Ginkgo Biloba

Effects and Benefits

Core Identification

Common Names:
- Ginkgo
- Ginkgo Biloba
- Maidenhair Tree
- Kew Tree

Latin Name: Ginkgo biloba

Category: Herb

Uses

Traditional Uses

• Ginkgo nuts (not leaves) used in Traditional Chinese Medicine for respiratory conditions and urinary issues
• No traditional use documented for leaf preparations; modern clinical use developed in Europe

Modern Uses

• Cognitive Function & Memory (Older Adults) - Improves short-term and long-term memory, concentration, and mental sharpness in people with age-associated memory impairment | Research quality: Strong
• Key findings: Numerous European studies show improvements in memory, attention, and cognitive performance; increases alpha wave activity and decreases theta wave activity on EEG; not effective in young healthy volunteers

• Source citations: Balch - Prescription for Herbal Healing, Barrett - Handbook of Clinically Tested Herbal Remedies, Bone - Clinical Guide to Blending Liquid Herbs

• Alzheimer's Disease & Dementia - May stabilize or improve cognitive function and social functioning in mild to moderate cases | Research quality: Moderate

• Key findings: Standardized extract EGb 761 showed improvements comparable to acetylcholinesterase inhibitor drugs in some studies; results mixed across trials

• Source citations: Barrett - Handbook of Clinically Tested Herbal Remedies, Balch - Prescription for Herbal Healing

• Peripheral Vascular Disease / Intermittent Claudication - Increases pain-free walking distance in patients with leg pain and cramps | Research quality: Strong

• Key findings: Meta-analysis of 8 studies showed average 34-meter increase in pain-free walking distance; dose of 120-160mg daily for 24 weeks; 240mg may be more effective than 120mg

• Source citations: Barrett - Handbook of Clinically Tested Herbal Remedies, Bone - Clinical Guide to Blending Liquid Herbs

• Vertigo & Dizziness - Effective for vertigo of vascular or vestibular origin | Research quality: Moderate

• Key findings: Randomized trial showed efficacy comparable to betahistine (a vasodilator); improved oculomotor and visuovestibular function

• Source citations: Bone - Clinical Guide to Blending Liquid Herbs

• Tinnitus - May reduce symptoms if treatment begins within 6-8 weeks of onset | Research quality: Mixed

• Key findings: One well-conducted trial showed statistical reduction in sound volume after 10 weeks; however, a large trial (909 subjects with chronic tinnitus >12 months) showed no benefit over placebo; appears more effective when accompanied by other symptoms of cerebral insufficiency

• Source citations: Barrett - Handbook of Clinically Tested Herbal Remedies, Bone - Clinical Guide to Blending Liquid Herbs, Balch - Prescription for Herbal Healing

• Eye & Retinal Health - Supports retinal blood flow and may help various eye conditions | Research quality: Moderate

• Key findings: Improved blood vessels, visual acuity, and color recognition in patients with retinal vein blockage; improvements in macular degeneration and fundus hypertonicus; increased end-diastolic velocity in ophthalmic artery suggesting benefit for glaucoma

• Source citations: Barrett - Handbook of Clinically Tested Herbal Remedies, Bone - Clinical Guide to Blending Liquid Herbs

• PMS (Congestive Symptoms) - Significantly improves breast tenderness and edema | Research quality: Moderate

• Key findings: Double-blind, placebo-controlled study of 165 women showed marked improvement in breast tenderness, edema, anxiety, depression, and headaches; 160mg/day from day 16 to day 5 of next cycle

• Source citations: Bone - Clinical Guide to Blending Liquid Herbs

• Altitude Sickness Prevention - May help prevent acute mountain sickness | Research quality: Preliminary

• Key findings: Randomized, placebo-controlled trial showed 160mg/day for duration of expedition significantly prevented acute mountain sickness
• Source citations: Bone - Clinical Guide to Blending Liquid Herbs

Active Compounds

Primary Active Ingredients:
- Ginkgo flavone glycosides (22.5-25%) - Antioxidant compounds that protect cells from oxidative damage and support blood vessel health
- Terpenoids / Ginkgolides (6-8%) - Potent and specific platelet-activating factor (PAF) antagonists; effects are long-lived and rapidly established after oral doses
- Bilobalide - A terpenoid that provides neuroprotective effects against hypoxia and ischemia

Dosage Information

Standard Dosage:
- Form: Standardized extract (50:1 concentrated)
- Amount: 120 mg per day
- Frequency: 40mg three times daily or 120mg once daily

Therapeutic Dosage:
- Form: Standardized extract
- Amount: 120-240 mg per day
- Purpose: 240mg/day may be more effective for peripheral vascular disease
- Duration: Minimum 6 weeks before assessing clinical benefit; 6-8 weeks for tinnitus; 8-12 weeks for memory; 24 weeks for peripheral vascular disease

Maximum Safe Dosage:
- Daily maximum: 240 mg standardized extract
- Warning threshold: Extremely large doses may cause diarrhea, nausea, vomiting, dizziness, and/or restlessness

Bioavailability Notes:
- Standardized extracts are required for central nervous system effects
- Teas are less effective for memory/cognitive conditions as active compounds are concentrated in extracts
- Look for extracts standardized to 22.5-25% flavonoid glycosides and 6-8% terpenoids

How to Take It

Timing:
- Can be taken with or without food
- Best divided into multiple doses (40mg 3x daily) though once-daily dosing (120mg) has shown effectiveness
- Allow minimum 6 weeks of consistent use before evaluating benefits

Synergies - What It Works Well With

Complementary Supplements:
1. Panax Ginseng - Well-studied combination (Ginkoba M/E); demonstrated improvements in quality of memory index by 7.5% in healthy middle-aged volunteers | Enhanced cognitive function
2. Bilberry - Both improve peripheral circulation | Combine for circulatory and cognitive support, potential synergy for blocking amyloid plaques
3. Vinpocetine - Both support cerebral circulation | Combine for enhanced cognitive effects

Avoidance - What NOT to Combine With

Supplement Interactions:
1. High-dose antiplatelet herbs (Garlic, Ginger, Fish Oil) - May have additive blood-thinning effects | Use standard doses and monitor

Drug Interactions:
1. Warfarin (Coumadin) - Ginkgo is a PAF antagonist which may affect bleeding | Increased bleeding risk | Severity: Moderate - use with medical supervision
2. Aspirin and other antiplatelet drugs - Potential additive effects on bleeding | Increased bleeding risk | Severity: Moderate - case reports of bleeding
3. Antidepressants - Some studies excluded patients on antidepressants; however, one study showed improved sleep when combined with trimipramine | Consult healthcare provider | Severity: Mild

Food Interactions:
- No significant food interactions known
- Avoid consuming raw ginkgo leaves or fruit (contain neurotoxins)

Safety Information

Contraindications:
- None definitively established
- Exercise caution in patients with bleeding disorders

Side Effects:
- Common: Mild headaches (lasting 1-2 days), mild GI upset (rare)
- Rare: Isolated episodes of spontaneous bleeding reported; one case of Stevens-Johnson syndrome reported with a combination product

Long-Term Use:
- No restriction found on long-term use
- Clinical trials have safely used ginkgo for 6-12 months
- Monitor for any signs of unusual bleeding

Special Precautions:
- Surgery: Discontinue 2 weeks before scheduled surgery due to potential bleeding effects
- Pregnancy: No adverse effects expected per Bone
- CRITICAL: Only use standardized leaf extracts; raw leaves and fruit contain a neurotoxin that can cause coma, convulsion, and death; extracts do not contain sufficient amounts of toxins to produce ill effects
- German Commission E defines strict preparation methods to avoid ginkgolic acid toxicity
- Orthostatic hypotension (sudden blood pressure drop when standing) reported rarely

Primary Uses At-a-Glance

Primary: Cognitive function and memory support in older adults, Peripheral vascular disease (intermittent claudication), Circulation support

Secondary: Vertigo/dizziness (vascular origin), Tinnitus (recent onset), Eye/retinal health, PMS symptoms

Sources

Local Library:
- Bone, Kerry - A Clinical Guide to Blending Liquid Herbs
- Barrett, Marilyn - The Handbook of Clinically Tested Herbal Remedies Vol 1 & 2
- Balch, Phyllis - Prescription for Herbal Healing
- WRCHM - Western Materia Medica II

General Knowledge:
- Core identification and traditional background
- German Commission E monograph references