Panax ginseng Meyer supplementation and potential associations with telomere length and NAD+/NADH ratio in middle-aged adults: An exploratory study.

Both high-dose short-term and low-dose long-term ginseng supplementation were significantly associated with increased leukocyte telomere length.

• High-dose cohort: 6 g/day for 7 days (n=20); low-dose cohort: 3 g/day for 28 days (n=30)
• Participants were overweight middle-aged adults aged 45-50 years with BMI >24 kg/m²
• Blood samples were collected before and after supplementation and during follow-up periods
• The beneficial effect on telomere length persisted during the follow-up period (21 or 28 days after completion of medication)

Both ginseng supplementation cohorts showed significant associations with increased NAD+/NADH ratio in peripheral blood.

• NAD+/NADH ratio was measured as a primary outcome in both cohorts
• High-dose group received 6 g/day for 7 days; low-dose group received 3 g/day for 28 days
• The increased NAD+/NADH ratio persisted during the follow-up period after cessation of supplementation
• NAMPT (nicotinamide phosphoribosyltransferase) activity in PBMCs was also significantly increased in both cohorts

Ginseng supplementation was associated with increased POT1 (protection of telomeres 1) expression in both cohorts.

• POT1 expression was measured in peripheral blood mononuclear cells (PBMCs) as a secondary outcome
• Both the high-dose (6 g/day, 7 days) and low-dose (3 g/day, 28 days) groups showed significant associations with increased POT1 expression
• The beneficial effect on POT1 expression persisted during the follow-up period

Both ginseng supplementation cohorts were associated with significant reductions in oxidative stress and metabolic biomarkers including ROS, MDA, AGEs, and lactic acid.

• Secondary outcomes included reactive oxygen species (ROS), malondialdehyde (MDA), advanced glycation end-products (AGEs), and lactic acid (LA) levels
• Both the high-dose short-term and low-dose long-term cohorts showed significant reductions in all four biomarkers
• Reductions in these biomarkers persisted during the follow-up period after supplementation ended
• These markers represent oxidative stress (ROS, MDA), glycation (AGEs), and anaerobic metabolism (LA) pathways

Ginseng supplementation was associated with improved scores across all clinical scales assessing sleep quality, cognitive function, fatigue, erectile function, and menopausal symptoms.

• Clinical scales assessed included Pittsburgh Sleep Quality Index (PSQI), Ascertain Dementia 8 (AD8), Fatigue Scale-14 (FS-14), International Index of Erectile Function-5 (IIEF-5), and Kupperman index
• Both the high-dose (6 g/day, 7 days, n=20) and low-dose (3 g/day, 28 days, n=30) cohorts showed improved scores on all clinical scales
• Improvements in clinical scale scores persisted during the follow-up period
• The study enrolled overweight middle-aged adults (BMI >24 kg/m²) aged 45-50 years

This was designed as an exploratory hypothesis-generating study examining ginseng's effects on aging biomarkers in healthy middle-aged adults, a population previously lacking clinical validation.

• The study involved two cohorts rather than a randomized controlled trial design: high-dose short-term (6 g/day, 7 days; n=20) and low-dose long-term (3 g/day, 28 days; n=30)
• Participants were followed up at 21 or 28 days after completion of medication respectively
• The study explicitly acknowledges clinical validation in healthy middle-aged individuals was previously lacking despite experimental evidence
• Primary outcomes were leukocyte telomere length and NAD+/NADH ratio