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Clinician’s Corner: GINKGO BILOBA

Alzheimer’s disease, which is the most common cause of dementia and affects as many as 5.1 million Americans age 65 and older in the U.S., may triple in the next 40 years.

Many of our caregivers, sometimes out of desperation will turn to herbals or over the counter supplements to help their loved ones.  Gingko biloba and DHA, a component of fish oil are touted as being beneficial for “memory support”.

GINKGO BILOBA

Ginkgo biloba “maiden hair tree” said to be the world’s oldest living tree species.  The leaves are used with the highest concentrations occurring in the autumn when the leaves begin to change color. Even so, the compounds need to be extracted. Dried leaves, and teas are probably ineffective.  Dose 120-240mg daily in 2-3 doses.

USE: dementia, including Alzheimer’s, vascular, and mixed dementia.  Also used for cerebral vascular insufficiency. Ginkgo has also been used for peripheral occlusive vascular disease (intermittent claudication).  It has also been tried for sexual dysfunction, multiple sclerosis and tinnitus.

CAUTION: if taking blood thinner therapy.  Stop 2-3 weeks before elective procedure.  Also use caution if given with other NSAIDS (like Motrin and Aleve) and herbals like turmeric.

SIDE EFFECTS: headache, nausea, gastrointestinal upset, diarrhea, dizziness, or allergic skin reactions. More severe allergic reactions have occasionally been reported.

CANCER: According to a study done on rats and mice by the National Toxicology Program, Ginkgo biloba extract caused cancers of the thyroid gland in male and female rats and male mice and cancers of the liver in male and female mice.

German Commission E: monograph states that Ginkgo Biloba Extract formulation (which is the dry leaf extract and is standardized) is effective for symptomatic treatment of organic brain syndrome caused by cerebral insufficiency or dementia syndromes. German physicians still consider Ginkgo extract to be the first choice for their dementia patients; it is also used for depression, Raynaud’s disease and ringing in the ears.

Here is what the studies say: (and it is all bad news for gingko)

GEM Study (Gingko Evaluation of Memory study) which enrolled 3,000 volunteers over the age of 75, were taking 240mg of standardized gingko daily. They were followed for an average of 6 years.  Analysis of the data was disappointing, showing that ginkgo was ineffective in slowing cognitive decline, lowering blood pressure, or reducing the incidence of hypertension.  This study was funded by NCCIH (National Center for Complementary and Integrative Health)

National Institute on Aging did a trial of more than 200 healthy adults over age 60 found similar results in that ginkgo taken for 6 weeks showed no improvement in memory.

Your Thompson Pharmacist is an excellent resource for our aging patients, whether you are taking prescription medications for memory improvement, or considering ginkgo over the counter. We are here to help, because at Thompson Pharmacy its all for YOU.