Ginkgo Biloba; Health Benefits, Uses, Dosage, Side Effects

Ginkgo biloba commonly known as ginkgo or gingko^[1] also known as the maidenhair tree,^[2] is the only living species in the division Ginkgophyta. Ginkgo is popularly known as living fossils. It is also known by other names like Fossil tree, Kew Tree and Silver Apricot. Ginkgo trees are in a position to live long for thousands of years

It is used in most randomized control trials. Indications include cognition and memory in Alzheimer disease, age-associated dementia, cerebral insufficiency, intermittent claudication, schizophrenia, and multi-infarct dementia. Dosages range from 80 to 720 mg/d for durations of 2 weeks to 2 years. Mechanisms of action include increasing cerebral blood flow, antioxidant and anti-inflammatory effects, with antiplatelet effects attributed to flavone and terpene lactones.

Uses And Health Benefits of Ginko Biloba

• To increase memory – Ginkgo biloba extract has been increasingly popular for the treatment of memory problems. However, it is not commonly understood that this extract is composed of numerous chemicals, including flavonoid glycosides, terpene lactones, biflavones, and other miscellaneous components. It remains to be established exactly which components are biologically helpful. The extracts come from the leaves of the Ginkgo biloba tree which is cultivated extensively for this purpose.  Since memory disorders increase dramatically with age, this poses a major challenge to both the pharmaceutical and nutritional industries to provide products which improve or prevent problems with memory. Our culture is based on the ability to recall information, therefore problems with memory are fundamental to our entire social system. Dementias are disorders that affect memory and intellectual functioning and are caused primarily by Alzheimer’s disease and vascular disorders (multi-infarct dementia). New drug therapies have been developed to improve cognition, through stimulation of the cholinergic system. In recent decades, an extract of the leaves of the tree Ginkgo biloba L. has been used to improve memory in these disorders.[3]
• Antioxidant properties  – During the aging process, tissues suffer DNA oxidative damage, protein oxidative injury, lipid peroxidation, etc. Subsequently, neurological function, sensorial tissues and cardiovascular system can all be impaired [4]. These impairments significantly contribute to the progression of degenerative diseases [5].
• Anti-lipid peroxidation – Polyunsaturated fatty acids (PUFAs) are sensitive to oxidative damage and they improve the response to oxidative injury and fluidity of the cell membrane [6]. Treatment with EGb 761 could increase the levels of circulating PUFAs in erythrocyte membranes, which enhances the ability to protect against oxidative damage in adult male Wistar rats [7]. Fibrosis in various organs is related to aging. EGb 761 decreased the levels of liver malondialdehyde and metalloproteinase and increased the activity of SOD to prevent the impairment of oxidative stress on aging liver fibrosis [8].
• Parkinson’s disease – Parkinson’s disease (PD) is a common aging-related disease resulting in the progressive loss of dopamine neurons. In Kim’s research [9], EGb 761 pretreatment could decrease dopamine neuron loss in the substantia nigra and improve the behavioral deficit in a rat Parkinson’s disease model. Kang and colleagues [10] reported that EGb 761 maintenance kept the stability of mitochondrial membrane potential and decreased caspase-3 levels in paraquat-induced apoptosis of PC12 cells; it was an experimental basis for using EGb 761 to treat PD. In another animal models of PD, which was induced by 1-methyl-4-phenylpyridinium, the authors found that EGb 761 could protect against neurotoxicity via preventing changes of copper content in the striatum, midbrain, and hippocampus [11]. Tanaka systematically reviewed the effect of EGb in animal models of PD in 32 English language articles and found that most studies reported focused on EGb protection against neurotoxin, anti-oxidative stress, anti-apoptotic and reduced loss of the neurotransmitter, dopamine, in the striatum [12].
• Treatment of Cancer – Cancer has a huge impact all over the world. According to the NIH, an estimated 1.7 million new cases of cancer will be diagnosed in the United States and 0.6 million people died from cancer in 2016. Therefore, new therapeutics for the treatment of cancer is critical. Several studies have focused on the anti-apoptotic effect of EGb. Ahmed and colleagues [13] examined the efficacy of EGb in the suppression of hepatocellular carcinoma (HCC) in rats. EGb was found to improve the histological features of the liver tissue significantly. Gene expressions of ING-3 were also up-regulated while Foxp-1 was down-regulated in the liver after EGb treatment. Further, EGb could decrease the levels of alpha-fetoprotein (AFP), glypican-3 (GPC-3) and carcinoembryonic antigen (CEA) in HCC rats, suggesting that the anti-cancer efficacy of EGb was induced through its anti-proliferative and apoptotic properties in the HCC animal model.
• Multiple Sclerosis – In theory, ginkgo could have disease-modifying as well as symptomatic effects in MS. Ginkgo, which contains platelet-activating factor (PAF) antagonists and flavonoids, has both anti-inflammatory and anti-oxidant effects. In EAE, some, but not all, studies indicate that ginkgo decreases disease severity. Ginkgo does not appear to be effective for treating attacks in MS patients and has never been studied for preventing attacks. In small MS clinical studies, ginkgo was shown to improve cognition and decrease fatigue.[14]Gingko may cause side effects. Because of its PAF antagonist action, ginkgo has anticoagulant effects. Also, it may rarely provoke seizures. Other possible side effects include dizziness, rashes, headaches, nausea, vomiting, diarrhea, and flatulence.
• Anti-neuroinflammatory – For many years, neuroinflammation has been known as a common phenomenon in the pathology of many brain diseases (Bidstrup, 1972). Neurodegenerative diseases such as AD and PD have been a major focus on neuroscience research. In fact, much effort is being devoted to understanding the cellular changes that underlie their pathology (. The principal cells involved in the innate immune response in the CNS, play essential roles in the maintenance of homeostasis and responses to neuroinflammation. When activated, these highly plastic cells play dualistic roles in neuronal injury and recovery and are known for their ability to assume diverse phenotypes [15]
• Strokes – Scientists continue to study the prevention and treatment benefits to stroke patients that are attributed to GBE. It’s believed that by preventing blood clots from developing and increasing the blood flow to the brain, ginkgo biloba may help stop strokes from occurring. It’s also believed that the herb inhibits free-radical damage of brain cells after a stroke.
• Intermittent claudication – Intermittent claudication is a condition that causes cramping pain in the legs typically after a strenuous physical activity. It occurs due to the poor circulation of blood in the legs as a result of an obstruction in the arteries. It also causes an aching, tired, and burning sensation in the legs, which comes periodically and subsides in a few minutes. The pain typically goes away with rest. Intermittent claudication can occur in one or both legs and continue to worsen over time. Gingko can help in treating this condition by acting as a vasodilator. It improves the blood circulation in the legs and prevents pain and fatigue thus allowing a person to perform physical activities for a longer period of time.
• Anxiety disorders – Anxiety disorder is a form of the psychological condition that is characterized by a feeling of fear and phobia. Unlike in normal individuals, who too may feel anxious for some reasons, in the patients with an anxiety disorder, the feeling of anxiety does not go away and may get worse over time. It can interfere with their daily activities and affect their job performance, relationships, and school work.
• Depression – Patients suffering from depression due to varying degrees of vascular insufficiency have noted remarkable improvement in the mood following the use of ginkgo biloba extract. Patients with depression have found that Gingko can enhance the effect of other treatments and thus, assist in faster recovery. Regular use of Gingko has been associated with a lower incidence of relapse of depression. In case of mild depression, Gingko can help control the symptoms even without the use of any pharmaceutical treatment.
• Improve Asthma and COPD Symptoms – Some research indicates that ginkgo may improve symptoms of asthma and other inflammatory respiratory diseases like COPD. This is attributed to the anti-inflammatory compounds in ginkgo, which may allow for reduced inflammation of the airways and increased lung capacity [16]. One study in 75 people evaluated the use of ginkgo extract alongside glucocorticosteroid medication therapy for managing asthma symptoms [17]. The levels of inflammatory compounds in the saliva of those who received ginkgo were significantly lower than those who received traditional medication alone. Another study in 100 people evaluated the use of a mixture of Chinese herbs, which included ginkgo, for treating COPD symptoms. Those who used the herbal formula reported a considerable reduction in cough and bronchitis at a three-month follow-up, compared to the control group [18].
• Attention Deficit Hyperactivity Disorder (ADHD) – Ginkgo has been widely touted as a “brain herb” thanks to its neuroprotective and performance enhancing properties. Some studies have shown that it helps in the management of Attention Deficit Hyperactivity Disorder, a condition characterized by reduced attention span, hyperactive behavior, and impulsivity. It is a behavioral disorder that is more common in children. Regular use of gingko in a dose of 240 mg per day can help in treating these symptoms of ADHD. It can improve the social skills of the affected children and enhance their overall performance by increasing their attention span and ability to concentrate.
• Improve Glaucoma & Eye Health – Gingko has been found to be useful in the management of glaucoma. It can help to delay the progress of the disease and prevent vision loss. Glaucoma is a condition that causes damage to the optic nerve. The condition tends to gets worse over time and can lead to permanent vision loss. The damage to the optic nerve can occur due to high intraocular pressure. One study has found that taking 120 mg of ginkgo daily for 8 weeks can lead to an improvement in the vision in the patients with glaucoma. It helps maintain the intraocular pressure and prevents strain on the eyes and the optic nerves. It also works as a neuroprotective agent and protects the nerves from damage. It also produces a strong antioxidant action thus preventing loss of vision due to the effect of free radicals on the optic nerves. Another review of two studies evaluated the effect of ginkgo extract on the progression of age-related macular degeneration. Some participants reported an improvement in vision, but this wasn’t statistically significant across the board [19].
• Treatment of Headaches and Migraines – In traditional Chinese medicine, ginkgo is a very popular treatment for headaches and migraines [20]. Very little research is available on ginkgo’s ability to treat headaches. However, depending on the root cause of a headache, it may help. For example, it’s well known that ginkgo has anti-inflammatory and antioxidant effects. If a headache or a migraine is caused by excessive stress, ginkgo may be useful. Additionally, if a headache is related to reduced blood flow or constricted blood vessels, ginkgo’s ability to dilate blood vessels may improve symptoms. On the contrary, some migraines are caused by the excessive dilation of blood vessels. In this situation, ginkgo may have little to no effect.
• Improving thinking problems caused by old age – Taking ginkgo leaf extract by mouth seems to improve thinking skills in some elderly people with mild to moderate age-related memory loss or thinking problems. Ginkgo leaf extract might modestly improve short-term visual memory and speed of mental processing in non-demented people with age-related memory loss.
• Improving thinking in young people – Taking ginkgo leaf extract by mouth seems to improve some thinking skills in healthy young to middle-aged people. Ginkgo might modestly improve memory and speed of mental processing in people without memory loss. Some evidence suggests a combination of Panax ginseng and ginkgo is effective for improving memory and that the combination might be more effective than either product alone.
• Painful response to cold especially in the fingers and toes (Raynaud’s syndrome) – Taking ginkgo leaf extract by mouth seems to decrease the number of painful attacks per week in people with Raynaud’s syndrome.
• Leg pain when walking due to poor blood flow (claudication, peripheral vascular disease) –  Some evidence shows that taking ginkgo seems to increase the distance people with poor blood circulation in their legs can walk without pain. Taking ginkgo might also reduce the chance of requiring surgery.
• Vertigo and dizziness – Taking ginkgo leaf by mouth seem to significantly improve symptoms of dizziness and balance disorders.
• Premenstrual syndrome (PMS) – Taking ginkgo leaf extract by mouth seems to produce significant relief in breast tenderness and other symptoms associated with PMS when started during the 16th day of the menstrual cycle and continued until the 5th day of the following cycle.
• Improving color vision in people with diabetes – There is some evidence that taking ginkgo leaf extract by mouth for six months can significantly improve color vision in people whose retinas have been damaged by diabetes.
• Hearing loss – There is some evidence that ginkgo might help short-term hearing loss due to unknown causes. However, many of these people recover their hearing on their own. So it’s hard to know if ginkgo has any effect.
• Fibromyalgia – There is some preliminary research that suggests taking ginkgo along with coenzyme Q-10 might increase feelings of wellness and perception of overall health and reduced pain.
• Radiation exposure – There is some research that suggests taking ginkgo might decrease some of the negative effects of radiation on the body.
• Vitiligo – There is some preliminary research that taking ginkgo might decrease the size and spread of skin lesions.

The dosage of Ginkgo Biloba

Powder (A standardized extract containing 24% Ginkgo flavonglycosides of 40 mg thrice-a-day).

• For anxiety: 80 mg or 160 mg of a ginkgo leaf extract called EGb 761 has been taken three times per day for 4 weeks.
• For dementia: 60-480 mg per day of ginkgo leaf extract, divided into two or three doses, has been taken for up to one year. The most commonly studied dose is 120-240 mg per day with 240 mg possibly being more effective. Most of the clinical studies on the effectiveness of ginkgo leaf for dementia have used the standardized extracts EGb 761 (Dr. Willmar Schwabe Pharmaceuticals and Ipsen) and LI 1370 (Lichtwer Pharma).
• For retinal damage caused by diabetes: 120 mg of a ginkgo leaf extract called EGb 761 has been taken daily for 6 months.
• For walking leg pain related to poor circulation (claudication, peripheral vascular disease): 120-240 mg per day of ginkgo leaf extract (EGb 761), divided into two or three doses, has been used for up to 6.1 years. The higher dose may be more effective.
• For dizziness (vertigo): 160 mg of a ginkgo leaf extract called EGb 761 has been taken once daily or in two divided doses daily for 3 months.
• For premenstrual syndrome (PMS): 80 mg of a ginkgo leaf extract called EGb 761 has been taken twice daily, starting on the sixteenth day of the menstrual cycle until the fifth day of the next cycle. Also, 40 mg of a ginkgo leaf extract called Ginko T.D. has been taken three times daily starting on the sixteenth day of the menstrual cycle until the fifth day of the next cycle.
• For vision loss related to glaucoma: 120 to 160 mg of ginkgo leaf extract has been taken in two or three divided doses per day for up to 12.3 years.
• For schizophrenia: 120-360 mg of a ginkgo leaf extract called EGb 761 (Yi Kang Ning, Yang Zi Jiang Pharmaceuticals Ltd., Jiangsu, China) has been used daily for 8-16 weeks.
• For the movement disorder called tardive dyskinesia: 80 mg of a ginkgo leaf extract called EGb 761, three times daily for 12 weeks, has been used.

Side Effects of Ginkgo Biloba

References

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