Siberian Ginseng

Eleutherococcus senticosus (syn. Acanthopanax senticosus) is in the same botanic family as the Panax ginsengs (Araliaceae), but is not a member of the Panax genus and is therefore not considered a true ginseng. E. senticosus, also known as Eleuthero, is commonly referred to as Siberian or Russian ginseng because it is indigenous to Eastern Russia. The root or root bark is used medicinally.

Uses and Benefits:

Siberian ginseng is claimed to have powerful adaptogenic and tonic properties that can modulate stress and improve mental and physical performance under a wide variety of stressful conditions. It was discovered by Soviet researchers who were searching for an alternative to Asian ginseng and other adaptogenic herbs. Officially approved for use in Russia in 1962, Siberian ginseng became a popular commercial drink to help improve endurance. In traditional Chinese medicine, this plant is considered a minor tonic (named ci wu jia). It has been employed for bronchitis, digestion, heart ailments, rheumatism, headaches, and insomnia, and to generally restore vigor and health.

Pharmacology:

The eleutherosides (A-G) are considered the most important constituents in the roots of Siberian ginseng. Unlike the ginsenosides of the Panax genus, however, the eleutherosides are a chemically diverse group of plant chemicals (Iignans, sterols, phenylpropanoids, coumarins, and others), and are not unique to E. senticosus.Soviet researchers conducted numerous animal experiments with Siberian ginseng, and reported enhanced physical en�durance and resistance to infection, radiation, cancer, toxins, and iI variety of environmental extremes. Anabolic, estrogenic, an�liviral, hypotensive, and many other effects have also been demonstrated in animal models. Conflicting reports in which extracts induced both hypoglycemia and hyperglycemia in animals, or enhanced both CNS sedation and stimulation, have been explained by the "adaptogenic" properties of the herb. Alternatively, it may also be explained by different extracts or experimental conditions. Most of the earlier animal endurance studies were unblinded, which also raises the question of investigator bias; a more recent blinded study was negative.

Limited pharmacologic data is available in humans. In a report�edly double-blind, placebo-controlled study, 10 ml t.i.d. of a German product for 4 weeks significantly increased lymphocytes by about 50% in 36 healthy volunteers. In an unblinded, randomized, con�trolled study, 25 drops t.i.d. of an ethanolic root extract decreased glucose and cholesterol (total, LOL, and triglycerides), and increased neutrophil and lymphocyte activity in 50 healthy volunteers.

Clinical Trials:

Most of the original Russian clinical studies have been reviewed and summarized. Initial research reported that athletes performed better; sportsmen had better endurance and concentration; and workers had fewer sick days when taking Siberian ginseng. In multiple studies that included over 2100 healthy subjects, Siberian ginseng was reported to demonstrate adaptogenic effects to help subjects withstand various adverse conditions and stressors (work load, noise, motion, heat, etc.), resulting in enhanced work performance. Studies in over 2200 unhealthy patients reported "benefits" in various diseases such as atherosclerosis and heart disease, acute pyelonephritis, diabetes, chronic bronchitis, hypertension and hypotension, trauma, neuroses, and cancer. However, outcome measures and actual clini�cal benefits are not well defined. Moreover, these studies were uncontrolled or unblinded, and would not meet today's standards for high-quality clinical research.

In more recent controlled trials, benefits for athletic endurance were initially reported in a single-blind, placebo-controlled study, and improvements in muscle strength demonstrated in a placebocontrolled trial with unclear blinding. A Chinese study also reported an increased anaerobic threshold of power load emd decreased respiratory quotient (suggesting enhanced fat metabo" lism during exercise). However, more rigorous double-blind studies have failed to verify these potential beneficial effects. A series of small controlled trials using treadmill or cycle ergometry found no ergonomic benefits for a brand of Siberian ginseng called Endurox. Another well-designed trial of 20 runners found no ergonomic benefits with an ethanolic extract of eleutherosides Band E given daily for 6 weeks compared to placebo. A well-designed, double-blind, crossover study found no measurable ergonomic or metabolic benefits in nine cyclists, randomly given placebo or 1200 mg Siberian ginseng daily for 7 days before two separate endurance cycling trials.

Adverse Effects:

Siberian ginseng is considered safe and nontoxic, although data is limited. No side effects were reported in any of the recent human trials, and there are no well-documented case reports of adverse effects. In the original Russian studies, adverse events were not reported in otherwise healthy subjects, although it was suggested that Siberian ginseng should not be used when blood pressures exceed 180/90. In "unhealthy" patients, insomnia, arrhythmias, hypertension, headaches, irritability, and anxiety reactions were occasionally reported. Caution is thus advised for patients with cardiac disease, hypertension, psychiatric diseases, or when using caffeine or other stimulants, although these potential side effects are not well established.

Side Effects and Interactions:

In two separate case reports, adulterated or mislabeled eleutherococcus preparations (most likely with Periploca sepium, which contains cardioactive glycosides) were associated with androgenization in a newborn and with an increased digoxin level absent toxicity. Safety of Siberian ginseng is unknown in women who are pregnant or breast feeding.

Preparations & Doses:

Multiple products are on the U.S. market, from dried herb preparations to a variety of extracts. In the original Russian studies, doses were usually taken for up to 4-8 weeks at a time, interrupted by 2-to 3-week ginseng-free in�tervals; however, there is no data to support these regimens. Common doses of encapsulated extracts currently on the market include one to three 100-400 mg capsules given 2-3 times daily, roughly equivalent to 1-4 g/day or more of a dried root product.

Summary Evaluation:

Siberian ginseng is commonly used as an adaptogen to help modulate responses to stressors and to enhance mental and physical stamina and endurance. These claims are primarily based on animal studies and early clinical investigations by Soviet researchers. Siberian ginseng does not enhance physical endurance based on more recent, well-designed clinical trials. Limited studies suggest that Siberian ginseng may enhance WBC activity, reduce cholesterol and glucose, enhance memory, and benefit patients with herpes simplex infections, but these studies require confirmation and, in general, the efficacy of Siberian gin�seng is not established beyond a reasonable doubt for any indica�tion. Based on limited data, Siberian ginseng appears safe, with no well-documented adverse effects.