Explored in the 1950s as an alternative to Asian ginseng, which was expensive and difficult to grow, Siberian ginseng is used today to increase physical and mental stamina, speed convalescence, and provide resistance to the detrimental effects of stress. Mirroring the functions of Asian and American ginseng, these uses also reflect thousands of years' use by the people of Russia and China.

All three types of ginseng occur in the same plant family, Araliaceae. While their constituents differ, studies conducted in Russia since the late 1950s conclude that like its distant cousins, Siberian ginseng has similar adaptogenic functions. Adaptogens increase physiologic resistance to stressors. They also normalize processes within the body that may have been altered in response to those stressors, and are nontoxic and nonspecific in action. By 1985, studies of Siberian ginseng conducted in the Soviet Union, with the involvement of over 4,300 healthy and diseased subjects, confirmed these effects. In 1962, consequent to approval of 33% alcohol Siberian ginseng extract for human use by the Pharmacological Committee of USSR Ministry of Health, 3 million Soviets were estimated to be taking it regularly. Among these were Soviet astronauts and Olympic team members. Ongoing studies are looking into the effects of ginseng in terms of its adjunctive therapeutic use for diabetes, infertility, atherosclerosis and rheumatic heart disease, cancer, and conditions due to depressed immune function, such as chronic fatigue syndrome.

American and Asian ginsengs are indicated in stress, fatigue, convalescence and diabetes, and Siberian ginseng in stress, fatigue, atherosclerosis, and impaired kidney function. Confusion regarding which ginseng to use for stress, fatigue, and convalescence (American, Asian, or Siberian) stems from the suggestion that active components in one type are superior to those in another type, e.g., ginsenosides versus eleutherosides. Such superiority has not been demonstrated. Early Russian studies indicated that Siberian ginseng's positive effects exceed those of Asian ginseng's. These results are supported by empirical reports, but are challenged by investigators who question the validity of the studies and the quality of the Siberian ginseng preparation. At this time, all three ginsengs are regarded as adaptogens, all three share contraindication and side effect profiles, and despite qualitative differences, each is used for similar indications. Cost, standardization, and the reputation of the manufacturer may be the deciding points in determining which product to use.

Siberian ginseng is cultivated from a shrub that grows one to three meters in height. Palmate leaves with five serrated, thorny-veined leaflets are attached to long petioles that are covered with bristles. Petioles are attached to stems, which are noted for their backward-pointing prickles. Stem bark is gray-brown.

Flowers grow in umbels from a peduncle; male flowers are violet, female flowers, yellow. These produce round black berries.

The Siberian ginseng root is 1.5 to 4 cm long, brown to brownish gray, with lengthwise wrinkles. It is twisted, variably branched with a few rootlets. It smells aromatic and tastes bitter and astringent.

• Roots

Root contains 0.6% to 0.9% eleutheroside components common to many plant species. Many are glycosides. Eleutheroside A is a sterol (daucosterol); B is a phenylopropanoid (syringin); B1 (isofraxidin) and B3 are coumarins; C is a monosaccharide (methyl-alpha-D-galactoside); B4, D, and E (acanthoside D) are lignans; and I, K, L, and M are triterpene saponins. Root also contains aglycones, polysaccharide glycans (eleuthocans A-G) and various sugars, phenylpropanoids, oleanolic acid, dihydroxybenzoic acid (DBA), and volatile oil.

• Crude drug (bark, whole root, and rhizome)
• Aqueous-alcohol liquid extracts
• Solid extracts
• Powders
• Capsules
• Tablets

Traditional:

• Stimulant
• Tonic
• Diuretic
• To treat insomnia
• To enhance virility
• To increase the body's resistance to stress

Clinical applications:

• Stress
• Fatigue
• Atherosclerosis
• Impaired kidney function
• Lower back/kidney pain
• Anorexia
• Rheumatoid arthritis
• Chronic fatigue syndrome
• Blood pressure disorders
• Symptoms of coronary atherosclerosis
• Symptoms of radiotherapy- and chemotherapy-induced leukopenia
• Attention-deficit/hyperactivity disorder
• Debility
• Diminished capacity for work or concentration
• To help during convalescence

Siberian ginseng has normalizing, stress-resistant, and immune stimulant effects. In studies involving over 4,300 subjects, Siberian ginseng was administered orally to determine its effects on disease, or to assess its ability to help the body tolerate stress. Subjects who had atherosclerosis, pyelonephritis, diabetes mellitus, hypertension, hypotension, craniocerebral trauma, neurosis, rheumatic heart disease, chronic bronchitis, and pulmonary tuberculosis noted overall improvements in their condition. Healthy subjects in these studies were exposed to extremes in temperature, sound, working conditions, exercise, and deep-sea diving decompression. They noted enhanced physical labor and stamina, mental concentration and acuity. They were better able to tolerate extreme conditions, had improved capillary function, and improved resistance to hypoxemia. New blood formation was enhanced in blood donors. In both healthy and nonhealthy subjects, a 33% alcohol extract was used, for up to 39 days followed by a two-to-three week break if the study was to be continued.

Immune stimulant effects, noted through increases in lymphocyte count (particularly T-lymphocytes) were reported in a double-blind, placebo-controlled study of healthy subjects.

In studies in animals, Siberian ginseng polysaccharides were immunostimulating. Intraperitoneal injection resulted in eleutheran-stimulated hypoglycemia in alloxan-induced hyperglycemic mice. DBACK reduced collagen- and ADP-induced platelet aggregation comparably to aspirin.

Infusions of Siberian ginseng increased stress resistance in rats and improved work performance in mice. Intraperitoneal injections increased gonadotrophic action in both male and female mice. Mineralcorticoid, glucocorticoid, and steroid receptor binding was observed. Siberian ginseng had sedative and CNS stimulant effects.

• Dried root (tea, or in capsules): 2 to 3 g daily or equivalent preparations
• Tincture: 5 ml tid
• 33% aqueous-alcohol extract, 2 to 4 ml, one to three times daily
• Solid extract (dried, powdered), with at least 1% eleutheroside F: 100 to 200 mg tid

Note: Take before 3 p.m. to avoid insomnia. A three-month course, followed by a two-to-three week Siberian ginseng–free interval, or occasional use for one month, followed by two-month Siberian ginseng–free intervals, should be observed.

American Herbal Products Association safely rating: class 1 (safe with appropriate use); German Commission E lists no side effects. High doses (4.5 to 5 ml tid) may cause insomnia, irritability, melancholy, anxiety; in studies conducted in the Soviet Union, some patients with rheumatic heart disease noted pericardial pain, high blood pressure, headaches, and palpitations.

Hypertension (>180/90 mm Hg) contraindicates use. Although studies in animals suggest Siberian ginseng is nonteratogenic, its safety during pregnancy has not been determined.

Siberian ginseng reportedly elevated synthetic digoxin drug levels causing no toxic effects (McRae 1996). The mechanism for this apparent interaction may be conversion in vivo of a component of ginseng to digoxin, interference with digoxin elimination, or digoxin assay. However, based on previously documented adulteration, it is possible that the commercial E. senticosus product used was actually Periploca sepium, which is known to contain cardiac glycosides (Awang 1996).

U.S. FDA: dietary supplement; German Commission E: approved for nonprescription use; not licensed through the General Sale List in the United Kingdom.

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