Ginkgo Biloba - Photo by P. Schonfelder

Ginkgo Biloba is regarded as one of the most ancient tree species on earth, belonging in a family of plants, the story of which, is lost in the depths of prehistory. It is the only alive representative of the ginogoaceae family, of the class Ginkgoales. The plant is coniferous and deciduous, indigenous to both China and Japan. Was regarded as holly and planted near pagodas. It can reach up to 40meters high and can live for more than a thousand years. There are plants in China of certified age exceeding 3000 years. Its survival is reasoned by its ability to stand up to insects, diseases, and pollution because of its unique mixture of active ingredients that lie within its leafs.

The name Ginkgo comes from the Chinese, and later, respectively Japanese word Ginkyo, where "gin" means silver and "kyo" apricot. Hence, the name Ginkgo could be interpreted as silver apricot and was given due to the silver color of the matured fruit of the female tree, whereas silver is the color of blossom that emerges above the fruit The spelling is attributed to a mistake of the herbalist Engelbert Kaempfer.

The word biloba comes from the leaf of the plant which forms a fan with a cavity in the middle separating it in two lobes. Thus bi-loba means with two lobes. There are many names that the plant is associated with. The most common is the one in China, Kung Sun Shu which means Grandfather-grandson tree. This name is associated with the fact that only the mature trees produce fruit and when a man grows such a plant, only the grandson will see its fruit. Its first report as a healing aid is written in Chen Houng Pen Tsao 2800 BC in asthma and other ailments. In Chinese medicine, the seeds of the plant were used too( as digestive aid and reduction of toxic effects of alcohol, asthma and cough),whereas in Western medicine only the leaves are utilized.

-Uses with high documentation-

Alzheimer’s disease and dementia of vessel causality [1,2,3]
Intermittent claudication
Mild cognitive dysfunction

-Uses with significant evidence of effectiveness-

Erectile disorder due to low blood flow in penis [4,5]
Neuroaesthetic disorders like vertigo, nausea and tinnitus
Depression in patients over 50years old. 

-Under investigation-

Asthma, multiple sclerosis, menopause, glaucoma, migraines, antithrombotic action, inflammatory diseases, height anxiety, hypertension, vertigo.

The leaf extracts contain many active ingredients.Only two major categories will be discussed. The flavonoids and the terpenes. The first one, exceeds 40 in number ( such as quercetin, kaempherol, isohamnetin) while the latter includes the gingolides A, B and C. Sixty per cent of the extract is absorbed by the stomach and the small intestine. The rest is absorbed by the neural and glan tissue, and the eyes. The terpenes of ginkgo biloba inhibit the activation of the platelet factor at the receptor of the membrane. The activity of the particular factor not only does it contain the inductive accumulation of platelets, but also the generation of oxygen free radicals leading to increased micro-vessel permeability[3].

In dementia…

The death of many neuron cells is the underlying reason of Alzheimer’s disease. Aging, bad nutrition and stress, cause damage in the cell’s energy factory, the chondriosomes. The free radicals, produced by the chondriosomes during cellular respiration, activate a vicious circle of respiratory enzyme dysfunction, which entails too in additional free radical production. The latter, give an expiry date to chondriosomes and the cells themselves. A crucial research study in JAMA[6] designed and approved by Harvard and New York Institute for Medical Research, showed that patients who received 120mg daily for a year, had striking results ( as stated in the publication) enforcing the proof for use of the herb in Alzheimer’s disease. Not only did it stabilise the disease, it also lead to significant improvement of cognitive functions in 64% of the patients, without noticing any side effects. Moreover, it is officially recommended from the Harvard medical school in the symptomatic treatment of mild cognitive disorder and in mild-moderate senility syndromes, including Alzheimer’s disease, vessel senility or mixed forms.

In memory enhancement…

According to the studies in healthy people, it seems that the herb aids the enhancement of memory straightaway and efficiently in a dose-dependent manner at 120mg in ages between 50 and 59 years, while in the same dose, with chronic prescription lasting 52 weeks, a favourable action (at the whole of mental functions) in healthy people of age between 18 and 41 years is ascertained.

In intermittent claudication…

The above disease appears in middle aged and senile population and is characterized by pain in the legs after walk. The pain fades away when relaxing. Drugs have a limited effect in this particular pain. A research with placebo showed that the Ginkgo biloba team had supremacy with statistic important difference in increasing the walking distance without pain [7].

In tinnitus…

Studies are limited, but there exists,(little though) proved efficiency of the herb[8] and it is worth trying since there is absence of conventional pharmaceutical factors for the disease.

In depression…

Patients with mild to moderate senility syndromes used the herb in dose 3x80mg in parallel with their existing antidepressant treatment (in which they did not correspond). Remission percentages were noticed at the end of 8 weeks, meaning that the herb can be used in combination with antidepressants to enforce their efficiency in patients over 50 years[9].

In other ailments…

The herb is recommended at the treatment of neuroaesthetic disorders, like chronic dizziness, vertigo, sleepiness, reflexive loss of hearing. It is suggested too for other diseases as ischemia or macular degeneration. The action of the drug is attributed to its vessel-regulating ability.

-Dose and directions-

( pill ) of 120-240mg in 2-3 times daily.
( liquid extract ) 1:1, 0,5ml tree times daily.

Note that the drug acts in a slow manner and you may have to wait for up to 6 months before noticing any improvement.  Quality herbs are expensive but they are worth it. So be patient and do not expect miracles to happen once you have taken the herb.

-Contraindications and Warnings-

High dosages may reduce the efficiency of spasmolytic therapies in patients with carbazepine or valproic acid.

Ginkgo biloba possesses anticoagulant properties and therefore should not be prescribed in combination with other anticoagulants like aspirin, clopidogrel, dipridamol, heparin, tiklodipin or warfarin.

Caution with monoamino oxidase inhibitors.
Caution with diuretics. 

There was a patient under trazodone that when received the herb fell into coma.

Note:

Dear reader, as with all herbs and supplements, do not attempt any, if you are on any medication, unless you consult your GP first.

References :

1.Le Bars PL, et al, Influence of the severity of cognitive impairment on the effect of Gingko Biloba EGb 761 in Alzheimer’s disease.Neuropsychobiology 2002:45:19-26
2.Massey AJ. Effectivenes of Ginko Biloba in memory disorders.J Pharm Pract 1999: 12: 217-224
3 G Ramalanjaona. Ginkgo Biloba for memory enhancement : an update. Alternative medicine Alert 2003, Vol.6, January,pp. 1-5
4.R.Sikora, et al. Ginkgo Biloba extract in the Therapy of Erectile Dysfunction. Journal of Urology 141(1989):188A
5. M. Sohn and R.Sikora. Ginkgo Biloba extract in the therapy of Erectile Dysfunction. J sex Educ Ther (1991): 53-61
6.  P.L Le Bars et al. A Placebo- Controlled, Double blind, Randomized Trial of an extract of Ginkgo Biloba for Dementia. JAMA 278 (1997): 1327-32
7. Pittler MH, Ernst E.Ginkgo Biloba extract for the treatment of intermittent claudication: a meta-analysis of randomized trials. Am J Med 2000; 108:276-281
8. Ernst e, Stevinson C. ginkgo biloba for tinnitus: a review. Clin Otolaryngol 1999;24:164-7
9.Η. Schubert and P.Halama. Depressive Episode primarily Unresponsive to Therapy in Elderly Patients. Efficacy in Ginkgo Biloba in combination with Antidepressants. Geriatr Forsch 3(1993): 45-
10. Alternative Medicine , Herbs & Supplements Review March – April 2005, vol 1, p24-33, K.C.Spiggos Neurologist, “Gingko biloba leaves”