The term “ginseng” derives from the Chinese “jen-shen”, which translates to “plant-man”. This name probably stems from the resemblance of ginseng roots to the shape of a human body. The term Panax originates from the Greek “pan akheia” (panacea) meaning “cure of all diseases”.^[6] In traditional Chinese medicine, ginseng holds significant importance and is also sometimes referred to as “the lord of herbs”, as it is believed that its roots contain the three main human essences: the body, the mind, and the spirit. The use of ginseng in traditional Chinese medicine dates back to Emperor Shennong (5000 years ago), who classified hundreds of medicinal and poisonous herbs, including ginseng, in what today we would call a pharmacopeia.^[6]

There are multiple types of Panax ginseng that can be obtained by treating the plant with different mechanical processing methods. Depending on the method used, the ginsenoside composition in the plant changes. Red ginseng, also known as Korean red ginseng, is obtained by steaming Panax ginseng at 95–100°C, followed by drying it. This processing method leads to significant changes in the bioactive profile of the plant. While Panax ginseng typically contains ginsenosides Rb1, Ro, and Re as its main components, Korean red ginseng is characterized by a high content of ginsenoside Rb(3), which can be metabolized to Rb(2) by intestinal bacteria. Additionally, Korean red ginseng contains ginsenoside Rg(3), which is unique to this variety.^[21] Another variety of ginseng, black ginseng, is obtained by subjecting Panax ginseng to nine cycles of steaming at a temperature of 98°C. However, black ginseng is not as commonly used in traditional medicine or supplements.^[10] White Ginseng is a term used to refer to Panax ginseng that has been cultivated and then air dried, as opposed to steam dried. The air drying process involves peeling and drying the root until the moisture content is reduced to below 12% and the root acquires a yellowish-white color. Some of the bioactives may be lost during this process.^[22]

Another relatively new type, sun ginseng, is obtained by processing Panax ginseng at higher temperatures, between 100–120°C, for 2 hours.^[10]

Additionally, ginseng can undergo fermentation using fermentation organisms, such as Lactobacillus and Aspergillus, or various fungal species (e.g., Ganoderma lucidum).^[10]

G115 is a patented extraction of Panax ginseng by Pharmaton (Switzerland) that contains 4% ginsenosides by total weight,^[23][24] while NAGE is a standardized extract from the same company containing 10% ginsenosides by weight.^[24] These standardized extracts are commonly used in research to ensure quality standards and control for the total amount of ginsenosides.

Animal studies suggest that the ginsenoside content in Korean red ginseng (and in Panax ginseng in general) may play a role in regulating abnormal feeding patterns, while it has no effect on normal feeding patterns. Surprisingly, little research has been done on the appetite-stimulating effects of ginseng, despite its traditional use for this purpose. There are no human studies directed to answer this topic, either, but potent acute suppression of appetite is seen in obese mice that overeat, and results are mixed in lean mice.^[25][26][27]

The mechanism behind this appetite suppression may involve the downregulation of orexigenic neuropeptides, which stimulate appetite, and the upregulation of anorexigenic neuropeptides, which inhibit appetite.^[28]

Ginseng might be a useful addition to multivitamin formulations for improving mood due to having some bioactivity at low doses (40–100mg).^[29][30] However, data regarding its inclusion in multivitamin formulations is conflicting.

Whether Panax ginseng can have positive effects on metabolic parameters is still uncertain, with more high-quality studies needed to reach a conclusion.

One meta-analysis found that supplementation with 200–20,000 mg per day of Panax ginseng dry extract for 2–12 weeks decreased total cholesterol and low-density lipoprotein (LDL) levels compared to a placebo but didn't have a significant effect on triglycerides or high-density lipoprotein (HDL) levels. It's worth noting that the studies in this meta-analysis included people both with and without cardiovascular risk factors, and there was high variability in the types of ginseng extracts used and their administration frequencies.^[5] Another meta-analysis found inconclusive results regarding the effect of ginseng on blood pressure while noting a decrease in total cholesterol, triglycerides, LDL levels, and body fat percentage compared to a placebo.^[2]

Regarding blood glucose parameters, dosages of Panax ginseng between 200 mg and 8,000 mg per day were associated with a reduction in blood glucose levels compared to a placebo. However, no significant effect was observed on fasting glucose, fasting insulin, postprandial glucose (glucose levels after food), postprandial insulin, or Hb1Ac levels.^[2] Similar results were reported in another meta-analysis where supplementation with 780 mg to 6 grams per day of red Korean ginseng for 12 weeks did significantly affect fasting blood glucose, fasting insulin, and HbA1c levels compared to a placebo.^[31]

Preliminary evidence suggests that supplementation with Panax ginseng may not significantly increase testosterone levels in athletes, although the quality of the study providing this evidence is questionable.^[32] However, Panax ginseng supplementation may be effective in cases where testosterone levels are suppressed during periods of infertility and hypogonadism (low testosterone production).^[33]

In men with erectile dysfunction, Panax ginseng does not appear to affect testosterone levels.^[34][3] Nevertheless, some studies have shown promising results regarding its efficacy in improving erectile function. One study found that a dosage of 1,000 mg of red Korean ginseng three times daily improved symptoms of mild to moderate erectile dysfunction compared to a placebo over a period of 3 months.^[3] Another study noted a significant improvement in erectile function with 1,000 mg of Panax ginseng supplemented twice daily over 8 weeks, although the study suffered from a large dropout rate.^[35] It can be concluded that Korean red ginseng holds promise as a potential treatment for erectile dysfunction, but further rigorous testing is needed to establish its efficacy and safety.

It has been suggested that Panax ginseng may improve skin quality and reduce wrinkles when taken orally, but the evidence is currently limited. Only one human study is available on this topic, and it involved the use of a combination of ginseng with two other herbs.^[36] Further studies focusing solely on Panax ginseng supplementation and its effect on skin quality are necessary to establish its effectiveness in this area.

One meta-analysis revealed that Panax ginseng did not significantly improve overall sexual function in women compared to a placebo. However, subgroup analysis found that it did have a positive effect on specific domains of sexual function, including sexual arousal and sexual desire. Interestingly, no effects were observed on other aspects of sexual function such as orgasm, pain, lubrication, and sexual satisfaction.^[37]

Only a limited number of clinical studies (human studies) have investigated the effect of Panax ginseng on menopausal symptoms, and the overall evidence remains inconclusive. While some studies found that supplementation with Korean red ginseng in menopausal women improved sexual arousal, overall health, and menopausal symptoms compared to a placebo, others failed to observe a significant reduction in hot flash frequency, although they found significant improvements in well-being and depression.^[38]

It’s worth highlighting that one of these studies noted that physiological parameters such as follicle-stimulating hormone and estradiol levels, endometrial thickness, maturation index, and vaginal pH were not affected by supplementation with ginseng. This suggests that any potential beneficial effects of Panax ginseng on menopause are unlikely to be mediated by hormone-replacement-like mechanisms.^[39] However, in vitro studies have reported that several ginsenosides are agonists (activators) of estrogen receptors.^[40] Further research is required to clarify this mechanism of action.