Ginkgo biloba | The Wonder of a "Living Fossil"

WRITTEN BY TRANG TRAN AND DR. SWATHI

What is Ginkgo biloba?

Ginkgo biloba is derived from the leaf of the Maidenhair tree, which is believed to live 2,000 to 4,000 years and is the last remaining member of the Ginkgoaceae family. The term ginkgo means “silver apricot” in Chinese, and the term biloba refers to the two-folded, fan-shaped leaves. Ginkgo biloba leaves are used to treat asthma, bronchitis, heart dysfunction, and swelling of the hands and feet in traditional Chinese medicine. Historically, the Chinese and Japanese ate its roasted seeds as a digestive aid.

In Germany, the leaf extract is approved for various clinical indications. Notably, Ginkgo is the most frequently prescribed herbal product in Germany and France and is one of the most commonly used herbal products in the United States. Flavonoids, terpenoids, and terpene lactones (ginkgolides and bilobalide) are the active components of Ginkgo.

What is Ginkgo biloba used for?

Ginkgo biloba extract has been shown to improve short-term memory and long-term memory in healthy subjects; furthermore, Ginkgo extract has shown to exhibit positive effect in patients with age-related memory impairment and a modest but significant effect in patients with Alzheimer’s disease. Although it is purported to improve cognition and memory and sharpen mental focus in healthy adults as well as in those with Alzheimer’s disease and dementia, studies carried out to study the effectiveness of Ginkgo in improving memory and cognition yielded conflicting results with some studies demonstrating no effect or only modest improvement. In essence, controlled studies suggest that its extract has limited effectiveness in improving memory and cognition in elderly subjects with dementia or healthy subjects. However, in Germany, the primary uses for ginkgo are circulation problems in the limbs or brain.

In addition to playing a role in memory and cognition, Ginkgo biloba has been shown to decrease the rise in blood pressure in response to stress.

How does Ginkgo biloba work?

The ginkgolide B component helps to not only decrease the “stickiness” of the platelets which thereby helps inhibit blood clot formation, but it also helps to decrease inflammation. Thus, it works to dilate blood vessels and improve blood circulation. Ginkgo biloba has also been shown to reverse cognitive impairment and reduce fatigue in patients with multiple sclerosis, a type of autoimmune disease.

Oxidative stress may contribute to Alzheimer’s disease, but the flavonoids found in Ginkgo possess antioxidant properties that may be neuroprotective. Moreover, flavonoids and terpenoids possess antioxidant properties that are believed to help slow down the progression of age-related macular degeneration, a condition affecting the back of the eye.

The cognitive enhancing effect may also have to do with its ability to increase the availability of the neurotransmitter called acetylcholine, which plays an important role in learning and memory.

What are the side effects of Ginkgo biloba?

Although rare, cases of skin reactions, headache, and mild stomach upset have been reported. 

Does Ginkgo biloba interact with prescription drugs?

Because Ginkgo biloba makes the platelets less “sticky,” concurrent use with aspirin, ibuprofen, naproxen, or warfarin may increase the risk of bleeding. Additionally, before surgery, it is recommended to stop Ginkgo two to three weeks due to an increased risk of bleeding.

Trazodone (a drug used to treat depression) interacts with Ginkgo, resulting in a coma in patients with Alzheimer’s disease. If you have any questions and concerns regarding adding ginkgo biloba to your daily routine, do not hesitate to reach out to your trust healthcare provider and/or Dr. Swathi.

The bottom line

Overall, Ginkgo biloba leaf extract is purported to improve blood circulation. Flavonoids and terpenoids are the most important constituents and are responsible for some of the biological activities. Potential activities of this incredible plant include increasing blood flow and inhibiting blood clot formation, reducing oxidative stress, and improving memory. Ginkgo biloba interacts with prescription drugs especially with blood thinning medications.

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This article was edited by Dr. Swathi and was written by Element Apothec Scientific Communications Intern, Trang Tran. She is a Doctor of Pharmacy (PharmD) student at Oregon State University and Oregon Health & Science University College of Pharmacy in Portland, Oregon.