Panax quinquefolius

 

Panax quinquefolius

Synonyms

No documentation

Vernacular Name

Wild ginseng, Sang, American ginseng, redberry, fivefingers.

Description

A close relative of the Chinese Panax ginseng, Panax quinquefolious itself grows solitarily from its notably large and fleshy rhizome.  Reaching a height of 50cm, P. quinquefolius is a glabrous, broad, erect, and fragrant herb. The leaves are a broad palmate whorl, with each leaflet toothed and gradually wider until a steep taper at the tip.  From the center of the whorl sprouts small, light-green flower clusters which are most often seen in midsummer.  Each flower is roughly only 2mm in length, but grows in clusters of about twenty-five or so.  From the apex of the flower cluster grow numerous 1cm wide berries, initially green but ripen a bright crimson.  The fleshy rhizome of P. quinquefolius, the medicinal part of the plant, is rather large for an herb of this size.  The light-brown spindle can grow more than 10cm in length and more than 7cm across.  As P. quinquefolius ages, the rhizome branches and occasionally obtains what appears to be a rather humanoid shape.  For the rhizome to become of a marketable size, P. quinquefolius must sometimes mature for a full six years.

Origin / Habitat

P. quinquefolious, or Wild ginseng, is an herb native to the mild climates of the eastern half of the North American continent.  P. quinquefolius flourishes best on steep, well-drained slopes, often in the shade of hardwood forests.  It is presently considered ‘vulnerable’ to ‘endangered’ in many parts of North America.

Chemical Constituents

Ginsenosides (mostly Rb1)(1),(2); sapogenins (panaxadiol or panaxatriol)(3); polysaccharide gycans (quinquifolan A, B and C)(4); homodimeric protein (quinqueginsin)(5)

Plant Part Used

Root (6)

Traditional Use

P. quinquefolius has been a staple, if not center point of many traditional Native American medical systems across the Eastern half of the continent.  Either the raw juice of the root or a root infusion has been used for its tonic properties by the Algonquin, Iroquois, Mohegan and Cherokee tribes.(6) The Iroquois, Delaware, Meskwaki and Mohegan all revered P. quinquefolius as a panacea, to be used for almost any instance in which medical attention is required.(7) P. quinquefolius has also been used as a stimulant(6), to rejuvenate both the body and mind.(7)

One of the most prevalent uses is that of a gastrointestinal aid.(8) Having been used in cases of nausea, colic, and vomiting,(9) many Native American tribes view P. quinquefolius as a staple in treating gastrointestinal disorders.  In cases of vomiting, a decoction of the root has been used by the Iroquois and Houma tribes.(7)

People of the Creek tribe in North America used a concoction with P. quinquefolius and Ginger to relieve fever.(10) The Creek also used American Gingseng as a diaphoretic in cases of fever.  The Iroquois used an infusion of the root in order to treat high fevers.(7) In cases of respiratory and pulmonary maladies, P. quinquefolius has established itself as an effective treatment, according to many Native American tribes. The Cherokee also used the root as an expectorant.(7) The root has been used, not only in cases of treatment, but also as a prophylactic against mild respiratory infection.(11) The Creek used P. quinquefolius in order to ease general shortness of breath.(12)

P. quinquefolius is also thought to have antispasmodic, and is therefore considered useful in cases of reflex nervous diseases, such as asthma and whooping cough.(11) P. quinquefolius has been used in external applications as well as internal applications.  Often, a poultice of the root has been used to treat numerous skin disorders and wounds, specifically open wounds.(7) In cases of bleeding wounds, a poultice of the root has been used as a hemostat.(7) A poultice has also been applied to the eyes, in cases of mild infection.(13) A compound infusion has been used as ear drops in order to ease infection and earache.(7)

Various Native American tribes have used the root in order to not only treat infertility(14), but increase the sex drive of women.

Dosage

Dosages vary by tribe, indication and preparation.  Often P. quinquefolius root was chewed in either fresh or dried form.  It was also ground and used as an infusion.

Pharmacology

Pre-clinical

The main bio-active ingredients of ginseng root (American and Korean/Asian) are the more than 20 saponin triterpenoid glycosides called "ginsenosides" (including Rg1 among others).  The Rb1 groups, predominant in the diol series, are reported to have an ability to improve stamina and learning capacity, as well sedative and hypoglycemic properties. P. quinquefolius contains more of the Rb1 diols than Asian/Korean, and may be more suitable for individuals who are coffee drinkers, overweight, or with insomnia.(15) The Rg1 groups, predominant in the triol series, reportedly raise blood pressure slightly in some instances and are mild central nervous system stimulants. Asian or Korean ginseng (Panax ginseng) contains more Rg1 triols and may be more suitable for individuals who are non-hypertensive, athletes, fatigued or with high stress jobs.

 

In laboratory studies, ginsenosides (Rb1) stimulated glucose uptake in sheep erythrocytes dose-dependently.(16) Several laboratory animal studies have reported blood sugar lowering activity in both American and Asian/Korean(Panax) ginseng.(4),(17),(18) Studies suggest that this effect may be due to enhanced insulin secretion.(19) In a human study, a glucose challenge test was conducted with ten non-diabetic and nine Type II diabetic subjects (regular medications and diet adherence along with the ginseng).(20) The subjects were randomized to take either placebo or 3gm P. quinquefolius root either 40 minutes before or together with a 25gm oral glucose challenge.  In nondiabetic subjects, no differences were found in prostprandial glycemia between placebo and ginseng when administered together with the glucose challenge. When the ginseng was taken 40 minutes before the glucose challenge, significant reductions were observed. In individuals with type 2 diabetes mellitus, the same was true whether capsules were taken before or together with the glucose challenge.  The results were that P. quinquefolius attenuated postprandial glycemia in both study groups.

Another study by the same researchers studied the effects of further reductions in blood sugar with the increasing dosages of P. quinquefolius root or alterations in dosage time.(21) The conclusions were that P. quinquefolius root reduced postprandial glucose irrespective of dose and time of administration. No more than 3g P. quinquefolius was required at any time in relation to the challenge to achieve reductions. A conclusion by the authors was that due to the reductions of glycemia at the 2-h diagnostic end point, there may be implications for diabetes diagnosis and treatment.  It should be noted that this dose is the whole root and typical standardized daily dosages do not exceed 600mg.

Another study done in non-diabetics refined these findings. It indicated that postprandial glycemia was reduced the greatest when P. quinquefolius was administered 40 minutes prior to a glucose challenge compared to administration 20, 10 or zero minutes before the challenge. There were no differences noted between the doses given, 1g, 2g or 3g.(22)

P. quinquefolius has also been reported to have anti-aging effects in laboratory animals and human subjects.(23) One laboratory animal study reported an increase in learning capability.(24) In vitro studies show that Rb1 has no effect on receptor binding or on acetylcholinesterase activity, but facilitates the release of acetylcholine (ACh) from the hippocampus.(26) The increase in ACh release is associated with an increased uptake of choline into nerve endings, reportedly with calcium influx unaltered in this study.  Another laboratory study reported that calcium levels decreased in ginsenoside treated animals.(27) This acetylcholine facilitation could make P. quinquefolius beneficial in Alzheimer’s therapy. The ginsenosides Rb1 and Rg1 have been reported to be neuroprotective, and specifically Rb1 (again found in higher concentrations in P. quinquefolius) have been reported to protect the brain from ischemic and reperfusion injuries in animal studies.(28),(29) Among the neuroprotective qualities of the ginsenosides, including Rb1, are inhibition of dopaminergic activation induced by cocaine at the presynaptic DA receptors in laboratory mice.(30)

 

It is thought that ginsenosides act at hormone receptor sites, especially in the hypothalamus and pituitary glands, stimulating secretion of adrenocorticotropic hormone (ACTH).(31) ACTH stimulates the production of adrenal hormones and other factors, leading to balance and regulation of the hypothalamic/adrenal axis that may have been influenced by stress. The proliferation of splenic lymphocytes, the humoral immune response to sheep red blood cells, and the phagocytotic function of intraperitoneal macrophages were all suppressed by cold water (4°C) swim stress for 5 min in rats and for 3 min in mice.  The levels of serum corticosterone increased. Ginseng root saponins (100mg/kg) or ginsenoside Rb1 completely antagonized the immunosuppression induced by the swim test, and inhibited the increase of serum corticosterone in these animals, but increased the level of serum corticosterone further in the swim test mice.(32) Rb1 was also reported to enhance thermogenic capacity and that both young and old rats when treated for cold tolerance.(33)

The literature has reported that P. quinquefolius may be used in breast cancer therapies.(34) The results of this study suggested that ginseng may exhibit estrogen-like effects on estrogen receptor-positive breast cancer cells, with the effect of ginseng possible being mediated in part via the estrogen receptor. A study evaluating the estrogenic effects of various plants, an estrogen-inducible gene in breast cancer cells (S30) was expressed when exposed to P. quinquefolius. No other estrogenic activity was noted in this laboratory study.(35) Because ginseng does not exhibit a proliferative effect, it may play a protective role against breast cancer rather than serve as a mitogen. Ginseng, especially P. quinquefolius, is claimed to exhibit some estrogen-like activity and may improve vaginal lubrication in menopausal women.(36)  There have been reports of ginseng products increasing vaginal bleeding also.(37),(38)

 

A study in laboratory rats has reported that P. quinquefolius significantly facilitated male copulatory behavior.(40) The reduction in plasma prolactin levels suggests that ginseng may induce alterations in dopaminergic neurotransmission which may play a role in the ability of P. quinquefolius to stimulate the rat copulatory behavior.  Other possible effects include and increase in nitric-oxide mediated relaxation of the corpus cavernosum, seen in another laboratory animal study.(41)

A study done in mice demonstrated some possible analgesic effects of P. quinquefolius. Compared to placebo, pain markers in the rodent chronic pain model were significantly decreased in the P. quinquefolius extract group.(42)

A study identified a nueroprotective effect of P. quinquefolius during times of ischemia is likely due to inhibition of the sodium channel activity.(43)

Another animal study has demonstrated that P. quinquefolius interacted with ligand-bindings of GABA(A) receptors and modulated brainstem GABAergic mechanisms.(44) The authors concluded that regulation of GABAergic neurotransmission may be an important action of P. quinquefolius and probably has to do with the sedative qualities of P. quinquefolius.

Use of P. quinquefolius also reduced LDL oxidation in laboratory animals, making it a potential supportive agent in the fight against atherosclerosis.(45),(46) Another study has reported that Wild ginseng has antioxidant properties.(47) Of interest is that the antioxidant properties of Wild ginseng saponins may be further enhanced with the use of vitamin C.(48) Another laboratory study reported that the free radical damage to the cultured myocardiocytes of rat was decreased when incubated with the ginsenoside Rb1, predominant in P. quinquefolius root.(49)

A homodimeric protein named quinqueginsin has been isolated from the roots of P. quinquefolius.  In In Vitro studies, the protein displayed a variety of biological activities, including antifungal activity and activity toward the human immunodeficiency virus-1 reverse transcriptase, making it of potential value in the war against AIDS. (5)

Clinical

One study (based on Traditional Chinese Medicine diagnostic procedures) of 71 individuals over age 60 reported that ginsenoside Rb1 extracted from P. quinquefolius exerted a beneficial effect on memory and learning, possibly through its actions on the cholinergic system.(25)

A preliminary study evaluating the use of a combination product containing P. quinquefolius extract (200 mg) and Ginkgo biloba extract (50 mg) for attention-deficit hyperactivity disorder (ADHD) had promising results. Thirty-six children diagnosed with ADHD, ages 3 to 17, were given the combination herbal product and evaluated over 4 weeks. Based on a statistical standard set in the study, 44% demonstrated improvement with social problems and 74% demonstrated improvement for the Conners' ADHD index and the DSM-IV hyperactive-impulsive attribute.(39)

Interaction and Depletions

Interaction with other Herbs

No documentation

Interaction with Drugs

Based on pharmacology, do not use this herb in combination with MAO inhibitors such as phenelzine, tranylcypromine, isocarboxazid.  A human case report described that constituents contained in Panax (Asian) ginseng root interacted with phenylzine. This may alter the effects of these medications and possibly the dose needed for treatment. Use with caution.(51)

Precautions and Contraindications

Side effects

P. quinquefolius root is reported safe in recommended dosages.(50)

Until further information is gathered the estrogenic activity of P. quinquefolius should be avoided in women with estrogen fed cancers.

The ginsengs may cause breast tenderness or menopausal bleeding in some women.(38),(52)

Pregnancy

If pregnant or nursing, consult a physician before use.

Age limitation

Do not use in children under 2 years of age, unless recommended by a physician.

Adverse reaction

No documentation

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  1) Medicinal Herbs

References

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