Ginseng

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A root of cultivated Korean ginseng (Panax ginseng)

Ginseng (Template:IPAc-en)<ref>Template:Cite encyclopedia</ref> is the rootTemplate:Efn of plants in the genus Panax, such as South China ginseng (P. notoginseng), Korean ginseng (P. ginseng), and American ginseng (P. quinquefolius), characterized by the presence of ginsenosides and gintonin. Ginseng is common in the cuisines and medicines of China and Korea.

Ginseng has been used in traditional medicine over centuries, though modern clinical research is inconclusive about its medical effectiveness.<ref name="drugs">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name="nccih2">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> There is no substantial evidence that ginseng is effective for treating any medical condition and it has not been approved by the US Food and Drug Administration (FDA) to treat or prevent a disease or to provide a health benefit.<ref name=drugs/><ref name=nccih2/><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Although ginseng is sold as a dietary supplement, inconsistent manufacturing practices for supplements have led to analyses of some ginseng products contaminated with unrelated filler compounds, and its excessive use may have adverse effects or untoward interactions with prescription drugs.<ref name=drugs/><ref name=":3">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

HistoryEdit

One of the first written texts covering the use of ginseng as a medicinal herb was the Shen Nong Pharmacopoeia, written in China in 196 AD. In his Compendium of Materia Medica herbal of 1596, Li Shizhen described ginseng as a "superior tonic". However, the herb was not used as a "cure-all" medicine, but more specifically as a tonic for patients with chronic illnesses and those who were convalescing.<ref name=Mahady>Template:Cite book</ref> Control over ginseng fields in China and Korea became an issue in the 16th century.<ref>Template:Cite journal</ref>

In folk beliefEdit

In Chinese folk tales from the northeastern regions, ginseng is said to transform into children, often depicted with skyward-reaching braids, sometimes tied with red ribbons, and occasionally dressed in bellybands. In these stories, a ginseng child will typically enter a house to play with another child. However, if the adults tie a red ribbon around the child's feet, the child vanishes. When they follow the ribbon, they find it tied to a blade of grass, and upon digging, they uncover a ginseng root.<ref>Template:Cite book</ref>

Ginseng speciesEdit

Ginseng plants belong only to the genus Panax.<ref name="CMHP" /> Cultivated species include Panax ginseng (Korean ginseng), Panax japonicus (Japanese ginseng), Panax notoginseng (South China ginseng), Panax quinquefolius (American ginseng).<ref name="baeg" /> Ginseng is found in cooler climates – Korean Peninsula, Northeast China, Russian Far East, Canada and the United States, although some species grow in warm regions – South China ginseng being native to Southwest China and Vietnam. Panax vietnamensis (Vietnamese ginseng) is the southernmost Panax species known.Template:Cn

Wild and cultivated ginsengEdit

Wild ginsengEdit

Wild ginseng (Template:Korean) grows naturally in mountains and is hand-picked by gatherers known as simmani (Template:Korean).<ref name=":4">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> The wild ginseng plant is almost extinct in China and endangered globally.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> This is due to high demand for the product in recent years, leading to the harvesting of wild plants faster than they can grow and reproduce (a wild ginseng plant can take years to reach maturity<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>). Wild ginseng can be processed to be red or white ginseng.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Wild American ginseng has long been used by Native Americans for medicine.<ref name=":1">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Since the mid-1700s, it has been harvested for international trade.<ref name=":1" /> Wild American ginseng can be harvested in 19 states and the Appalachian Mountains but has restrictions for exporting.<ref name=":1" /><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

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Wild Korean ginseng (P. ginseng)
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Wild American ginseng (P. quinquefolius)

Cultivated ginsengEdit

Cultivated ginseng (Template:Korean) is less expensive than the rarely available wild ginseng.<ref name=":4" />

Cultivated ginseng (Template:Korean) is planted on mountains by humans and is allowed to grow like wild ginseng.<ref name=":4" />

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Cultivated Korean ginseng (P. ginseng)
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Cultivated American ginseng (P. quinquefolius)

Ginseng processingEdit

File:Preserved ginseng.png

Cultivated ginseng

Ginseng seed normally does not germinate until the second spring following the harvest of berries in autumn. They must first be subjected to a long period of storage in a moist medium with a warm/cold treatment, a process known as stratification.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Fresh ginsengEdit

Fresh ginseng (Template:Korean), also called "green ginseng", is non-dried raw product.<ref name="PK">Template:Cite news</ref> Its use is limited by availability.Template:Cn

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Fresh ginseng (P. ginseng)

White ginsengEdit

White ginseng (Template:Korean) is peeled and dried ginseng.<ref name="PK" /> White ginseng is fresh ginseng which has been dried without being heated. It is peeled and dried to reduce the water content to 12% or less.<ref name="PK" /> Drying in the sun bleaches the root to a yellowish-white color.Template:Cn

Red ginsengEdit

Red ginseng (Template:CJKV) is steamed and dried ginseng, which has reddish color.<ref name="PK" /> Red ginseng is less vulnerable to decay than white ginseng.<ref name="Fulder">Template:Cite book</ref> It is ginseng that has been peeled, heated through steaming at standard boiling temperatures of Template:Convert, and then dried or sun-dried. It is frequently marinated in an herbal brew which results in the root becoming extremely brittle.Template:Cn

Korean red ginseng.jpg

Red ginseng (P. ginseng)

ProductionEdit

Commercial ginseng is sold in over 35 countries, with China as the largest consumer. In 2013, global sales of ginseng exceeded $2 billion, of which half was produced by South Korea.<ref name="baeg">Template:Cite journal</ref> In the early 21st century, 99% of the world's 80,000 tons of ginseng was produced in just four countries: China (44,749 tons), South Korea (27,480 tons), Canada (6,486 tons), and the United States (1,054 tons).<ref name=baeg/> All ginseng produced in South Korea is Korean ginseng (P. ginseng), while ginseng produced in China includes P. ginseng, South China ginseng (P. notoginseng),<ref name="baeg" /> and the recently introduced American ginseng (P. quinquefolius).<ref name="FoC:200015253">Template:EFloras</ref> Ginseng produced in Canada and the United States is mostly P. quinquefolius.<ref name="baeg" /><ref name="MAFRA">{{#invoke:citation/CS1|citation |CitationClass=web }}

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As of 2020, global P. ginseng and P. quinquefolius production each sum to an approximate 7,000 tons on a dry-weight basis. On a dry-weight basis, 70% of P. ginseng and 30% of P. quinquefolius is produced in China; 60% of P. quinquefolius is produced in Canada; and 10% of P. quinquefolius is produced in the US. P. ginseng is also cultivated in Japan.<ref>Template:Cite journal</ref>

UsesEdit

Ginseng may be included in energy drinks or herbal teas in small amounts or sold as a dietary supplement.<ref name=drugs/><ref name="nccih2"/><ref name=":3" /><ref name="liu">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Food or beverageEdit

The root is most often available in dried form, either whole or sliced. In Korean cuisine, ginseng is used in various banchan (side dishes) and guk (soups), as well as tea and alcoholic beverages.<ref name=":2">Template:Cite journal</ref> Ginseng-infused tea and liquor, known as insam-cha (Template:Literal) and insam-ju ('ginseng liquor') is consumed.<ref name=":2"/> Ginseng leaves are also used to prepare foods and beverages. Leaves are used to prepare Asian soups, steamed with chicken or combined with ginger, dates, and pork, or are eaten fresh.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>Template:Cite journal</ref>

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Insam-twigim (ginseng fritters)
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Samgye-tang (ginseng chicken soup)
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Insam-cha (ginseng tea) and yugwa (rice puffs)
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Insam-ju (ginseng liquor)
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Sansam-ju (wild ginseng liquor)

Traditional medicine and phytochemicalsEdit

Although ginseng has been used in traditional medicine for centuries, there is no good evidence it causes any improvement of health or lowers the risk of any disease.<ref name=":0">Template:Cite journal</ref><ref name="mlp-pan">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name="mlp-us">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Clinical research indicates there are no confirmed effects on memory, fatigue, menopause symptoms, and insulin response in people with mild diabetes.<ref name="nccih2"/> A 2021 review indicated that ginseng had "only trivial effects on erectile function or satisfaction with intercourse compared to placebo".<ref name=":0" /> Although the roots are used in traditional Chinese medicine, the leaves and stems contain larger quantities of the phytochemicals than the roots, and are easier to harvest.<ref>Template:Cite journal</ref> The constituents include steroid saponins known as ginsenosides, as well as polyacetylenes, polysaccharides, peptidoglycans, and polyphenols, among other compounds.<ref name="drugs" /><ref name="mlp-pan" /><ref name="pmid30000873" /><ref name="Attele">Template:Cite journal</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Ginsenosides from the leaves and stem ({{#invoke:Lang|lang}}) is an approved over-the-counter medication in China. The indication is written in traditional Chinese medicine language.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

FDA warning lettersEdit

As of 2019, the United States FDA and Federal Trade Commission have issued numerous warning letters to manufacturers of ginseng dietary supplements for making false claims of health or anti-disease benefits, stating that the "products are not generally recognized as safe and effective for the referenced uses" and are illegal as unauthorized "new drugs" under federal law.<ref name="fda1">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name="fda2">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name="fda3">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Animal feedEdit

A tincture of Korean ginseng is approved by the EFSA for use in horses, dogs, and cats as a sensory additive (animal feed flavoring). Within the provided dose limits, the tincture is considered non-toxic.<ref>Template:Cite journal</ref> A dried extract of Korean ginseng was declined by the EFSA, since its manufacturer cannot provide data on its complete composition.<ref>Template:Cite journal</ref>

Safety and side effectsEdit

Ginseng supplements are not subjected to the same pre-market approval process in the US by the Food and Drug Administration (FDA) as pharmaceutical drugs. FDA mandates that manufacturers must ensure the safety of their ginseng supplements before marketing, without the necessity to substantiate the safety and efficacy of these supplements in a pre-market scenario.<ref name="pmid30000873">Template:Cite book</ref> Ginseng supplements can be complex, often containing multiple constituents. It is not uncommon to observe discrepancies between the ingredients listed on the product label and the actual components or their quantities present in the supplement.<ref name="pmid30000873" /> While manufacturers can employ independent organizations to authenticate the quality of a product or its ingredients, such verification does not equate to a certification of the product's safety or effectiveness. These independent quality checks primarily focus on the integrity of the product in terms of its composition and do not extend to safety evaluations or purported clinical efficacy.<ref name="pmid30000873" />

Ginseng generally has a good safety profile and the incidence of adverse effects is minor when used over the short term.<ref name=drugs/><ref name="kim2">Template:Cite journal</ref> The FDA has classified ginseng as "generally recognized as safe" (GRAS), indicating its general tolerability in adult populations.<ref name="pmid30000873"/>

The risk of interactions between ginseng and prescription medications is believed to be low, but ginseng may have adverse effects when used with blood thinners.<ref name=drugs/><ref name="nccih2"/> Ginseng interacts with certain blood thinner medications, such as warfarin, leading to decreased blood levels of these drugs.<ref name="pmid30000873"/> Ginseng can also potentiate the effects of sedative medications.<ref name="pmid30000873"/> Concerns exist when ginseng is used over a longer term, potentially causing side effects such as skin rashes,<ref name="pmid30000873" /> headaches, insomnia, and digestive problems.<ref name="drugs" /><ref name="nccih2" /><ref name="kim2" /> The long-term use of ginseng may result in nervousness, anxiety, diarrhea, confusion, depression, or feelings of depersonalization,<ref name="pmid30000873" /> nausea, and fluctuations in blood pressure (including hypertension).<ref name="drugs" /><ref name="liu" /> There have been reports of gynecomastia and breast pain associated with ginseng use.<ref name="pmid30000873" /> Other side effects include breast pain and vaginal bleeding.<ref name="drugs" /><ref name="liu" /><ref name="pmid30000873" /> As of 2023, there is a lack of data regarding the safety and efficacy of ginseng in lactating mothers and infants.<ref name=drugs/> Given its potential estrogenic activity and the absence of safety data during lactation, ginseng is not recommended for use during breastfeeding.<ref name=drugs/><ref name="pmid30000873" /> Ginseng also has adverse drug reactions with phenelzine,<ref>Template:Cite journal</ref> and a potential interaction has been reported with imatinib,<ref name="pmid20332334">Template:Cite journal</ref> resulting in hepatotoxicity, and with lamotrigine.<ref name="pmid25756365">Template:Cite journal</ref>

OverdoseEdit

The common ginsengs (P. ginseng and P. quinquefolia) are generally considered to be relatively safe even in large amounts.<ref name="shergis">Template:Cite journal</ref> One of the most common and characteristic symptoms of an acute overdose of P. ginseng is bleeding. Symptoms of mild overdose may include dry mouth and lips, excitation, fidgeting, irritability, tremor, palpitations, blurred vision, headache, insomnia, increased body temperature, increased blood pressure, edema, decreased appetite, dizziness, itching, eczema, early morning diarrhea, bleeding, and fatigue.<ref name="CMHP">Chinese Medical Herbology and Pharmacology, by John K. Chen, Tina T. Chen</ref><ref name=shergis/>

Symptoms of severe overdose with P. ginseng may include nausea, vomiting, irritability, restlessness, urinary and bowel incontinence, fever, increased blood pressure, increased respiration, decreased sensitivity and reaction to light, decreased heart rate, cyanotic (blue) facial complexion, red facial complexion, seizures, convulsions, and delirium.<ref name="CMHP" /><ref name=shergis/>

Terminology and etymologyEdit

The English word "ginseng" comes from the Teochew Chinese {{#invoke:Lang|lang}} (Template:Script; where this transliteration is in Pe̍h-ōe-jī). The first character Template:Zh (pinyin rén; {{#invoke:IPA|main}} or {{#invoke:IPA|main}}) means "person"<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> and the second character Template:Zh (Template:Zh; {{#invoke:IPA|main}}) means "plant root" in a forked shape.<ref>The word 參 shēn "plant root" itself, from Old Chinese *srəm, has been compared to words meaning 'root' in other languages of the Sino-Tibetan family such as Japhug tɤ-zrɤm "root", see Template:Cite journal </ref>

The Korean loanword insam comes from the cultivated ginseng (Template:Korean), which is less expensive than wild ginseng.Template:Cn The botanical genus name Panax, meaning "all-healing" in Greek, shares the same origin as "panacea" and was applied to this genus because Carl Linnaeus was aware of its wide use in Chinese medicine as a muscle relaxant.Template:Cn

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Other plants sometimes called ginsengEdit

True ginseng plants belong only to the genus Panax.<ref name="CMHP" /> Several other plants are sometimes referred to as ginseng, but they are from a different genus or even family. Siberian ginseng is in the same family, but not genus, as true ginseng. The active compounds in Siberian ginseng are eleutherosides, not ginsenosides. Instead of a fleshy root, Siberian ginseng has a woody root.

Angelica sinensis (female ginseng, dong quai)
Codonopsis pilosula (poor man's ginseng, dangshen)
Eleutherococcus senticosus (Siberian ginseng)
Ficus microcarpa (Ginseng ficus)
Gynostemma pentaphyllum (five-leaf ginseng, jiaogulan)
Kaempferia parviflora (Thai ginseng, krachai dum)
Lepidium meyenii (Peruvian ginseng, maca)
Oplopanax horridus (Alaskan ginseng)
Pfaffia paniculata (Brazilian ginseng, suma)
Pseudostellaria heterophylla (Prince ginseng)
Schisandra chinensis (five-flavoured berry)
Trichopus zeylanicus (Kerala ginseng)
Withania somnifera (Indian ginseng, ashwagandha)
Eurycoma longifolia (Malaysian ginseng, tongkat ali)

ReferencesEdit

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