Effect of Ginseng Extracts on the Improvement of Osteopathic and Arthritis Symptoms in Women with Osteopenia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

The short version

This randomized, double-blind, placebo-controlled trial with 85 postmenopausal women with osteopenia explored whether Panax ginseng extract (GE) improves bone metabolism and knee symptoms. Osteopenia is lower-than-normal bone density that can progress to osteoporosis, and after menopause falling estrogen leads women to lose roughly 20 to 30% of spongy bone. Cell and animal research suggests that ginseng's ginsenosides, especially ginsenoside Re, stimulate bone-building cells (osteoblasts) and slow bone-dissolving cells (osteoclasts), but controlled human trials were scarce. Women in Korea older than 40 and past menopause with low bone density scores were randomly assigned to placebo, 1 g of GE a day or 3 g of GE a day for 12 weeks, with 30 per group at the start. The extract was a freeze-dried hot-water ginseng extract in capsules; placebo capsules held cellulose and looked and smelled the same. Researchers measured bone-formation markers such as osteocalcin (a protein made by osteoblasts), a bone-resorption marker in urine called deoxypyridinoline, blood calcium and the 24-item WOMAC questionnaire of knee pain, stiffness and function. Only the 3 g dose showed clear effects. Osteocalcin rose, the ratio of resorption to formation (DPD/OC) fell, and blood calcium and the osteocalcin-to-CTX ratio increased significantly (p < 0.05, meaning unlikely to be chance), results that held after adjusting for physical activity, which had risen in the placebo group. Urinary DPD and several other bone markers (CTX, NTX, BsALP, P1NP) did not differ among groups. On the WOMAC, knee pain that disturbed sleep and afternoon joint stiffness improved more at 3 g, although the three-group difference in total WOMAC score was not significant. Sixteen mild to moderate adverse events, mostly colds, occurred equally across groups, and laboratory tests stayed normal. Compliance was about 90 to 95% in all arms. The authors consider the 3 g dose beneficial and safe, but they say 12 weeks is short and the study cannot show a definitive effect on bone. It measured blood and urine markers rather than bone density or fractures, and the numeric results sit in tables not available here. Longer trials of more than a year with larger groups are proposed, and the 1 g dose showed no clear benefit.

Key findings

• In a 12-week trial of 85 postmenopausal women with osteopenia (thinner-than-normal bones), 3 g a day of Panax ginseng extract raised serum osteocalcin, a blood marker of new bone formation, and lowered the DPD/OC ratio, which compares bone breakdown with bone building.
• Blood calcium and the osteocalcin-to-CTX ratio also rose significantly at 3 g (p < 0.05), while the lower 1 g dose and placebo did not show these changes.
• Knee pain that disturbed sleep and afternoon joint stiffness improved more with 3 g, although the three-group difference in total WOMAC knee score (a 24-item joint questionnaire) was not significant.
• Sixteen mild or moderate adverse events, mostly colds, occurred equally in all groups and were not linked to the extract; the trial measured bone markers rather than bone density or fractures and lasted only 12 weeks.

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