Information about ginseng is often confusing because the herb comes in several different forms. Panax ginseng (often called Korea or Asian ginseng) is a root widely used in Chinese medicine and can be processed in different ways. Steaming the root produces red ginseng; drying it and stripping off the outer coat produces white ginseng. North American ginseng (Panax quinquefolium) is closely related to Panax ginseng and will not be discussed separately here. Siberian ginseng (Eleutherococcus senticosus) is botanically in the same family but has somewhat different properties. Chinese herbalists call Siberian ginseng wujia. In all cases, the root of the plant is the part used for medicinal purposes.
All forms of ginseng are known as tonic herbs, which are said to give a person more stamina and to stimulate mental alertness. In Russia, beverages containing Siberian ginseng are common and used in the same way that many North Americans use coffee. Panax ginseng is also used to combat fatigue.
The ginseng herbs are also known as adaptogens, which are substances that help the body cope with changes and stress. Students reportedly do better on tests when using panax ginseng, and workers are said to cope better with stresses in the workplace when using Siberian ginseng. The normalizing effects of ginseng in several different disease conditions have also been studied. Both panax and Siberian ginseng are said to normalize cholesterol and triglyceride levels, and some studies that support this use for panax ginseng have been done on animals. It's not known how useful ginseng is in treating drug-associated increases in cholesterol and triglyceride levels in people with HIV. Small studies suggest that capsules of American ginseng may be useful in the management of type 2 diabetes and high blood pressure.
The immune system may also benefit from ginseng, particularly the cell-mediated immune system, which is damaged in HIV infection. Again, most of the research done to date has been done on animals, but Siberian ginseng has been shown to improve the function of some types of immune cells and increase the number of circulating T-cells in HIV-negative adults. A test-tube study involving cells from HIV-positive people suggests that panax ginseng might also stimulate the production and function of immune cells. These immune enhancements have been observed in healthy volunteers, too. As always, caution is required when using immune stimulating compounds, because some immune stimulation may actually increase the amount of HIV in the blood. This possibility may be of less concern for people taking antiretrovirals that are effectively lowering the amount of HIV in the blood.
Unfortunately, the quality control of many ginseng products available in North American is very poor. This reality is of serious concern, because ginseng products that contain little or no ginseng are bound to be ineffective, and those containing too much ginseng may be dangerous. A few standardized products are available, but they have only been studied as adaptogens in HIV-negative people.
Ginseng should not be taken for prolonged periods of time. High doses or long-term use of Siberian and panax ginseng may elevate blood pressure as well as cause anxiety and insomnia. Some people report insomnia even when taking lower doses, so ginseng should not be taken right before bed. Both forms of ginseng may interact with a number of common drugs, including acetylsalicylic acid and corticosteroids. People taking ginseng may also need to increase regular doses of vitamins B1, B2 and C, and high doses of panax ginseng may suppress the immune system. Due to these possibilities, it may be best to use ginseng products (panax ginseng, in particular) while under the care of a qualified traditional Chinese medicine practitioner. No form of ginseng should be used during pregnancy. Like most herbal products, it is not known if ginseng interacts with antiretroviral drugs.