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ASIAN MEDICINE & ELDERLY HEALTH : THERAPEUTIC APPLICATIONS OF GINSENGby David Puchol EsparzaINTRODUCTIONGinseng is the most famous Chinese psychoactive herb.Asians consider Ginseng the king of all herbs.It is the most widely recognized plant used in traditional medicine. Various forms of Ginseng have been used in medicine for more than 7000 years.Ginseng is one of the most popular healing herbs used today throughout the world as a dietary supplement by consumers seeking to improve general energy and vitality, particularly during times of stress and fatigue.Ginseng's reputation and popularity are not paralleled by any other medicinal herb,especially in Asia.Unlike other psychoactive herbs that produce immediate or specific therapeutic effects, Ginseng's ‘influence’ is accumulative and slow, and usually not noticeable within days. Ginseng's action is also rather gentle, non-specific, and broad, which is the reason why Ginseng is a general ingredient for almost every Oriental herbal formula.Ginseng has been used as a cure-all by many different cultures. The Chinese, however, view Ginseng not only as a cure-all, but also as a plant that brings longevity, strength, and wisdom to its users. There are actually three different herbs commonly called Ginseng: 1.-Asian or Korean Ginseng (Panax Ginseng). 2.-American Ginseng (Panax Quinquefolius). 3.-Siberian Ginseng (Eleutherococcus Senticosus). The most commonly used type of Ginseng is Asian Ginseng (Panax Ginseng),often sold as Panax,Chinese, or Korean Ginseng.Closely related to Asian Ginseng is American Ginseng (Panax Quinquefolius),which is sometimes preferred for its milder effects.Siberian Ginseng, also known as ‘Eleuthero’ (Eleutherococcus Senticosus),is not as closely related to the other two, is often considered somewhat weaker in action, and is a less expensive ingredient. Ginseng has often been referred to as an ‘Adaptogen Herb’.It increases ELDERLY and physical efficiency and resistance to stress and disease.Ginseng's adaptogenic qualities help balance the body,depending on the individual's needs.Adaptogens help to produce adjustments as needed in the body.Ginseng helps normalize blood pressure.In addition, adaptogens help modify the effects of environELDERLY and internal stresses from different forms such as radiation,chemical pollutants,some poisons, weather,temperature changes, poor nutrition habits, exercise (overtraining) and emotional stress.It also helps normalize and adjust the body restoring and regulating natural immune response. The biochemical mechanisms of Ginseng remain unclear, although there is extensive literature that deals with its effects on the brain (leraning,memory,energy and behavior), neuroendocrine function, carbohydrate and lipid metabolism, immune function and the cardiovascular system. Clinical studies are often contradictory, perhaps because the ginsenoside content of Ginseng root or root extracts can differ, depending on the species, method of extraction, subsequent treatment or even the season of collection. DOSAGE RECOMMENDATIONS 1.-Asian Ginseng (Panax Ginseng),the best researched form of Ginseng is standardized herbal extracts that supply approximately 5–7% ginsenosides,more concentrated extracts may be less effective due to reduction of panaxan levels. -Standardized extracts can be taken in the amount of 100–200 mg per day. -Non-standardized extracts require a higher intake... -1–2 grams per day for tablets -2–3 ml for dried root tincture three times per day. Ginseng is usually used for two to three weeks continuously, followed by a one- to two-week “rest” period before resuming (Brown,1996). 2.-When taking American Ginseng (Panax Quinquefolius), standardized products are highly recommended.Choose white American Ginseng,standardized to 0.03 percent ginsenosides (Rb1). -1 to 2 g fresh root. -0.6 to 2 g dried root. -200 to 600 mg liquid extract. If you are using Ginseng to increase your physical or ELDERLY performance, to improve resistance to stress or to prevent illness, you should take Ginseng in ‘cycles’.For example,daily for 15 to 20 days, followed by two weeks without taking Ginseng. 3.-Siberian Ginseng (Eleutherococcus Senticosus)... -2–3 grams per day (dried, powdered root and rhizomes). -300-400mg (concentrated solid extract standardized on eleutherosides B and E). -8–10 ml (alcohol-based extracts) in two to three divided dosages. Historically, Eleuthero is taken continuously for six to eight weeks, followed by a one- to two-week break before resuming (Brown,1996). INTERACTIONS & SIDE EFFECTS Possible Interactions (Bratman et al.,2000).... 1.-MAO inhibitor drugs or digitalis : Ginseng might cause problems. 2.-Drugs processed by an enzyme called "CYP 3A4” : Ginseng might interfere. 3.-Coumadin (warfarin) : Ginseng might decrease its effect. 4.-Influenza vaccine : Ginseng might help it work better Used at the recommended dosage,Ginseng is generally safe.Persons with uncontrolled high blood pressure should not use Ginseng.In rare instances,it may cause overstimulation and possibly insomnia.Those individuals prone to hypoglycemia should use Ginseng with caution due to the reported effects of Ginseng extracts to reduce blood sugar levels.Consuming caffeine with Ginseng increases the risk of overstimulation and gastrointestinal upset.Ginseng is not recommended for pregnant or lactating women.Use of Ginseng (long-term) may cause menstrual abnormalities and breast tenderness in some women..Ginseng can act as a mild stimulant and should probably be avoided in association with other stimulants or in patients with cardiovascular disease (Siegel,1979 ; Bratman et al.,2000). CLINICAL APPLICATIONS OF GINSENG : SCIENTIFIC EVIDENCES 1.-A double-blind placebo-controlled trial of 60 elderly individuals found that 50 or 100 days of treatment with Panax Ginseng produced improvements in numerous measures of ELDERLY function,including attention,memory,concentration and overall ability to cope. Benefits were still evident at the 50-day follow-up (Siegl & Siegl,1979). 2.-American Ginseng contains ginsenosides, which stimulate the immune system and fight fatigue and stress by supporting the adrenal glands and the use of oxygen by exercising muscles (Foster,1991). 3.-Researchers have isolated what they believe are the primary active ingredients in Ginseng,chemicals termed ‘Saponin Triterpenoid Glycosides’, or commonly called ginsenocides.There are nearly 30 ginsenocides in Korean Ginseng.Recent research in China was summarized by Dr. C. Lui in the February 1992 issue of the Journal of Ethnopharmacology, where he wrote that Panax Ginseng was found to contain 28 ginsenocides that "Act on the central nervous system, cardiovascular system and endocrine secretion, promote immune function, and have effects on anti-aging and relieving stress." 4.-A double-blind study compared the effects of a nutritional supplement with and without Ginseng extract on the feeling of well-being in 625 people, whose average age was just under 40 years old.Quality of life was measured by a set of 11 questions. People taking the Ginseng-containing supplement reported significant improvement compared to those taking the non-Ginseng supplement -the control group- (Caso et al.,1996). 5.-A recent clinical trial has found that a unique combination of Panax Ginseng and Ginkgo Biloba Extracts (GBE) can significantly enhance ELDERLY performance in healthy,middle-aged people.The study (2001) showed the unique GBE / Ginseng formulation can promote fast, accurate thinking, improve short and long-term memory retention and reduce ELDERLY fatigue."This is one of the first demonstrations that a unique combination of botanical extracts can beneficially affect the memory of healthy, middle-aged volunteers," said principal investigator Professor Keith Wesnes of Cognitive Drug Research Ltd., "These results suggest that individuals functioning in a fast-paced and demanding environment can improve their ability to process and retain new information and work with better ELDERLY efficiency.(...) The 14-week, double-blind, placebo-controlled, randomized, multi-center trial studied the cognitive effects of the herbal combination in 256 healthy volunteers between the ages of 38 and 66 years.The study showed the group of volunteers receiving the active herbal combination had statistically significant improvements in cognitive function (average of +7.5%) compared to the control group receiving placebo. The combination product was well tolerated by study volunteers.” CONCLUSION Ginseng's therapeutic applications has generated a constellation of interest throughout history and across many of the cultures of the globe.The word Ginseng is said to mean 'The Wonder of the World’.Ginseng has long been recognized by Asian culture as a general tonic that invigorates the body's system by restoring and maintaining vitality in order for it to operate at an optimal capacity. Most advocates of Ginseng take it everyday in some forms to help cope with busy daily activities,work, worries and stress. German Commission E monograph and WHO support the use of Ginseng as a prophylactic and restorative agent for enhancement of ELDERLY and physical capacities, in cases of weakness,exhaustion,tiredness,loss of concentration, and during convalescence. In general,Ginseng is used as a tonic, aphrodisiac, immune booster,stimulant,and modulator of blood sugar/pressure levels. Judging from the European and Asian experiments and studies with Ginseng for improving the ELDERLY state of the elderly, there are psychological benefits to be obtained from its long-term use. It can be recommended for depression and insomnia. As it has been documented repeatedly, Ginseng is able to ‘raise spirits’ and improve outlook on life,especially among the elderly. Ginseng is certainly the best healing herb and "cure-all" that nature has to offer us. However,pharmacochemical constituents of Ginseng remain to be remarkably complex,esoteric and unknown.Despite overwhelming interest and effort to characterize pharmacological nature and adaptogenic properties of Ginseng extracts, our scientific understanding is only ‘infantile’ or inconclusive and much of the studies and clinical trials are yet to be performed.At least for the time being,western science may only unravel and confirm some of the benefits of Ginseng that humans have learned for thousands of years. REFERENCES Blumenthal,M. ; Goldberg,A. ; Brinckmann,J. & Tyler,V.(2000).Herbal Medicine: Expanded Commission E Monographs. American Botanical Council. Bratman,S. ; Kroll,D. & DePalma,A.(2000).The Natural Pharmacist : Natural Health Bible.California : Prima Health. Brown,D.(1996).Herbal Prescriptions for Better Health..California : Prima Publishing . Caso,A. ; Vargas,R. ; Salas,A. et al.(1996).Double-blind study of a multivitamin complex supplemented with Ginseng extract. Drugs Exp Clin Res., 22 , 323–329. Foster,S.(1991)American Ginseng : Panax Quinquefolius. Austin : American Botanical Council. Licata,M.(1993).Ginseng Is Food For Thought.The Canadian Journal of Health & Nutrition , November. Siegel,R. (1979). Ginseng Abuse Syndrome. Journal of the American Medical Association , 241 , 1614-1615. Siegl,C. & Siegl,H.(1979) The possible revision of impaired ELDERLY abilities in old age: a double-blind study with Panax Ginseng.Therapiewoche , 29 (4206) , 4209–4216. Sticher,O.(1998).Getting to the root of ginseng. Chem tech , 28 (4) , 26-32 . Licensed Psychologist.
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