Ginkgo extract side effects, information

Extracts from the leaves of the ginkgo biloba tree have been used therapeutically in China for millennia. According to fossil records, the ginkgo tree has been around for over 200 million years and is one of the oldest still existing tree species on earth. Individual trees live up to 1,000 years. Ginkgo, like ginseng, is mentioned in the traditional Chinese pharmacopoeia. Ginkgo extracts are among the most widely studied and prescribed drugs in Europe to alleviate symptoms associated with a wide range of conditions. The main indications for these extracts are peripheral vascular disease and the therapy of age related cognitive decline and memory improvement. Ginkgo biloba is a mind booster underutilized by the medical profession. For more up to date ginkgo information.

Buy Ginkgo extract, 60 mg and 40 mg

Ginkgo extract 50:1 is standardized at 24% ginkgoflavonglycosides and a minimum of 6% terpene lactones.

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Buy Ginkgo extract -  60 mg (50:1 Standardized Extract)

 

What's in Ginkgo extract?
Ginkgo extract contains many different substances but most of them fall into two main categories: Terpenoid lactones and Flavonoids. The most unique components of ginkgo extracts are the terpene trilactones which are structurally complex molecules. Terpene lactones give ginkgo a bitter and strong flavor. The most important terpenes are the ginkgolides and bilobides. Ginkgolides have not yet been found in any other living plant species. Other compounds in ginkgo biloba include proanthocyanidins, carboxylic acids and non-flavone glycosides.

Flavonoids are natural substances that are also found in fruits and vegetables. Flavonoids act as antioxidants, have an influence on the immune system, and interfere with tumor formation. Ginkgo contains many flavonoids but the most concentrated are kaempferol, quercetin, and isorhamnetin. Most ginkgo products on the market list a flavonoid concentration of 24%. You will often see 24% printed on packages or bottles of ginkgo.

How Does extract work?
The active ingredients in gingko extract are believed to have their beneficial effects by acting as antioxidants, preventing red blood cells and platelets from aggregating to form clots, allowing more oxygen to reach neurons, and improving circulation in tiny blood vessels by inducing relaxation of the muscles surrounding blood vessels. Even circulation to the eyes improves when subjects are given ginkgo extract.

Clinical Uses of ginkgo extract
 The primary indications for ginkgo extract are age related cognitive decline (ARCD) and Alzheimer's disease. Age related cognitive decline is a term that describes a collection of symptoms. These include difficulty in concentration and memory, absent-mindedness, confusion, lack of mental energy, and sometimes, depressive mood. Some of these symptoms may be associated with not enough blood reaching the brain, hence a potential justification for the use of gingko in lessening these symptoms. Ginkgo improves communication between nerve cells and enhances blood flow to the brain. It is licensed in Germany for the treatment of ARCD. Ginkgo extract may have promise in the treatment of Parkinson's disease and Alzheimer's when used together with other conventional medicines. A well publicized study in the Journal of the American Medical Association indicated that 120 mg of ginkgo extract per day for one year was able to slightly improve cognitive performance in patients with Alzheimer’s disease.
   Ginkgo extract may show a beneficial effect on attention, memory and functioning in Multiple Sclerosis patients.
   Patients with dementia are helped by ginkgo extract.
   It is unlikely that those with normal memory function will notice a significant effect from ginkgo extract.
   Ginkgo has been recommended for tinnitus, but research is not consistent.

Ginkgo biloba helps you live longer?
You might be interested in hearing about a French study that found that older people who take Ginkgo biloba may be living longer. Surprisingly, this same study did not find ginkgo biloba reduced the risk of cognitive decline. Dr. Jean-Francois Dartigues at the University of Bordeaux followed a group of 3,500 men and women 65 and older for over a period of 13 years. Those who used ginkgo lived a little longer than those who did not take the supplement. Ginkgo biloba extract has been sold in France for more than three decades. At the start of the study, 6 percent of the participants were taking Ginkgo biloba extract, The researchers found that while the effect of the herb on mortality risk remained significant, it had no effect on the likelihood of developing dementia. Journal of the American Geriatrics Society, March 2007.
   Comments: We can't say for sure that taking ginkgo will help you live longer. It is possible that the individuals who began taking ginkgo biloba may have been more health conscious to begin with and paid more attention to their overall diet which was the real factor for life extension. Or, the reason ginkgo blioba was not found to be helpful in reducing dementia is perhaps those who started the ginkgo may have had a family history of dementia or were already starting to notice some form of cognitive decline. Nevertheless, gingko biloba is a good supplement and I can't imagine taking 20 mg or 60 mg of the extract with breakfast a few times a week would pose any danger. I don't think it is necessary to take a ginkgo supplement every day. Mind Power Rx has 30 mg of ginkgo biloba extract per capsule. Those who are taking blood thinning medicines such as Coumadin should be careful since ginkgo has mild blood thinning properties.
   We don't think one herb or nutrient alone can be counted on to prevent dementia or treat cognitive decline. The brain is too complicated and needs many different nutrients. We prefer a mind boosting supplement that has a number of different vitamins, nutrients, and herbs combined in small amounts.

Ginkgo and memory
Ginkgo biloba may help delay the onset of cognitive impairment and memory loss in normal elderly adults. Dr. Hiroko H. Dodge, from the Oregon State University in Corvallis conducted a three-year study involving 118 people age 85 and older with no memory problems. Half of them took ginkgo biloba extract three times a day and half took a placebo. Patients who reliably took ginkgo biloba supplement had a 68 percent lower risk of developing mild memory problems than those who took the placebo. However, there may have been ginkgo side effects. More strokes and mini-strokes were seen in the ginkgo group. Seven people taking ginkgo had strokes, while none of those taking placebo did. The strokes were due to blood clots, not excessive bleeding, and were generally not severe. Neurology, online February 27, 2008.
   Comments: Perhaps the risk of stroke would be reduced if ginkgo supplements were taken once or twice a day rather than 3 times a day. Acetylcarnitine is the acetyl form of carnitine and useful in terms of mental enhancement. Bacopa is a popular Ayurvedic herb used for mental enhancement.

Ginkgo biloba Improves Blood Flow to the Eyes
 Individuals with diabetes mellitus have problems with circulation and increased clotting tendencies, particularly in small blood vessels. This can sometimes lead to poor vision due to small clots that form in the retina of the eye. In a recent study done in Taiwan, ginkgo biloba was given to type 2 diabetes mellitus patients with eye problems (retinopathy). After taking ginkgo biloba orally for 3 months, the tendency for blood to clot was significantly reduced, red blood cells became more flexible, and blood flow to the retina of the eye was increased. When red blood cells become more flexible, they are able to squeeze through and maneuver easier through tiny blood vessels called capillaries and thus bring more oxygen to tissues and cells.
     It's difficult to know how much ginkgo to take, but it appears that 40 mg daily is a good option. If you are taking aspirin or other blood thinners, consult with your doctor to make sure you are not thinning your blood too much. Ginkgo is best taken in the morning or midday. Sometimes it can cause shallow sleep if taken late in the evening.

Ginkgo supplement products
Jarrow Formulas 40 mg
Source Naturals
Enzymatic Therapy - Ginkgo Biloba 24%, 90 Capsules - Enzymatic Therapy's Ginkgo Biloba-24% is standardized for its potency and natural constituents to produce the finest botanical extract available to support improved short-term memory and mild memory problems. Developed in accordance with monograph standards set forth by the German
Ginkgo biloba Leaf Extract  standardized to contain 24% ginkgoflavonglycosides, 6% terpene lactones, and 2% bilobalide.
GNC ginkgo supplement
Ginkgo extract and Erectile Dysfunction
Ginkgo extract has been found to partially reverse erectile dysfunction in those who take Prozac and other SSRIs, however other studies have not shown the same benefits. There are better herbs to treat impotence.
Dosages of Ginkgo extract
The majority of the studies done thus far with ginkgo extract have used daily dosages of 120 to 160 mg (50:1 concentration, 24% flavonoids). Patients generally took 40 milligrams three to four times a day. Treatment may be needed for a few weeks before positive results can be fully appreciated. Most manufacturers have pills that contain 40 or 60 mg of ginkgo extract. You may wish to start with one 40 mg pill a day to see if there is any improvement in memory or thinking. Ginkgo is best taken early in the day, and no later than afternoon.

Ginkgo side effects
Common ginkgo side effects include mild stomach or intestinal complaints, headache, and allergic skin reactions have been reported. Rare ginkgo side effects may include cases of seizures in very old individuals. There have been rare mentions of ginkgo side effects that involve internal bleeding when ginkgo was combined with other blood thinners such as aspirin or coumadin (and even ibuprofen). Ginkgo has anti-platelet activity and hence may prolong the time it takes to form a blood clot.

Review and summary
Ginkgo extract appears to be useful in memory loss due to aging or Alzheimer's disease, but is probably of little benefit in the young who have normal brain function and memory. Middle aged and older individuals may find ginkgo extract to be helpful in sharpening the mind. For more details, see Mind and Memory Boosters book.
     Because of its antioxidant properties, it may be useful in individuals with cerebrovascular disease. Due to its blood thinning properties, a dose of 60 mg ginkgo extract a day should not be exceeded on a daily, long-term basis to avoid a ginkgo side effect unless a health care provider monitors you. Keep in mind that other nutrients and drugs have blood-thinning properties including coumadin, aspirin, fish oils, and vinpocetine.

 Ginkgo side effect and benefit research update - new ginkgo biloba information
Ginkgo extract Compared with Cholinesterase Inhibitors in the Treatment of Dementia: A Review Based on Meta-Analyses by the Cochrane Collaboration.
Kurz A, Van Baelen B. Department of Psychiatry and Psychotherapy, Technical University Munich, Munich, Germany.
Dement Geriatr Cogn Disord. 2004.
Data were derived from the Cochrane Collaboration meta-analyses of the efficacies of ginkgo, donepezil, rivastigmine and galantamine on changes in cognitive function in patients with dementia and, where necessary, were transformed to standardized mean differences. The proportion of patients discontinuing trials was used as a proxy measure of tolerability. Outcomes were assessed after 6 months of treatment. Trial data for cholinesterase inhibitors were more consistent than those for ginkgo, particularly regarding patient populations and outcome measures. Significant benefits on cognition vs. placebo were seen with donepezil, 5 and 10 mg, rivastigmine, 6-12 mg, and galantamine, 16 and 24 mg. Significant benefit vs. placebo with ginkgo was seen only when all doses were pooled. Similar proportions of patients discontinued treatment with ginkgo biloba and placebo. Cholinesterase inhibitors were also well tolerated, although a significantly greater proportion of patients receiving active treatment discontinued vs. placebo with some doses. An evidence-based medicine approach, taking into account the quality of clinical trials, is essential when assessing the safety and efficacy of medications.

Age-related effects of Ginkgo extract on synaptic plasticity and excitability.
Williams B.The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA.
Neurobiol Aging. 2004.
EGb 761 is a standardized extract from the Ginkgo biloba leaf and is purported to improve age-related memory impairment. The acute and chronic effect of Ginkgo biloba on synaptic transmission and plasticity in hippocampal slices from young adult (8-12 weeks) and aged (18-24 months) C57Bl/6 mice was tested because hippocampal plasticity is believed to be a key component of memory. Acutely applied Ginkgo biloba significantly increased neuronal excitability in slices from aged mice by reducing the population spike threshold and increased the early phase of long-term potentiation, though there was no effect in slices from young adults. In chronically treated mice fed for 30 days with an Ginkgo biloba-supplemented diet, Ginkgo biloba significantly increased the population spike threshold and long-term potentiation in slices from aged animals, but had no effect on slices from young adults. The rapid effects of Ginkgo biloba on plasticity indicate a direct interaction with the glutamatergic system and raise interesting implications with respect to a mechanism explaining its effect on cognitive enhancement in human subjects experiencing dementia.

Ginkgo extract EGb 761 in dementia: intent-to-treat analyses of a 24-week, multi-center, double-blind, placebo-controlled, randomized trial.
Kanowski S, Hoerr R. Abteilung Gerontopsychiatrie, Psychiatrische Klinik und Poliklinik der Freien Universitat Berlin.
Pharmacopsychiatry. 2003.
In 1996, Kanowski et al. reported about the beneficial effects of ginkgo biloba special extract EGb 761 (240 mg/day) in outpatients with pre-senile and senile primary degenerative dementia of the Alzheimer type (DAT) and multi-infarct dementia (MID) of mild to moderate severity. The comparison of the results of this double-blind, placebo-controlled, randomized, multi-center study with other dementia studies is hampered by the fact that only the responder analysis of the per-protocol (PP) population, which was pre-specified in the protocol as confirmatory analysis, has been published in detail so far. Moreover, cognitive functioning was measured using the Syndrom-Kurztest (SKT), whereas results of other studies are based on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog). Therefore, the conventional intention-to-treat (ITT) analysis of this study is provided with an estimation of ADAS-cog scores based on measured SKT scores. After 24 weeks of treatment, the ITT analysis of the SKT and estimated ADAS-cog scores revealed a mean decrease in the total score by -2.1 points and -2.7 points, respectively, for theGinkgo biloba group, which indicates an improvement in cognitive function. On the contrary, the placebo group exhibited only a minimal change of -1.0 and -1.3 points, respectively. The changes from baseline differed significantly between treatment groups by 1.1 (SKT) and 1.4 (estimated ADAS-cog) points, respectively. The Clinical Global Impression of Change (CGI, Item 2) favored the Ginkgo biloba group with a mean difference of 0.4 points (P = 0.007). Changes in the rating related to activities of daily living (Nurnberger-Alters-Beobachtungs-Skala) showed a favorable trend for Ginkgo biloba. A subgroup analysis regarding patients with DAT yielded comparable results. Using a decrease of at least 4 points on the estimated ADAS-cog scores as cutoff criterion for treatment response, 35 % ofGinkgo biloba-treated patients were considered responders versus only 19 % for the placebo group. The results of this ITT analysis substantiate the outcomes previously obtained with a responder analysis of the per-protocol population and confirm that Ginkgo biloba improves cognitive function in a clinically relevant manner in patients suffering from dementia. The therapeutic effect is in line with the outcome of another Ginkgo biloba study conducted in the U.S.

 The effect of ginkgo extract on healthy elderly subjects
Cieza A, Maier P, Poppel E.
Fortschr Med Orig. 2003.
Over the past 25 years, numerous studies have confirmed the positive effect of the special ginkgo extract EGb 761 on the mental ability and emotional well-being of patients with cognitive disorders of vascular genesis, and Alzheimer-type dementia. The following study investigated the short-term effect of the special ginkgo extract EGb 761 on the subjective emotional well-being of healthy elderly subjects. The study was designed as a randomized double-blind, monocenter study with parallel groups. It included 66 healthy subjects of both sexes aged between 50 and 65 with no age-related cognitive impairments. For a period of 4 weeks, 34 subjects received a daily dose of 240 mg ginkgo extract, and 32 a placebo. RESULTS: The final examination revealed a statistically significant difference between the two groups for the VAS mental health and quality of life, as also for SIS Mood at the telephone interview in week 2. A comparison of baseline with the final examination within the groups showed a statistically significant improvement in the ginkgo biloba group for the variables: depression, fatigue, anger and SDS. For none of the variables investigated was a worsening observed in the ginkgo extract group. CONCLUSIONS: The results suggest a positive effect of ginkgo extract on the subjective emotional well-being of healthy elderly persons.

Ginkgo extract EGb 761 in dementia: intent-to-treat analyses of a 24-week, multi-center, double-blind, placebo-controlled, randomized trial.
Kanowski S, Hoerr R. Psychiatrische Klinik und Poliklinik der Freien Universitat Berlin.
Pharmacopsychiatry. 2003.
In 1996, Kanowski et al. reported about the beneficial effects of ginkgo biloba special extract EGb 761 (240 mg/day) in outpatients with pre-senile and senile primary degenerative dementia of the Alzheimer type (DAT) and multi-infarct dementia (MID) of mild to moderate severity. The comparison of the results of this double-blind, placebo-controlled, randomized, multi-center study with other dementia studies is hampered by the fact that only the responder analysis of the per-protocol (PP) population, which was pre-specified in the protocol as confirmatory analysis, has been published in detail so far. Moreover, cognitive functioning was measured using the Syndrom-Kurztest (SKT), whereas results of other studies are based on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog). Therefore, the conventional intention-to-treat (ITT) analysis of this study is provided with an estimation of ADAS-cog scores based on measured SKT scores. After 24 weeks of treatment, the ITT analysis of the SKT and estimated ADAS-cog scores revealed a mean decrease in the total score by -2.1 points and -2.7points, respectively, for the ginkgo biloba group, which indicates an improvement in cognitive function. On the contrary, the placebo group exhibited only a minimal change of -1.0 and -1.3 points, respectively. The changes from baseline differed significantly between treatment groups by 1.1 and 1.4 (estimated ADAS-cog) points, respectively. The Clinical Global Impression of Change (CGI, Item 2) favored the EGb 761 group with a mean difference of 0.4 points. Changes in the rating related to activities of daily living showed a favorable trend for ginkgo biloba. A subgroup analysis regarding patients with DAT yielded comparable results. Using a decrease of at least 4 points on the estimated ADAS-cog scores as cutoff criterion for treatment response, 35 % of EGb 761-treated patients were considered responders versus only 19 % for the placebo group. The results of this ITT analysis substantiate the outcomes previously obtained with a responder analysis of the per-protocol population and confirm that ginkgo biloba improves cognitive function in a clinically relevant manner in patients suffering from dementia. The therapeutic effect is in line with the outcome of another ginkgo biloba study conducted in the U.S.

Memory - Ginkgo not helpful in healthy adults
Herbal supplement ginkgo biloba may not do much for healthy older adults' memory, at least in the short term,. Extracts of ginkgo biloba are among the most widely used dietary supplements. The ginkgo herb is marketed as a memory enhancer, and some studies have suggested it may help improve memory and other mental functions in people with dementia. Meanwhile, many older adults, while not suffering from dementia, do develop milder problems with memory, concentration and other mental functions -- and so far, studies have come to mixed conclusions as to whether ginkgo can slow such age-related cognitive decline. The new findings, published in the Journal of the American Dietetic Association, suggest that healthy older adults are unlikely to see any quick results from ginkgo biloba supplement. Among the 90 men and women ages 65 to 84 in the study, those who took a ginkgo biloba -containing supplement every day for 4 months performed no better on tests of memory, attention and other cognitive functions than those who took an inactive placebo. Overall, this and other well-designed studies suggest that, in the short term, ginkgo biloba does not benefit healthy older adults' cognitive function. However, it's still possible that ginkgo biloba has benefits over the long haul. Journal of the American Dietetic Association, March 2007.

Emails
Q. I am having much difficulty finding a mind boosting product that have ingredients that are safe enough to be used by breast cancer survivors. I finished radiation treatments in March of 07. I was taking ginkgo biloba which worked so well for me and I also felt better. Then I discovered that it had estrogenic like effects on the body and I stopped taking them because my cancer was 80% ER positive, and 10% progesterone positive. I am so frustrated. Its as if estrogen receptor positive breast cancer survivors are overlooked when it comes to this.
   A. I have not seen any research to indicate ginkgo biloba causes harm to those with breast cancer. One study concludes, "Ginkgo biloba extract can be considered as a potential alternative to HRT with chemopreventive effects on breast cancer. However, further studies on animals and humans will be required." J Steroid Biochem Mol Biol. 2006 Aug;100(4-5):167-76. Another study says, "In humans, Ginkgo extracts inhibit the formation of radiation-induced (chromosome-damaging) clastogenic factors and ultraviolet light-induced oxidative stress - effects that may also be associated with anticancer activity. Flavonoid and terpenoid constituents of Ginkgo extracts may act in a complementary manner to inhibit several carcinogenesis-related processes, and therefore the total extracts may be required for producing optimal effects." Fundam Clin Pharmacol. 2003 Aug;17(4):405-17.
Since human studies regarding various herbs and breast cancer are in short supply, it is premature to jump to conclusions regarding the role of a particular herb in being beneficial or harmful for breast cancer survivors. There's much yet that is not known. There are many factors that influence cancer cell growth or inhibition and herbs have dozens or hundreds of compounds in them that influence various stages of cancer growth or inhibition. In most cases, herbs have anti-cancer benefits.

Q. Can a ginkgo biloba supplement pill be taken the same day as a vinpocetine supplement?
   A. Only if the dosage is 40 mg and vinpocetine no more than 5 mg and they are taken at different times of the day.

Q. Since ginkgo increases the brain's circulation, could it also possibly help those with chronic inflammation of the sinus and nose?
   A. We have not seen research with ginkgo that evaluates its role in sinus problems so it is not easy to say whether this herb would be effective for sinus problems. There are quite a number of different types of sinus problems and each requires a different therapy.