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Ginkgo

Parts Used & Where Grown

Ginkgo biloba is the world’s oldest living species of tree. Individual trees live as long as 1,000 years. Ginkgo grows most predominantly in the southern and eastern United States, southern France, China, and Korea. The leaves of the tree are used in modern herbal medicine.

How It Works

The medical benefits of Ginkgo biloba extract are attributed primarily to two groups of active constituents: the ginkgo flavone glycosides and the terpene lactones. Ginkgo flavone glycosides, which typically make up approximately 24% of the extract, are primarily responsible for ginkgo’s antioxidant activity and may mildly inhibit platelet aggregation (stickiness). These two actions may help ginkgo prevent circulatory diseases, such as atherosclerosis, and support the brain and central nervous system.1 In addition to the cardiovascular system, ginkgo’s antioxidant action may also extend to the brain and retina of the eye.2 Preliminary trials have suggested potential benefit for people with macular degeneration3 and diabetic retinopathy.4 The terpene lactones found in ginkgo extracts, known as ginkgolides and bilobalide, typically make up approximately 6% of the extract. They are associated with increasing circulation to the brain and other parts of the body and may exert a protective action on nerve cells.5 ginkgo regulates the tone and elasticity of blood vessels,6 making circulation more efficient.7

Ginkgo is also well-known for its effect on memory and thinking (cognitive function). It may enhance cognitive performance in healthy older adults,8 in people with age-related cognitive decline, and in people with Alzheimer’s disease.

References

1. Drieu K. Preparation and definition of Ginkgo biloba extract. In: Rokan (Ginkgo biloba): Recent Results in Pharmacology and Clinic. Fünfgeld EW, ed. Berlin: Springer-Verlag, 32-6.

2. Ferrandini C, Droy-Lefaix MT, Christen Y, eds. Ginkgo biloba Extract (EGb 761) as a Free Radical Scavenger. Paris: Elsevier, 1993.

3. Lebuisson DA, Leroy L, Rigal G. Treatment of senile macular degeneration with Ginkgo biloba extract. A preliminary double-blind, drug versus placebo study. Presse Med 1986;15:1556-8 [in French].

4. Lanthony P, Cosson JP. The course of color vision in early diabetic retinopathy treated with Ginkgo biloba extract. A preliminary double-blind versus placebo study. J Fr Ophtalmol 1988;11:671-4 [in French].

5. Krieglstein J. Neuroprotective properties of Ginkgo biloba—constituents. Zeitschrift Phytother 1994;15:92-6.

6. Clostre F. From the body to the cell membranes: the different levels of pharmacological action of Ginkgo biloba extract. In: Rokan(Ginkgo biloba): Recent Results in Pharmacology and Clinic. Fünfgeld EW, ed. Berlin: Springer-Verlag, 1988, 180-98.

7. Jung F, Mrowietz C, Kiesewetter H, Wenzel E. Effect of Ginkgo biloba on fluidity of blood and peripheral microcirculation in volunteers. Arzneimittelforschung 1990;40:589-93.

8. Mix JA, Crews WD. An examination of the efficacy of Ginkgo biloba extract EGb761 on the neuropsychologic functioning of cognitively intact older adults. J Altern Complement Med 2000;6:219-29.

9. Quaranta L, Bettelli S, Uva MG, et al. Effect of Ginkgo biloba extract on preexisting visual field damage in normal tension glaucoma. Ophthalmology 2003;110:359-62.

10. Lebuisson DA, Leroy L, Reigal G. Treatment of senile macular degeneration with Ginkgo biloba extract: a preliminary double-blind study versus placebo. In Rokan (Ginkgo biloba): Recent Results in Pharmacology and Clinic, Fünfgeld FW, ed. Berlin: Springer-Verlag, 1988, 231-6.

11. Lanthony P, Cosson JP. The course of color vision in early diabetic retinopathy treated with Ginkgo biloba extract. A preliminary double-blind versus placebo study. J Fr Ophtalmol 1988;11:671-4 [in French].

12. Allain H, Raoul P, Lieury A, et al. Effects of two doses of ginkgo biloba extract (EGb 761) on the dual-coding test in elderly subjects. Clin Ther 1993;15(3):549-58.

13. Rai GS, Shovlin C, Wesnes KA. A double-blind, placebo-controlled study of Ginkgo biloba extract (‘tanakan') in elderly patients with mild to moderate memory impairment. Curr Med Res Opin 1991;12(6):350-5.

14. Brautigam MRH, Blommaert FA, Verleye G, et al. Treatment of age-related memory complaints with Ginkgo biloba extract: a randomized double-blind placebo-controlled study. Phytomedicine 1998;5:425-34.

15. Wesnes K, Simmons D, Rook M. A double-blind, placebo-controlled trial of Tanakan in the treatment of idiopathic impairment in the elderly. Human Psychopharmacol 1987;2:159-69.

16. Israel L, Dell'Accio E, Martin G, Hugonot R. Ginkgo biloba extract and memory training programs—comparative assessment on elderly outpatients. Psychologie Médicale 1987;19:1431-9.

17. Gräbel E. The influence of Ginkgo biloba extract (EGb 761) on mental performance: A double-blind study under computerized measurement conditions in patients with cerebral insufficiency. Fortschr Med 1992;110:73-6.

18. Winther K, Randlov C, Rein E, Mehlsen J. Effects of Ginkgo biloba extract on cognitive function and blood pressure in elderly subjects. Curr Ther Res 1998;59:881-8.

19. Gavrilova SI, Preuss UW, Wong JW, et al. Efficacy and safety of Ginkgo biloba extract EGb 761 in mild cognitive impairment with neuropsychiatric symptoms: a randomized, placebo-controlled, double-blind, multi-center trial. Int J Geriatr Psychiatry 2014;29:1087–95.

20. van Dongen M, van Rossum E, Kessels A, et al. The efficacy of ginkgo for elderly people with dementia and age-associated memory impairment: New results of a randomized clinical trial. J Am Geriatr Soc 2000;48:1183-94.

21. Ihl R, Bachinskaya N, Korczyn AD, et al. Efficacy and safety of a once-daily formulation of Ginkgo biloba extract EGb 761 in dementia with neuropsychiatric features: a randomized controlled trial. Int J Geriatr Psychiatry 2011;26:1186-94.

22. Lebuisson DA, Leroy L, Reigal G. Treatment of senile macular degeneration with Ginkgo biloba extract: a preliminary double-blind study versus placebo. In Rokan (Ginkgo biloba): Recent Results in Pharmacology and Clinic, Fünfgeld FW, ed. Berlin: Springer-Verlag, 1988, 231-6.

23. Le Bars PL, Katz MM, Berman N, et al. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group. JAMA 1997;278:1327-32.

24. Hofferberth B. The efficacy of EGb 761 in patients with senile dementia of the Alzheimer type, a double-blind, placebo-controlled study on different levels of investigation. Hum Psychopharmacol 1994;9:215-22.

25. Kanowski S, Herrmann W, Stephan K, et al. Proof of efficacy of the Ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Pharmacopsychiatry 1996;29:47-56.

26. Maurer K, Ihl R, Dierks T, Frolich L. Clinical efficacy of Ginkgo biloba special extract EGb 761 in dementia of the Alzheimer's type. J Psychiatr Res 1997;31:645-55.

27. Bachinskaya N, Hoerr R, Ihl R. Alleviating neuropsychiatric symptoms in dementia: the effects of Ginkgo biloba extract EGb 761. Findings from a randomized controlled trial. Neuropsychiatr Dis Treat 2011;7:209-15.

28. Mazza M, Capuano A, Bria P, Mazza S. Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer's dementia in a randomized placebo-controlled double-blind study. Eur J Neurol 2006;13:981-5.

29. van Dongen M, van Rossum E, Kessels A, et al. The efficacy of ginkgo for elderly people with dementia and age-associated memory impairment: New results of a randomized clinical trial. J Am Geriatr Soc 2000;48:1183-94.

30. Wettstein A. Cholinesterase inhibitors and Ginkgo extracts-are they comparable in the treatment of dementia? Comparison of published placebo-controlled efficacy studies of at least six months' duration. Phytomedicine 2000;6:393-401.

31. DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA 2008;300:2253-62.

32. Schneider B. Ginkgo biloba extract in peripheral arterial disease. Meta-analysis of controlled clinical trials. Arzneimittelforschung 1992;42:428-36 [in German].

33. Peters H, Kieser M, Hölscher U. Demonstration of the efficacy of Ginkgo biloba special extract EGb 761® on intermittent claudication—a placebo-controlled, double-blind multicenter trial. VASA 1998;27:106-10.

34. Bauer U. Six-month double-blind randomised clinical trial of Ginkgo biloba extract versus placebo in two parallel groups in patients suffering from peripheral arterial insufficiency. Arzneimittelforsschung 1984;34:716-20 [in German].

35. Blume J, Kieser M, Hölscher U. Placebo-controlled, double-blind study on the efficacy of Ginkgo biloba special extract EGb 761 in maximum-level trained patients with intermittent claudication. Vasa 1996;25:265-74.

36. Blume J, Kieser M, Hölscher U. Efficacy of Ginkgo biloba special extract EGb 761 in peripheral occlusive disease. Fortschr Med 1998;116:137-43.

37. Schweizer J, Hautmann C. Comparison of two dosages of Ginkgo biloba extract EGb 761 in patients with peripheral arterial occlusive disease Fontaine's stage IIb. Arzneimittelforschung 1999;49:900-4.

38. Wang J, Zhou S, Bronks R, et al. Supervised exercise training combined with ginkgo biloba treatment for patients with peripheral arterial disease. .Clin Rehabil 2007;21:579-86.

39. Braquet P, Touqui L, Shen TS, Vargaftig BB. Perspectives in platelet activating factor research. Pharmacol Rev 1987;39:97-210.

40. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 119-28.

41. Kiesewetter H, Jung F, Mrowietz C, et al. Effects of garlic on blood fluidity and fibrinolytic activity: A randomised, placebo-controlled, double-blind study. Br J Clin Pract Suppl 1990;69:24-9.

42. Jung F, Mrowietz C, Kiesewetter H, Wenzel E. Effect of Ginkgo biloba on fluidity of blood and peripheral microcirculation in volunteers. Arzneimittelforschung 1990;40:589-93.

43. Phelps S, Harris WS. Garlic supplementation and lipoprotein oxidation susceptibility. Lipids 1993;28(5):475-7.

44. Yan LJ, Droy-Lefaix MT, Packer L. Ginkgo biloba extract (EGb 761) protects human low density lipoproteins against oxidative modification mediated by copper. Biochem Biophys Res Comm 1995;212:360-6.

45. Singh K, Chander R, Kapoor NK. Guggulsterone, a potent hypolipidaemic, prevents oxidation of low density lipoprotein. Phytother Res 1997;11:291-4.

46. Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992;340:1136-9 [review].

47. Clement JL, Livecchi G, Jimenez C, et al. Modifications vasomotrices des extrémités lors l'exposition à des conditions thermiques défavorables. Méthodologie et résultant de l'étude de l'extrait de Ginkgo biloba. Acutal Angiol 1982;7:3-8.

48. Allain H, Raoul P, Lieury A, et al. Effects of two doses of ginkgo biloba extract (EGb 761) on the dual-coding test in elderly subjects. Clin Ther 1993;15(3):549-58.

49. Rai GS, Shovlin C, Wesnes KA. A double-blind, placebo-controlled study of Ginkgo biloba extract (‘tanakan') in elderly patients with mild to moderate memory impairment. Curr Med Res Opin 1991;12(6):350-5.

50. Brautigam MRH, Blommaert FA, Verleye G, et al. Treatment of age-related memory complaints with Ginkgo biloba extract: a randomized double-blind placebo-controlled study. Phytomedicine 1998;5:425-34.

51. Wesnes K, Simmons D, Rook M. A double-blind, placebo-controlled trial of Tanakan in the treatment of idiopathic impairment in the elderly. Human Psychopharmacol 1987;2:159-69.

52. Israel L, Dell'Accio E, Martin G, Hugonot R. Ginkgo biloba extract and memory training programs—comparative assessment on elderly outpatients. Psychologie Médicale 1987;19:1431-9.

53. Gräbel E. The influence of Ginkgo biloba extract (EGb 761) on mental performance: A double-blind study under computerized measurement conditions in patients with cerebral insufficiency. Fortschr Med 1992;110:73-6.

54. Winther K, Randlov C, Rein E, Mehlsen J. Effects of Ginkgo biloba extract on cognitive function and blood pressure in elderly subjects. Curr Ther Res 1998;59:881-8.

55. Gavrilova SI, Preuss UW, Wong JW, et al. Efficacy and safety of Ginkgo biloba extract EGb 761 in mild cognitive impairment with neuropsychiatric symptoms: a randomized, placebo-controlled, double-blind, multi-center trial. Int J Geriatr Psychiatry 2014;29:1087–95.

56. van Dongen M, van Rossum E, Kessels A, et al. The efficacy of ginkgo for elderly people with dementia and age-associated memory impairment: New results of a randomized clinical trial. J Am Geriatr Soc 2000;48:1183-94.

57. Ihl R, Bachinskaya N, Korczyn AD, et al. Efficacy and safety of a once-daily formulation of Ginkgo biloba extract EGb 761 in dementia with neuropsychiatric features: a randomized controlled trial. Int J Geriatr Psychiatry 2011;26:1186-94.

58. Krieglstein J. Neuroprotective properties of Ginkgo biloba—constituents. Zeitschrift Phytother 1994;15:92-6.

59. Clostre F. From the body to the cell membranes: the different levels of pharmacological action of Ginkgo biloba extract. In: Rokan(Ginkgo biloba): Recent Results in Pharmacology and Clinic. Fünfgeld EW, ed. Berlin: Springer-Verlag, 1988, 180-98.

60. Jung F, Mrowietz C, Kiesewetter H, Wenzel E. Effect of Ginkgo biloba on fluidity of blood and peripheral microcirculation in volunteers. Arzneimittelforschung 1990;40:589-93.

61. Schubert H, Halama P. Depressive episode primarily unresponsive to therapy in elderly patients; efficacy of Ginkgo biloba extract (EGb 761) in combination with antidepressants. Geriatr Forsch 1993;3:45-53.

62. Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998;24:139-45.

63. Sohn M, Sikora R. Ginkgo biloba extract in the therapy of erectile dysfunction. J Sex Educ Ther 1991;17:53-61.

64. Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998;24:139-43.

65. Sohn M, Sikora R. Ginkgo biloba extract in the therapy of erectile dysfunction. J Sex Educ Ther 1991;17:53-61.

66. Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998;24:139-43.

67. Vorberg G. Ginkgo biloba extract (GBE): A long-term study of cerebral insufficiency in geriatric patients. Clin Trials J 1985;22:149-57.

68. Claussen CF. Diagnostic and practical values of craniocorpography in vertiginous syndromes. Presse Med 1986;15:1565-8 [in French].

69. Haguenauer JP, Cantenot F, Koskas H, Pierart H. Treatment of disturbances of equilibrium with Ginkgo biloba extract: A multicenter, double-blind, drug versus placebo study. Presse Med 1986;15:1569-72 [in French].

70. Ernst E, Stevinson C. Ginkgo biloba for tinnitus: a review. Clin Otolaryngol 1999;24:164-7.

71. Drew S, Davies E. Effectiveness of Ginkgo biloba in treating tinnitus: double blind, placebo-controlled trial. BMJ 2001;322:1-6.

72. Meyer B. A multicenter randomized double-blind study of Ginkgo biloba extract versus placebo in the treatment of tinnitus. In Rokan (Ginkgo biloba): Recent Results in Pharmacology and Clinic, ed. EW Funfgeld. New York: Springer-Verlag, 1988, 245-50.

73. Morgenstern C, Biermann E. Ginkgo biloba special extract EGb 761 in the treatment of tinnitus aurium: Results of a randomized, double-blind, placebo-controlled study. Fortschr Med 1997;115:7-11.

74. Holgers K, Axelsson A, Pringle I. Ginkgo biloba extract from the treatment of tinnitus. Audiol 1994;33:85-92.

75. Clostre F. Ginkgo biloba extract (EGb 761). State of knowledge in the dawn of the year 2000. Ann Pharm Fr 1999 ;57:1S8-88 [review; in French].

76. Koltringer P, Langsteger W, Lind P, et al. [Ginkgo biloba extract and folic acid in the therapy of changes caused by autonomic neuropathy]. Acta Med Austriaca 1989;16:35–7 [in German].

77. Lanthony P, Cosson JP. The course of color vision in early diabetic retinopathy treated with Ginkgo biloba extract. A preliminary double-blind versus placebo study. J Fr Ophtalmol 1988;11:671-4 [in French].

78. Rhee K, Lee C, Kim S, et al. Extract of Ginkgo Biloba Ameliorates Streptozotocin-Induced Type 1 Diabetes Mellitus and High-Fat Diet-Induced Type 2 Diabetes Mellitus in Mice. Int J Med Sci 2015;12:987–94.

79. Bernardczyk-Meller J, Siwiec-Proscinska J, Stankiewicz W, et al. [Influence of Eqb 761 on the function of the retina in children and adolescent with long lasting diabetes mellitus—preliminary report]. Klin Oczna 2004;106:569–71.

80. Kim J, Yokoyama K, Araki S. The effects of Ginkgo biloba extract (GBe) on axonal transport microvasculature and morphology of sciatic nerve in streptozotocin-induced diabetic rats. Environ Health Prev Med 2000;5:53–9.

81. da Silva G, Zanoni J, Buttow N. Neuroprotective action of Ginkgo biloba on the enteric nervous system of diabetic rats. World J Gastroenterol 2011;17:898–905.

82. Koltringer P, Langsteger W, Lind P, et al. [Ginkgo biloba extract and folic acid in the therapy of changes caused by autonomic neuropathy]. Acta Med Austriaca 1989;16:35–7 [in German].

83. Tamborini A, Taurelle R. Value of standardized Ginkgo biloba extract (EGb 761) in the management of congestive symptoms of premenstrual syndrome. Rev Fr Gynecol Obstet 1993;88:447-57 [in French].

84. Chung KF, McCusker M, Page CP, et al. Effect of a ginkgolide mixture (BN 52063) in antagonising skin and platelet responses to platelet activating factor in man. Lancet 1987;i:248-51.

85. Tamborini A, Taurelle R. Value of standardized Ginkgo biloba extract (EGb 761) in the management of congestive symptoms of premenstrual syndrome. Rev Fr Gynecol Obstet 1993;88:447-57 [in French].

86. Guinot P, Brambilla C, Dunchier J, et al. Effect of BN 52063, a specific PAF-ascether antagonist, on bronchial provocation test to allergens in asthmatic patients—a preliminary study. Prostaglandins 1987;34:723-31.

87. Li M, Yang B, Yu H, Zhang H. Clinical observation of the therapeutic effect of ginkgo leaf concentrated oral liquor on bronchial asthma. Chinese J Integrative & Western Med 1997;3:264-7.

88. Parsad D, Pandhi R, Juneja A. Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Clin Exp Dermatol 2003;28:285-7.

89. Szczurko O, Shear N, Taddio A, Boon H. Ginkgo biloba for the treatment of vitilgo vulgaris: an open label pilot clinical trial. BMC Complement Altern Med 2011;11:21.

90. Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 136-8.

91. Matthews MK Jr. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998;50:1933-4 [letter].

92. Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997;336:1108 [letter].

93. Kellermann AJ, Kloft C. Is there a risk of bleeding associated with standardized Ginkgo biloba extract therapy? A systematic review and meta-analysis. Pharmacotherapy 2011;31:490-502.

94. Granger AS. Ginkgo biloba precipitating epileptic seizures. Age Ageing 2001;30:523-5.

95. Siegers CP. Cytotoxicity of alkylphenols from Ginkgo biloba. Phytomedicine 1999;6:281-3.

96. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract on pancreatic ß-cell function in response to glucose loading in normal glucose-tolerant individuals. J Clin Pharmacol 2000;40:647-54.

97. Le Bars PL, Katz MM, Berman N, et al. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group. JAMA 1997;278:1327-32.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2019.

Copyright © 2019 Healthnotes, Inc. All rights reserved.

The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2019.