Can Ginseng Boost the Immune System and Increase Performance?

Abstract & Commentary

Synopsis: The pill form of ginseng was no better than placebo at enhancing performance or boosting the immune system in response to stressful exercise.

Source: Engels HJ, et al. Effects of ginseng on secretory IgA, performance, and recovery from interval exercise. Med Sci Sports Exerc. 2003;35(4):690-696.

Extracts of Panax ginseng, better known as Chinese or Korean ginseng, are used commonly as medicine in Asian countries. Western medicine has adopted the herb and has suggested that ginseng offers relief and protection against stress, upper respiratory infection, and fatigue. Secretory immunoglobulin A (SIgA) is the primary immunoglobulin contained in secretions of the mucosal immune system, and its levels correlate with resistance to certain infection better than many serum antibodies.

Therefore, this study examined the efficacy of a standardized ginseng concentrate (400 mg d-1 of G115; equivalent to 2 g of Panax ginseng C.A. Meyer root material) to modulate SIgA, exercise performance, and recovery from strenuous physical exertion for 8 weeks.

A double-blind, placebo-controlled, randomized design was used to study 38 active healthy adults who supplemented their diets with the above ginseng extract or placebo. Each performed 3 consecutive 30-s Wingate tests interspersed with 3-minute recovery periods before and after the intervention. Whole saliva samples were collected before and after exercise to calculate SIgA: protein ratio and SIgA secretion rates. Mechanical power output (W.kg-1) was measured, and exercise recovery heart rate was determined.

Twenty-seven subjects (12 placebo, 15 ginseng) completed the study. Compared with rest, S-SigA measurements and mechanical power output declined (P < .01) across consecutive Wingate tests showing the effect of fatigue on the test parameters. No changes were measured between ginseng and placebo groups, and no improvements were measured with the recovery heart rate. Therefore, Engels and associates concluded diet supplementation with ginseng fails to improve physical performance, heart rate recovery, or improve immune status of individuals undergoing repeated bouts of exhausting exercise.

Comment by James R. Slauterbeck, MD

I often get asked questions about supplements ranging from steroids to ginseng. Many athletes are looking for the best herb to take to get the competitive edge. The numbers of supplements available today in stores and online are too numerous to count. Ginseng is a common herb supplement patients are taking. The Chinese, Siberian or Asian ginseng is a sought-after supplement in the United States and is a common herb used in Asian medicine. Western alternative medical practices are strongly advocating its effect on immunoactivation and suggesting it has an ergogenic effect on athletic performance. This study addressed some of these reported claims.

First, maximum heart rate and heart rate recovery was not different from the placebo group. Second, the immune system, as tested by Engels et al, showed no benefit from ginseng use in a fatigue model. These findings suggest that this pill form of ginseng is not efficacious. However, it does not address the outcomes of consumption of the native root. True believers note positive effects from certain kinds of roots, many of which are difficult to find in the United States. Additionally, the native root form contains other polysaccharides and ginsengoids that synergistically may have a positive effect not tested in this model.

So, how does this information help us as sports physicians? My answer is that the supplement pill form of the root is not effective at boosting the immune system and that performance is not positively affected. However, this study does not test the clinical effectiveness of the natural root. Now when asked about this supplement by patients, I have this new information to discuss with them.

Dr. Slauterbeck is Associate Professor, Department of Orthopaedic Surgery, Texas Tech University Health Sciences Center, Lubbock, TX.