You are on page 1of 19

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 –
 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.

 Dilation of blood vessels –


 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
STRONG
1. Early Stage Alzheimer’s Disease 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.
STRONG
2. Intermittent claudication scientific
evidence
(pain caused by inadequate blood flow to the legs).

 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
GOOD
3. Cerebral insufficiency 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 2-
3 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. 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.

6. 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 life-


threatening.

 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.

You might also like