Clinical note — Adaptogens

Adaptogens are innocuous agents, non-specifically increasing resistance against physical, chemical or biological factors (stressors), having a normalising effect independent of the nature of the pathological state (original definition of adaptogen by Brekhman & Dardymov 1969).

Adaptogens are natural bioregulators, which increase the ability of the organism to adapt to environmental factors and to avoid damage from such factor (revised definition by Panossian et al 1999).

(Refer to the Siberian ginseng monograph for more information about adaptogens and allostasis.)

The pharmacological effects of ginseng are many and varied, contributing to its reputation as a potent adaptogen. The adrenal gland and the pituitary gland are both known to have an effect on the body's ability to respond to stress and alter work capacity (Filaretov et al 1988), and ginseng is thought to profoundly influence the hypothalamic-pituitary-adrenal axis (Kim et al 2003d). The active metabolites of protopanaxadiol and protopanaxatriol saponins reduce acetylcholine-induced catecholamine secretion in animal models (Tachikawa & Kudo 2004, Tachikawa et al 2003) and this may help to explain the purported antistress effects of ginseng.

Ginseng has been shown in numerous animal experiments to increase resistance to a wide variety of chemical, physical and biological stressors. Ginseng extract or its isolated constituents have been shown to prevent immunosuppression induced by cold water swim stress (Luo et al 1993), to counter stress-induced changes from heat stress (Yuan et al 1989), food deprivation (Lee et al 1990), electroshock (Banerjee & Izquierdo 1982) and radiation exposure (Takeda et al 1981). As there are more than 1 500 studies on ginseng and its constituents, it is outside the scope of this monograph to include all studies, so we have attempted to include those studies most relevant to the oral use of ginseng.

Animal models suggest that ginseng is most useful for chronic rather than acute stress, significantly reducing elevated scores on ulcer index, adrenal gland weight, plasma glucose, triglycerides, creatine kinase activity, and serum corticosterone during chronic stress (Rai et al 2003).

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