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One study in laboratory animals showed possible effects of ginseng or its ginsenoside components on the central nervous system and [[Human gonad|gonadal]] tissues<ref name=impotence>{{cite journal |author=Hong B, Ji YH, Hong JH, Nam KY, Ahn TY |title=A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report |journal=J. Urol. |volume=168 |issue=5 |pages=2070–3 |year=2002 |month=November |pmid=12394711 |doi=10.1097/01.ju.0000034387.21441.87 |doi_brokendate=August 23, 2013}}</ref><ref>{{cite journal |author=Murphy LL, Lee TJ |title=Ginseng, sex behavior, and nitric oxide |journal=Ann. N. Y. Acad. Sci. |volume=962 |issue= |pages=372–7 |year=2002 |month=May |pmid=12076988 |doi=10.1111/j.1749-6632.2002.tb04081.x}}</ref> and another on penile erection.<ref>{{cite journal |author=de Andrade E, de Mesquita AA, Claro Jde A, ''et al.'' |title=Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction |journal=Asian J. Androl. |volume=9 |issue=2 |pages=241–4 |year=2007 |month=March |pmid=16855773 |doi=10.1111/j.1745-7262.2007.00210.x}}</ref>
One study in laboratory animals showed possible effects of ginseng or its ginsenoside components on the central nervous system and [[Human gonad|gonadal]] tissues<ref name=impotence>{{cite journal |author=Hong B, Ji YH, Hong JH, Nam KY, Ahn TY |title=A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report |journal=J. Urol. |volume=168 |issue=5 |pages=2070–3 |year=2002 |month=November |pmid=12394711 |doi=10.1097/01.ju.0000034387.21441.87 |doi_brokendate=August 23, 2013}}</ref><ref>{{cite journal |author=Murphy LL, Lee TJ |title=Ginseng, sex behavior, and nitric oxide |journal=Ann. N. Y. Acad. Sci. |volume=962 |issue= |pages=372–7 |year=2002 |month=May |pmid=12076988 |doi=10.1111/j.1749-6632.2002.tb04081.x}}</ref> and another on penile erection.<ref>{{cite journal |author=de Andrade E, de Mesquita AA, Claro Jde A, ''et al.'' |title=Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction |journal=Asian J. Androl. |volume=9 |issue=2 |pages=241–4 |year=2007 |month=March |pmid=16855773 |doi=10.1111/j.1745-7262.2007.00210.x}}</ref>


Ginseng is known to contain [[phytoestrogen]]s<ref>{{cite journal |author=Lee YJ, Jin YR, Lim WC, ''et al.'' |title=Ginsenoside-Rb1 acts as a weak phytoestrogen in MCF-7 human breast cancer cells |journal=Arch. Pharm. Res. |volume=26 |issue=1 |pages=58–63 |year=2003 |month=January |pmid=12568360 |doi=10.1007/BF03179933}}</ref><ref>{{cite journal |author=Chan RY, Chen WF, Dong A, Guo D, Wong MS |title=Estrogen-like activity of ginsenoside Rg1 derived from Panax notoginseng |journal=J. Clin. Endocrinol. Metab. |volume=87 |issue=8 |pages=3691–5 |year=2002 |month=August |pmid=12161497 |doi=10.1210/jc.87.8.3691}}</ref><ref>{{cite journal |author=Lee Y, Jin Y, Lim W, ''et al.'' |title=A ginsenoside-Rh1, a component of ginseng saponin, activates estrogen receptor in human breast carcinoma MCF-7 cells |journal=J. Steroid Biochem. Mol. Biol. |volume=84 |issue=4 |pages=463–8 |year=2003 |month=March |pmid=12732291 |doi=10.1016/S0960-0760(03)00067-0}}</ref> and may affect the pituitary gland to increase the secretion of gonadotropins.{{citation needed|date=June 2012}} Other mice studies found effects on sperm production and the [[estrous cycle]].<ref name="CMHP" />
Ginseng is known to contain [[phytoestrogen]]s<ref>{{cite journal |author=Lee YJ, Jin YR, Lim WC, ''et al.'' |title=Ginsenoside-Rb1 acts as a weak phytoestrogen in MCF-7 human breast cancer cells |journal=Arch. Pharm. Res. |volume=26 |issue=1 |pages=58–63 |year=2003 |month=January |pmid=12568360 |doi=10.1007/BF03179933}}</ref><ref>{{cite journal |author=Chan RY, Chen WF, Dong A, Guo D, Wong MS |title=Estrogen-like activity of ginsenoside Rg1 derived from Panax notoginseng |journal=J. Clin. Endocrinol. Metab. |volume=87 |issue=8 |pages=3691–5 |year=2002 |month=August |pmid=12161497 |doi=10.1210/jc.87.8.3691}}</ref><ref>{{cite journal |author=Lee Y, Jin Y, Lim W, ''et al.'' |title=A ginsenoside-Rh1, a component of ginseng saponin, activates estrogen receptor in human breast carcinoma MCF-7 cells |journal=J. Steroid Biochem. Mol. Biol. |volume=84 |issue=4 |pages=463–8 |year=2003 |month=March |pmid=12732291 |doi=10.1016/S0960-0760(03)00067-0}}</ref> and may affect the pituitary gland to increase the secretion of [[gonadotropins]].{{citation needed|date=June 2012}} Other mice studies found effects on sperm production and the [[estrous cycle]].<ref name="CMHP" />


==Side effects==
==Side effects==

Revision as of 09:29, 16 September 2013

Ginseng
Panax quinquefolius foliage and fruit
Scientific classification
Kingdom:
(unranked):
(unranked):
(unranked):
Order:
Family:
Subfamily:
Genus:
Panax

Species

Subgenus Panax

Section Panax
Series Notoginseng
Panax notoginseng
Series Panax
Panax bipinnatifidus
Panax ginseng
Panax japonicus
Panax quinquefolius
Panax vietnamensis
Panax wangianus
Panax zingiberensis
Section Pseudoginseng
Panax pseudoginseng
Panax stipuleanatus

Subgenus Trifolius

Panax trifolius

Ginseng (pronounced /ˈɪnsɛŋ/[1]) is any one of 11 species of slow-growing perennial plants with fleshy roots, belonging to the genus Panax of the family Araliaceae.

Ginseng is found only in the Northern Hemisphere, in North America and in eastern Asia (mostly Korea, northeastern China (Manchuria), Bhutan, and eastern Siberia), typically in cooler climates. Panax vietnamensis, discovered in Vietnam, is the southernmost ginseng known. This article focuses on the series Panax ginsengs, which are the adaptogenic herbs, principally Panax ginseng and P. quinquefolius. Ginseng is characterized by the presence of ginsenosides.

Siberian ginseng (Eleutherococcus senticosus) is in the same family, but not genus, as true ginseng. Like ginseng, it is considered to be an adaptogenic herb. The active compounds in Siberian ginseng are eleutherosides, not ginsenosides. Instead of a fleshy root, Siberian ginseng has a woody root.

Etymology

The English word ginseng derives from the Chinese term rénshēn (simplified: 人参; traditional: 人蔘). Rén means "man" and shēn means "plant root"; this refers to the root's characteristic forked shape, which resembles the legs of a man.[2] The English pronunciation derives from a southern Chinese reading, similar to Cantonese yun sum (Jyutping: jan4sam1) and the Hokkien pronunciation "jîn-sim".

The botanical/genus name Panax means "all-heal" in Greek, sharing the same origin as "panacea", and was applied to this genus because Linnaeus was aware of its wide use in Chinese medicine as a muscle relaxant.

Besides P. ginseng, many other plants are also known as or mistaken for the ginseng root. The most commonly known examples are xiyangshen, also known as American ginseng 西洋参 (P. quinquefolius), Japanese ginseng 东洋参 (P. japonicus), crown prince ginseng 太子參 (Pseudostellaria heterophylla), and Siberian ginseng 刺五加 (Eleutherococcus senticosus). Although all have the name ginseng, each plant has distinctively different functions. However, true ginseng plants belong only to the Panax genus.[3]

Ginseng (generic term)
Chinese name
Traditional Chinese人蔘 or 人參
Simplified Chinese人参
Transcriptions
Standard Mandarin
Hanyu Pinyinrén shēn
Bopomofoㄖㄣˊ ㄙㄣ
Wu
Romanizationzen sen
Hakka
Romanizationngin11 sem24
Yue: Cantonese
Jyutpingjan4sam1
Southern Min
Hokkien POJjîn-sim; lîn-sim
Vietnamese name
Vietnamese alphabetNhân Sâm
Korean name
Hangul인삼
Hanja人蔘
Transcriptions
Revised Romanizationin-sam
McCune–Reischauerin sam
Japanese name
Kanji朝鮮人参
Kanaちょうせんにんじん
Transcriptions
Romanizationchōsen ninjin
Ginseng species
Chinese name
Traditional Chinese人蔘屬
Simplified Chinese人参属
Transcriptions
Standard Mandarin
Hanyu Pinyinrén sēn shǔ
Bopomofoㄖㄣˊ ㄙㄣ ㄕㄨˇ
Wu
Romanizationzen sen tsoh
Hakka
Romanizationngin11 sem24 sug5
Yue: Cantonese
Jyutpingjan4sam1suk6
Southern Min
Hokkien POJjîn-sim-sio̍k
Korean name
Hangul인삼
Hanja人蔘
Transcriptions
Revised Romanizationin-sam
McCune–Reischauerin sam
Japanese name
Kanjiトチバニンジン属
Transcriptions
Romanizationtochibaninjin zoku
Ginseng field in Wisconsin

Traditional uses

The root is most often available in dried form, either whole or sliced. Ginseng leaf, although not as highly prized, is sometimes also used; as with the root, it is most often available in dried form. Folk medicine attributes various benefits to oral use of American ginseng and Asian ginseng (P. ginseng) roots, including roles as an aphrodisiac, stimulant, type II diabetes treatment, or cure for sexual dysfunction in men.[4]

Ginseng may be included in small doses in energy drinks or tisanes, such as ginseng coffee.[5] It may be found in hair tonics and cosmetic preparations, as well, but those uses have not been shown to be clinically effective.

Research

Ginsenosides, unique compounds of the Panax species, are under basic and clinical research to reveal their potential properties in humans.[6]

Ginseng remains under preliminary research for its potential properties or therapeutic effects, such as for respiratory illnesses,[7] quality of life,[8] influenza[7] or fatigue in cancer patients.[9] P. ginseng may affect cancer in animal models but this effect remains unclear.[10]

One study in laboratory animals showed possible effects of ginseng or its ginsenoside components on the central nervous system and gonadal tissues[11][12] and another on penile erection.[13]

Ginseng is known to contain phytoestrogens[14][15][16] and may affect the pituitary gland to increase the secretion of gonadotropins.[citation needed] Other mice studies found effects on sperm production and the estrous cycle.[3]

Side effects

A common side effect of P. ginseng may be insomnia,[17] but this effect is disputed.[18] Other side effects can include nausea, diarrhea, headaches, nose bleeds,[19] high blood pressure, low blood pressure, and breast pain.[20] Ginseng may also lead to induction of mania in depressed patients who mix it with antidepressants.[21]

Ginseng has been shown to have adverse drug reactions with phenelzine and warfarin, but has been shown to decrease blood alcohol levels.[22]

Overdose

The common adaptogen ginsengs (P. ginseng and P. quinquefolia) are generally considered to be relatively safe even in large amounts. One of the most common and characteristic symptoms of acute overdose of Panax ginseng is bleeding. Symptoms of mild overdose may include dry mouth and lips, excitation, fidgeting, irritability, tremor, palpitations, blurred vision, headache, insomnia, increased body temperature, increased blood pressure, edema, decreased appetite, dizziness, itching, eczema, early morning diarrhea, bleeding, and fatigue.[3]

Symptoms of gross overdose with Panax ginseng may include nausea, vomiting, irritability, restlessness, urinary and bowel incontinence, fever, increased blood pressure, increased respiration, decreased sensitivity and reaction to light, decreased heart rate, cyanotic (blue) facial complexion, red facial complexion, seizures, convulsions, and delirium.[3]

Patients experiencing any of the above symptoms are advised to discontinue the herbs and seek any necessary symptomatic treatment.[3]

Common classification

Ginseng roots in a market in Seoul, 2003

Asian ginseng (root)

Ginseng and reishi mushrooms in bottles being sold in Seoul, Korea

Panax ginseng is available commercially in four forms: fresh, red, white and sun ginsengs. Wild ginseng is used where available.

Red ginseng

Red ginseng

Red ginseng (Korean; Hanja; RRhong-sam; traditional Chinese: ; simplified Chinese: ; pinyin: hóng shēn), P. ginseng, has been peeled, heated either through steaming at standard boiling temperatures of 100 °C (212 °F), and then dried or sun-dried. It is frequently marinated in an herbal brew which results in the root becoming extremely brittle. It is more common as herbal medicine than white ginseng. This version of ginseng is traditionally associated with stimulating sexual function and increasing energy. Red ginseng is always produced from cultivated roots, generally from Korea.

A study of ginseng's effects on rats found, while both white ginseng and red ginseng appear to reduce the incidence of cancer, the effects appear to be greater with red ginseng.[23]

Another study showed potentially beneficial effects of a combination of Korean red ginseng and highly active antiretroviral therapy in HIV-1-infected patients.[24]

Falcarinol, a 17-carbon diyne fatty alcohol isolated from carrot and red ginseng, was thought to have potent anticancer properties on primary mammary epithelial (breast cancer) cells.[25] Other acetylenic fatty alcohols in ginseng (panaxacol, panaxydol and panaxytriol) have antibiotic properties.[26]

Fresh ginseng

Fresh ginseng is the raw product. Its use is limited by availability.

White ginseng

White ginseng, native to America, is fresh ginseng which has been dried without being heated. It is peeled and dried to reduce the water content to 12% or less. White ginseng air-dried in the sun may contain less of the therapeutic constituents. It is thought by some that enzymes contained in the root break down these constituents in the process of drying. Drying in the sun bleaches the root to a yellowish-white color.

Sun ginseng

Sun ginseng is created from a heat processing method which increases ginsenoside components such as ginsenoside-[Rg.sub.3], -[Rk.sub.1] and -[Rg.sub.5] by steaming white ginseng at a higher temperature than red ginseng. The herb is steamed for three hours at 120 °C (248 °F). Sun ginseng has increased nitric oxide, superoxide, hydroxyl radical and peroxynitrite scavenging activities compared with conventionally processed red or white versions. The increased steaming temperature produces an optimal amount of biological activity due to its ability to amplify specific ginsenosides.[citation needed]

Wild ginseng

Harvested ginseng in Germany

Wild ginseng grows naturally and is harvested from wherever it is found. It is relatively rare, and even increasingly endangered, due in large part to high demand for the product in recent years, which has led to the wild plants being sought out and harvested faster than new ones can grow (it requires years for a root to reach maturity). Wild ginseng can be either Asian or American, and can be processed to be red ginseng.

Woods-grown American ginseng programs in Vermont, Maine, Tennessee, Virginia, North Carolina, West Virginia and Kentucky,[27][28] and United Plant Savers have been encouraging the planting of ginseng both to restore natural habitats and to remove pressure from any remaining wild ginseng, and they offer both advice and sources of rootlets. Woods-grown plants have a value comparable to wild-grown ginseng of similar age.

Partially germinated ginseng seeds harvested the previous Fall can be planted from early Spring until late Fall, and will sprout the following Spring. If planted in a wild setting and left to their own devices, they will develop into mature plants which cannot be distinguished from native wild plants. Both Asian and American partially germinated ginseng seeds can be bought from May through December on various eBay sales. Some seed sales come with planting and growing instructions.

P. quinquefolius American ginseng (root)

According to traditional Chinese medicine, American ginseng promotes yin energy, cleans excess yang and calms the body. The reason it has been claimed that American ginseng promotes yin (shadow, cold, negative, female) while Asian ginseng promotes yang (sunshine, hot, positive, male) is that, according to traditional Chinese medicine, things living in cold places or northern side of mountains or southern side of rivers are strong in yang and vice versa, so the two are balanced.[citation needed] Chinese/Korean ginseng grows in Manchuria and Korea, the coldest area known to many Koreans in ancient times. Thus, ginseng from there is supposed to be very yin.

Originally, American ginseng was imported into China via subtropical Guangzhou, the seaport next to Hong Kong, so Chinese doctors believed American ginseng must be good for yang, because it came from a hot area. They did not know, however, that American ginseng can only grow in temperate regions. Nonetheless, the root is legitimately classified as more yin because it generates fluids.[29]


Most North American ginseng is produced in the Canadian provinces of Ontario and British Columbia and the American state of Wisconsin, according to Agri-food Canada. P. quinquefolius is now also grown in northern China.

The aromatic root resembles a small parsnip that forks as it matures. The plant grows 6 to 18 in tall, usually bearing three leaves, each with three to five leaflets two to five inches long.

Other plants sometimes called ginseng

These mostly "adaptogenic" plants are sometimes referred to as ginsengs, but they are either from a different family or genus. Only jiaogulan actually contains compounds closely related to ginsenosides, although ginsenosides alone do not determine the effectiveness of ginseng. Since each of these plants has different uses, one should research their properties before using.[30]

Other plants which are referred to as ginsengs may not be adaptogens (although notoginseng is in the genus Panax):

See also

References

  1. ^ "ginseng". Cambridge Dictionaries Online. Retrieved 2011-06-04.
  2. ^ Oxford Dictionaries Online, s.v. "ginseng".
  3. ^ a b c d e Chinese Medical Herbology and Pharmacology, by John K. Chen, Tina T. Chen
  4. ^ "As ginseng prices soar, diggers take to the backcountry". Retrieved 28 September 2012.
  5. ^ Clauson KA, Shields KM, McQueen CE, Persad N (2008). "Safety issues associated with commercially available energy drinks". J Am Pharm Assoc (2003). 48 (3): e55–63, quiz e64–7. doi:10.1331/JAPhA.2008.07055. PMID 18595815.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  6. ^ Qi LW, Wang CZ, Yuan CS (2011). "Ginsenosides from American ginseng: chemical and pharmacological diversity". Phytochemistry. 72 (8): 689–99. doi:10.1016/j.phytochem.2011.02.012. PMC 3103855. PMID 21396670. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  7. ^ a b McElhaney JE, Gravenstein S, Cole SK; et al. (2004). "A placebo-controlled trial of a proprietary extract of North American ginseng (CVT-E002) to prevent acute respiratory illness in institutionalized older adults". J Am Geriatr Soc. 52 (1): 13–9. doi:10.1111/j.1532-5415.2004.52004.x. PMID 14687309. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  8. ^ Caso Marasco A, Vargas Ruiz R, Salas Villagomez A, Begoña Infante C (1996). "Double-blind study of a multivitamin complex supplemented with ginseng extract". Drugs Exp Clin Res. 22 (6): 323–9. PMID 9034759.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ^ Barton DL, Soori GS, Bauer BA; et al. (2010). "Pilot study of Panax quinquefolius (American ginseng) to improve cancer-related fatigue: a randomized, double-blind, dose-finding evaluation: NCCTG trial N03CA". Support Care Cancer. 18 (2): 179–87. doi:10.1007/s00520-009-0642-2. PMID 19415341. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  10. ^ Shin HR, Kim JY, Yun TK, Morgan G, Vainio H (2000). "The cancer-preventive potential of Panax ginseng: a review of human and experimental evidence". Cancer Causes Control. 11 (6): 565–76. doi:10.1023/A:1008980200583. PMID 10880039. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  11. ^ Hong B, Ji YH, Hong JH, Nam KY, Ahn TY (2002). "A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report". J. Urol. 168 (5): 2070–3. doi:10.1097/01.ju.0000034387.21441.87. PMID 12394711. {{cite journal}}: Unknown parameter |doi_brokendate= ignored (|doi-broken-date= suggested) (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  12. ^ Murphy LL, Lee TJ (2002). "Ginseng, sex behavior, and nitric oxide". Ann. N. Y. Acad. Sci. 962: 372–7. doi:10.1111/j.1749-6632.2002.tb04081.x. PMID 12076988. {{cite journal}}: Unknown parameter |month= ignored (help)
  13. ^ de Andrade E, de Mesquita AA, Claro Jde A; et al. (2007). "Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction". Asian J. Androl. 9 (2): 241–4. doi:10.1111/j.1745-7262.2007.00210.x. PMID 16855773. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  14. ^ Lee YJ, Jin YR, Lim WC; et al. (2003). "Ginsenoside-Rb1 acts as a weak phytoestrogen in MCF-7 human breast cancer cells". Arch. Pharm. Res. 26 (1): 58–63. doi:10.1007/BF03179933. PMID 12568360. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  15. ^ Chan RY, Chen WF, Dong A, Guo D, Wong MS (2002). "Estrogen-like activity of ginsenoside Rg1 derived from Panax notoginseng". J. Clin. Endocrinol. Metab. 87 (8): 3691–5. doi:10.1210/jc.87.8.3691. PMID 12161497. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  16. ^ Lee Y, Jin Y, Lim W; et al. (2003). "A ginsenoside-Rh1, a component of ginseng saponin, activates estrogen receptor in human breast carcinoma MCF-7 cells". J. Steroid Biochem. Mol. Biol. 84 (4): 463–8. doi:10.1016/S0960-0760(03)00067-0. PMID 12732291. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  17. ^ http://www.umass.edu/cnshp/faq.html
  18. ^ "The Ginseng Book." Stephen Fulder, PhD
  19. ^ "Ginseng definition - Medical Dictionary definitions of some medical terms defined on MedTerms". Medterms.com. 2012-09-20. Retrieved 2013-03-26.
  20. ^ Kiefer D, Pantuso T (2003). "Panax ginseng". Am Fam Physician. 68 (8): 1539–42. PMID 14596440. {{cite journal}}: Unknown parameter |month= ignored (help)
  21. ^ Fugh-Berman A (2000). "Herb-drug interactions". Lancet. 355 (9198): 134–8. doi:10.1016/S0140-6736(99)06457-0. PMID 10675182. {{cite journal}}: Unknown parameter |month= ignored (help)
  22. ^ Izzo AA, Ernst E (2001). "Interactions between herbal medicines and prescribed drugs: a systematic review". Drugs. 61 (15): 2163–75. doi:10.2165/00003495-200161150-00002. PMID 11772128.
  23. ^ Yun TK, Lee YS, Lee YH, Kim SI, Yun HY (2001). "Anticarcinogenic effect of Panax ginseng C.A. Meyer and identification of active compounds". J. Korean Med. Sci. 16 (Suppl): S6–18. doi:10.3346/jkms.2001.16.S.S6. PMC 3202204. PMID 11748383. {{cite journal}}: Unknown parameter |doi_brokendate= ignored (|doi-broken-date= suggested) (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  24. ^ Sung H, Jung YS, Cho YK (2009). "Beneficial effects of a combination of Korean red ginseng and highly active antiretroviral therapy in human immunodeficiency virus type 1-infected patients". Clin. Vaccine Immunol. 16 (8): 1127–31. doi:10.1128/CVI.00013-09. PMC 2725544. PMID 19535541. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  25. ^ "fatty alcohols and aldehydes". Cyberlipid.org. Retrieved 2013-03-26.
  26. ^ "fatty alcohols and aldehydes". Cyberlipid.org. Retrieved 2013-03-26.
  27. ^ state.tn.us TDEC: DNH: Ginseng Program
  28. ^ "Care and Planting of Ginseng Seed and Roots". Ces.ncsu.edu. 1914-06-30. Retrieved 2013-03-26.
  29. ^ Chinese Herbal Medicine: Materia Medica, Third Edition by Dan Bensky, Steven Clavey, Erich Stonger, and Andrew Gamble 2004
  30. ^ Winston, David (2007). Adaptogens: Herbs for Strength, Stamina, and Stress Relief. Healing Arts Press. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)