the action of ginsenosides, especially related to the mechanisms of energy production in the muscles. However, a recent systematic review did not show any improvement in aerobic and anaerobic capacities , excluding, on the basis of the data produced so far, any improvement effects in this area. In addition, the data on antioxidant capacities were also evaluated as conflicting, therefore, to date, there is no valid scientific basis for the use of ginseng in sports.

Erectile dysfunction

Preliminary data has been collected for the use of ginseng for the treatment of erectile dysfunction . This activity is suggested by some studies that support the use of ginsenosides to improve the blood supply to the corpus cavernosum, with endothelial and neurogenic mechanisms that induce the release of nitric oxide.

The latter induces the formation of cyclic guanosine 5′-monophosphate (cGMP), the molecule responsible for the relaxation of the corpus cavernosum. Another possible mechanism of action of ginseng involves the inhibition of phosphodiesterase type 5, the enzyme responsible for the degradation of cGMP, already the target of other drugs against impotence. Other clinical studies attribute to ginsenosides the ability to reduce plasma levels ofprolactin , resulting in increased libido , testosterone levels and fertility , but the results are often contradictory . In the various clinical trials, the expected treatment for erectile dysfunction was long-lasting, ranging from two to three months. Although encouraging, the data should be taken with due caution, as further confirmation is required to ensure its real effectiveness.

Menopause

A first double-blind study showed that ginseng does not change the biological parameters of menopause , leaving the values ​​of estradiol and follicle-stimulating hormone unchanged .
However, the study found a slight improvement in mood , a condition that does not occur in healthy subjects. A more recent meta-analysis evaluated the effectiveness of red ginseng in reducing the symptoms of menopause, the result of this study shows that the preparation improves in most cases the sexual functions of patients , but does not improve vasomotor symptoms, such as hot flashes and sweating.

Side effects

Prolonged use, beyond two months , or high root dosages (greater than 15 g / day), can induce a clinical condition called ginseng abuse syndrome . This syndrome manifests with symptoms such as nervousness, insomnia, rapid heartbeat, diarrhea (especially in the morning), skin rashes , mood swings and high blood pressure . In addition, the abrupt cessation of consumption can cause other side effects, such as orthostatic hypotension , hypoglycemia , asthenia and muscle tremors .

The use of ginseng is not recommended in pregnant womenIt can also cause heavy bleeding during menopause (metrorrhagia). Due to its possible hormonal influences, its use is not recommended during puberty and in women undergoing mastectomy .

In patients with type 2 diabetes , the use of ginseng can cause a reduction in blood glucose , therefore it should be carefully monitored, especially in the case of concomitant insulin therapies.
Suspected cases of interaction between ginseng and warfarin , with lowering of INR , and with monoamine oxidase inhibitors (MAOIs) have been reported , resulting in headache and nervousness .
Other reported but not documented effects are mastalgia , gynaecomastia and cerebral arthritis .

Conclusion

In conclusion, ginseng is a proven remedy as an adaptogen and immunostimulant and appears to have promising results for glycemic control and erectile dysfunction in humans as well . The coexistence in ginseng of molecules capable of determining opposite effects complicates the studies and requires careful titration of the active ingredients, without which it is difficult to draw adequate conclusions (for example, Rg1 increases blood pressure and has stimulating effects on the central nervous system, while Rb1 lowers blood pressure and has a sedative action).
Furthermore, it is important to remember that ginseng is also one of the most sophisticated drugs, to which principles or drugs are voluntarily added with the intention of altering its effects. To avoid encountering unpleasant consequences it is essential to contact authorized resellers and traceable products .

BIBLIOGRAPHICAL REFERENCES

  • Book: Pharmacognosy and phytotherapy: pharmacological bases and application aspects.
    Authors: Mazzanti G, Dell’Agli M, Izzo A.
    Publisher: Piccin
    Year: 2020
  • Book: Dictionary of Phytotherapy and Medicinal Plants.
    Authors: Campanini E.
    Publisher: Tecniche Nuove
    Year: 2012
  • Book: Phytotherapy: rational use of plant drugs
    Authors: Capasso F, Grandolini G, Izzo A.
    Publisher: Springer
    Year: 2006

Questions and answers

WHAT ARE THE SCIENTIFICALLY VALIDATED BIOLOGICAL EFFECTS OF GINSENG? 

So far, scientific studies have confirmed the use of ginseng as an adaptogen and immunostimulant, in particular for people with chronic diseases. Other studies confirm positive effects on the glycemic level, with improvement in insulin and glycemia. Promising, but still preliminary, are the effects against erectile dysfunction.

IS THE CONSUMPTION OF GINSENG GOOD FOR THE HEART? 

The scientific data are conflicting, although there are some activities considered positive associated with some of its components and it is good to pay close attention to use, in order not to cause side effects such as hypertension, especially in subjects suffering from heart diseases and being treated with drugs for management. blood pressure or anticoagulants.

IS GINSENG ABLE TO IMPROVE BRAIN CAPACITIES? 

To date there are not enough data to support this activity, the drug is a valid aid against stress, but it does not seem able to increase the cognitive abilities of a healthy person.

ARE ALL COMMERCIAL SOURCES OF GINSENG VALID? 

No, ginseng contains several active ingredients, the concentrations of which vary both at the time of collection and the method of preparation. As with other herbal preparations, it is essential to contact serious retailers and products that clearly indicate the titration of the active ingredients, in this case the ginsenosides.

 

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