Panax notoginseng root extract
Also known as: Notoginseng, Tienchi ginseng, Sanchi, Panax notoginseng (Burk.) F.H. Chen, Panax notoginseng
Overview
Panax notoginseng is a perennial herb native to China, widely utilized in traditional Chinese medicine (TCM) for its purported benefits in cardiovascular and cerebrovascular health. The root extract is particularly rich in bioactive saponins, primarily Panax notoginseng saponins (PNS), including various ginsenosides (e.g., R1, Rg1, Re, Rb1, Rd) and Panaxatriol saponins (PTS), which are considered its main active compounds. It is commonly employed to enhance blood circulation, reduce platelet aggregation, offer cardioprotection, and support recovery following ischemic events like stroke. Research on Panax notoginseng is of moderate maturity, with a growing body of randomized controlled trials (RCTs) and systematic reviews, especially in cardiovascular applications. While some studies originate from Chinese populations and may have methodological limitations, recent meta-analyses have contributed to a stronger evidence base, supporting its role as an adjunctive therapy.
Benefits
Panax notoginseng offers several evidence-based benefits, primarily in cardiovascular and cerebrovascular health. For cardiovascular health, meta-analyses of RCTs indicate that Panax notoginseng preparations, when combined with aspirin, significantly reduce platelet aggregation and improve coagulation parameters in patients with coronary heart disease (CHD) and ischemic stroke, suggesting an additive antithrombotic effect. Preclinical studies further support its cardioprotective role by demonstrating improved survival post-myocardial infarction, reduced cardiac remodeling, and enhanced cardiomyocyte autophagy. In the context of stroke and neuroprotection, animal models show that the extract reduces brain infarct volume, oxidative stress, and inflammation, while activating pro-survival pathways. Clinical evidence for stroke recovery is emerging but requires more high-quality human trials. Additionally, a randomized controlled trial reported that 1350 mg/day of Panax notoginseng root extract significantly extended exercise time to exhaustion in healthy adults over 30 days. There is also some indication of benefits in diabetic nephropathy when combined with Astragalus membranaceus, though the specific contribution of Panax notoginseng alone needs further clarification.
How it works
The therapeutic effects of Panax notoginseng are primarily attributed to its saponin content, particularly ginsenosides, which exert their actions through multiple biological pathways. It inhibits platelet aggregation and modulates coagulation factors, enhancing the effects of antiplatelet drugs like aspirin. For cardioprotection, it activates AMPK and calcium/calmodulin-dependent protein kinase II pathways, promoting autophagy and reducing cardiac remodeling after myocardial infarction. Its neuroprotective effects stem from its antioxidant properties, which reduce lipid peroxidation, and its anti-inflammatory actions, achieved by downregulating inflammatory mediators such as iNOS, COX-2, and NF-κB. Furthermore, it activates pro-survival signaling pathways like IGF-1/Akt/mTOR in brain tissue. The oral bioavailability of ginsenosides can vary, with gut microbiota playing a role in their metabolic transformation and subsequent activity.
Side effects
Panax notoginseng is generally considered safe when used within recommended dosages. Adverse effects are rare, but some individuals may experience mild gastrointestinal discomfort. A significant concern is its potential interaction with antiplatelet or anticoagulant medications, such as aspirin or warfarin, due to its additive blood-thinning effects. This combination can increase the risk of bleeding, and therefore, medical supervision is strongly advised if taken concurrently with such drugs. Panax notoginseng is contraindicated in individuals with bleeding disorders or those on strong anticoagulants without prior consultation with a healthcare professional. Safety data for special populations, including pregnant and breastfeeding women, are insufficient, and its use in these groups is not recommended. While serious side effects are uncommon, users should be vigilant for any signs of increased bleeding or unusual bruising, especially if they are also on blood-thinning medications.
Dosage
Effective dosages of Panax notoginseng vary depending on the intended use and specific formulation. For enhancing exercise endurance, a dose of 1350 mg/day of Panax notoginseng root extract taken orally for 30 days has shown benefits in healthy adults. In cardiovascular clinical trials, doses and formulations are diverse, often standardized to their saponin content, and a universally established typical range is not yet available. For chronic cardiovascular support or before exercise, oral administration is common. While intravenous formulations exist for acute clinical use in China, they are not widely available or recommended outside of specialized medical settings. Absorption may be enhanced when taken with food, though no specific cofactors have been definitively established. It is crucial to adhere to product-specific dosing instructions and consult a healthcare professional, especially when combining with other medications, due to potential interactions.
FAQs
Is Panax notoginseng effective for heart disease?
Evidence suggests it can be an effective adjunctive therapy, particularly when combined with aspirin, to reduce platelet aggregation and improve coagulation parameters in patients with coronary heart disease and ischemic stroke. It is not a standalone treatment.
Can it improve stroke recovery?
Preclinical studies and some clinical data indicate potential benefits in reducing brain damage and aiding recovery after stroke. However, more high-quality human trials are needed to confirm these effects definitively.
Is it safe to take with blood thinners?
Caution is advised due to its additive blood-thinning effects, which can increase the risk of bleeding. Medical supervision is strongly recommended if you are taking Panax notoginseng concurrently with anticoagulant or antiplatelet medications.
How long before effects appear?
For exercise endurance, benefits were observed after 30 days of consistent use. For cardiovascular effects, the timeline can vary depending on the specific condition and whether it's used as part of a combination therapy.
Research Sources
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.1015048/full – This systematic review and meta-analysis of randomized controlled trials found that Panax notoginseng preparations, when combined with aspirin, significantly reduced platelet aggregation and improved coagulation parameters in patients with coronary heart disease and ischemic stroke compared to aspirin alone. The study highlighted the additive antithrombotic effects, despite some heterogeneity in study designs and saponin types.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11242943/ – This pharmacological review summarized preclinical studies demonstrating the cardioprotective and neuroprotective effects of Panax notoginseng. It detailed its mechanisms, including activation of AMPK and IGF-1/Akt/mTOR pathways, and its ability to reduce infarct size, oxidative stress, and inflammation in animal models of myocardial infarction and stroke. The review emphasized the need for further human translation.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8950061/ – This randomized controlled trial investigated the effect of Panax notoginseng root extract on exercise endurance in healthy adults. It reported that 1350 mg/day for 30 days significantly increased time to exhaustion compared to placebo. While promising, the study was limited by its small sample size and focus on healthy young adults.
- https://onlinelibrary.wiley.com/doi/10.1155/2023/2945234 – This meta-analysis evaluated the combination therapy of Astragalus membranaceus and Panax notoginseng for diabetic nephropathy. It indicated improved renal function markers with the combined treatment. However, the study noted that the individual contribution of Panax notoginseng was unclear due to the combination therapy and variable study quality.