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Ginseng, primarily Korean and American ginseng, have been used in diabetes. It may work by decreasing the rate of carbohydrate absorption into the portal hepatic circulation and possibly increasing glucose transport and uptake. It may also regulate insulin secretion. The most common side effects are nervousness and excitability. Others include headache, increased blood pressure, insomnia and some adverse hormonal effects in women, including breast pain and untimely vaginal bleeding. Drug interactions have been reported with diuretics, where the diuretics do not work appropriately, insomnia, headache and tremors with an MAO inhibitor, and decreased warfarin effects. It may interfere with steroids, potentiate stimulants, and cause additive hypoglycemic activity with secretagogues. Studies have been done only in type 2 diabetes. A problem with ginseng has been adulteration with other substances. In one case this even led to a positive doping test in an Olympic athlete.

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Laura Shane-McWhorter, PharmD, BCPS, FASCP, CDE, BC-ADM
November 24, 2001

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