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Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
People with known allergies to Panax species and/or plants in the Araliaceae family should avoid ginseng. Signs of allergy may include rash, itching, or shortness of breath. Inhalation of ginseng root dust has been associated with immediate and late-onset asthma.
Side Effects and Warnings
Ginseng has been well tolerated by most people in scientific studies when used at recommended doses, and serious side effects appear to be rare.
Based on limited evidence, long-term use may be associated with skin rash or spots, itching, diarrhea, sore throat, loss of appetite, excitability, anxiety, depression, or insomnia. Less common reported side effects include headache, fever, dizziness, chest pain, difficult menstruation, heartburn, heart palpitations, rapid heart rate, leg swelling, nausea/vomiting, or manic episodes in people with bipolar disorder.
Consumption of ginseng may increase or and decrease blood pressure. Caution should be used in those with high or low blood pressure or in those taking drugs for either of these conditions.
There is report of seizures after high consumption of energy drinks containing caffeine, guarana, and herbal supplements, including ginseng.
Based on human research, ginseng may lower blood sugar levels. This effect may be greater in patients with diabetes than in non-diabetics. Use cautiously in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.
There are reports of nosebleeds and vaginal bleeding with ginseng use, although scientific study is limited in this area. There is also evidence in humans of ginseng reducing the effectiveness of the "blood thinning" medication warfarin (Coumadin®). Caution is advised in patients with bleeding disorders or taking drugs that may affect the risk of bleeding or blood clotting. Dosing adjustments may be necessary.
Several cases of severe drops in white blood cell counts were reported in people using a combination product containing ginseng in the 1970s; this may have been due to contamination.
Ginseng may have estrogen-like effects and has been associated with reports of breast tenderness, loss of menstrual periods, vaginal bleeding after menopause, breast enlargement (reported in men), difficulty developing or maintaining an erection, or increased "sexual responsiveness." Avoid use of ginseng in patients with hormone sensitive conditions, such as breast cancer, uterine cancer, or endometriosis.
A severe life-threatening rash known as Stevens-Johnson syndrome occurred in one patient and may have been due to contaminants in a ginseng product. A case report describes liver damage (cholestatic hepatitis) after taking a combination product containing ginseng.
High doses of ginseng have been associated with rare cases of temporary swelling of blood vessels in the brain (cerebral arteritis), abnormal dilation of the pupils of the eye or confusion.
Pregnancy and Breastfeeding
Ginseng has been used traditionally in pregnant and breastfeeding women. Animal studies and early human research suggests that ginseng may be safe, although safety has not been clearly established in humans. Therefore, ginseng use cannot be recommended during pregnancy or breastfeeding. Neonatal death and the development of male characteristics in a developing baby girl after her mother was exposed to ginseng during pregnancy has been reported.
Many tinctures contain high levels of alcohol and should be avoided during pregnancy.
NS_patient-ginseng
Portions of this document last updated:Sept. 1, 2009
THE NATURAL STANDARD RESEARCH COLLABORATION
(www.naturalstandard.com)
