Eleutherococcus senticosus is the plant commonly referred to as Eleuthero and Siberian Ginseng. It is a member of the Araliaceae or ginseng family.  Botanically, Eleuthero is a slender, thorny shrub that grows to heights ranging from 3 to 15 feet tall.  It has grey-brown colored branches with downward pointing spikes. The plant’s leaves are colored bright green and divided into 3 - 5 leaflets. The flowers can vary in color from a light violet to a rich yellow. The root of eleuthero is the part of the plant commonly used for medicinal application, as it is long, woody, and pliable. Preparation methods vary, and many are considered quite bitter in taste.
Eleuthero has a long history of use in the Far East, more specifically, within Siberia and China culture. It has been used as a therapeutic agent, credited with increasing the length and quality of life, preventing infections, improving memory, stimulating appetite. This plant is also native to Russia, Korea, and Japan.
The traditional view of eleuthero remains as an adrenal adaptogen. Adaptogens are a category of herbs which, by definition, are innocuous substances that cause minimal disorders in physiological functions of an organism. They have nonspecific actions, acting to increase the resistance to adverse influences by a range of factors; and also have a normalizing action no matter if the imbalance is hyper or hypo in nature. [1-3]
The main constituents in eleuthero are glycosides (including eleutherosides, such as eleutherosides B and E, syringin, phenylpropanes), polysaccharides (eleutheran glycans and ciwujianoside), and phenolic compounds.  Eleuthero also contains vitamin E, β-carotene, caffeic acid, and copper.
Eleutherosides are essential to the pharmacologic activity of Eleuthero. This category of compounds can inactivate free radicals and accelerate lipid mobilization, thus exerting a cellular protective effect.  This antioxidant effect has demonstrated improved survival and resistance to pesticides, heavy metals, narcotics, industrial chemicals, and chemotherapeutic drugs in animal studies. As well, the eleutherosides protect cells against ionizing radiation.  Eleutherocccoccus demonstrates immunostimulatory effects, specifically increasing numbers of CD4 and CD8 cells.  Other pharmacologic activity includes its ability to bind to progestin, estrogen, mineralocorticoid and glucocorticoid receptors.
Medicinal actions ascribed to Eleuthero include:
- hypertensive (in a hypotensive state)
- cardiotonic and general tonic
Traditionally Eleuthero has been used for general exhaustion and weakness, immune dysfunctions, acute kidney infections, joint pain, edema, difficult urination, and muscular spasm. 
Traditional use of Eleuthero as an adrenal adaptogen is supported by research, the bulk of which has been conducted overseas. Evidence supports this use, by measured enhancements on both mental and physical function. A double-blind placebo controlled study conducted in Japanese male athletes showed that with administration of Eleuthero, maximal work capacity (measured by total exercise duration and stamina) increased 23.3% versus 7.5% in the placebo group.  This is likely due to the improved oxygen metabolism in muscle, which has also been demonstrated in animal studies.  Eleuthero may also work to support mental alertness, with research showing that it is able to enhance mental acuity without the ‘letdown’ that comes with caffeinated products. 
Clinical trial evidence has supported the use of Eleutherococcus as an immune stimulant. In one study, Eleuthero extracts were administered daily to 13,000 workers for two months at the Volga Automobile Plant in Russia.  The incidence of colds, influenza, and other infections (all of which result in the increased absence from work) was reduced by 1/3 compared to a control group.
Another study conducted in West Germany supported its use for the prevention of viral illness. In a double-blind, placebo-controlled study, 36 healthy volunteers were given either Eleutherococcus or placebo. The group receiving Eleuthero demonstrated an enhanced activation of CD4 T-lymphocytes (T helper cells). A supporting study also showed enhanced T-lymphocyte activity with administration of 1.96 grams of a 1:1 alcohol root extract was administered three times daily.  These immune cells are important in combating viral infections.
Eleuthero may also be of benefit in the treatment of patients suffering from cancer. Administration of Eleuthero extract it thought to reduce the chance of metastasis if started early in the course of the disease.  Eleuthero is also beneficial in improving the quality of life in these patients. A clinical trial conducted in Russia in women with breast cancer examined the effect of a liquid extract containing Eleuthero.  The results demonstrated significant improvement in reducing the side effects of radiation and chemotherapy; including nausea, dizziness and loss of appetite. Another study showed that Eleutherococcus improves appetite, weight gain, shortens healing time, and increases lymphocyte activity in people with certain forms of cancer. 
In addition, Eleuthero may be useful for patients with chronic fatigue syndrome, hyperlipidemia, diabetes mellitus, HIV infection, lupus, chronic hepatitis, and recovery following long term steroid use. [16-18]
Dosages are dependent on the type of preparation and the intended condition to be treated. If using Eleuthero for adaptogenic purposes, lower doses should be taken while acute therapy, for other conditions described above (e.g. immune stimulation), would warrant the higher end of dosages outlined below. Eleuthero should be taken first in the early morning, then around noon to match the diurnal rhythms of the adrenal gland.
Standardized extracts can be obtained in 100 milligram capsules, standardized to greater than 1% eleutheroside E. The common dose ranges from 200 – 400 milligrams daily, divided into two separate doses. Solid extracts of 4:1 or 6:1 potency can be administered as ¼ teaspoon, 1 - 2 times daily. If taking a decoction of the root powder, 2 - 4 grams per cup of water two times daily is the recommended dose. 
As with all adaptogenic herbs, preparations can be taken for about 6 weeks, followed by a 2 week break to evaluate the therapy. Supplementation may be resumed if necessary. Eleuthero can be taken long term, however, it is recommended that one follow the aforementioned schedule or 6 weeks on, 2 weeks off.
Eleuthero is contraindicated in hypertension, having been evaluated in human studies. Acute infections are listed as a contraindication, though Eleuthero demonstrates T-cell stimulating properties. The cautionary advice for those suffering from an acute infection may change. It has also been evaluated in some acute gastrointestinal infections in conjunction with antibiotics. Eleuthero has also been traditionally contraindicated in depleted states.
Eleuthero may interact with a number of prescription medications.  Eleuthero can increase the efficacy of monmycin and kanamycin in treating Shigella dysentery and Proteus enterocolitis (human). It has been shown to inhibit the metabolism of hexobarbitol in vitro, thus enhancing the subsequent effects. Eleuthero may also have certain additive effects with insulin. This is speculative, as studies have been based based on the hypoglycemic effects of animals. Digoxin levels may falsely elevate, affecting the digoxin assay, but does not cause toxicity. Previous reports of cardiac glycoside activity are also unfounded.
Adverse effects of eleuthero use include; insomnia, palpitations, tachycardia and hypertension.  These effects are more common if higher than recommended doses are consumed. Mild diarrhea, which resolves rapidly, has also been reported.  No overdose symptoms have ever been reported with the use of eleuthero-containing products.
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