Ginseng and Furosemide, a Diuretic

Dear Dr. Dean,

Recently we bought a bottle of your company’s organic Korean Red Ginseng. Due to a heart operation I had a few years back, I’m still taking furosemide, a diuretic. I was told that Ginseng and furosemide may not be taken at the same time.

Can you give me more information about this?

YIANNIS, Syros, Greece

Dear Yiannis,

Thanks for your interesting question. I use a fair amount of furosemide (Lasix) on my patients—a number of whom are also taking ginseng—and have done so for nearly 40 years of practice. I have never experienced any problems with this combination.

Nevertheless, I searched the internet and was surprised to find vague warnings about alleged adverse interactions between ginseng and furosemide on a number of websites. I traced these warnings to ONE case report that appeared in JAMA in 1996, involving a patient with membranous glomerulonephritis, who was being treated with furosemide and cyclosporine.1 (Cyclosporine is an immune suppressant, used in patients who are preparing for or who have undergone kidney transplants.) Cyclosporine is a known cause of renal failure2 (as described in the JAMA article). Notwithstanding, the authors of the JAMA case study leaped quickly to blame THE cause of the patient’s renal failure on a combination of furosemide and a negligible amount of germanium in a ginseng supplement which the patient had begun to use—neglecting to consider a possible contribution of the cyclosporin. To be sure, there have been reports of high-dose germanium as a cause of renal dysfuncion.3

To test whether germanium and/or ginseng had any adverse effects on renal function, a fairly recent study was conducted in which diuretic-resistant rats were given doses of low, medium and high germanium concentrations. The authors found NO evidence of ginseng-induced nephrotoxicity from any concentration of germanium in the ginseng. Interestingly, the total Ge in ginseng root was in the range of 0.35–0.41µg/g, which is comparable with tomato, bamboo shoot, potato, and other vegetables. The authors confirmed that ginseng samples contain low levels of Ge, and are NOT nephrotoxic.4

Consequently, I believe that you can take RedGidity and furosemide without concern for any internet-reported adverse interactions.

Thanks again for your interesting question. I hope we can put this internet-generated myth to rest.

Ward Dean, MD

References

  1. Becker BN, Evanson J, Chidsey G, Stone WJ. Ginseng-induced diuretic resistance. JAMA. 1996;276(8):606-607. doi:10.1001/jama.1996.03540080028021
  2. Vítko S, Viklický O. Cyclosporine renal dysfunction. Transplant Proc. 2004 Mar;36(2 Suppl):243S-7.
  3. Sanai T, Okuda S, Onoyama K, Oochi N, Oh Y, Kobayashi K, Shimamatsu K, Fujimi S, Fujishima M. Germanium dioxide-induced nephropathy: a new type of renal disease. Nephron. 1990; 54:53–60.
  4. Tan C, Xiao L, Chen W, Chen S. Germanium in ginseng is low and causes no sodium and water retention or renal toxicity in the diuretic-resistant rats. Exp Biol Med (Maywood). 2015 Nov;240(11):1505-12. doi: 10.1177/1535370215571874. Epub 2015 Feb 23.

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