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Ginkgo: Herbal Medications, What Works

Considered a "living fossil," Ginkgo biloba is the world's oldest living deciduous tree. It originated some 200 million years ago, and was almost entirely destroyed in the last Ice Age, except for a small population that survived in northern China. The trees live up to one thousand years, and are remarkably adaptable to a wide range of climates, insects, and diseases.

Ginkgo biloba extract, or GBE, is the most frequently used phytomedicine in Europe, available in Germany by prescription and over-the-counter. Commission E in Germany has approved GBE for the symptomatic treatment of dementia-related memory deficits, concentration problems, and depression; for intermittent claudication (pain on walking due to compromised blood flow to the extremities); and for vertigo and tinnitus (ringing in the ears) of senile vascular origin. Daily doses of 120 to 240 mg have been shown to elicit response.

Ginkgo leaves contain many pharmacologically active compounds, including unique flavonoids and terpenoids, with chemical properties similar to vitamin P, known as ginkolides, which are found nowhere else in nature. All the many constituents of ginkgo act together; single components do not show the same activity as the whole leaf extract. GBE's pharmacological actions include free radical destruction, reduction of lipid peroxidation, and reduction of blood platelet aggregation.

  • A review of forty trials of GBE by Kleijnen and Knipschild indicated GBE's effectiveness in treating insufficient cerebral blood flow to the brain, although many of the studies were poorly designed.

  • During a double-blind trial by Vesper and Hansgen in 1994, the GBE preparation kaveri was tested on ninety elderly patients with cerebral insufficiency, and improvement was found with a daily dose of the ginkgo preparation over twelve weeks.

  • From a review of ten studies with people who had intermittent claudication, or temporary blood flow blockages, ginkgo appeared to be effective. Based on some of these studies, Commission E concluded that there was enough evidence to approve the use of ginkgo for such intermittent claudication.

  • Bauer in 1984 used a daily dose of ginkgo preparation for six months to treat intermittent claudication in a randomized clinical trial of patients with insufficient circulation to their extremities. Significant improvement was observed in the ginkgo group after twenty-four weeks of treatment.

  • Ginkgo has been promoted for some time as a treatment for Alzheimer's disease, and recent studies indicate that it does have potential benefit in slowing progression of the disease.

  • In an important 1997 study of Alzheimer's patients by LeBars and associates, published in the Journal of the American Medical Association, ginkgo induced modest improvement in, or a delay in the decline of, cognitive function, living skills, and social behavior.

  • Claims have also been made for ginkgo's ability to improve mental functioning among healthy people. Some studies have been positive. Whether the widely publicized claims for ginkgo as a "smart pill" for normal individuals will ever be proved remains a controversial but interesting question. It appears likely that ginkgo will be definitely proved capable of producing noticeable increases in intellectual performance in normal, healthy subjects.



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Copyright © 2000 by Dr. Kenneth R. Pelletier, Inc.

Reprinted by permission of Simon & Schuster, Inc., New York, New York.


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