Adverse Reactions

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Clinical trials of 6 months' duration have shown no side-effects from treatment (Bohn et al 1987). High doses may cause slight drowsiness, irritability, anxiety, mastalgia, palpitations or tachycardia although these side effects may be more relevant to Panax ginseng.

Clinical note — Case reports of Siberian ginseng need careful consideration

Some adverse reactions attributed to Siberian ginseng have subsequently been found to be due to poor product quality, herbal substitution and/or interference with test results. For example, initial reports linking maternal ginseng use to neonatal androgenisation are now suspected to be due to substitution with another herb, Periploca sepium (silk vine), as American herb companies importing Siberian ginseng from China have been known to be supplied with two or three species of Periploca (Awang 1991). Additionally, rat studies have failed to detect significant androgenic action (Awang 1991, Waller et al 1992) for Siberian ginseng.

Another example is the purported interaction between digoxin and Siberian ginseng, which was based on a single case report of a 74-year-old man found to

have elevated dlgoxln levels for many years (McRae 1996). It was subsequently purported that the herbal product may have been adulterated with digitalis. Additionally, Siberian ginseng contains glycosides with structural similarities to dlgoxln that may modestly Interfere with dlgoxln (Dasgupta & Reyes 2005, Dasgupta et al 2003). Considering that clinical symptoms of dlgoxln toxicity were not observed, It appears likely that an Interference with the test methods used Is responsible.

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