Ginkgo Biloba supplement benefit and side effects, how well does it work as a brain booster?
October 2 2016 by
Ray Sahelian, M.D., author of Mind Boosters: natural supplements that enhance your mind, memory, and mood

Ginkgo biloba tree leaf extract has 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. Like ginseng, it is mentioned in the traditional Chinese pharmacopoeia. Ginkgo biloba 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 are in peripheral vascular disease and the therapy of age related cognitive decline. It is also is a mind booster underutilized by the medical profession.

Benefit and review, which medical diseases or conditions does it help?
Ginkgo biloba appears to benefit some people with 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 the use of ginkgo to be helpful in sharpening the mind, vision, or sexual enhancement.
    Because of its antioxidant properties, it may be useful in individuals with diseases of blood vessels. Due to its blood thinning properties, and potential to cause heart rhythm disturbances, a dose of 40 mg a day should not be exceeded on a daily, long-term basis 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 and even certain common kitchen herbs and spices such as garlic, onions, etc.

Rexall Sundown Naturals, Ginkgo Biloba, Standardized Extract, 60 mg, 100 Tablets




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Supplement Facts
Serving Size: 1 Tablet
  Amount Per Serving: % Daily Value
Ginkgo Biloba Extract (leaf)
(Standardized to contain 24% Ginkgo Flavone Glycosides, 14.4 mg)
60 mg **
**Daily Value not established.

Dosage: One capsule a few times a week. I do not think it is a good idea to take 60 mg or higher dosages. Buy Ginkgo Biloba supplement extract, 40 mg per pill.

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Ashwagandha, Bacopa, Fo-Ti, Ginkgo biloba extract, Ginseng, Mucuna pruriens, Rhodiola, and Reishi.  The nutrients and vitamins in Mind Power Rx include Acetyl-l-carnitine, Carnosine, choline nutrient, DMAE, Inositol, Methylcobalamin, Pantothenic acid, Trimethylglycine, Tyrosine, and vinpocetine.

Nat Prod Res. 2014 Feb 5. Phytochemical and medicinal importance of Ginkgo biloba. This plant possesses a variety of biological and pharmacological activities. The leaf extract EGb 761 has been used for years to treat age-related memory-deficit problems, including Alzheimer's and dementia. Experimental and clinical studies have revealed its beneficial effects on a wide range of pathological conditions including hepatoprotective, photoprotective effects, DNA repair mechanism, antioxidant and anti-inflammatory activities. Recent studies have also suggested that leaf extract of G. biloba may exert beneficial effects on cancer.

Blood circulation
Increased cerebral circulation has been found.

Blood thinner
Most, but not all, studies have shown ginkgo Biloba extract to thin the blood.

Breast cancer, estrogen
Q. I am having much difficulty finding a mind boosting product that has ingredients that are safe enough to be used by breast cancer survivors. I finished radiation treatments in the past. 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. 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. 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.

Cataract in eye
Effects of oral Ginkgo biloba supplementation on cataract formation and oxidative stress occurring in lenses of rats exposed to total cranium radiotherapy.
Jpn J Ophthalmol. 2004.
Ginkgo biloba is an antioxidant that protects the rat lens from radiation-induced cataracts.

Improved haemorrheological properties by Ginkgo biloba extract Egb 761 in type 2 diabetes mellitus complicated with retinopathy.
Clin Nutr. 2004.
Abnormal haemorrheological property changes in erythrocyte deformability, plasma and blood viscosity, and blood viscoelasticity may play very important roles in the development of microangiopathies in diabetes mellitus. In this preliminary clinical study, 3 months of oral administration of ginkgo biloba significantly reduced malondialdehyde levels of erythrocytes membranes, decreased fibrinogen levels, promoted erythrocytes deformability, and improved blood viscosity and viscoelasticity, which may facilitate blood perfusion. Furthermore, this herb effectively improved retinal capillary blood flow rate in type 2 diabetic patients with retinopathy.

Cognitive decline
The most commonly promoted benefit is for 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. the theoretical benefit of ginkgo biloba is that it improves communication between nerve cells and enhances blood flow to the brain. It is licensed in Germany for the treatment of ARCD. However, studies have provided mixes results in regards to cognitive benefits of this herbal extract.
   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 provide some benefit in cognitive performance in patients with Alzheimer’s disease. However, a later study in the November 2008 issue of the Journal of the American Medical Association using ginkgo biloba 120 mg twice daily for a few years did not seem to reduce the rate of Alzheimer's disease. I think 120 mg twice daily is a very high dose and may interfere with sleep.
   Some patients with dementia may benefit from gingko biloba use. It is unlikely that those with normal memory function will notice a significant benefit from ginkgo biloba.

Researchers at six universities across the U.S., led by Dr. Steven DeKosky at the University of Virginia School of Medicine, report that elderly people taking ginkgo supplements showed no notable differences in scores on brain-function tests from people taking placebo pills. Dr. Steven DeKosky tested volunteers on a range of tasks, including memory, attention, language, and visual and spatial constructions, and found that the plant extract did little to slow the decline of these functions. Steven DeKosky admits that the study has its limitations - the subjects were more than 70 years old, and it's not clear whether ginkgo's effect on the brain may be more profound if introduced earlier. Then there is the question of exactly how ginkgo is acting on the body; if the compound works by improving circulation not just in the brain but throughout the body, for example, then this study may not have been refined enough to pick up those subtle, more indirect effects. Journal of the American Medical Association 2009.

Dementia and Alzheimer's disease, the evidence is not conclusive yet
Results of studies using this herbal extract as a treatment or for prevention of various types of dementia have been mixed. Another nootropic to consider is Galantamine mind enhancer.

J Med Assoc Thai. 20153 .Ginkgo biloba for prevention of dementia: a systematic review and meta-analysis. To determine the efficacy of Ginkgo biloba for the prevention of dementia in individuals without dementia. English databases including Medline, Embase, Cochrane Library and PsycINFO, were searched, and randomized double-blind controlled studies comparing Ginkgo biloba with placebo in prevention of dementia were considered. Two trials met inclusion criteria. There is no convincing evidence from this review that demonstrated Ginkgo biloba in late-life can prevent the development of dementia. Using it for this indication is not suggested at present.

Phytomedicine. 2014. Effects of Gingko biloba supplementation in Alzheimer's disease patients receiving cholinesterase inhibitors: Data from the ICTUS study. Our findings suggest that Gb may provide some added cognitive benefits in AD patients already under cholinesterase inhibitor treatment.

This study included 410 patients with mild to moderate dementia who were randomized to receive either 240 mg of a gingko biloba extract (EGb 761) or placebo for 24 weeks. The results revealed that treatment appears to improve neuropsychiatry symptoms in patients with dementia. Significant improvements were seen in the symptoms of apathy / indifference, sleep / night-time behavior, irritability / lability, depression / dysphoria and aberrant motor behavior. Alleviating neuropsychiatric symptoms in dementia: the effects of Ginkgo biloba extract EGb 761. Findings from a randomized controlled trial. Neuropsychiatr Dis Treat. 2011.

Ginkgo biloba extract EGb 761 in dementia: intent-to-treat analyses of a 24-week, multi-center, double-blind, placebo-controlled, randomized trial.
Pharmacopsychiatry. 2003.
Ginkgo biloba improves cognitive function in a clinically relevant manner in patients suffering from dementia.

Erectile dysfunction or impotence
Ginkgo biloba 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.

Liver health
Ginkgo biloba extract is able to protect the liver from damage since it has antioxidant properties, prevents lipid peroxidation and replenishes the glutathione level. The benefit may be comparable to that of silymarin from milk thistle.

Memory effect
Most young adults are already close to their ideal memory capacity and a ginkgo biloba supplement use will not likely have a significant effect.

Multiple sclerosis
Ginkgo biloba may provide benefit in terms of attention, memory and functioning in multiple sclerosis patients.

Peripheral artery disease, claudication
There is evidence that this herb, similar to aspirin, prevents blood cells called platelets from clumping together to form clots. Dr. Lewis H. Kuller, of the University of Pittsburgh randomly assigned more than 3,000 adults older than 75 to take either 120 milligrams of ginkgo or inactive placebo pills twice a day. Over the next six years, ginkgo patients were no less likely to suffer a heart attack or stroke as those on the placebo. The herbal group did, however, have a lower risk of developing peripheral artery disease (PAD), a buildup of artery-clogging plaques in the legs that reduces blood flow and can lead to pain and cramps when a person walks. Circulation: Cardiovascular Quality and Outcomes, 2009.

Sexual dysfunction
A placebo-controlled, double-blind trial of Ginkgo biloba extract for antidepressant-induced sexual dysfunction.
Hum Psychopharmacol. 2002.
Both the Ginkgo biloba group and the placebo group showed improvement in some part of the sexual function, which is suggestive of the importance of the placebo effect in assessing sexual function. This study did not replicate a prior positive finding supporting the use of this herb for antidepressant, especially SSRI, induced sexual dysfunction.

What's in the plant?
Ginkgo biloba extract contains many different substances but most of them fall into two main categories: Terpenoid lactones and Flavonoids.
The most unique components of ginkgo biloba extracts are the terpene trilactones which are structurally complex molecules. Terpene lactones give ginkgo a bitter and strong flavor. Ginkgolides A, B, C and J, together with bilobalide, are unique terpenoid components of the Ginkgo biloba tree. Ginkgolides have not yet been found in any other living plant species.

   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 biloba extract 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.
   Other compounds in this herb include proanthocyanidins, carboxylic acids and non-flavone glycosides.
   Ginkgo biloba leaf extract is available in various potencies, including 24%/6%, 24% / 4%, 28% / 8%, 30% / 10% ginkgoflavoglycosides / terpene lactones.

Vision and 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 extract was given to type 2 diabetes mellitus patients with eye problems (retinopathy). After taking it 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.

Research studies - Salisburia adiantifolia
Electrophysiological analysis of the effects of ginkgo biloba on visual processing in older healthy adults.
J Gerontol A Biol Sci Med Sci. 2005.
Several studies have tested the efficacy of ginkgo biloba extract using compromised visual systems and have found improvement in vision.

Tinnitus testimonial
I have found ginkgo biloba to be a wonderful supplement for the treatment of tinnitus (ringing in the ears) that was do to exposure to loud noise as a teenager. I would notice a significant improvement a day or two after taking the gingko biloba (100mg 2x daily 24% standardization) and the ringing would gradually return after I would stop taking them. After using it on and off for several years the problem has faded into the background and they are now unnecessary.
   Some studies do show ginkgo biloba benefit for tinnitus, although my clinical experience with this herb for tinnitus has not shown a consistent beneficial response.

How does it work?
The active ingredients 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.

What dosages are best?
The majority of the studies done thus far with ginkgo have used daily dosages of 120 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. You may wish to start with one 40 mg pill a day to see if there is any improvement in memory or thinking. Ginkgo biloba extract is best taken early in the day, and no later than afternoon. Those who take more than one pill may notice adverse reactions.

Ginkgo biloba side effects, safety, caution, danger, risk
The most common ginkgo biloba side effects are stomach or intestinal complaints, headache, and allergic skin reactions.
Sometimes it can cause shallow sleep if taken late in the evening. Heart palpitations can occur with dosages higher than 40 mg. A rare adverse reaction is seizures which are more likely to occur in older individuals. Ginkgo may increase the risk of seizures in people with epilepsy and could reduce the effectiveness of anti-seizure drugs. Ginkgo biloba and ginkgotoxin. J Nat Prod. 2010.
   An infrequent but potentially serious consequence is internal bleeding when it is combined with other blood thinners such as aspirin or Coumadin (and even ibuprofen). Ginkgo biloba extract has anti-platelet activity and hence may prolong the time it takes to form a blood clot. However, a study published in 2003 indicates that
Coenzyme Q10 and Ginkgo biloba do not influence the clinical effect of warfarin. An additional study did not find ginkgo to alter platelet function or coagulation time. Just to be cautious, at this time those who take aspirin or Coumadin should be very careful and discuss with their doctor before they use this herbal extract or any product that contains ginkgo.

The effect of ginkgo biloba extract on healthy elderly subjects
Fortschr Med Orig. 2003.
The study 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 biloba , and 32 a placebo. The results suggest a positive effect on the subjective emotional well-being of healthy elderly persons.

Other products
GINKGO herb 50:1 standardized, extract, containing 24% ginkgoflavonglycosides. Extracts Egb 761 and LI 1370, contain ginkgo flavonol glycosides 16-25 % and terpene trilactones 6%. Ginkgo does not inhibit MAO A or B. Ginkgolides are potent inhibitor of Platelet Activating Factor.

Trademarked Ginkgo products: latin name is Salisburia adiantifolia
BioGinkgo 27/7 by Pharmanex (Utah)
Blackmore's Ginkgo Biloba Forte by Blackmores (Australia)
EGb 761 - Ginkgoba - by Dr. Willmar Schwabe (Germany)
Tanakan by Ipsen Boufour (France)

Ginkgo Biloba extract 40 mg (50:1 Standardized Extract)
   Contains a minimum of 24% ginkgo flavon glycosides and minimum of 6% terpene lactones in the following properties: (Ginkgolide A 1.3%) (Ginkgolide B 1.0%) (Ginkgolide C 1.2%) (Bilobalide 2.7%)

often misspelled as gingko or ginkgo baloba