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When incubated in Whitten’s medium with 20 mg/ml BSA for 1 hr, sperm from both stst and STST males also displayed changes in motility consistent with hyperactivation (not shown). The testis histology, sperm counts, and sperm morphology of stst males have been reported previously by us (13) and others (25) to be indistinguishable from those in STST males by light microscopy. In fact, most clinical studies with ginseng or ginsenosides reported no psychiatric or neurological side effects or statistically insignificant effects compared to placebo, and were not included in Table 1 [223,224,225,226,227]. Recently, LaBryer et al. hypothesized that kratom may have restored testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin levels in a patient with hypogonadotropic hypogonadism . 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