Siberian ginseng is used to improve physical and mental responses during convalescence or fatigue states. Its ability to increase levels of noradrenaline, serotonin, adrenaline and Cortisol provide a theoretical basis for its use in situations of fatigue. However, controlled studies are limited.

A randomised, double-blind, placebo-controlled trial of 300 mg/day (E. senticosus dry extract) for 8 weeks assessed health-related QOL scores in 20 elderly people. Improvements were observed in social functioning after 4 weeks of therapy but did not persist to the 8-week time point. It would appear that improvements diminish with continued use (Cicero et al 2004), which may help to explain the practice of giving Siberian ginseng for 6 weeks with a 2-week break before repeating.

A recent randomised placebo-controlled trial evaluated the effectiveness of Siberian ginseng in chronic fatigue syndrome (CFS). No significant improvements were demonstrated overall; however, sub-group analysis showed improvements in fatigue in CFS sufferers with less severe fatigue (Hartz et al 2004). Further studies are required to determine whether Siberian ginseng may be a useful therapeutic option in cases of mild to moderate fatigue.

Commission E approves the use of Siberian ginseng as a tonic in times of fatigue and debility, for declining capacity for work or concentration, and during convalescence (Blumenthal et al 2000). In practice, it is often used in low doses in cases of fatigue due to chronic stress (Gaffney et al 2001 a).

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