What is ginkgo biloba?



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Date Posted : 2009-12-20

Drug Nomenclature
Synonyms: Salisburia adiantifolia; EGB-761; Fossil Tree; GBE-761; Ginkgo biloba; Ginkgoblad (ginkgo leaf); Ginkmedžių lapai (ginkgo leaf); Jinanový list (ginkgo leaf); Kew Tree; Maidenhair Tree; Neidonhiuspuunlehti (ginkgo leaf); Páfrányfenyőlevél (ginkgo leaf).
Pharmacopoeias:
Ph. Eur. 5.5 (Ginkgo Leaf). The whole or fragmented dried leaf of Ginkgo biloba containing not less than 0.5% of Flavonoids, calculated as flavone glycosides with reference to the dried drug. The leaf is grayish or yellowish-green or yellowish-brown.
USP 29 (Ginkgo). The dried leaf of Ginkgo biloba (Ginkgoaceae) containing not less than 0.5% of Flavonoids, calculated as flavones glycosides, with a mean molecular mass of 756.7, and not less than 0.1% of terpene lactones, both on the dried basis. The leaf is khaki green to greenish-brown. Protect from light and moisture.
What is ginkgo biloba?
Ginkgo extract, from the leaves of the Ginkgo biloba tree, has been used for thousands of years
in traditional Chinese medicine. It also is the most commonly used herbal medicine in Europe.
 Although the benefits of ginkgo are not entirely understood, it is known that ginkgo has
 properties that may help treat certain conditions. Ginkgo may:
• Improve blood flow in the brain and elsewhere in the body.
• Reduce inflammation.
• Act as an antioxidant (like vitamin E) to fight cell damage.
• Improve memory in people with memory impairment.
• Blockage of many effects of platelet activating factor (PAF).
In the United States, ginkgo is considered a dietary supplement.

Medicinal uses
Extracts of Ginkgo leaves contain flavonoid glycosides and Terpenoids (Ginkgolides, Bilobalides) and have been used pharmaceutically. Ginkgo supplements are usually taken in the range of 40–200 mg per day.

In memory enhancement

Ginkgo has many alleged nootropic properties, and is mainly used as memory[1] and concentration enhancer, and anti-vertigo agent. According to some studies, in a few cases, Ginkgo can significantly improve attention in healthy individuals.[2][3] Allegedly, the effect is almost immediate and reaches its peak in 2.5 hours after the intake.[4]

In dementia

A 2004 conference paper[5] summarizes how various trials indicate that Ginkgo shows promise in the treatment of Alzheimer's disease, In ongoing studies, a research team led by Luan Luo, PhD, associate professor at the University of Maryland School of Pharmacy, found that giving mice with the human Alzheimer’s gene the ginkgo extract called Egb 761 improved the process of making new nerve cells in part of the brain much affected by the disease. The team found evidence that the protective effect of the extract also could be due to decreasing senile plaques or the clumping of beta-amyloid in the brain tissues.[6]

In other symptoms

Out of the many conflicting research results, Ginkgo extract may have three effects on the human body: improvement in blood flow (including microcirculation in small capillaries) to most tissues and organs; protection against oxidative cell damage from free radicals; and blockage of many of the effects of platelet-activating factor (platelet aggregation, blood clotting)[7] that have been related to the development of a number of cardiovascular, renal, respiratory and central nervous system disorders. Ginkgo can be used for intermittent claudication.
Some studies [8] suggest a link between ginkgo and the easing of the symptoms of tinnitus.
Preliminary studies suggest that Ginkgo may be of benefit in multiple sclerosis, showing modest improvements in cognition [9] and fatigue [10] without increasing rates of serious adverse events in this population.
A study conducted in 2003 by the Department of Dermatology, Postgraduate Institute of Medical Education and Research in Chandigarh, India concluded that Ginkgo is an effective treatment for arresting the development of vitiligo [11].

Dosing
Adults (over 18 years old)
80 to 240 milligrams of a 50:1 standardized leaf extract taken daily by mouth in 2 to 3 divided doses has been used and studied (standardized to 24% to 25% ginkgo flavone glycosides and 6% terpine lactones). Other forms used include tea (bags usually contain 30 milligrams of extract), 3 to 6 milliliters of 40 milligrams per milliliter extract daily in three divided doses, and "fortified" foods. Ginkgo seeds are potentially toxic and should be avoided. The German ginkgo product Tebonin®, given through the veins (IV), was removed from the German market due to significant side effects.

Children (under 18 years old)
There is not enough scientific evidence to recommend use of ginkgo in children.
Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies
Allergy/hypersensitivity to Ginkgo biloba or members of the Ginkgoaceae family may occur which is very rare.

Side Effects and Warnings
Overall, ginkgo leaf extract (used in most commercial products) appears to be well tolerated in most healthy adults at recommended doses for up to six months. Minor symptoms including headache, nausea, and intestinal complaints have been reported.
Recent studies have found that ginkgo has little or no effect on the anticoagulant properties or pharmacodynamics of Warfarin.[12][13]
Ginkgo should be stopped prior to some surgical or dental procedures. Eating the seeds is potentially deadly, due to risk of tonic-clonic seizures and loss of consciousness.

Pregnancy and Breastfeeding
Use of ginkgo is not recommended during pregnancy and breastfeeding due to lack of reliable scientific study in this area.
This information is not intended to replace the advice of a doctor.

References
1. ^ Mahadevan S, Park Y. (Jan 2008). "Multifaceted therapeutic benefits of Ginkgo biloba L.: chemistry, efficacy, safety, and uses". J Food Sci. 73 (1): R14–9. doi:10.1111/j.1750-3841.2007.00597.x (inactive 2008-06-26). ISSN 0022-1147. PMID 18211362.
2. Elsabagh S, Hartley DE, Ali O, Williamson EM, File Se (May 2005). "Differential cognitive effects of Ginkgo biloba after acute and chronic treatment in healthy young volunteers". Psychopharmacology (Berl) 179 (2): 437–446. doi:10.1007/s00213-005-2206-6. ISSN 0033-3158. PMID 15739076.
3. ^ BBC News: Herbal remedies "boost brain power".[1]
4. ^ Dose-dependent cognitive effects of acute administration of Ginkgo biloba to healthy young volunteers.
5. L. Witkam and I. Ramzan (2004). "Ginkgo biloba in the treatment of Alzheimer’s disease: A miracle cure?". From Cell to Society. full text pdf  Conference page.
6. ^ Ginkgo Extract Has Multiple Actions on Alzheimer Symptoms Newswise, Retrieved on August 25, 2008.
7. Smith PF, Maclennan K, Darlington CL (Mar 1996). "The neuroprotective properties of the Ginkgo biloba leaf: a review of the possible relationship to platelet-activating factor (PAF)". Journal of ethnopharmacology 50 (3): 131–9. doi:10.1016/0378-8741(96)01379-7. ISSN 0378-8741. PMID 8691847.
8. Sun (1998). Ginkgo biloba. 2006. IUCN Red List of Threatened Species. IUCN 2006. www.iucnredlist.org. Retrieved on 11 May 2006. Listed as Endangered (EN B1+2c v2.3)
9. ^ Julie Jalalpour, Matt Malkin, Peter Poon, Liz Rehrmann, Jerry Yu (1997). "Ginkgoales: Fossil Record" (HTML). University of California, Berkeley. http://www.ucmp.berkeley.edu/seedplants/ginkgoales/ginkgofr.html. Retrieved 2008-06-03.
10. ^ Shen, L; Chen, XY; Zhang, X; Li, YY; Fu, CX; Qiu, YX (Apr 2005). "Genetic variation of Ginkgo biloba L. (Ginkgoaceae) based on cpDNA PCR-RFLPs: inference of glacial refugia". Heredity 94 (4): 396–401. doi:10.1038/sj.hdy.6800616. ISSN 0018-067X. PMID 15536482. http://www.nature.com/hdy/journal/v94/n4/full/6800616a.html#bib48.
11. ^ Royer et al., pp. 86-87 .
12. Jiang, X; Williams, KM; Liauw, WS; Ammit, AJ; Roufogalis, BD; Duke, CC; Day, RO; Mclachlan, AJ (Apr 2005). "Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects". British Journal of Clinical Pharmacology 59 (4): 425–432. doi:10.1111/j.1365-2125.2005.02322.x. ISSN 0306-5251. PMID 15801937.


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