Ginseng After 40

After the age of forty, a person develops new focal points of concern: slower recovery, the first changes in glucose metabolism, complaints about memory and concentration, and regular medications that were not part of life at twenty. It is precisely at this age that interest in ginseng grows the most. Our editorial team analyzed which of these expectations have a scientific basis and which remain marketing.

Why age changes the question

Ginseng (the genus Panax) acts on the body of a forty-year-old through the same mechanisms as in a twenty-year-old: ginsenosides influence the stress response, glucose metabolism, vascular tone, and the nervous system. However, with age the baseline state on which these mechanisms act changes, and with it the balance of benefit and risk.

First, after 40 impaired glucose tolerance, elevated blood pressure, and changes in the lipid profile occur more often. Second, the likelihood of taking daily medication rises: antihypertensives, glucose-lowering drugs, anticoagulants, antidepressants. In such a situation any herbal supplement becomes one more element of a pharmacological system.

Third, the goals change. An older person is less often interested in a personal record in the gym and more often in steady energy throughout the day, clarity of thought, quality of sleep, and preserving physical activity. It is from this angle that we consider the research data.

Finally, with age the liver and kidneys work more slowly, so the metabolism of active substances may differ. This does not mean ginseng is dangerous, but it does mean that the principle «the more, the better» is especially inappropriate here.

Fatigue and performance

A meta-analysis by Bach and colleagues (2016) showed that ginseng may moderately reduce the feeling of fatigue, whereas the evidence for improved objective physical performance is insufficient. For people over 40 this is a realistic benchmark: the supplement may slightly ease subjective fatigue, but it does not restore the endurance of earlier years.

Fatigue at this age often has medical causes: anemia, hypothyroidism, sleep disorders including apnea, depression, side effects of medications, and in men a decline in testosterone. Our editorial team insists: before «treating» fatigue with ginseng, it is worth undergoing a basic examination.

As for muscle mass and strength after 40, there is essentially no data indicating a benefit from ginseng. The most effective way to counter age-related muscle loss remains strength training and adequate protein intake. No herbal supplement compensates for their absence.

At the same time, ginseng sometimes helps people who begin training in mature age feel more energetic during the first weeks of adaptation. But if the supplement causes insomnia, any possible benefit is offset by poorer recovery.

Memory and concentration

Cognitive effects are one of the most popular reasons for taking ginseng after 40. A review by Kennedy and Scholey (2003) described a number of studies in which single doses of a standardized extract improved certain measures of attention and working memory in healthy volunteers.

In a study by Reay and colleagues (2005), single doses of the G115 extract lowered blood glucose and improved performance on prolonged mental tasks. The authors attribute the effect, in part, to an influence on glucose utilization. However, these are short-term laboratory models, not years of use.

A Cochrane systematic review (Geng et al., 2010) on ginseng for improving cognitive function concluded that there is no convincing evidence of benefit: the studies were small, short, and had methodological limitations. Ginseng is not recommended for the prevention of dementia by any clinical guidelines.

So if you are troubled by noticeable memory changes, the first step should be a consultation with a neurologist, a check of vitamin B12 levels, thyroid function, and sleep quality. Ginseng can be considered only as an addition to a healthy lifestyle, not as a treatment.

Glucose, the heart, and erectile function

A meta-analysis by Shishtar and colleagues (2014) showed that ginseng is able to slightly lower fasting glucose levels. For a person with prediabetes this sounds appealing, but the effect is small and does not replace diet, physical activity, and, if needed, medication therapy.

For those already taking glucose-lowering drugs, this same effect becomes a risk: an additional drop in glucose can lead to hypoglycemia. People on insulin and sulfonylurea derivatives should be especially careful.

As for blood pressure, the data are mixed: in various studies ginseng either had no effect on blood pressure or caused small changes in both directions. Our editorial team does not advise people with uncontrolled hypertension to experiment with stimulating supplements.

A systematic review by Jang and colleagues (2008) on red ginseng for erectile dysfunction found signs of benefit, but the quality of the studies was limited. Erectile dysfunction after 40 is often an early marker of cardiovascular disease, so it is worth discussing with a doctor rather than merely seeking a supplement.

Medications, interactions, and choosing a product

The best-known interaction is with warfarin. A randomized study by Yuan and colleagues (2004) showed that American ginseng reduces the effect of warfarin. For people taking anticoagulants after thrombosis or because of atrial fibrillation, such a combination without a doctor is unacceptable.

Product quality is decisive. Choose supplements that state the Latin name (Panax ginseng or Panax quinquefolius), the part of the plant, and standardization by ginsenosides. The extracts studied in research have a stable composition, whereas cheap powders can vary considerably from batch to batch.

In traditional use, according to the EMA monograph, roughly 0.6–2 g of dried root per day is used, with a limited course duration. For standardized extracts, follow the manufacturer’s dose. It is sensible to take ginseng in the first half of the day and to take breaks between courses.

• Start with the minimum dose recommended by the manufacturer.
• Assess sleep and blood pressure during the first week.
• Tell your doctor about taking it if you are on chronic therapy.

Editorial conclusions

After the age of 40, ginseng may be moderately useful for reducing subjective fatigue and, possibly, for short-term support of mental performance. There is no evidence for the prevention of dementia, age-related muscle loss, or cardiovascular disease.

The main feature of this age is medications and chronic conditions. Interactions with anticoagulants, glucose-lowering agents, and antidepressants may outweigh any potential benefit.

The most valuable thing a person over 40 can do for energy and clarity of thought is regular training, adequate sleep, and control of blood pressure and glucose. Within this system ginseng is only an optional addition.

We also recommend our materials «Cordyceps After 40», «Curcumin After 40», and «Ginseng for Women: Are There Any Special Considerations», where we analyze other popular supplements from the standpoint of age-related changes.

References

1. Bach HV, Kim J, Myung SK, Cho YA. Efficacy of ginseng supplements on fatigue and physical performance: a meta-analysis. J Korean Med Sci. 2016;31(12):1879–1886.
2. Kennedy DO, Scholey AB. Ginseng: potential for the enhancement of cognitive performance and mood. Pharmacol Biochem Behav. 2003;75(3):687–700.
3. Reay JL, Kennedy DO, Scholey AB. Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity. J Psychopharmacol. 2005;19(4):357–365.
4. Geng J, Dong J, Ni H, et al. Ginseng for cognition. Cochrane Database Syst Rev. 2010;(12):CD007769.
5. Shishtar E, Sievenpiper JL, Djedovic V, et al. The effect of ginseng (the genus Panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials. PLoS One. 2014;9(9):e107391.
6. Jang DJ, Lee MS, Shin BC, Lee YC, Ernst E. Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol. 2008;66(4):444–450.
7. Yuan CS, Wei G, Dey L, et al. Brief communication: American ginseng reduces warfarin's effect in healthy patients: a randomized, controlled trial. Ann Intern Med. 2004;141(1):23–27.
8. European Medicines Agency. Community herbal monograph on Panax ginseng C.A. Meyer, radix. London: EMA, HMPC.