Safety and efficacy of panax ginseng during pregnancy and lactation.

BACKGROUND: There is a lack of basic knowledge on the part of both clinicians and patients as to the indications for use and the safety of herbs used by women during pregnancy and lactation. This is one article in a series that systematically reviews the evidence for herbs commonly used during pregnancy and lactation. OBJECTIVES: To systematically review the literature for evidence on the use, safety and pharmacology of Panax ginseng, focusing on issues pertaining to pregnancy and lactation. METHODS: We searched 7 electronic databases and compiled data according to the grade of evidence that was found. RESULTS: Based on strong scientific evidence from a cohort study, Panax ginseng was not associated with adverse effects when used during pregnancy. Panax ginseng was misreported in the literature as causing androgenization, when, in fact, the case reported was due to an adulterant. There is in vitro evidence of teratogenicity with exposure to ginsenosides; however, this evidence is derived from animal embryos and is based on exposure to isolated ginsenosides at much higher levels than achievable through normal consumption in humans. There is also conflicting evidence as to whether or not Panax ginseng has estrogenic properties. In lactation, there are no human studies on the safety of Panax ginseng, only in vitro evidence based on three animal studies reporting minimal risk. CONCLUSIONS: Panax ginseng should be consumed with caution during pregnancy, especially during the first trimester, and during lactation. Key words: Panax ginseng, asian ginseng, ginseng, pregnancy, lactation, breastfeeding, systematic review.