Taxonomic Class

Araliaceae

Common Trade Names

Multi-ingredient preparations: Activex 40 Plus, Elton, Gincosan (with gingko biloba), Ginkovit, Ginseng Complex, Leuzea, Leveton, Minadex Mix Ginseng, Panax Complex, Siberian Ginseng, Taiga Wurzel, Vigoran

Common Forms

Available as capsules, oils, powders, tablets, teas, and tinctures. Source The drug is extracted from the root and root bark of Eleutherococcus senticosus, which belongs to the same family as panax or chinese ginseng.

Chemical Components

Constituents of the root include saponins (termed eleutherosides), which appear to be the active drug and are found in equal concentrations in above-ground parts and roots. The eleutherosides are subgrouped A to G. Other components include essential oil, resin, starch, and vitamin A.

Actions

The saponin portion of Siberian ginseng appears to have affinity for progestin, mineralocorticoid, and glucocorticoid receptors, although not to the extent of panax ginseng. Unlike panax ginseng, Siberian ginseng binds to estrogen receptors.

When the extract was injected into the peritoneal cavity of mice, a marked hypoglycemic effect was observed . Orally administered Eleutherococcus was found to decrease blood glucose levels in rats but had no effect on plasma lactic acid, glucagon, insulin, or liver glycogen levels . It is not known if this effect occurs in humans.

Despite the claim that Siberian ginseng enhances the ability to tolerate stress, ingestion of Eleutherococcus was not found to significantly affect the survival of mice under major environmental stress, but a more aggressive behavior was noted .

Reported Uses

Siberian ginseng is described as a pungent, bittersweet, warming herb with the purported ability to stimulate the immune and circulatory systems, regulate blood pressure, reduce inflammation, treat insomnia caused by prolonged anxiety, and increase stamina and the ability to cope with stress. Preliminary Russian studies have attempted to verify adaptogenic effects of ginseng in studies of both healthy and nonhealthy patients. These trial results are at best inconsistent but suggest some favorable effects in certain parameters associated with the patients’ ability to withstand stressful conditions. An abstract of a trial published in a Russian journal describes a trial that supposedly documented an increase in working capacity and rehabilitation of trained athletes after a 20-day ingestion of new dosage formulations of Eleutherococcus . Also, the apparent increase in blood coagulability seen with highly trained athletes was in part abrogated by the Eleutherococcus treatments. Another trial out of Poland concluded that an Eleutherococcus preparation, when given to 10 healthy men for 30 days, revealed a higher oxygen plateau, as measured by ergospirometry, and demonstrated beneficial effects on the lipid profile compared with echinacea . Some questions exist in regard to the study’s design.

Studies with animals have indicated no effect on stamina or stress tolerance. In a study involving highly trained distance runners, the herb had no effect on improving exercise tolerance . As with other ginseng plants, Siberian ginseng claims to have immunomodulatory actions; it is thought to stimulate macrophages, promote antibody formation, activate complement, and increase T-Iymphocyte proliferation. An increase in the T-Iymphocyte count and in the activation state ofT cells were shown in human patients neither the extent of the proliferation nor the duration of these effects can be determined from this study alone.

Extensive human studies are needed to verity claims of radioprotective or chemotherapeutic effects of Siberian ginseng.

Dosage

No guidelines exist. The most common regimen is 500 to 2,000 mg/day P.O. Use cautiously because of the lack of uniform content of capsules and the substitution of less expensive plants.

Adverse Reactions

CNS: agitation, decreased concentration, dizziness, euphoria, insomnia, nervousness.

CV: hypertension.

GI: diarrhea.

GU: estrogenic effects, vaginal bleeding.

Hematologic: reduced coagulation potential (unknown mechanism).

Skin: rash.

Interactions

Digoxin: Elevated serum digoxin levels. Monitor digoxin use closely.

Hexobarbital: Inhibited hexobarbital metabolism. Avoid administration with Siberian ginseng.

Vitamins B1, B2 and C: Siberian ginseng may increase excretion of these vitamins. Avoid administration with Siberian ginseng.

Contraindications And Precautions

Siberian ginseng use is contraindicated in children and in patients who are hypersensitive to ginseng, Siberian ginseng, or ingredients in the preparation.

Special Considerations

Advise the patient not to use Siberian ginseng for longer than 3 weeks.

Siberian ginseng is not uniform in content when packaged, and less expensive plant products are commonly substituted for this herb.

Siberian ginseng may be sold as a combination product with panax ginseng. Monitor for adverse reactions also associated with panax or Chinese ginseng.

Urge the patient to report agitation, diarrhea, euphoria, insomnia, menstrual irregularities, nervousness, and rash.

Caution the diabetic patient to closely monitor blood glucose levels and to watch for increased effects of antidiabetic drugs because of the herb’s hypoglycemic effect in animals.

Commentary

The most prevalent claim for Siberian ginseng is its ability to improve energy, exercise performance, and stamina. This claim has proved to be untrue. Also, the adaptogenic response, which claims increased resistance to stress, has also been found to be false.

The immunomodulating and radioprotective effects have been studied mostly in animal and foreign trials. Although the data thus far ap pear promising, particularly for a radioprotective action, larger controlled studies are needed in humans to determine whether the herb not only increases the T-lymphocyte count and response but also clinically prevents or hastens recovery from infections.

There are no data to substantiate other claims for Siberian ginseng. There are also no long-term studies, and thus its effects over time are not known. Consequently, the use of Siberian ginseng beyond 3 weeks is not recommended.