What are the side effects and contraindications of ginseng?

Side effects of ginseng generally include heatiness symptoms, insomnia, blood pressure fluctuations, gastrointestinal discomfort, and allergic reactions. Contraindications typically include avoiding use during colds or fever, contraindication in individuals with excess-heat syndromes, cautious use in those with uncontrolled hypertension, caution for pregnant women, and avoiding concurrent use with certain medications. Detailed analysis is as follows:

I. Side Effects

1. Heatiness symptoms: Excessive or long-term use of ginseng may lead to symptoms such as dry mouth, sore throat, constipation, and swollen gums—commonly referred to as "heatiness." These effects are more pronounced in individuals with inherently warm body constitutions, as ginseng is warming in nature and excessive intake can cause accumulation of internal heat.

2. Insomnia: Ginseng contains ginsenosides, which can stimulate the central nervous system. Taking ginseng before bedtime or at high doses may overexcite the nerves, leading to difficulty falling asleep, light sleep, or vivid dreams, thereby impairing sleep quality.

3. Blood pressure fluctuations: Some individuals may experience abnormal blood pressure changes after taking ginseng, including both increases and decreases in blood pressure. Hypertensive patients should closely monitor their blood pressure to avoid significant fluctuations.

4. Gastrointestinal discomfort: Taking ginseng on an empty stomach or by individuals with weak spleen and stomach function may cause nausea, vomiting, bloating, and diarrhea. This is because ginseng can irritate the gastrointestinal tract, and those with poor digestive function have lower tolerance.

5. Allergic reactions: A small number of people may be allergic to components of ginseng. Symptoms may include rash, itching, and rapid breathing. In severe cases, anaphylactic shock may occur, requiring immediate discontinuation of the herb and medical attention.

II. Contraindications

1. Avoid during colds or fever: During a cold or fever, the body is engaged in a struggle between pathogenic factors and defensive Qi. As ginseng is warming in nature, taking it at this time may intensify internal heat, worsen fever symptoms, and delay recovery.

2. Contraindicated in excess-heat conditions: Individuals presenting with excess-heat symptoms such as flushed face, red eyes, irritability, bitter taste in the mouth, dry throat, and constipation should avoid ginseng, as it may exacerbate internal heat and aggravate symptoms, interfering with proper bodily regulation.

3. Use with caution in uncontrolled hypertension: Patients with uncontrolled high blood pressure may experience further elevation in blood pressure when taking ginseng, increasing the risk of cardiovascular and cerebrovascular events. Use should be cautious and under medical supervision.

4. Use with caution during pregnancy: Ginseng may stimulate uterine activity, potentially affecting fetal stability. Pregnant women, especially in the first trimester, should avoid ginseng unless under strict medical guidance.

5. Avoid concurrent use with certain medications: Ginseng should not be taken with anticoagulants such as enteric-coated aspirin or warfarin sodium, as it may increase the risk of bleeding. It should also not be combined with corticosteroids like dexamethasone tablets, as this may amplify side effects. Consult a physician before combining ginseng with any medication.

When using ginseng routinely, dosage should be strictly controlled to avoid overdose. It is best to take it under medical supervision according to individual constitution, avoiding blind supplementation.