More “Natural” Alternative Treatments for Dry Eye and Dry Eye Syndrome: Positive, Negatives, and Risks of Korean Red Ginseng (KRG)

More “Natural” Alternative Treatments for Dry Eye and Dry Eye Syndrome: Positive, Negatives, and Risks of Korean Red Ginseng (KRG)
Dry eye and Dry Eye Syndrome (a combination of symptoms including dry eye) is most often due to an unstable tear film from 3 main causes:
1. Too little aqueous production from the lacrimal gland (often due to an inner immunological condition)
2. Too little mucin or abnormal mucin layer which comes from the goblet cells on conjunctiva (the clear covering of the white part of the eye0.
3. Too little or abnormal lipid (fatty material) coming from the meibomian gland located at the base of the eyelashes on the eyelid margins: this is the MOST COMMON cause.
All of these, though, can be affected by too much inflammation in the body or around the eyes or an abnormal immune function.
The most natural way to improve dry eye symptoms is the address those top 3 issues and by improving one’s immune system and decreasing total body inflammation.
Many natural ways have note been studied enough. 
In my “Step Ladder Approach to Dry Eye” handout I give to patients, I emphasize STEP 2 as a must read. Even though we do not have double blinded, randomized, controlled studies on natural remedies, we know that many of those natural treatments noted in STEP 2 work for many patients. (see blog post at bottom: 
Another “Natural” treatment for Dry Eyes may be Korean Red Ginseng (KRG).
The European Journal of Pharmacology and International Immunopharmacology in 2013 published 2 studies showing Ginsenosides decreased the production of cytokines and other infammatory mediators. This is consistent with research published in 1999 in Biochemical Pharmacology noting that Ginseng Extracts and Ginsenosides (Rb1, Rb2, Rc, Rd, Re, Rf, Rg1, Rg2) have anti-inflammatory properties.

Currently some studies are underway to see if Korean Red Ginseng really does work on dry eye patients.

In the meantime, here is what you need to know.

Benefits: Studies show that KRG/Ginseng possibly:
1. Helps decrease inflammation in the eye
2. Has anti-inflammatory, anti-oxidant properties in other parts of body and may help in:
-cardiovascular disease
-cerebrovascular disease
-hyperlipidemic disease
-sexual dysfunction
-not yet clear but may help with Alzheimer’s disease

Side Effects/RISKS of KRG/Ginseng: Risks are low and not all patients experience same side effects. The reported ones include:
1. trouble sleeping
2. increased heart rate
3. elevated blood pressure
4. headache
5. diarrhea
6. dizziness
7. rashes
8. menstruation changes
9. constipation
10. abdominal pain

Do not take KRG/Ginseng if on these meds below as it can interfere with their function:
1. Blood pressure meds
2. Blood thinners
3. MAOI: monamine oxidase inhibitors
4. Antidepressants
5. Immune system suppressants
6. Insulin for Diabetes
Also avoid KRG/Ginseng if:
Do not take if you have following conditions:
1. Have endometriosis
2. Have Breast or Uterine Cancer
3. Pregnant or breastfeeding: possible adverse effect on baby and newborns
4. Have any other hormonal problem or hormone based diseases or conditions

KRG increases effects from nicotine and caffeine: so avoid using Ginseng with smoking and coffee.

Each patient along with their eyeMD will need to determine if the  potential benefits outweighs potential side effect. If a patient has none of the above “do not take if you have following” conditions list and is on none of the “do not take if on these meds,” then taking
KRG/Ginseng will most likely cause no harm and may be worth a short trial. 

The best dosage of KRG/Ginseng still remains controversial.
The best brands are likely Swanson and Nature Made.
Still we wait for good studies to prove which milligram dose per day is best and real proof that KRG really does improve dry eye scores.

Just to note below another natural product I use and love (though sometimes, I have to dilute it a bit so it does not burn): Tea Tree Oil.
Using it in this little towelette works great when starting to use Tea Tree Oil. My favorite is below.

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