Ginseng Side Effects

The side effects of ginseng are generally mild but can include both common and rare adverse reactions. The most frequently reported side effects are gastrointestinal symptoms such as abdominal discomfort, diarrhea, constipation, and dyspepsia. Other possible reactions are headache, insomnia, palpitations, and skin rash. Some users may also report flushing^[3].

Rare but significant side effects have been documented, including allergic reactions (hives, swelling), hypertensive crisis (especially in those not previously suffering from high blood pressure), uterine or vaginal bleeding, arrhythmias (abnormal heart rhythms), gynecomastia (enlarged breast tissue in men), and manic episodes (even in individuals with no prior psychiatric illness). There are isolated reports of serious cardiac events such as long QT syndrome and atrial fibrillation^[1].

Additional reported risks include increased morning diarrhea, skin problems, excess nervousness, high or low blood pressure, depression, decreased appetite, and bodily swelling (edema), particularly with prolonged or high-dose use^[5]. Cases of acute hepatitis have also been linked to ginseng in rare instances^[1].

Ginseng can interact with numerous medications (over 100 recorded interactions), some of which may be clinically significant. Notably, ginseng can reduce the effect of warfarin (a blood thinner), potentially increasing the risk of clotting^[6]. Ginseng may also modify the effects of antidiabetic medicines, potentially causing hypoglycemia, and can interact with drugs for heart rhythm (such as amiodarone or thioridazine), increasing risks of arrhythmia. There are also interactions with antidepressants (MAO inhibitors), certain cancer drugs (imatinib, raltegravir), hormone therapies, and blood thinners such as aspirin and NSAIDs^[4].

Some sources also note a possible phytoestrogenic effect of ginseng, which could theoretically impact hormone-related conditions^[5]. Pregnancy and breastfeeding are considered contraindications for ginseng use due to insufficient safety data^[4].

References

• [1] Review of cases of patient risk associated with ginseng abuse and misuse
• [3] Ginseng and health outcomes: an umbrella review – Frontiers
• [4] Ginseng – Merck Manual Consumer Version
• [5] What Are the Dangers of Taking Ginseng? – MedicineNet
• [6] Does Ginseng interact with any drugs? – Drugs.com