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1. Vuksan V, Sievenpiper JL, Koo VYY, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med. 2000;160:1009–1013.

2. Vuksan V, Stavro MP, Sievenpiper JL, et al. Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetics. Diabetes Care. 2000;23:1221–1226.

3. Vuksan V, Sievenpiper JL, Wong J, et al. American ginseng (Panax quinquefolius L) attenuates postprandial glycemia in a time-dependent but not dose-dependent manner in healthy individuals. Am J Clin Nutr. 2001;73:753–758.

4. Court WE. Ginseng: The Genus Panax. Amsterdam: Harwood Scientific Publishers, 2000.

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10. Pang PPT, Shan JJ, Chiu KW, inventors. Chemical and pharmacological standardization of herbal extracts. US Patent 6,156,291. December 5, 2000.

11. Shan JJ, Pang PPT, Huang B, Ling L, inventors. Process of making North American ginseng fractions, products containing them, and use as immunomodulators. US Patent 6,432,454 B1. August 14, 2002.

12. Quality systems and quality standards of COLD-fX®. Unpublished document provided by CV Technologies; October 2006.

13. Product License Issuance NPN 80002849 Non-Traditional – Cold-fX®. Letter received by CVT from the NHPD, February 13, 2007. Approval listing available at:

14. McElhaney JE, Goel V, Toane B, et al. Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: A randomized, double-blinded, placebo-controlled trial. J Alternative Complementary Med. 2006;12:153–157.

15. McElhaney JE, Gravenstein S, Cole SK, et al. A placebo-controlled trial of a proprietary extract of North American ginseng (CVT-E002) to prevent acute respiratory illness in institutionalized older adults. J Am Geriatr Soc. 2004;52:13–19.

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20. Tomoda M, Hirabayashi K, Shimizu N, et al. The core structure of ginsenan PA, a phagocytosis-activating polysaccharide from the root of Panax ginseng. Biol Pharm Bull. 1994;17:1287–1291.

21. Gao QP, Kiyohara H, Cyong JC, Yamada H. Chemical properties and anti-complementary activities of polysaccharide fractions from roots and leaves of Panax ginseng. Planta Medica. 1989;55:9–12.

22. Wang M, Guilbert LJ, Ling L, et al. Immunomodulating activity of CVT-E002, a proprietary extract from North American ginseng (Panax quinquefolium). J Pharm Pharmacol. 2001;53:1515–1523.

23. Wang M, Guilbert LJ, Li J, et al. A proprietary extract from North American ginseng (Panax quinquefolium) enhances IL-2 and IFN-gamma productions in murine spleen cells induced by Con-A. International Immunopharmacol. 2004;4:311–315.

24. Jing Y, Chen N, Gravenstein S, Deng Y. A proprietary extract of Panax quinquefolius (CVT-E002) stimulates inflammatory cytokine secretion from monocytes and augments IFN-g secretion from NK cells in response to influenza virus stimulation. Unpublished manuscript provided by CV Technologies, September 2006.

25. Miller SC. The role of phytocompounds in immunoenhancement and cancer abatement. Presented at the North American Conference on Complementary and Integrative Medicine, Edmonton, Alberta, Canada, May 27, 2006.

26. Yang JC, Pang CS, Tsang SF, Ng KF. Effect of American ginseng extract (Panax quinquefolius) on formalin-induced nociception in mice. Am J Chin Med. 2001;29:149–154.

27. Predy GN, Goel V, Lovlin RE, Basu TK. Immune modulating effects of daily supplementation of COLD-fX (a proprietary extract of North American ginseng) in healthy adults. J Clin Biochem Nutr. 2006;39:162–167.

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29. Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. Variable effects of American ginseng: a batch of American ginseng (Panax quinquefolius L.) with a depressed ginsenoside profile does not affect postprandial glycemia. European J Clin Nutr. 2003;57:243–248.

30. CVT-E002—Safety Summary. Unpublished document provided by CV Technologies; October 2006.

31. Coon JT, Ernst E. Panax ginseng: a systematic review of adverse effects and drug interactions. Drug Safety. 2002;25:323–344.

32. Bressler R. Herb-drug interactions: interactions between ginseng and prescription medications. Geriatrics. 2005;60:16–17.

33. King ML, Adler SR, and Murphy LL. Extraction-dependent effects of American ginseng (Panax quinquefolium) on human breast cancer cell proliferation and estrogen receptor activation. Integrative Cancer Ther. 2006;5:236-243.

34. Ng TB, Liu F, Wang HX. The antioxidant effects of aqueous and organic extracts of Panax quinquefolium, Panax notoginseng, Codonopsis pilosula, Pseudostellaria heterophylla and Glehnia littoralis. J Ethnopharmacol. 2004;93:285-­288.

35. Stavro PM, Woo M, Heim TF, et al. North American ginseng exerts a neutral effect on blood pressure in individuals with hypertension. Hypertension. 2005:46:406–411.

36. Ueng YF, Chen CF. Effects of CVT-E002, a proprietary extract from the North American ginseng (Panax quinquefolium) on hepatic drug-metabolizing enzymes in C57BL/6J mice. J Chin Med. 2002;13:89–96.

37. Holt A, Shan J. Inhibition of human hepatic cytochrome P450 enzymes by COLD-fX and REMEMBER-fX proprietary extracts of North American ginseng (Panax quinquefolium). J Complementary Integrative Med. 2005;2:28.

38. Yuan CS, Wei G, Dey L, et al. Brief communication: American ginseng reduces warfarin‘s effect in healthy patients: a randomized, controlled trial. Ann Intern Med. 2004;141:23–27.

39. Dasgupta A, Reyes MA. Effect of Brazilian, Indian, Siberian, Asian, and North American ginseng on serum digoxin measurement by immunoassays and binding of digoxin-like immunoreactive components of ginseng with Fab fragment of antidigoxin antibody (Digibind). Am J Clin Pathol. 2005;124:229–236.

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41. Mills S, Bone K. The Essential Guide to Herbal Safety. St. Louis: Elsevier Churchill Livingstone, 2005.

42. Goel DP, Geiger JD, Shan JJ, et al. Doping-control urinalysis of a ginseng extract, COLD-fX, in athletes. Int J Sport Nutr Exerc Metab. 2004;14:473–480.

43. McElhaney J, Guilbert L, Hooten J, et al. Summary of studies with COLD-fX in high performance professional athletes assessing the tolerability and outcomes related to cold and flu like symptoms. Unpublished abstract presented at: First International Scientific Congress on Nutrition and Athletic Performance; August 10, 2001; Edmonton, Alberta.

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52. Liu J, Wang S, Liu H, et al. Stimulatory effect of saponin from Panax ginseng on immune function of lymphocytes in the elderly. Mechanisms Age Devel. 1995;83:43–53.

53. Liu M, Zhang JT. Studies on the mechanisms of immunoregulatory effects of ginsenoside Rg1 in aged rats. Acta Pharmaceutica Sinica. 1996;31:95–100.

54. Luo YM, Cheng XJ, Yuan WX. Effects of ginseng root saponins and ginsenoside Rb1 on immunity in cold water swim stress mice and rats. Zhongguo Yao Li Xue Bao/Acta Pharmacologica Sinica. 1993;14:401–404.

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56. Song Z, Kharazmi A, Wu H, et al. Effects of ginseng treatment on neutrophil chemiluminescence and immunoglobulin G subclasses in a rat model of chronic Pseudomonas aeruginosa pneumonia. Clin Diag Lab Immunol. 1998;5:882–887.

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62. Hu S, Concha C, Johannisson A, et al. Effect of subcutaneous injection of ginseng on cows with subclinical Staphylococcus aureus mastitis. J Veterinary Med. 2001; Series B.48(7):519–528.

63. Hu S, Concha C, Lin F, Persson WK. Adjuvant effect of ginseng extracts on the immune responses to immunisation against Staphylococcus aureus in dairy cattle. Veterinary Immunol Immunopathol. 2003;91:29–37.

64. Liou CJ, Li ML, Tseng J. Intraperitoneal injection of ginseng extract enhances both immunoglobulin and cytokine production in mice. Am J Chin Med. 2004;32:75–78.

65. Rivera E, Daggfeldt A, Hu S. Ginseng extract in aluminium hydroxide adjuvanted vaccines improves the antibody response of pigs to porcine parvovirus and Erysipelothrix rhusiopathiae. Veterinary Immunol Immunopathol. 2003;91:19–27.

66. Rivera E, Ekholm PF, Inganas M, et al. The Rb1 fraction of ginseng elicits a balanced Th1 and Th2 immune response. Vaccine. 2005;23:5411–5419.

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