Ginkgo Biloba
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Ginkgo Biloba
Loh Xin Hui 26/08/09
Background – Ginkgo Biloba
Ginkgo is thought to be the oldest tree on the planet, first growing about 200 million years ago.
Although Chinese herbal medicine has used both the ginkgo leaf and seed for centuries, modern research has focused on the standardized Ginkgo biloba extract (EGb 761), which is prepared from the dried green leaves.
More than 40 components isolated from the ginkgo tree have been identified.
Standardized preparations contain: 24% gingko flavone glycosides (flavonoids) 6% terpenoids (ginkgolides & bilobalides)
Properties – Ginkgo Biloba
Potent antioxidant properties –
Dilation of blood vessels –
Antioxidants(flavonoids and terpenoids) can neutralize free radicals in the body and reduce or even help to slow down damage of body cells caused by these free radicals.
Ginkgo flavonoids directly dilate the fine vessels of the circulatory system, which increase both blood circulation and oxygen levels in the brain, as well as other critical organ tissues. It has been shown that oxygen-rich blood enhances the memory.
Increased ability of brain to utilise glucose –
Ginkgo can enhance the ability of brain cells to make use of glucose. With improved energy levels, the brain is supplied with required fuel to perform better.
Properties – Ginkgo Biloba
Improves mental alertness –
It has been shown that ginkgo increases the rate at which nerve cell impulses occur, which equates to an increase in mental sharpness or alertness.
Prevents the formation of blood clots (thrombosis)
Ginkgo can inhibit Platelet Activating Factor(PAF), a mediator released from cells that causes platelets to aggregate (clump together).
Excessive amount of PAF may lead to the formation of blood clots (thrombosis) within the circulatory system, potentially resulting in heart disease, strokes and intermittent claudication.
Health applications of Ginkgo Biloba 1. Early Stage Alzheimer’s Disease
STRONG scientific evidence
may provide benefits for people with AD: Improvement in thinking, learning, and memory (cognitive function) Improvement in activities of daily living & social behavior Fewer feelings of depression
may delay the onset of AD in someone who is at risk for this type of dementia (for example, family history).
Gingko biloba presented statistically significant mild effectiveness in the treatment of cognitive deficit in AD.
A review of studies of at least 6 months in duration demonstrated that ginkgo extract may be as effective as the 2nd generation cholinesterase inhibitors in treating mild-to-moderate Alzheimer’s disease.
A randomized, placebo-controlled trial in healthy adults without dementia or other known mental deficit found no benefit from 6 weeks of ginkgo therapy (120 mg daily). However, another study using similar design with a higher dose (180mg daily) shown clinically significant cognitive benefits in healthy persons.
Health applications of Ginkgo Biloba. 2. Intermittent claudication (pain caused by inadequate blood flow to the legs).
STRONG scientific evidence
Numerous studies have shown that 120 – 160 mg of ginkgo biloba extract daily for 3 – 6 months is efficient in treatment of intermittent claudication.
An analysis of eight published studies revealed that people taking ginkgo improved walking distance and decreased pain in patients with intermittent claudication. They tend to walk roughly 34 meters farther than those taking placebo.
Ginkgo has been shown to be as effective as a leading medication in improving pain-free walking distance. However, regular walking exercises are more beneficial than ginkgo in improving walking distance.
Health applications of Ginkgo Biloba 3. Cerebral insufficiency
GOOD scientific evidence
Conditions may include poor concentration, confusion, absent-mindedness, decreased physical performance, fatigue, headache, dizziness, depression, and anxiety.
It is believed that cerebral insufficiency is caused by decreased blood flow to the brain.
Clinical studies show that daily doses of 120 – 240 mg in 23 divided doses lead to an improvement in the symptoms associated with cerebrovascular insufficiency.
Some research reports benefits of ginkgo in patients with these symptoms, but most have been poorly designed without reliable results. Better studies are needed before a strong recommendation can be made.
Health applications of Ginkgo Biloba 4. Memory Impairment
UNCLEAR scientific evidence
Ginkgo is widely touted as a "brain herb“.
Researchers recently reviewed all of the high-quality published studies on ginkgo and mild memory impairment (without Alzheimer's or other form of dementia), and concluded that ginkgo was significantly more effective than placebo in enhancing memory and cognitive function.
Some smaller studies had promising results, but a trial sponsored by the National Institute on Aging of more than 200 healthy adults over age 60 found that ginkgo taken for 6 weeks did not improve memory.
Medicinal Uses & Indications 5.
6.
Tinnitus
UNCLEAR scientific evidence
Some researchers have investigated whether ginkgo relieves symptoms of this hearing disorder.
Although the quality of most studies was poor, the reviewers concluded that extracts of ginkgo moderately effective in treating tinnitus.
Eye problems
UNCLEAR scientific evidence
The flavonoids found in ginkgo may help halt or lessen some retinal problems (that is, problems to the back part of the eye). Retinal damage has a number of potential causes, including diabetes and macular degeneration.
Macular degeneration (often called age-related macular degeneration or ARMD) is a progressive, degenerative eye disease that tends to affect older adults and is the number one cause of blindness in the United States.
Studies suggest that gingko may help preserve vision in those with ARMD.
Health applications of Ginkgo Biloba
Other uses
Some studies have shown positive results from the use of ginkgo for: Mountain sickness Decreasing vasoactivity in response to cold Asthma Hypoxia Premenstrual symptoms Multiple sclerosis
Recommended Dose
Available in the form of tablets, capsules, liquid extracts or teas.
In most clinical studies, the effective dosage of standardized extract was about 40mg three times a day, approximately 120mg of ginkgo leaf extract daily.
If more serious dementia or Alzheimer's disease is present, up to 240 mg daily, in 2 or 3 divided doses, may be necessary.
Precautions/Contraindications Pregnancy and Breastfeeding Use of ginkgo is not recommended during pregnancy and breastfeeding. The risk of bleeding associated with ginkgo may be dangerous during pregnancy. Children Ginkgo is not routinely used in children by the medical community. It is not recommended for use in children under 18. There has not been enough testing on adverse reactions or side effects.
Precautions/Contraindications Allergies
Allergy/hypersensitivity to Ginkgo biloba or members of the Ginkgoaceae family may occur.
A severe reaction called Stevens-Johnson syndrome, which includes skin blistering and sloughing-off, has been reported.
People allergic to urushiols (such as poison sumac, poison ivy or poison oak, cashews, mango rind) may have a similar reaction to ginkgo.
Precautions/Contraindications
Uncooked ginkgo seeds contain a chemical known as ginkgotoxin, which can cause seizures or loss of consciousness(coma), and possibly death.
Eating ginkgo seeds may be hazardous or even lifethreatening.
Contact with or consuming ginkgo fruit or pulp from the fruit may cause skin reactions and intestinal spasms.
Side Effects
Side effects of ginkgo may include Headache Nausea Gastrointestinal upset Diarrhea Dizziness Allergic skin reactions.
More severe allergic reactions (such as rash, itching, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue), fainting, pounding in the chest, skin redness, trouble speaking, weakness, unusual bruising or bleeding have occasionally been reported.
Interactions
Ginkgo may increase bleeding risk.
Caution if taking together with warfarin, aspirin, antiplatelet or NSAIDs, have bleeding disorders, or have scheduled surgery or dental procedures. Ginkgo use should be discontinued at least 36hours prior to surgery. Risk of bleeding when taken in conjunction with other herbs and dietary supplements, such as garlic, saw palmetto, ginseng, dong guai, feverfew, ginger, red clover, vitamin E.
Food interactions with ginkgo may also occur.
Ginkgo may interact with foods containing tyramine (found in wine, cheeses, sausages, yogurt and bean curd). When combined with ginkgo biloba, it may lead to increased blood pressure.
Interactions
Other possible drug interactions associated with ginkgo include:
Antihypertensives. Ginkgo may decrease blood pressure and may add to the effects of medications designed to lower blood pressure.
Antidepressants. Ginkgo may add to the effects of antidepressants and increase the risk of developing serotonin syndrome.
Sexual dysfunction drugs. Ginkgo’s ability to increase vascular blood flow may increase the effects of drugs taken to improve erectile dysfunction.
Important Safety Information
Ginkgo Biloba may cause dizziness.
Taking ginkgo alone, with certain other medicines, or with alcohol may affect the ability to drive or to perform other potentially dangerous tasks.
If ginkgo is used for brain conditions, consumer should be advised to consult health professionals. A medical evaluation or prescription medicine may be needed to treat the condition.
Check with doctor before commencing any new medicine, either prescription or over-the-counter, including any medicine that contains aspirin or other NSAIDs.
References
http://www.umm.edu/altmed/articles/gin kgo-biloba-000247.htm http://nccam.nih.gov/health/ginkgo/ http://www.nlm.nih.gov/medlineplus/dru ginfo/natural/patient-ginkgo.html#grade Sierpina VS, et al. Ginkgo biloba. Am Fam Physician. 2003;68;p923-6.
Loh Xin Hui 26/08/09
Background – Ginkgo Biloba
Ginkgo is thought to be the oldest tree on the planet, first growing about 200 million years ago.
Although Chinese herbal medicine has used both the ginkgo leaf and seed for centuries, modern research has focused on the standardized Ginkgo biloba extract (EGb 761), which is prepared from the dried green leaves.
More than 40 components isolated from the ginkgo tree have been identified.
Standardized preparations contain: 24% gingko flavone glycosides (flavonoids) 6% terpenoids (ginkgolides & bilobalides)
Properties – Ginkgo Biloba
Potent antioxidant properties –
Dilation of blood vessels –
Antioxidants(flavonoids and terpenoids) can neutralize free radicals in the body and reduce or even help to slow down damage of body cells caused by these free radicals.
Ginkgo flavonoids directly dilate the fine vessels of the circulatory system, which increase both blood circulation and oxygen levels in the brain, as well as other critical organ tissues. It has been shown that oxygen-rich blood enhances the memory.
Increased ability of brain to utilise glucose –
Ginkgo can enhance the ability of brain cells to make use of glucose. With improved energy levels, the brain is supplied with required fuel to perform better.
Properties – Ginkgo Biloba
Improves mental alertness –
It has been shown that ginkgo increases the rate at which nerve cell impulses occur, which equates to an increase in mental sharpness or alertness.
Prevents the formation of blood clots (thrombosis)
Ginkgo can inhibit Platelet Activating Factor(PAF), a mediator released from cells that causes platelets to aggregate (clump together).
Excessive amount of PAF may lead to the formation of blood clots (thrombosis) within the circulatory system, potentially resulting in heart disease, strokes and intermittent claudication.
Health applications of Ginkgo Biloba 1. Early Stage Alzheimer’s Disease
STRONG scientific evidence
may provide benefits for people with AD: Improvement in thinking, learning, and memory (cognitive function) Improvement in activities of daily living & social behavior Fewer feelings of depression
may delay the onset of AD in someone who is at risk for this type of dementia (for example, family history).
Gingko biloba presented statistically significant mild effectiveness in the treatment of cognitive deficit in AD.
A review of studies of at least 6 months in duration demonstrated that ginkgo extract may be as effective as the 2nd generation cholinesterase inhibitors in treating mild-to-moderate Alzheimer’s disease.
A randomized, placebo-controlled trial in healthy adults without dementia or other known mental deficit found no benefit from 6 weeks of ginkgo therapy (120 mg daily). However, another study using similar design with a higher dose (180mg daily) shown clinically significant cognitive benefits in healthy persons.
Health applications of Ginkgo Biloba. 2. Intermittent claudication (pain caused by inadequate blood flow to the legs).
STRONG scientific evidence
Numerous studies have shown that 120 – 160 mg of ginkgo biloba extract daily for 3 – 6 months is efficient in treatment of intermittent claudication.
An analysis of eight published studies revealed that people taking ginkgo improved walking distance and decreased pain in patients with intermittent claudication. They tend to walk roughly 34 meters farther than those taking placebo.
Ginkgo has been shown to be as effective as a leading medication in improving pain-free walking distance. However, regular walking exercises are more beneficial than ginkgo in improving walking distance.
Health applications of Ginkgo Biloba 3. Cerebral insufficiency
GOOD scientific evidence
Conditions may include poor concentration, confusion, absent-mindedness, decreased physical performance, fatigue, headache, dizziness, depression, and anxiety.
It is believed that cerebral insufficiency is caused by decreased blood flow to the brain.
Clinical studies show that daily doses of 120 – 240 mg in 23 divided doses lead to an improvement in the symptoms associated with cerebrovascular insufficiency.
Some research reports benefits of ginkgo in patients with these symptoms, but most have been poorly designed without reliable results. Better studies are needed before a strong recommendation can be made.
Health applications of Ginkgo Biloba 4. Memory Impairment
UNCLEAR scientific evidence
Ginkgo is widely touted as a "brain herb“.
Researchers recently reviewed all of the high-quality published studies on ginkgo and mild memory impairment (without Alzheimer's or other form of dementia), and concluded that ginkgo was significantly more effective than placebo in enhancing memory and cognitive function.
Some smaller studies had promising results, but a trial sponsored by the National Institute on Aging of more than 200 healthy adults over age 60 found that ginkgo taken for 6 weeks did not improve memory.
Medicinal Uses & Indications 5.
6.
Tinnitus
UNCLEAR scientific evidence
Some researchers have investigated whether ginkgo relieves symptoms of this hearing disorder.
Although the quality of most studies was poor, the reviewers concluded that extracts of ginkgo moderately effective in treating tinnitus.
Eye problems
UNCLEAR scientific evidence
The flavonoids found in ginkgo may help halt or lessen some retinal problems (that is, problems to the back part of the eye). Retinal damage has a number of potential causes, including diabetes and macular degeneration.
Macular degeneration (often called age-related macular degeneration or ARMD) is a progressive, degenerative eye disease that tends to affect older adults and is the number one cause of blindness in the United States.
Studies suggest that gingko may help preserve vision in those with ARMD.
Health applications of Ginkgo Biloba
Other uses
Some studies have shown positive results from the use of ginkgo for: Mountain sickness Decreasing vasoactivity in response to cold Asthma Hypoxia Premenstrual symptoms Multiple sclerosis
Recommended Dose
Available in the form of tablets, capsules, liquid extracts or teas.
In most clinical studies, the effective dosage of standardized extract was about 40mg three times a day, approximately 120mg of ginkgo leaf extract daily.
If more serious dementia or Alzheimer's disease is present, up to 240 mg daily, in 2 or 3 divided doses, may be necessary.
Precautions/Contraindications Pregnancy and Breastfeeding Use of ginkgo is not recommended during pregnancy and breastfeeding. The risk of bleeding associated with ginkgo may be dangerous during pregnancy. Children Ginkgo is not routinely used in children by the medical community. It is not recommended for use in children under 18. There has not been enough testing on adverse reactions or side effects.
Precautions/Contraindications Allergies
Allergy/hypersensitivity to Ginkgo biloba or members of the Ginkgoaceae family may occur.
A severe reaction called Stevens-Johnson syndrome, which includes skin blistering and sloughing-off, has been reported.
People allergic to urushiols (such as poison sumac, poison ivy or poison oak, cashews, mango rind) may have a similar reaction to ginkgo.
Precautions/Contraindications
Uncooked ginkgo seeds contain a chemical known as ginkgotoxin, which can cause seizures or loss of consciousness(coma), and possibly death.
Eating ginkgo seeds may be hazardous or even lifethreatening.
Contact with or consuming ginkgo fruit or pulp from the fruit may cause skin reactions and intestinal spasms.
Side Effects
Side effects of ginkgo may include Headache Nausea Gastrointestinal upset Diarrhea Dizziness Allergic skin reactions.
More severe allergic reactions (such as rash, itching, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue), fainting, pounding in the chest, skin redness, trouble speaking, weakness, unusual bruising or bleeding have occasionally been reported.
Interactions
Ginkgo may increase bleeding risk.
Caution if taking together with warfarin, aspirin, antiplatelet or NSAIDs, have bleeding disorders, or have scheduled surgery or dental procedures. Ginkgo use should be discontinued at least 36hours prior to surgery. Risk of bleeding when taken in conjunction with other herbs and dietary supplements, such as garlic, saw palmetto, ginseng, dong guai, feverfew, ginger, red clover, vitamin E.
Food interactions with ginkgo may also occur.
Ginkgo may interact with foods containing tyramine (found in wine, cheeses, sausages, yogurt and bean curd). When combined with ginkgo biloba, it may lead to increased blood pressure.
Interactions
Other possible drug interactions associated with ginkgo include:
Antihypertensives. Ginkgo may decrease blood pressure and may add to the effects of medications designed to lower blood pressure.
Antidepressants. Ginkgo may add to the effects of antidepressants and increase the risk of developing serotonin syndrome.
Sexual dysfunction drugs. Ginkgo’s ability to increase vascular blood flow may increase the effects of drugs taken to improve erectile dysfunction.
Important Safety Information
Ginkgo Biloba may cause dizziness.
Taking ginkgo alone, with certain other medicines, or with alcohol may affect the ability to drive or to perform other potentially dangerous tasks.
If ginkgo is used for brain conditions, consumer should be advised to consult health professionals. A medical evaluation or prescription medicine may be needed to treat the condition.
Check with doctor before commencing any new medicine, either prescription or over-the-counter, including any medicine that contains aspirin or other NSAIDs.
References
http://www.umm.edu/altmed/articles/gin kgo-biloba-000247.htm http://nccam.nih.gov/health/ginkgo/ http://www.nlm.nih.gov/medlineplus/dru ginfo/natural/patient-ginkgo.html#grade Sierpina VS, et al. Ginkgo biloba. Am Fam Physician. 2003;68;p923-6.
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