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[[File:Ginseng plant.png|alt=Image of panax ginseng plant, and chemical structures|thumb|Source: Sun et al. (2015).<ref name="Sun2016">{{Cite journal | last = Sun | first = Yingying | last2 = Liu | first2 = Yue | last3 = Chen | first3 = Keji | date = 2016-01-20 | title = Roles and mechanisms of ginsenoside in cardiovascular diseases: progress and perspectives| url = https://engine.scichina.com/doi/10.1007/s11427-016-5007-8;JSESSIONID=ac185989-6069-4511-b0cb-100634151255?slug=fulltext|journal=SCIENCE CHINA Life Sciences|language=en|volume=59|issue=3 | pages = 292β298|doi=10.1007/s11427-016-5007-8|issn=1869-1889}}</ref> License: CC BY-4.0.]] '''Ginseng''' usually refers to '''ginseng radix''' (panax ginseng) is the root of the plants in the genus "Panax", subspecies coming from Appalachia, South China, and Korea and has been used in traditional medicine for centuries.<ref name="EMA-radix">{{Cite web | url = https://www.ema.europa.eu/en/medicines/herbal/ginseng-radix | title = Ginseng Radix | last = | first = | authorlink = | date = | website = [[European Medicines Agency]]|archive-url=|archive-date=|url-status=|access-date=Aug 23, 2020}}</ref> It is commonly used for general fatigue and weakness.<ref name="EMA-radix" /> Traditional Chinese medicine uses it as a muscle relaxant and a tonic for patients with chronic illnesses.{{Citation needed|reason= | date = 23 August 2020}} There are many different types of ginseng, with several types of ginseng coming from a number of different plants.<ref name="MeylerBook">{{Cite book | title = Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions | pages = 546|isbn=978-0-444-53716-4|edition=|volume=|language=en|title-link=| url = https://books.google.com/books?id=NOKoBAAAQBAJ&lpg=RA2-PA546&pg=RA2-PA546#v=onepage&q&f=false|access-date= | date = 2015-10-15| publisher = Elsevier | last = | first = | authorlink = |veditors=|others=|doi=|oclc=|quote=|archive-url=|archive-date=|location=|editor-last = Aronson|editor-first = Jeffrey K.|editor1-link=|editor-last2 = |editor-first2 = }}</ref> [[Siberian ginseng]] has the most evidence to help improve fatigue and weakness in the short term.{{citation needed | date = Jul 2020}} ==Types== ===American === Panax quincefolius is commonly known as American ginseng, and is found in Canada and the US.<ref name="MeylerBook" /><ref name="Arring2018" /> Typical doses uses in trials for [[cancer-related fatigue]] and fatigue from [[multiple sclerosis]] were 750 - 2000mg, for up to six months. Most studies found American ginseng moderately effective for fatigue, particularly when used at higher doses or for six months.<ref name="Arring2018" /> ===Panax radix=== Asian, Chinese and Korean ginseng terms all refer to '''panax radix''', which is also found in Russia.<ref name="MeylerBook" /> Panax radix is [[Adaptogens|adaptogenic]], and was found to be moderately effective in most trials for [[cancer-related fatigue]] or [[fatigue]] caused by [[multiple sclerosis]], particularly when used for around six months or in doses of course to 2000mg.<ref name="Mukherjee2018">{{Cite book | last = Mukherjee | first = Dhrubojyoti | last2 = Palit | first2 = Partha | last3 = Roychoudhury | first3 = Shubhadeep | last4 = Kundu | first4 = Sukalyan K. | last5 = Mandal | first5 = Subhash C. | date = 2018-01-01|editor-last = Mandal|editor-first = Subhash C.|editor2-last = Mandal|editor2-first = Vivekananda|editor3-last = Konishi|editor3-first = Tetsuya | title = Chapter 14 - Role of Stress in Diseases and Its Remedial Approach by Herbal and Natural Products in Stress-Related Disease Management: Experimental Studies and Clinical Reports| url = https://www.sciencedirect.com/science/article/pii/B9780081020814000149|language=en| publisher = Elsevier | pages = 375β410|isbn=978-0-08-102081-4}}</ref><ref name="Arring2018" /> Doses used in the trials are typically between 800 - 2000mg.<ref name="Arring2018" /> ===Siberian=== Siberian ginseng refers to a different but related plant, known as '''eleutherococcus''', which has different properties.<ref name="MeylerBook" /><ref name="drugscom" /> {{See|Siberian ginseng}} === White and Red === Ginseng may be described as white or red depending on the method used to prepare or process it, typically these are a form of ginseng radix (Chinese ginseng).<ref name="EMA-radix" /> ==Ginsenosides== Ginsenosides is a name that refers to the bioactive components of ginseng.<ref name="Sun2016" /> The three types of ginsenosides are: *'''Oleanolic acid type''', also known as oleanic acid, caryophyllin, astrantiagenin C or giganteumgenin C<ref name="oleanic">{{Cite web | url = https://pubchem.ncbi.nlm.nih.gov/compound/10494 | title = Oleanolic acid | last = | first = | authorlink = | date = | website = PubChem|language=en|archive-url=|archive-date=|url-status=|access-date=2021-03-11}}</ref> *'''Protopanaxadiol (PPD) type''', also known as protopanaxdiol, (20R)-Protopanaxdiol, (20R)-Protopanaxadiol or 24-Dammarene-3beta,12beta-20S-triol<ref name="protopanaxadiol">{{Cite web | url = https://pubchem.ncbi.nlm.nih.gov/compound/9920281 | title = Protopanaxadiol | last = | first = | authorlink = | date = | website = PubChem|language=en|archive-url=|archive-date=|url-status=|access-date=2021-03-11}}</ref> and *'''Protopanaxatriol (PPT) type'''<ref name="Sun2016" /> ==Uses== ==Theory== ==ME/CFS== There is a lack of evidence about the benefits or risks of ginseng in patients with [[ME/CFS]];<ref name="Arring2018">{{Cite journal | last = Arring | first = NoΓ«l M. | last2 = Millstine | first2 = Denise | last3 = Marks | first3 = Lisa A. | last4 = Nail | first4 = Lillian M. | date = 2018-04-06 | title = Ginseng as a Treatment for Fatigue: A Systematic Review | url =https://www.liebertpub.com/doi/full/10.1089/acm.2017.0361|journal=The Journal of Alternative and Complementary Medicine|volume=24|issue=7 | pages = 624β633|doi=10.1089/acm.2017.0361|issn=1075-5535}}</ref> a recent systematic review found that clinical trials have assessed only the effects of ginseng on [[fatigue]] caused by other illnesses, including [[fibromyalgia]], [[multiple sclerosis]], and cancer-related fatigue, or have assessed only the symptom of fatigue in people with [[idiopathic chronic fatigue]], some of whom may have also had ME/CFS.<ref name="Hartz2004" /><ref name="Kim2013">{{Cite journal | last = Kim | first = Hyeong-Geug | last2 = Cho | first2 = Jung-Hyo | last3 = Yoo | first3 = Sa-Ra | last4 = Lee | first4 = Jin-Seok | last5 = Han | first5 = Jong-Min | last6 = Lee | first6 = Nam-Hun | last7 = Ahn | first7 = Yo-Chan | last8 = Son | first8 = Chang-Gue | date = 2013-04-17 | title = Antifatigue Effects of Panax ginseng C.A. Meyer: A Randomised, Double-Blind, Placebo-Controlled Trial| url = https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0061271|journal=PLOS ONE|language=en|volume=8|issue=4| pages = e61271|doi=10.1371/journal.pone.0061271|issn=1932-6203|pmc = 3629193|pmid=23613825}}</ref> The effect of ginseng on symptoms of ME/CFS other than fatigue are not known due to the absence of clinical trials as a treatment for ME/CFS. ==Risks and side effects== There is a lack of information from clinical trials,<ref name="Arring2018" /> but it is generally regarded as safe for adult use by the European Medicines Agency, which describes possible risks and side effects.<ref name="EMA-radix" /> Ginseng can also cause a hypersensitivity reaction or anaphylaxis in some people.<ref name="drugscom">{{Cite web | url = https://www.drugs.com/npp/ginseng.html | title = Ginseng Uses, Benefits & Dosage | last = | first = | authorlink = | date = | website = Drugs.com Herbal Database|language=en|archive-url=|archive-date=|url-status=|access-date=2021-03-11}}</ref> Interactions with other drugs are likely unknown.<ref name="drugscom" /> Ginseng abuse syndrome causes hypertension, diarrhea, [[insomnia]], mastalgia, [[skin rash]]es, [[confusion]], and [[depression]]. A very small number of cases of new onset acute manic episodes subsequent have been reported after usage of high doses.<ref name="drugscom" /> ==Costs and availability== Asian and American ginseng supplements are readily available over the counter, with American ginseng being significantly cheaper.<ref name="MeylerBook" /><ref name="drugscom" /> == Notable studies == * 2003, Antifatigue Effects of Panax ginseng C.A. Meyer: A Randomised, Double-Blind, Placebo-Controlled Trial<ref name="Kim2013" /> - [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0061271 (Full text)] * 2004, Randomized controlled trial of Siberian ginseng for chronic fatigue<ref name="Hartz2004">{{Cite journal | last = Hartz | first = A.J. | authorlink = | last2 = Bentler | first2 = S. | authorlink2 = | last3 = Noyes | first3 = R. | authorlink3 = | last4 = Hoehns | first4 = J. | authorlink4 = | last5 = Logemann | first5 = C. | authorlink5 = | last6 = Sinift | first6 = S. | authorlink6 = | last7 = Butani | first7 = Y. | last8 = Wang | first8 = W. | last9 = Brake | first9 = K. | date = Jan 2004 | title = Randomized controlled trial of Siberian ginseng for chronic fatigue | url =https://www.cambridge.org/core/journals/psychological-medicine/article/randomized-controlled-trial-of-siberian-ginseng-for-chronic-fatigue/B9941CDB55F4C53FF5DB1D48B5C350A7|journal=Psychological Medicine|language=en|volume=34|issue=1 | pages = 51β61|doi=10.1017/S0033291703008791|issn=1469-8978|pmc=|pmid=|access-date=|quote=|via=}}</ref> [https://www.cambridge.org/core/journals/psychological-medicine/article/randomized-controlled-trial-of-siberian-ginseng-for-chronic-fatigue/B9941CDB55F4C53FF5DB1D48B5C350A7 (Full text)] * 2018, Ginseng as a Treatment for Fatigue: A Systematic Review<ref name="Arring2018" /> - [https://www.liebertpub.com/doi/full/10.1089/acm.2017.0361 (Full text)] ==Learn more== * [https://www.ema.europa.eu/en/medicines/herbal/ginseng-radix Ginseng] - European Medicines Agency * [https://books.google.com/books?id=NOKoBAAAQBAJ&lpg=RA2-PA546&pg=RA2-PA546#v=onepage&q&f=false Ginseng] - Meyer's Side Effects of Drugs * [https://www.drugs.com/npp/ginseng.html Ginseng] - drugs.com ==See also== *[[List of approved herbal medicines by the EU Committee for Herbal Medicinal Products]] *[[:Category:Herbs|Herbs]] (category) *[[Siberian ginseng]] ==References== {{Reflist}} [[Category:Potential treatments]] [[Category:Herbs]] [[Category:Supplements]] [[Category:Medicinal foods]] [[Category:Traditional Chinese medicine]] [[Category:Traditional Korean medicine]] [[Category:Muscle relaxants]] [[Category:Adaptogens]]
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