Some authors suggest that high-dose Siberian ginseng should be avoided by those with cardiovascular disease or hypertension (BP >80/90 mmHg) (Mahady et al 2000). Others merely suggest a caution, as reports are largely unsubstantiated (Holford & © 2007 Elsevier Australia
Cass 2001). As such, it is recommended that people with hypertension should be monitored if using high doses. A study in elderly people with hypertension over 8 weeks did not affect blood pressure control (Cicero et al 2004).
Due to possible effects on glycaemic control (Sievenpiper et al 2004), care should be taken in people with diabetes until safety is established. Suspend use 1 week before major surgery.
Traditional contraindications include hormonal changes, excess energy states, fever, acute infection, concurrent use of other stimulants and prolonged use.
/jv PREGNANCY USE
VJ/ Insufficient reliable information is available, but the herb is not traditionally used in pregnancy.
PRACTICE POINTS/PATIENT COUNSELLING
• Siberian ginseng appears to alter the levels of different neurotransmitters and hormones involved in the stress response, chiefly at the HPA axis.
• It is widely used to treat individuals with nervous exhaustion or anxiety due to chronic exposure to stress, or what are now termed 'allostatic load situations'. It is also recommended during convalescence or fatigue to improve mental and physical responses.
• Siberian ginseng may increase resistance to infection and has been shown to reduce frequency of genital herpes outbreaks with long-term use.
• The herb is popular among athletes in the belief that endurance, performance and power may improve with its use, but clinical studies have produced inconsistent results.
• It is not recommended for use in pregnancy and people with hypertension should be monitored if using high doses.
ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS
What will this herb do for me?
Siberian ginseng affects many chemicals involved in switching on and off the body's stress responses. As such, it is used to improve wellbeing during times of chronic stress; however, scientific research has yet to fully investigate its use in this regard. It may also boost immune function and reduce the frequency of genital herpes outbreaks. Evidence for improved performance in athletes in unconvincing. When will it start to work?
Effects on stress levels should develop within 6 weeks, whereas immune responses develop within 30 days.
Are there any safety issues?
It should not he used In pregnancy and high doses should be used with care by those with hypertension.
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