Ginseng (Panax ginseng) — also known as Rén Shēn (人参)

On this page

1. Overview
2. Why Korean ginseng is superior
3. Properties
4. Actions and indications
5. Key formulas
6. Modern research
7. Cautions and contraindications
8. Treatment at my clinic

1. Overview

Ginseng — Panax ginseng, known in traditional Chinese medicine as Rén Shēn (人参) — is the single most important Qi tonic in the Chinese Materia Medica. It is the original “ginseng” referenced in all classical Chinese medical texts and the species that gave the entire plant genus (Panax, from Greek panakes, “all-healing”) its name. Also called Korean ginseng or Asian ginseng, it belongs to the category of Herbs that tonify Qi and was classified as a superior herb in the Shen Nong Ben Cao Jing (circa 200 CE). Used in Chinese herbal medicine for over two thousand years, ginseng remains the foundation of countless classical herbal formulas and tailored prescriptions.

I prescribe ginseng as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan. Herbs are always combined with other herbs selected to match the patient’s individual TCM pattern. Online consultations are available for patients who cannot attend my clinic in person.

2. Why Korean ginseng is superior to other ginsengs

Not all ginsengs are equal. The name “ginseng” is used commercially for several botanically distinct plants, and the differences between them are clinically significant. The pharmacologically active compounds in true ginseng are ginsenosides — saponins found in the root — and the concentration, ratio and diversity of these compounds vary enormously between species, growing region and processing method.

Korean ginseng (Panax ginseng) grown in Korea, particularly Goryeo insam from the Geumsan and Punggi regions, is regarded in both traditional Chinese medicine and modern pharmacology as the most potent form of ginseng. Korean soil and climate produce roots with higher ginsenoside content — typically containing over 30 different ginsenosides compared to around 13 in American ginseng. The six-year cultivation cycle used in Korea allows the root to mature fully, developing the distinctive red colour when steam-processed into Korean red ginseng (hong sam) that contains unique ginsenosides (Rg3, Rg5, Rk1) formed only through steaming.

Chinese ginseng (Panax ginseng, grown in China) is botanically the same species but is generally cultivated for four years rather than six, producing lower ginsenoside concentrations. Wild Chinese ginseng from the Changbai mountains is exceptional but now extremely rare and prohibitively expensive.

American ginseng (Panax quinquefolius) — known as Xī Yáng Shēn in TCM — is a different species entirely. It is cooler in nature and tonifies Yin and Qi, making it appropriate for Yin deficiency with Heat but not for the profound Qi collapse that Korean ginseng addresses.

Siberian ginseng (Eleutherococcus senticosus) is not a ginseng at all. It contains eleutherosides rather than ginsenosides and has adaptogenic properties but lacks the Yuan Qi-tonifying action of true Panax ginseng. See my article on Siberian ginseng benefits for more detail.

For these reasons, when ginseng is specified in a classical formula (as Rén Shēn), Korean ginseng — particularly six-year-old Korean red ginseng — is the form I prefer clinically.

Korean red ginseng vs white ginseng

Red and white ginseng come from the same plant — Panax ginseng — but are processed differently, and the clinical effects are distinct enough that they are treated almost as separate medicines.

White ginseng (Bai Shen) is prepared by peeling the fresh root and air-drying it. The ginsenoside profile remains close to that of the raw root, dominated by the original ginsenosides Rb1, Rb2, Rc, Rd, Re, Rf, Rg1 and Rg2. It is classified as slightly warm and sweet, gently tonifies Spleen and Lung Qi, and is generally better tolerated by patients prone to Heat or agitation.

Korean red ginseng (Hong Shen, hong sam) is produced by steaming the unpeeled six-year-old root for several hours and then drying it, giving the characteristic reddish-brown colour. Steaming drives a chemical conversion — the original ginsenosides undergo hydrolysis, dehydration and isomerisation to produce ginsenosides unique to red ginseng, including Rg3, Rg5, Rk1, Rh2 and compound K. These converted ginsenosides are generally more bioavailable and more pharmacologically active than their precursors, which is why red ginseng shows stronger effects in cognitive, circulatory, immune and anticancer research.

In TCM terms, red ginseng is warmer than white, more strongly tonifies Yang alongside Qi, and is preferred for severe Qi and Yang deficiency, cold extremities, profound fatigue and convalescence from serious illness or surgery. White ginseng is preferred when there is Qi deficiency with some Yin depletion or a tendency to Heat — for example in Qi deficiency with dry mouth, night sweats or irritability, where the warming nature of red ginseng would be too forceful.

In my practice I most often prescribe six-year-old Korean red ginseng within tailored formulas, reserving white ginseng for patients whose pattern requires a gentler, less warming action.

3. Properties

4. Actions and indications

Principal actions

1. Powerfully tonifies Yuan Qi — the primary herb for Qi collapse and severe Qi deficiency
2. Tonifies Lung Qi — for shortness of breath, wheezing and chronic cough from Lung deficiency
3. Strengthens Spleen and benefits the Stomach — for fatigue, poor appetite and loose stools
4. Generates Body Fluids and stops thirst — for Qi and fluid injury from high fever or profuse sweating
5. Benefits the Heart Qi and calms the Spirit — for palpitations, insomnia and anxiety from Heart Qi and Blood deficiency

Indications

1. Collapse of Yuan Qi with cold extremities, profuse sweating and weak pulse — the classical emergency indication
2. Chronic fatigue, shortness of breath and spontaneous sweating from Qi deficiency
3. Poor appetite, loose stools and lethargy from Spleen Qi deficiency
4. Wasting and thirsting disorder (Xiao Ke, often correlating with diabetes)
5. Palpitations, forgetfulness, insomnia and restlessness from Heart Qi and Blood deficiency
6. Male infertility and erectile dysfunction from Qi and Yang deficiency
7. Convalescence and recovery from serious illness, surgery or childbirth

5. Key formulas containing ginseng

Ginseng (Rén Shēn) appears as the principal or deputy herb in many of the most important classical formulas in Chinese medicine, including:

• Bu Zhong Yi Qi Tang — tonifies Spleen Qi and raises sinking Middle Qi
• Si Jun Zi Tang — the foundational Qi-tonifying formula
• Ba Zhen Tang — tonifies Qi and Blood simultaneously
• Gui Pi Tang — tonifies Heart and Spleen for insomnia and palpitations
• Sheng Mai San — generates Qi and fluids, protects the Heart
• Ren Shen Yang Rong Tang — nourishes the Nutritive Qi in severe deficiency
• Du Huo Ji Sheng Wan — for chronic joint pain with underlying deficiency

See the full Chinese herbal medicine formula directory for detailed information on all 70 classical formulas.

6. Modern research

Panax ginseng is one of the most extensively researched herbs in modern pharmacology. Over 180 ginsenosides have been identified, with Rg1, Rb1, Rg3 and Rh2 among the most studied. Research confirms significant adaptogenic effects, immunomodulation through increased natural killer cell activity and regulation of T-cell function, and neuroprotection via reduction of oxidative stress and modulation of neurotransmitters. Cognitive research demonstrates improvements in memory and mental performance, particularly with Korean red ginseng in older adults. Cardiovascular studies show vasodilatory effects, improved endothelial function and modest reductions in blood pressure. Fertility research confirms improvements in sperm count, motility and morphology in men with idiopathic infertility, and modulation of the hypothalamic-pituitary-ovarian axis in women. The anti-fatigue effects have been demonstrated in multiple randomised controlled trials, with Korean red ginseng showing the strongest evidence. Anticancer research has focused particularly on Rg3, with demonstrated effects on apoptosis, angiogenesis inhibition and chemotherapy sensitisation in several tumour models.

7. Cautions and contraindications

Avoid in Yin deficiency with Heat, Liver Yang rising, and hypertension from excess patterns — the warming and Qi-raising action will aggravate these. Avoid during acute febrile illness and in conditions of excess Heat. Classically contraindicated alongside Li Lu (Veratrum nigrum) and Wu Ling Zhi. Use with caution in pregnancy and alongside anticoagulants, stimulants and diabetic medications due to potential interactions. Excessive doses may cause headache, insomnia, palpitations, hypertension and nosebleeds — the “ginseng abuse syndrome” described in Western literature. Start with low doses and adjust based on individual response.

Important: Chinese herbs should always be prescribed by a fully qualified herbalist who is a member of the Register of Chinese Herbal Medicine (RCHM). Never self-prescribe Chinese herbs without professional guidance. Dr (TCM) Attilio D’Alberto is a member of the RCHM with over 25 years of clinical experience.

8. Treatment at my clinic

I prescribe ginseng as part of tailored herbal formulas for a range of conditions including Chronic fatigue syndrome, Long COVID, Burnout, Male infertility, and Low sperm count. Every prescription is individually formulated following a full TCM assessment and adjusted throughout treatment as the pattern responds.

I see patients in person at my clinic in Wokingham, Berkshire. Online Chinese herbal medicine consultations are available throughout the UK and internationally. Visit the prices page for consultation fees.

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