Traditional uses
The root is most often available in dried form, either whole or sliced. Ginseng leaf, although not as highly prized, is sometimes also used; as with the root, it is most often available in dried form. By folk medicine practices, American ginseng and Asian ginseng (P. ginseng) roots may be taken orally for diverse supposed benefits, such as for aphrodisia, stimulants, type II diabetes, or for sexual dysfunction in men.
Ginseng may be included in small doses in energy drinks or tisanes. It may be found in cosmetic preparations, as well, but has not been shown to be clinically effective.
Research
Ginsenosides, unique compounds of the Panax species, are under basic and clinical research to reveal their potential properties in humans.
Possibly an adaptogen, ginseng remains under preliminary research for its potential properties or therapeutic effects, such as for respiratory illnesses, quality of life, influenza or fatigue in cancer patients. P. ginseng may affect cancer in animal models but this effect remains unclear.
One study in laboratory animals showed possible effects of ginseng or its ginsenoside components on the central nervous system and gonadal tissues and another on penile erection.
Ginseng is known to contain phytoestrogens and may affect the pituitary gland to increase the secretion of gonadotropins.[citation needed] Other mice studies found effects on sperm production and the estrous cycle.
Side effects
A common side effect of P. ginseng may be insomnia, but this effect is disputed. Other side effects can include nausea, diarrhea, headaches, nose bleeds, high blood pressure, low blood pressure, and breast pain. Ginseng may also lead to induction of mania in depressed patients who mix it with antidepressants.
Ginseng has been shown to have adverse drug reactions with phenelzine and warfarin, but has been shown to decrease blood alcohol levels.
Overdose
The common adaptogen ginsengs (P. ginseng and P. quinquefolia) are generally considered to be relatively safe even in large amounts. One of the most common and characteristic symptoms of acute overdose of Panax ginseng is bleeding. Symptoms of mild overdose may include dry mouth and lips, excitation, fidgeting, irritability, tremor, palpitations, blurred vision, headache, insomnia, increased body temperature, increased blood pressure, edema, decreased appetite, increased sexual desire, dizziness, itching, eczema, early morning diarrhea, bleeding, and fatigue.
Symptoms of gross overdose with Panax ginseng may include nausea, vomiting, irritability, restlessness, urinary and bowel incontinence, fever, increased blood pressure, increased respiration, decreased sensitivity and reaction to light, decreased heart rate, cyanotic (blue) facial complexion, red facial complexion, seizures, convulsions, and delirium.
Patients experiencing any of the above symptoms are advised to discontinue the herbs and seek any necessary symptomatic treatment.
Wild ginseng
Wild ginseng grows naturally and is harvested from wherever it is found. It is relatively rare, and even increasingly endangered, due in large part to high demand for the product in recent years, which has led to the wild plants being sought out and harvested faster than new ones can grow (it requires years for a root to reach maturity). Wild ginseng can be either Asian or American, and can be processed to be red ginseng.
Woods-grown American ginseng programs in Maine, Tennessee, Virginia, North Carolina, West Virginia and Kentucky, and United Plant Savers have been encouraging the planting of ginseng both to restore natural habitats and to remove pressure from any remaining wild ginseng, and they offer both advice and sources of rootlets. Woods-grown plants have a value comparable to wild-grown ginseng of similar age.
Growth of Wild American Ginseng
The first year of growth produces a small plant with one compound leaf having three leaflets. With successive growing seasons, the plant matures and produces additional leaves until a maximum of five compound leaves or "prongs" with five leaflets is attained. Second and third year plants have two prongs, four year old plants may have three prongs, and plants older than four years of age may have three to five prongs. Some plants may remain dormant for several years. Plants are reproductively mature at three years of age. During June and July a stalked inflorescence of six to thirty small, greenish-white flowers is produced at the top of the stem. Flowers are cross-pollinated by halictid bees or are self-pollinated. Fertilized flowers produce small berries that are green at first, but turn a brilliant red when mature. Each fruit contains two or three wrinkled seeds. In early autumn the berries ripen and fall from the plant, where they become vulnerable to predation from rodents and birds. After the first frost, the leaves turn a golden-yellow before dying. Ginseng seeds require a germination period of eighteen to twenty-one months. Roots in the Southern United States grow rapidly for the first few months of late spring and early summer then level off during the warm summer months with little weight gain. After flowering and seed production is another root growth spurt before die off in mid-autumn.
Differences between Wild and Cultivated Ginseng
Wild ginseng grows naturally within its natural habitat conditions.
Cultivated ginseng is grown as a crop by sowing seeds and consists of three types: woodsgrown, wild-simulated, and field-cultivated.
Woodsgrown ginseng is sown under natural shade in prepared beds and may require the use of fertilizers and pesticides.
Wild-simulated ginseng is sown under natural shade and natural habitat conditions but scattered and not in beds. This category is not recognized by all states, including Tennessee, and is treated as wild ginseng.
Field-cultivated ginseng is sown under artificial shade in prepared beds and often requires the use of fertilizers and pesticides.
Wild ginseng roots are about the size of an adult's thumb and are lightweight, wrinkled, ringed, often branched, and dark tan in color . In comparison, cultivated ginseng roots are larger than an adult's thumb and are heavy, smoother, few ringed, less branched, and light straw colored. The growth of cultivated ginseng is much faster than wild ginseng under normal conditions. Cultivated ginseng plants are more robust and produce more berries and seeds than wild ginseng plants.
Why is Ginseng Regulated?
Wild American ginseng is one of many plant and animal species protected under the Convention on International Trade in Endangered Species of Wild Fauna and Flora of 1973 (CITES), an international trade agreement which the United States and 134 other nations have signed. The objective of the Convention is to monitor, control, and restrict, as necessary, the international trade of certain wild plant and animal species to prevent adverse impacts to their populations and to insure the continued existence of those species in their natural habitat.
In the United States, the Fish and Wildlife Service (USFWS) has been delegated the U.S. CITES scientific and management authority since the treaty went into effect in 1975. Before a CITES export permit can be issued, the USFWS must determine whether the ginseng roots were legally acquired and whether further exports will be detrimental to the species' survival. The Office of Management Authority (OMA) determines whether the ginseng was legally acquired, and the Office of Scientific Authority (OSA) determines whether export of ginseng roots is detrimental to the species' survival.
The USFWS has established a joint ginseng management program with the states in order to monitor and regulate ginseng harvest and commerce, and meet the CITES requirements. The states must establish regulations that ensure ginseng populations under their jurisdiction will not be harmed by harvest. The Tennessee ginseng program was approved in 1978. Ginseng dealers must register with each state in which they purchase and sell ginseng roots and must report their transactions to the states. The states must inspect, weigh and certify that the ginseng was legally harvested within the state of origin. The states then compile the dealers' reports and other information on ginseng biology, harvest, regulation and commerce into an annual report that is sent to USFWS. These annual reports are used by OMA and OSA to evaluate the state ginseng management programs, harvest levels, and impacts of harvest on wild ginseng populations in order to determine whether the states should be approved for ginseng export ("non-detriment" finding). Without the annual approval of the USFWS a ban will be placed on the export of wild ginseng from Tennesee.
CITES does not require a "non-detriment" finding for cultivated ginseng, but the cultivated ginseng stock must be established in a manner not detrimental to the species' survival in the wild. "Woodsgrown" ginseng is considered "Cultivated" ginseng and should never be reported as "Wild" ginseng.
Once ginseng is approved by USFWS for export, each shipment is inspected and approved by a port inspector of the U.S. Department of Agriculture (USDA), Division of Plant Protection and Quarantine (PPQ), a division of the Animal and Plant Health Inspection Service (APHIS). If all the USFWS and CITES requirements are met, the port inspector will validate the CITES export documents and approve the shipment for export.
As part of Tennessee's wild ginseng management program, the Department of Environment and Conservation is asking that all merchants or firms which purchase wild or cultivated ginseng with the intent to resale or export and/or that cultivate ginseng with the intent to export, obtain a Dealer Permit from the Department. In addition, each ginseng dealer is required to complete and submit monthly purchase reports and an annual report of their purchases. All the necessary forms and purchase receipts are provided by the Department. Unlike the 1978 management program, the Department is not asking Tennessee ginseng collectors to obtain a permit and submit an annual report of their harvests.
Without strong cooperation from the ginseng dealers of the state on providing the data on the quantity of wild ginseng harvested and the counties from which it was collected, the OSA may rule against export of Tennessee ginseng for the upcoming year. Therefore, it is in the best interest of all ginseng collectors and dealers to comply with the rules and regulations of the Tennessee Ginseng Program.
No ginseng can be harvested on State or Federal land without written permission of the land management agency. Ginseng harvesting is not permitted in State Parks, State Forests, or State Wildlife Management Areas (WMA), except Royal Blue WMA. Ginseng harvesting is not permitted in National Parks, such as Great Smoky Mountains National Park. Annual permits for harvesting ginseng in Cherokee National Forest may be obtained for a small fee at the District Ranger offices.
• Snow, rain, and extreme wind have forced the closure of most sections of the Blue Ridge Parkway. Until the weather improves and cleanup is completed, travel on the Parkway is not advised.
• Snow, rain, and extreme wind have forced the closure of most sections of the Blue Ridge Parkway. Until the weather improves and cleanup is completed, travel on the Parkway is not advised. 
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