Can ginseng improve physical

performance?
Prof Chia-Hua Kuo
University of Taipei, Taipei, Taiwan
 Evolution of ginseng as a plant
• Ginseng can grow in cold weather in land with
large temperature fluctuation
• High content of various steroid compounds
(more than 30)
• Most popular herbal in the global market
Plasma membrane and temperature
Phase separation of membrane during temperature shift
 Is ginseng safe?
A long tradition (>2000 y) and an extensive
history of use (millions of people, many elderly
or infirm) suggests an affirmative answer
HOWEVER….
 Appears to be no risk of
disqualification from drug-tested
sporting events from use of ginseng
Bahrke et al. Sports Med
1994;18:229–48.
Ergogenic effect (improving performance) of ginseng?
Current results using ginseng are mixed

You cannot answer the question

unless components profile of ginseng
can be controlled
 Mixed outcomes
• Engels et al. J Strength Cond Res. 2001
Aug;15(3):290.
• Bahrke et al. Sports Med 1994;18:229–48.
 Geographic variations
Sievenpiper, et al. Journal of the American College of Nutrition, Vol. 23, No. 3, 248–258 (2004)
Variable effect of ginseng
Sievenpiper et al, Eur J Clin Nutr. 2003 Feb;57(2):243-8.
Seasonal Variation
 Ginsenosides and Steroid Hormones
• Protopanaxadiol (PPD) • Protopanaxatriol (PPT)
– Rb1, Rb2, Rc, Rd – Rg1, Re, Rf, and Rg2

• Testosterone • Estrogen
 Background: Inflammation
• Local response when cells are unhealthy
– Results of Injury, infection, aging, traumatic challenges
• Essential for wound healing (damage recovery)
• Sequential process
– M1 macrophage (CD68+, TNF-apha): Free radical
release, Cell lysis, stem cell recruitment
– M2 macrophage (CD126+, IL-10): Antioxidant
upregulation, Cell repopulation
• Paradox of previous data: Increase cell death vs.
Anti-inflammation
Necrosis induced by exercise eliminated in
ginseng steroid pretreatment
Macrophage M1 infiltration induced by exercise
prevented after ginseng steroid pretreatment
 Nitrotyrosine increased but exercise-induced
nitrotyrosine increase prevented after ginseng steroid
pretreatment
NOS increased but exercise-induced NOS increase
prevented after ginseng steroid pretreatment
Similar pattern in inflammatory mediators
Similar pattern in NFkB signaling pathway
Similar pattern in MAPK signaling pathway
Antioxidants
Muscle strength, fiber regeneration, and M2a
macrophage increased after ginseng steroid
pretreatment
IL-10 increased after ginseng steroid
pretreatment
 Conclusion
• Ginseng-based steroids have a hermetic property
– High dose may be harmful
– Low dose is beneficial
• Ginseng steroids potentiate inflammatory signaling system
(Pro-inflammatory at rest)
– Increase nitrotyrosine as dose increases
– Increase inflammatory cytokine levels as dose increases
• Potentiation of inflammatory signaling system by ginseng
steroids causes (Anti-inflammatory against challenge)
– Increases myofiber regeneration
– Increases muscle strength at young animals
– Prevent inflammation against muscle-damaging exercise
Rg1 is the ergogenic components

Hou et al. PLoS One. 2015

 Previous studies in ergogenic action
• One animal study that 4 days of ginseng saponin
supplementation (10 and 20 mg/kg/day) can
significantly increase endurance performance of
rats exercising at approximately 70% of maximal
oxygen consumption (VO2max).
• Ginseng saponin devoid of Rg1 and Rb1 failed to
demonstrate this positive effect, suggesting that
these major steroidal compounds of ginseng may
be responsible for the performance-enhancing
attribute (Wang et al, 1998).
 What happen during exercise
• Increased carbohydrate oxidation
• Increased oxidative damage on cell membrane
• Molecular attrition in cell membrane may
undermine performance
Study I- Selecting steroids

Purpose is to select the ginsenoside

which can influence glucose
metabolism
Oral glucose tolrance test

Rb1 Rg1
Reconfirmation on Rg1 action for 10 weeks
Response to insulin
Human trial 1: Post-exercise glucose tolerance
Human trial 1: Muscle glycogen recovery
Mitochondrial Enzyme Activity
No difference in PGC-1 and GLUT4
Rg1 minimizes lipid peroxidation
Rg1 shifts Inflammatory Balance
Rg1 minimizes autophagy markers
Rg1 minimizes ATG5 mRNA increase
Rg1 improves endurance performance
Rg1 has no effect on muscle strength
 Concluding remarks
• Rg1 is an ergogenic component which can
improve insulin sensitivity and accelerate
glycogen recovery after exercise in humans
• Rg1 increases endurance performance and
glycogen recovery, but no any effect on maximal
oxygen consumption and muscle strength
• Ergogenic benefit may be associated with
increased membrane lipid stability against free
radical attack from contracting muscle
• Rg1 and Rb1 at low dose have no effect on weight
lifting power (unpublished data)