What is Ginkgo Biloba?
Ginkgo biloba, known as gingko or maidenhair tree, is the only living species of the division Ginkgophyta, all others have gone extinct. For this reason, it has been referred to as a “living fossil”. Native to China, its seeds have been used in traditional medicine for thousands of years and cooked seeds are occasionally eaten .
Ginkgo leaf extract is used to make tablets, capsules or teas and has historically been used to treat a variety of ailments and conditions including asthma, bronchitis, and fatigue. Ginkgo extracts are also used in skin products .
EGb 761 is a standardized extract of Ginkgo Biloba leaves and has antioxidant properties as a free radical scavenger. It was originated by Dr. Willmar Schwabe Pharmaceuticals and has been available in Europe as a herbal extract since the early 1990s .
In Norway products of Ginkgo leaf have been approved by the Norwegian Medicines Agency to improve blood circulation .
- Enhances memory
- Natural anticoagulant and good for circulation
- Aids in healing eye and hearing problems
- Protects the Brain
- Interacts with anti-coagulant and anti-platelet medications
- cannot be taken by pregnant and lactating women
Health Benefits of Ginkgo
Ginkgo biloba extract (EGb 761) prevented hydrogen peroxide-induced cellular damage of G6PD (glucose-6-phosphate dehydrogenase) deficient red blood cells from patients subjected to oxidative stress, with similar results to vitamin E .
Ginkgo biloba (EGb 761) could reduce injury resulting from having a body temperature greatly above normal. Pretreatment with EGB 761 prevented edema and hemoxygenase production in rat brains following hyperthermic insult .
Ginkgo biloba extract (EGb 761) as an antioxidant could inhibit or reduce the functional and morphological retina impairments observed after lipoperoxide release in rats .
Ginkgo Biloba extract ginkgolide A reduces the inflammatory response of human umbilical vein endothelial cells (HUVECs) to high glucose levels (possibly mediated by the action of the STAT3 pathway). It might be a promising candidate for reducing vascular inflammation in diabetic vascular complications .
Compounds isolated from Ginkgo biloba stem bark inhibited TNF alpha-induced NF-kB gene production activity significantly in cellular models. It could thus be used for the prevention and treatment of inflammatory and metabolic diseases .
Ginkgo biloba (bilobalide) inhibits inflammatory pain in rats .
3) Helps Improve Blood Circulation and is a Natural Anticoagulant
Ginkgo biloba effectively reverses the thrombogenic coagulation profile without increasing the risk of bleeding in chronic peritoneal dialysis patients .
Ginkgo biloba extract increases the microcirculation significantly in the skin and liver of elderly patients. It could be used as an adjuvant treatment option for patients suffering from impaired microcirculation .
Ginkgo biloba was significantly better than placebo in treating patients suffering from peripheral arterial insufficiency .
Ginkgo biloba along with parenteral therapy decreased the collagen-induced thrombocyte aggregation to normal range in patients suffering from atherosclerotic disorders .
Ginkgo biloba extract is effective in the inhibition of platelet aggregation both in platelet-rich blood and whole blood. It could thus be used as a potential oral antiplatelet therapeutic agent .
4) Neuroprotective and Helps Improve Cognition
Ginkgo biloba extract (Ginaton) improves brain oxygen supply, promotes Superoxide dismutase (SOD) activity in patients undergoing cardiopulmonary bypass (CPB) and thus shows a protective effect on the brain .
Ginkgo Biloba tablets could improve the therapeutic efficacy, cognitive ability, and brain blood flow supply in patients with Vascular Cognitive Impairment with no Dementia (VCIND) .
Tanakan, a trade name for Ginkgo biloba extract (EGb 761), improved the mental efficiency in elderly patients. It could be helpful in treating the early stages of primary degenerative dementia .
One trial showed a significant improvement of short-term memory following 600 mg of Ginkgo biloba extract as compared with placebo in healthy female volunteers .
A meta-analysis has shown that taking a 240 mg daily dose of Ginkgo biloba extract is effective and safe in the treatment of dementia .
Ginkgo biloba speeds short-term working memory processing in normal adults .
Ginkgo biloba extract (EGb 761) had good efficacy and tolerability in patients with dementia with neuropsychiatric symptoms [30, 31]. Also, the progression of dependency and need for care could be slowed down with Egb 761 .
In one study Ginkgo biloba (Tanakan) was safe and effective in treating headaches due to tension (a significant decrease of 50% was observed) in young patients .
Ginkgo biloba extract (EGb 761) is said to improve age-related memory impairment. EGb 761 significantly increased neuronal excitability in hippocampal slices from aged mice .
Ginkgo biloba extract may be a promising therapy for impaired memory function induced by aluminum in rats .
Ginkgo biloba extract 761 can provide a neuroprotective/neuro recovery effect against the damage to midbrain DA (dopamine) neurons in an animal model of Parkinson’s Disease (PD) .
5) May Help with Depression and Anxiety
Ginkgo biloba extract (EGb 761) was effective in treating elderly patients with anxiety and adjustment disorders. Previous studies using Egb 761 have shown that it could also reduce symptoms of anxiety in people with mental decline .
Ginkgo biloba extract (EGb 761) was effective in treating anxiety, depression, and dementia in elderly patients (> 60 years of age) .
6) May Help With Antidepressant-Induced Sexual Dysfunction
Ginkgo biloba was found to be 84% effective in treating antidepressant-induced sexual dysfunction .
7) May Help Improve Symptoms of Psychiatric Disorders
Ginkgo biloba extract (EGb 761) administered at a dosage of 240 mg/day in 20 children with ADHD (Attention Deficit Hyperactivity Disorder) improved ADHD symptoms as well as brain electrical activity . Further evidence is required for firm conclusions to be made .
Ginkgo biloba extract (EGb) improves both negative and positive symptoms of chronic schizophrenia .
8) May Improve Mood
Ginkgo biloba extract (LI 1370) improved mood and self-assessed task-performance in older volunteers .
In one study, Ginkgo biloba had the strongest evidence of a positive effect on certain aspects of mood and attention in healthy subjects . There was a significant variation in subjective intensity scores of mood for these subjects when compared to the control .
Ginkgo biloba had a significant positive effect relative to control on cognition and mood in postmenopausal women .
9) Prevents Eye Infections and Helps Restore Vision
Ginkgo biloba may improve blood flow to the optic nerve and hence may have a beneficial effect on glaucoma .
Ginkgo biloba extract administration appears to improve preexisting visual field damage in some patients with normal tension glaucoma (NTG) .
Ginkgo biloba extract could exert a positive effect on seasonal allergic conjunctivitis in patients with symptomatic Allergic Conjunctivitis (AC) .
Ginkgo biloba extract significantly increased end diastolic velocity in the ophthalmic artery in healthy volunteers. Further research is required for its implication for glaucomatous optic nerve damage as well as ischemic ocular diseases .
Ginkgo biloba extract (EGb 761) provided a protective effect on retinal ganglion cells in a rat model of chronic glaucoma .
10) May Help Stress
11) May Prevent Fatigue
A combined herbal supplement containing Rhodiola crenulata and Ginkgo biloba could improve endurance performance in healthy male volunteers by increasing oxygen consumption and “endpoint ratio of testosterone to cortisol,” indicator of “overtraining and fatigue in endurance exercises” .
12) Helps Prevent Infections
A chloroform fraction of Ginkgo biloba potently inhibits vancomycin-resistant Enterococcus (VRE) .
Ginkgo biloba leaf extracts exhibited inhibitory activities against the influenza virus in Madin-Darby canine kidney (MDCK) cells .
Alcoholic extract of Ginkgo biloba shows antibacterial activity against Bacillus subtilis, Escherichia coli, Erwinia chrysanthemi and Xanthomonas phaseoli .
Ginkgo biloba had an antibiofilm effect against Salmonella and listeria isolates from poultry. Ginkgo Biloba extracts could hence be used as a food additive to promote the quality and safety of poultry products .
13) May Improve Premenstrual Syndrome
14) Protects the Skin
Herbal anti-wrinkle cosmetics formulated from Ginkgo biloba increased skin moisturization (27.88%) and smoothness (4.32%) and reduced roughness (0.4%) and wrinkles (4.63%). When compared to other herbal formulations Ginkgo biloba significantly increased skin moisturization .
The association of Ginkgo biloba and Green tea (FBlend) significantly enhanced skin moisturizing effect, cell renewal, and improved skin microrelief. In addition, they synergistically acted on the skin elasticity and skin barrier function .
15) May be Used to Prevent Cancer
Ginkgo biloba possesses the following cancer chemopreventive qualities .
- It promotes apoptosis of cancer cells.
- A powerful therapeutic effect on the treatment of fibrosis-related cancer.
- A therapeutic effect on free-radical induced cancer.
- A therapeutic effect on the treatment of cancer incident as a result of numerous carcinogens (a substance capable of causing cancer in living tissue).
- An enhancing effect of radiation therapy in the treatment of cancer.
- A therapeutic effect on reducing the size of cancer tumors.
Ginkgo biloba exocarp polysaccharides (GBEP) preparation had some definite therapeutic effects on upper digestive tract malignant tumors of middle and late stage cancer patients. The preparation could relieve the inhibited hematopoietic function and weight loss due to radiotherapy .
Ginkgo biloba extract (EGb 761) has a chemopreventive effect against cisplatin ear toxicity in patients treated with cancer .
Ginkgo biloba extract may regulate cell proliferation and induce apoptosis of human liver cell lines, therefore may have protective effects against liver cancer .
Ginkgo biloba extract (EGb 761) has a chemopreventive effect against benzopyrene (BP)-induced forestomach carcinogenesis in mice .
16) Helps Protect the Heart
Ginkgo biloba extract improves heart blood flow in patients with heart disease which might relate to an improved endothelium-dependent vasodilatory capacity .
Ginkgo biloba (EGb 761) also works to maintain heart blood flow in healthy elderly subjects . This decreases the risk of developing heart disease in these subjects.
A 2-month therapy with Ginkgo biloba (EGb 761) in patients who had undergone an aortocoronary bypass operation reduced the formation of atherosclerotic nanoplaque. Possibly due to an increase in the body’s own radical scavenging enzymes .
Tanakan (trade name for EGb 761, Ginkgo biloba extract) is said to produce a positive effect on patients with primary open-angle glaucoma (POAG). There was an improved vasodilating ability of the vascular endothelium due to Tanakan use in these patients .
Ginkgo biloba extract could decrease the macrophage scavenger receptors (MSR) activity in patients with Heart disease (CHD) .
Ginkgo biloba extract (EGb 761) mediated its protective effect against Doxorubicin (DOX)-induced heart injury in rats .
The Terpenoid and the flavonoid constituents of Ginkgo biloba extract (EGb 761) had complementary protective effects during restriction of blood (ischemia) and reperfusion in rat heart .
17) Protects the Liver
Extract of Ginkgo biloba has antioxidant and liver protective effects and can inhibit liver scarring of tissue in rats of non-alcoholic steatohepatitis .
Ginkgo biloba phytosomes protect the liver from carbon tetrachloride (CCl4)-induced oxidative damage in rodents .
However, one study found that extremely high doses of Ginkgo in animals can be toxic to the liver.
18) Helps Prevent Metabolic Syndrome
19) Is Antidiabetic and Prevents Late Diabetic Complications
Ginkgo biloba is effective in treating patients with early diabetic kidney problems (decreases urinary albumin excretion rate, regulating blood lipids, improving kidney function) .
Ginkgo biloba extract ingestion by patients with Non-Insulin Dependent Diabetes mellitus increased the liver metabolic clearance rate, reduced insulin-mediated glucose metabolism and elevated blood glucose .
Ginkgo biloba extract decreased high blood glucose levels and excess lipids in diabetic rats .
Ginkgo biloba extract (EGb 761) appears to be promising as an adjuvant therapeutic drug in diabetes with respect to ischemic heart injury. It may contribute to the prevention of late diabetic complications in rats .
Ginkgo biloba extract might be effective in preventing and treating obesity-induced insulin signaling impairment in rats .
20) Has a DNA Protective Effect
Ginkgo biloba has an anti-mutagenic effect on chromosomes by repairing and reconstituting broken and damaged chromosomes.
Ginkgo biloba extract reduced the mutagenic factors in the blood of Chernobyl accident recovery workers .
Ginkgo biloba extract supplementation neutralized genotoxic damage induced by radioiodine treatment in patients with Graves’s disease (an immune system disorder of the thyroid gland) .
21) Protects from Hearing Disorders
Ginkgo biloba extract (EGb 761) is effective in treating patients with acute idiopathic (unknown cause) sudden sensorineural hearing loss (ISSHL). A higher dosage appears to speed up and secure the recovery of ISSHL patients [93, 94].
Ginkgo biloba extract combined with the traditional therapy could significantly improve tinnitus (ringing or buzzing in the ears) symptoms and the overall response rate in the treatment of explosive deafness in coal miners .
Oral administration of Ginkgo biloba extract (EGb 761) and a combination of infusion therapy in patients appeared to be effective and safe in reducing the symptoms associated with tinnitus aurium [96, 97].
Ginkgo biloba extract (EGb 761) treatment was as effective as pentoxifylline for treating patients with sudden deafness .
Ginkgo biloba extract (EGb 761) protects cochlear hair cells against ototoxicity induced by gentamicin (by reducing ROS and NO-related apoptosis) in guinea pigs .
Renexin (RXN), a combination of Ginkgo biloba extract (GbE) and Cilostazol, has protective effects against cisplatin (CDDP)-induced hearing loss and vestibular toxicity in rats .
Ginkgo biloba extract (EGb 761), when administered in rats with tinnitus, significantly decreased its behavioral manifestations .
22) Helps Prevent Respiratory Diseases and Allergies
Ginkgo biloba (along with Picrorhiza kurroa, and Zingiber officinale) may be efficacious as adjunctive therapy for patients with asthma, chronic obstructive pulmonary disease (COPD) and chronic cough. Further studies are required with a larger patient population .
Ginkgo biloba extract could significantly decrease the infiltration of inflammatory cells such as eosinophils and lymphocytes into the asthmatic airway and relieve airway inflammation in asthmatic patients. Hence it could be used as a complement to glucocorticosteroid therapy for asthma .
Ginkgo biloba effectively treats patients with Pulmonary interstitial fibrosis (a group of lung diseases affecting the tissue and space around the air sacs of the lung-interstitium) .
Secondary products (compounds isolated from plant extracts) of Ginkgo biloba have anti-eosinophilic activity and have activity on eosinophil-mediated inflammation, such as asthma and allergy in animal models .
23) Reduces Mucosal Damage
Ginkgo biloba pre-treatment before ischemia-reperfusion decreased malondialdehyde and myeloperoxidase levels and reduced mucosal damage .
In the short term, Ginkgo biloba-troxerutin-heptaminol HCE is effective, acceptable and safe in the treatment of patients with acute hemorrhoidal attacks .
24) Decreases the Symptoms of Intermittent Claudication
Randomized clinical trials have shown that Ginkgo biloba extract was superior to placebo in the symptomatic treatment of intermittent claudication .
Ginkgo biloba extract (Tanakan) was effective in improving walking distance and reducing pain severity in patients with intermittent claudication .
Ginkgo Biloba Synergies
Mice treated with Ginkgo biloba extract and ticlopidine showed “higher recovery” from acute thrombosis than control .
Ginkgo biloba (bai guo) and Codonopsis pilosula improved cognitive function and overall health of sixty subjects aged 21 – 60 years .
Possible Side Effects and Interactions
A spontaneous intracerebral hemorrhage occurred in a 56-year-old man with no unusual drug use or medical history other than having “been in the habit of taking Ginkgo biloba leaf extract 40 mg three times a day for the previous 18 months” .
Ginkgo nuts contain a potent neurotoxin (4-O-methoxypyridoxine) which indirectly inhibits the enzyme glutamate decarboxylase. A reduced concentration of GABA increases the likelihood of seizure [116, 117].
Highlighting the potential adverse events and drug interactions of ginkgo may help prevent adverse reactions in vulnerable individuals.
Ginkgo biloba has been reported to cause spontaneous bleeding and may interact with anticoagulants and antiplatelet agents. A case of post-laparoscopic cholecystectomy bleeding in a patient taking Ginkgo has been reported [118, 119, 120].
Safety, Dosing, and Timing
Ginkgo Biloba Extract (GBE) is taken orally. Ginkgo biloba has no standardly accepted dose.
Subgroup analyses showed that a dosage of 240 mg of ginkgo might be necessary to yield clinically relevant effects in patients with dementia .
A daily dose between 120 mg and 600 mg moderately enhances a number of cognitive processes in healthy young individuals .
Because it is a blood thinner, GBE may cause excessive bleeding .
Do not consume fresh Ginkgo seeds as they are poisonous and potentially deadly .
Decreases activation of PKCα .
Decreases Bcl-2/Bax ratio .
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