Alzheimer’s Disease affects millions of Americans, and has been a baffling enigma for doctors and scientists for decades. According to the Alzheimer's Association, 6 million Americans already suffer from the disease–that’s 1 in 9 people over the age of 65. That number is expected to more than double by 2050.
With the hunt for a cure constantly underway, many people have turned to alternative medicines to at least slow the effects of the debilitating condition, or even hopefully reverse them. With that in mind, many herbal remedies have become popular. This article will seek to find scientific evidence supporting or refuting the use of Panax ginseng (also known as Korean or Red Ginseng) in the treatment of Alzheimer’s.
✲ Several studies have found links to the benefits of Ginseng in particular uses and preparations.
✲ The scientific community has been quick to point out, however, that these results are not conclusive, for several reasons.
✲ Many researchers have posited that it is only specific compounds (ginsenosides) within ginseng that are beneficial, and that they should be isolated for further research.
✲ No Adverse Effects (AE) specifically related to ginseng have been reported.
At the beginning of this section, it needs to be pointed out that all decisions for someone’s individual treatment should be made in consultation with their primary care physician and a team of qualified experts on their condition and specific case. The purpose of this article is to expand people’s knowledge base, and to use as reference for further study.
Focusing on primary research, and not just review literature, gives us an important tool to investigate not only what the researchers actually found, but to evaluate that latter literature to discern what conclusions can be drawn. Most of the primary literature focusing on Alzheimer’s Disease (AD) or other cognitive impairment found promising results.
The review literature, however, has been more pessimistic. We’ll discuss why that may be in the section below.
One of the first clinical trials that I was able to find with rigorous scientific controls found good evidence to support further study. They used only patients diagnosed with AD, and took their study over the course of 12 weeks. They measured their results based on two respected metrics, the Alzheimer disease assessment scale (ADAS) and mini-mental state examination (MMSE).
Before the trials, researchers ensured that all the participants had the same baseline results on the two tests. They then treated one group with 4.5 grams of Panax ginseng for twelve weeks. After the twelve weeks, the treatment group had significantly higher scores on their mental assessments.
One important note from the study–after the patients were taken off of the ginseng, their scores went right back down to baseline. This means there is no permanent benefit seen here from ginseng.
24-Week and Longer Studies
Two more studies both used the MMSE and ADAS tests to measure efficacy of ginseng. One study used four different groups: 1.5 grams per day; 3 g/day; 4.5 g/day; and placebo. They found significant increases in test scores for all ginseng groups over the placebo, and sustained results for the highest dose group.
One drawback of this study was that each group only had 10 participants, quite low for most clinical trials.
Why These Studies are Criticized
In the world of scientific literature, much is made about conflicts of interest. It’s one thing, say researchers, for your research to be conducted in a lab funded by a private donor–it’s another thing for the research itself to be funded by a specific donor group.
We’ll let the reader decide. But it needs to be mentioned that all three of the above studies are the absolute best results that have been seen in clinical settings. Their research has been peer-reviewed and duplicated by their contemporaries. But all the reports have the same team of researchers, and two of them were funded in part by the Korean Ginseng Corporation.
This does not disprove their science. But it is a primary reason their research has not been fully embraced by mainstream science. In their favor, however, two of these trials were published in sterling journals–Nutritional Neuroscience and Alzheimer Disease and Associated Disorders.
Another study worth mentioning is a longitudinal study that took place over 5 years. I’ve mentioned it previously in a ginseng and memory article, and I mention it here because it did study mental acuity related to aging and degenerative brain diseases.
The study, which you can read here, found that there was a strong correlation between long-term, heavy ginseng use and better cognitive and memory performance later in life. One thing to take away from this is that ginseng can help brain function as we age; this is not causation, however. Perhaps people who consume ginseng also ingest vitamins, or drink more juice. The researchers were quick to point out–as is good scientific practice–that these data neither prove nor disprove that ginseng prevents AD. They only saw a statistically significant correlation in the numbers.
Oftentimes one of the best ways to review a subject is to find a qualified meta-analysis of the existing studies. Many journals require subscriptions that can cost thousands of dollars a year. That means trying to find all the data–good or bad–can be expensive.
With a literature review, doctoral candidates and other researchers use their journal subscriptions to comb through the research to find what meta-results can be determined. They often do this to defend requests for money doing their own research.
For instance, they may find that ginseng has been effective in X-Number of studies; but they find that the mechanism of ginseng has not been researched. Researchers can then justify more grant money to research that specific thing.
An article published in the Journal of Ginseng Research looked at over 4 dozen studies of ginseng, in vitro and in vivo, to determine what, if any, mechanisms are responsible for ginseng’s apparent effect on brain diseases. I’ve pulled out four important findings from their review.
A neurotoxic compound known as amyloid β-protein or (Aβ), is a symptom of what doctors refer to as “tau tangles” in the brain. This is thought to be the dual mechanism behind AD–neurons become tangled, inhibiting performance, and then release a toxic protein that literally eats away at brain tissue.
Researchers here found that in vitro studies have proven that ginsenosides Rb1, Rb2, and Rc are all effective at inhibiting the secretion of Aβ. Researchers point out that these studies need to be taken to the next level, where Rb1 and other ginsenosides can be isolated, and taken into live patients with Aβ.
Researchers have known for decades that Acetylcholine, the primary “trigger” of nerve and neuron function. In this review, scientists found several studies that showed increases in acetylcholine as a result of a ginseng compound called gintonin.
These studies were conducted on both live participants and in Petri dishes, showing there is a causal link no matter the circumstances.
AD doctors have long seen that the brain, as it detects Aβ consuming neuro tissue, attempts to compensate for this through something called hippocampal neurogenesis. One goal of mainstream AD medications is to assist the brain in this process.
Researchers in this literature review found no less than six studies showing positive effects of gintonin stimulating processes related to hippocampal neurogenesis.
A Second Opinion
The benefits of a second opinion can often be more than twice as valuable. Especially when the second opinion concurs with the first. In this case, I found a second literature review of even more molecular analysis that supports the findings of the first review. In addition, they added two further areas where Ginseng may help with AD.
Space between cells can play host to any number of vital or toxic compounds that the individual cells take into themselves to perform vital functions (such as taking in insulin to trigger sugar uptake). In the case of disease or toxicity, those intracellular compounds wreak havoc, instead.
Calcium ions and their uptake into brain cells are associated with a number of neurological disorders, from epilepsy to AD. This review found a positive link between Calcium ion reduction–but interestingly only in unhealthy cells.
As we learn more about diseases and their symptoms, we see that many of our natural functions can be turned against us. Similarly to how allergies are overactive immune cells, inflammation in the body can often be seen as the body being overprotective–even to its own detriment.
At a cellular level, there is a type of cell called Nuclear factor kappa-light-chain- enhancer of activated B, or NF-κB for short (thankfully). Without going into an organic chemistry lesson, these cells are responsible for “unzipping” genetic material in cells. In AD patients specifically, these NF-κB cells are triggered by the degeneration of brain tissue. However, the NF-κB cells work too well, and end up inflaming brain tissue to dangerous levels.
This review points to both life participant and laboratory studies showing that certain ginsenosides can stop NF-κB cells from expressing to dangerous levels.
It may seem that there is a mountain of evidence supporting the use of ginseng in treating Alzheimer’s Disease. And it has seemed that way to researchers, as well. Why, then, might some sources say that results have been mixed, or that there is no conclusive evidence?
There is no one answer, but I’ll explore the three most important ones.
Risk Management: No one wants to go on record as saying that an herbal tea will cure someone of a heartbreaking illness, only for the “cure” to fail. Alzheimer’s can wreck relationships, break hearts, and kill. Many sources will couch their reviews of findings so as to protect themselves from attack.
Bias Assessments: I discussed earlier the implication of bias. By that same turn, no one in the scientific community will come out and say, “I think researcher X and Z are biased.” That’s why you’ll see euphemisms like “possibly flawed,” “inconclusive,” or “mixed results.” That’s why it’s important to look at the primary research for ourselves and determine the bias on our own.
Unknown Mechanisms: Scientists don’t like to reach a conclusion they can’t explain. That’s why it was important to look at the literature reviews of all the laboratory studies, not just the clinical trials. Some sources are not comfortable making the connection between brain tissue in a Petri dish and a live patient with loved ones depending on the results.
Ginseng Gets Results
The bottom line is that Alzheimer’s Disease is a fatal one that causes emotional turmoil in its wake. No treatment option, no matter how promising, should be taken as a “cure.” That being said, Ginseng and its component ginsenosides have shown extremely compelling results.
But even the most ardent supporters of ginseng for AD urge the scientific community to research the specific mechanisms more. By using more targeted ginsenoside interventions, especially in combination with other medications, we may yet find the best treatments for one of our most troubling diseases.