Caitlyn

I have never tried American Ginseng. After reading
about it and its effect on BSL , I did a little
research and what you see is what I learned, which is
not much. I would try it if and when I get more info.
I’ll keep you informed.

Ephedrine and related alkaloids are the
pharmacologically active moieties of the extract of
Ephedra (a genus of shrubs).19 Ephedrine constitutes
30 to 90 percent of the alkaloids of Ephedra species.
The extract of some species also contains
pseudoephedrine.

Patients should be advised not to use
ephedrine-containing supplements if they have
cardiovascular disease, hyperthyroidism, diabetes
mellitus, benign prostatic hypertrophy or glaucoma.

Ephedra (ma huang) is commonly found in herbal

weight-loss products referred to as "herbal fen-phen."
Some weight loss clinics and retail outlets promote
herbal products as an alternative to the use of
fenfluramine (Pondimin) and dexfenfluramine (Redux),
the prescription anorexiants recently removed from the
U.S. market.20 Herbal fen-phen products that also
contain St. John’s wort are sometimes referred to as
"herbal Prozac."

Ephedrine-containing products are also marketed as
decongestants, bronchodilators and stimulants.21 Other
promoted uses include enhancement of athletic
performance and body-building efforts. Marketed uses
of ephedrine-containing products such as "herbal
ecstasy" include induction of a euphoric state and
heightening of awareness and sexual sensations.22 The
FDA has advised consumers not to use
ephedrine-containing products marketed as alternatives
to street drugs.23

In the past few years, the FDA has investigated more
than 800 reports of adverse reactions associated with
more than 100 different products that contained or
were thought to contain Ephedra alkaloids.21 Reported
adverse reactions have included insomnia, nervousness,
tremor, headaches, hypertension, seizures,
arrhythmias, heart attack, stroke and death.
Approximately 56 percent of the reported adverse
effects occurred in persons younger than 40 years old;
about another 25 percent occurred in persons 40 to 49
years of age. The relatively young age group in which
serious cardiovascular events have occurred is of
concern.

In response to the reports of cardiovascular effects,
the FDA has proposed a dosage limit of 8 mg every six
hours (24 mg per day) for ephedra alkaloids. The
proposed rule also calls for a label advising
consumers not to use an ephedrine-containing product
for more than seven days and warning that exceeding
the recommended dosage may result in heart attack,
stroke, seizure or death. The Association of Food and
Drug Officials (AFDO), which represents state food and
health department officials, believes that serious
adverse effects to ephedrine-containing products may
occur even at a dosage of 24 mg per day.24 In fact,
life-threatening adverse reactions have been reported
to occur with doses of 1 to 5 mg (dosages of 4 to 20
mg per day).25 AFDO is also concerned that setting a
dosage limit may imply that a safe dose exists.24

Ephedra-containing products have also been associated
with the development of kidney stones. Ephedrine,
pseudoephedrine and metabolites comprised almost 100
percent of a radiolucent stone removed from a
27-year-old male body builder who took up to 12
Pro-Lift tablets daily. Each tablet was found to
contain approximately 10 mg of ephedrine. Information
from a large kidney stone database shows that this is
not an isolated incident; over 100
ephedrine-containing kidney stones were identified
from January 1996 to June 1997. It is not known how
many of these stones were associated with the use of
herbal ephedrine-containing products.26

The risks of using ephedrine-containing supplements
appear to outweigh the benefits. Consequently,
patients should be advised not to use these products
if they are sensitive to the effects of
sympathomimetic agents.21 Such patients include those
with hypertension, hyperthyroidism, diabetes mellitus,
psychiatric conditions, glaucoma, prostate
enlargement, seizure disorders and cardiovascular
disease. Concomitant use of ephedrine-containing
products and caffeine or other stimulants should also
be discouraged

Sincerely,

=====
Anecdotes are useless precisely because they may point to idiosyncratic
responses.

Pediatric Allergy/Immunology
a peer-reviewed journal
1999 Nov;10(4) 226-234

Vuksan V, Sievenpiper JL, Koo VY, et al. Arch Intern
Med 2000;160:1009-1013.

BACKGROUND: Despite a lack of medical evidence to
support its therapeutic efficacy, the use of herbal
medicine has increased considerably. Ginseng, one of
the most widely used herbs, is hypothesized to play a
role in carbohydrate metabolism and diabetes mellitus.
We therefore undertook a preliminary short-term
clinical study to assess whether American ginseng
(Panax quinquefolius L) affects postprandial glycemia

in humans. DESIGN: On 4 separate occasions, 10
nondiabetic subjects (mean [+/-SD] age, 34+/-7 years;
mean [+/-SD] body mass index [BMI], 25.6 +/- 3 kg/m2)
and 9 subjects with type 2 diabetes mellitus (mean
[+/-SD] age, 62 +/- 7 years; mean [+/-SD] BMI, 29 +/-
5 kg/m2; mean [+/-SD] glycosylated hemoglobin A1c,
0.08+/-0.005) were randomized to receive 3-g ginseng
or placebo capsules, either 40 minutes before or
together with a 25-g oral glucose challenge. The
placebo capsules contained com flour, in which the
quantity of carbohydrate and appearance matched the
ginseng capsules. A capillary blood sample was taken
fasting and then at 15, 30, 45, 60, 90, and 120 (only
for subjects with type 2 diabetes mellitus ) minutes
after the glucose challenge. RESULTS: In nondiabetic
subjects, no differences were found in postprandial
glycemia between placebo and ginseng when administered
together with the glucose challenge. When ginseng was
taken 40 minutes before the glucose challenge,
significant reductions were observed (P<.05). In
subjects with type 2 diabetes mellitus, the same was
true whether capsules were taken before or together
with the glucose challenge (P<.05). Reductions in area
under the glycemic curve were 18%+/-31% for
nondiabetic subjects and 19+/-22% and 22+/-17% for
subjects with type 2 diabetes mellitus administered
before or together with the glucose challenge,
respectively. CONCLUSIONS: American ginseng attenuated
postprandial glycemia in both study groups. For
nondiabetic subjects, to prevent unintended
hypoglycemia it may be important that the American
ginseng be taken with the meal.

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Pharmacological Activity and Stability of Ginger
Extract Constituents.

Ginger is common condiment and carminative. It has
been used in traditional medicine for thousands of
years. It is a
fascinating herb used to treat a variety of illnesses.
Currently, the most common medicinal use of ginger is
as an anti-emetic
and an anti-inflammatory agent. The rhizome of ginger
contains a rich source of biologically active
constituents including
the pungent principles, mainly the gingerols and

shogaols. In fresh juice, the gingerols were
identified as major active components. However, it is
evident that these components are chemically unstable
towards heat treatment and acidic
conditions. The major degradation product, shogoal, is
formed by dehydration by way of the labile b
-hydroxyketone
moiety of the gingerols. A study is in progress to
determine the stability of the gingerols and other
ginger extract
constituents under physiological conditions. These
studies will enable further understanding of the fate
of gingerols,
either in fresh juice or in pharmaceutical
formulation, when administered internally. The project
involves the determination
of the kinetic profiles of the gingerols and other
ginger extract constituents. In addition, major
degradation products will be identified and their
biological significance evaluated. These studies are
being carried out as part of a postgraduate project.

Vuksan V, Stavro MP, Sievenpiper JL, et al. Diabetes
Care 2000;23:1221-1226.

OBJECTIVE: We previously demonstrated that 3 g
American ginseng (AG) reduced postprandial glycemia
(PPG) in type 2 diabetic individuals. We investigated
whether further reductions can be achieved with
escalation of dose and time of AG administration.
RESEARCH DESIGN AND METHODS: Ten type 2 diabetic
patients (6 men, 4 women; age 63+/-2 years; BMI

27.7+/-1.5 kg/m2; HbA1c 7.3+/-0.3%) were randomly
administered 0 g (placebo) or 3, 6, or 9 g ground AG
root in capsules at 120, 80, 40, or 0 min before a
25-g oral glucose challenge. Capillary blood glucose
was measured before ingestion of AG or placebo and at
0, 15, 30, 45, 60, 90, and 120 min from the start of
the glucose challenge. RESULTS: Two-way analysis of
variance (ANOVA) demonstrated that treatment (0, 3, 6,
and 9 g AG) but not time of administration (120, 80,
40, or 0 min before the challenge) significantly
affected PPG (P<0.05), with significant (P = 0.037)
interaction for area under the curve (AUC). Pairwise
comparisons showed that compared with 0 g (placebo),
3, 6, or 9 g significantly (P<0.05) reduced AUC (19.7,
15.3, and 15.9%, respectively) and incremental
glycemia at 30 min (16.3, 18.4, and 18.4%,
respectively), 45 min (12.5, 14.3, and 14.3%,
respectively), and 120 min (59.1, 40.9, and 45.5%,
respectively). However, pairwise comparisons showed no
differences between the 3-, 6-, or 9-g doses and any
of the times of administration. CONCLUSIONS: AG
reduced PPG irrespective of dose and time of
administration. No more than 3 g AG was required at
any time in relation to the challenge to achieve
reductions. Because these reductions included glycemia
at the 2-h diagnostic end point, there may be
implications for diabetes diagnosis and treatment.

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