Ginkgo (Ginkgo biloba)

 

Introduction
The extracts of the leaves of Ginkgo biloba have been used in traditional Chinese medicine for about 5000 years for various health disorders including memory and concentration problems, confusion, depression, anxiety, dizziness, tinnitus, and headache.
The mechanisms of action of Ginkgo biloba are thought to work by increasing blood supply and dilating blood vessels which reduces blood thickness, modifies neurotransmitter systems in the brain, and reduces free radicals.

 

Historical Medicinal Uses of Ginkgo
Ginkgo biloba is often considered as a ‘living fossil’ and is considered the oldest tree species to survive on earth, with a history dating back over 200 million years. The Ginkgo species were once common in North America and Europe. Ginkgo biloba is the only surviving member of the Ginkgo family. While its relatives became extinct in other parts of the world Ginkgo biloba survived in China, where it became known to Europeans in the eighteenth century, and subsequently it was introduced as an ornamental tree throughout the Western world. Gingko was first introduced to the US in 1784 and now Ginkgo trees are found in virtually every city in the United States.
     In Traditional Chinese Medicine, the seeds (with fleshy rind removed) are considered more important than the leaves. The seeds are used as an astringent for the lung, which helps to improve the symptoms of asthma. They are also thought to benefit chi (or qi = vital energy), coughs, and regulate urinary frequency. Studies have shown that the constituents of ginkgoic acid and ginnol inhibit certain bacteria and fungal infections. In large doses the seeds are thought to have some toxic effect, perhaps leading to skin disorders or mucous membrane irritation. However today, only the leaves are used for medicinal purposes.

MEDICAL USES OF GINGKO

Alzheimer’s Disease
Ginkgo biloba seems to produce neuroprotective effects in neurodegenerative diseases such as Alzheimer’s disease however there is still debate about the efficacy of Ginkgo biloba when compared with the latest medical drugs in the treatment of mild to moderate Alzheimer's dementia. One resent study found that there are no differences in the efficacy of Ginkgo and the latest medical Alzheimer’s drug (Donepezil) in the treatment of mild to moderate Alzheimer's dementia, so the use of both substances can be used equally well to treat Alzheimer’s disease. In other words, the Ginkgo was just as good as the latest medical Alzheimer’s drug, but without adverse side effects!
Stephen – these two sentences sound REALLY ambiguous – so have deleted the second one. Please confirm you agree….

Dementia
Dementia differs from Alzheimer’s disease as dementia describes the general lack of cognition and memory as an individual ages, whereas Alzheimer’s disease is a more severe, specific illness that results in a worse prognosis. In a randomised, double-blind, 22-week trial, 400 patients with dementia associated with neuropsychiatric features were treated with Ginkgo biloba extract (240 mg/day) or placebo. Ginkgo was significantly better than the placebo with respect to all the tests performed on the individuals. The symptoms that Ginkgo improved the most were found for apathy/indifference, anxiety, irritability/liability, depression/dysphoria and sleep/night time behaviour.

The prevention of heart disease (Atherosclerosis and Atherogenesis)
The prevention or reduction of atherogenesis (clogging of the arteries) is one of the most significant anti-aging objectives since this is a matter of avoidance of heart attack and stroke. Oxidized LDL (‘bad’ cholesterol) particles are highly atherogenic. A recent German study found that Ginkgo can prevent the oxidation of LDL, thus preventing heart disease (atherosclerosis). More specifically, the atherosclerosis inhibiting effect of Ginkgo is due to an up-regulation in the body's own antioxidant enzymes, which results in a reduction in the (bad) oxidised LDL cholesterol in the blood.

Dyslexia
A study was undertaken to collect preliminary information on the possible efficacy and tolerability of Ginkgo biloba as a treatment of dyslexia in school-aged children. Fifteen children (5-16 year old) with dyslexia were given a single morning dose of 80mg. The score of the standardized tests for dyslexia improved for the children taking the Ginkgo biloba. The data found that a standardized plant extract of Ginkgo biloba has acceptable acute tolerability at single doses up to 80mg/day and is beneficial in decreasing dyslexia difficulties in school children.

Cancer Prevention
There is considerable interest in herbal therapies for cancer prevention but often with little scientific evidence to support their use. A recent study examined data and the effects of Ginkgo biloba on the risk for ovarian cancer. Ginkgo was found to reduce ovarian cancer risk by a staggering 59%. This data provides some preliminary supportive evidence that Ginkgo prevents ovarian cancer.

Drug Interactions with Ginkgo
Although Ginkgo, like any herbal medicine, can conflict with medications, no significant herb/drug interactions with Ginkgo have been reported. As a precaution it is advised that before using this herb or any other herbal preparation, to consult your health care professional. It has been demonstrated that Ginkgo can thin the blood, so it should be avoided with people on blood thinning medication or at risk of stroke. Also, consuming Ginkgo with certain blood pressure medications (such as Nifedipine) should be avoided unless prescribed by your health care professional.

Therapeutic/safe dosages of Ginkgo
Ginkgo can be purchased in most health food stores around Australia. Apart from some individuals being sensitive to it, Ginkgo is remarkably safe with up to 8 grams per day being able to be consumed without adverse effects. However, most trials use 4-6g per day. For the benefits listed in this article, 80-240mg of the concentrated extract daily is suitable for most applications.

Dosage and duration of taking Ginkgo
Studies have found that short and long term consumption is beneficial for the treatment of mental fatigue, depression, Alzheimer’s disease, dementia and concentration problems. Longer intake of Ginkgo has been associated with enhanced sporting and sexual performance. Doses of up to 6 grams have been taken for extended periods of time (years) without adverse effects.

Other herbs that can be used with Ginkgo
As with many herbs, combinations can be used to add to the overall therapeutic value. The following is a list of herbs that can be prescribed with Ginkgo to boost its therapeutic properties:

  • Brahmi. Brahmi is best combined with Ginkgo if is there is a need to improve memory and to benefit concentration. Brahmi works by improving the function of the brain by increasing blood flow to the brain and improving neurotransmitter function in the brain.
  • Withania. One of the best all-round herbal adaptogens, Withania is a brilliant anti-fatigue herb. It will also help to improve sporting performance and reduce cardiovascular disease.
  • Panax Ginseng. Another good all-round herbal adaptogens, Panax Ginseng is a brilliant anti-fatigue herb. It will also help to improve sporting performance (like Withania) however, will have a greater effect on the improvement of mental health conditions and sexual functioning. Panax Ginseng is also highly prized for the prevention of cancer.
  • Hypericum (St. John’s Wort). Best known for the treatment of depression, Hypericum and Ginkgo are two of the most commonly prescribed herbs in Europe for mental health issues. Hypericum particularly combines well with Ginkgo for the treatment of depression.
  • Hawthorn Berries or leaves. Hawthorn is best known as a great herb for the treatment of heart disease, including high blood pressure. Ginkgo is a fantastic addition for the treatment of high blood pressure.

Conclusion
Ginkgo is a highly popular herbal medicine for those of us who find ourselves lacking mental power, developing dementia or other signs of the ageing process (ie. impotence or heart disease). With it’s use dating back to ancient history in nature, there is no doubt that Ginkgo is a highly-prized herb. As we age, Ginkgo becomes a more important herb to anyone who wants to maintain mental clarity, or to prevent cancer or vascular disease.

References:
Birks J, Grimley Evans J. Ginkgo biloba for cognitive impairment and dementia.
Cochrane Database Syst Rev. 2007

Korczyn AD. Comments on the article by Mazza et al. concerning Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer's dementia in a randomized placebo-controlled double-blind study. Eur J Neurol. 2007

Scripnikov A, Khomenko A, Napryeyenko O; GINDEM-NP Study Group. Effects of Ginkgo biloba extract EGb 761 on neuropsychiatric symptoms of dementia: findings from a randomised controlled trial. Wien Med Wochenschr. 2007;157(13-14):295-300.

Donfrancesco R, Ferrante L. Ginkgo biloba in dyslexia: a pilot study. Phytomedicine. 2007 Jun;14(6):367-70.

Ye B, Aponte M, Dai Y, Li L, Ho MC, Vitonis A, Edwards D, Huang TN, Cramer DW. Ginkgo biloba and ovarian cancer prevention: epidemiological and biological evidence. Cancer Lett. 2007 Jun 18;251(1):43-52.

Jiang, X., et al.  Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects.  Br J Clin Pharmacol.  59(4):425-432, 2005.

Yoshioka, M., et al.  Studies on interactions between functional foods or dietary supplements and medicines. IV. Effects of Ginkgo biloba leaf extract on the pharmacokinetics and pharmacodynamics of nifedipine in healthy volunteers.  Biol Pharm Bull.  27(12):2006-2009, 2004.




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