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Category

Synonyms

Arbre aux quarante écus, adiantifolia, baiguo, bai guo ye, BN-52063, duck foot tree, EGb, EGb 761, Elefantenohr, Eun-haeng, facherblattbaum, Fossil tree, GBE, GBE 24, GBX, ginan, gin-nan, Ginkgoaceae (family), ginkgo balm, ginkgoblätter, Ginkgo biloba blätter, Ginkgo folium, ginkgogink, ginkgold, ginkgopower, ginkyo, icho, ityo, Japanbaum, Japanese silver apricot, kew tree, kung sun shu, LI 1370, maidenhair tree, noyer du Japon, oriental plum tree, pei kuo, pei-wen, Pterophyllus, Pterophyllus salisburiensis, Rokan, salisburia, Salisburia adiantifolia, Salisburia macrophylla, silver apricot, sophium, tanakan, tanakene, tebofortan, tebonin, tempeltrae, temple balm, tramisal, valverde, vasan, vital, ya chio, yin-guo, yin-hsing.

Background

Ginkgo biloba has been used medicinally for thousands of years. Today, it is one of the top selling herbs in the United States.

Ginkgo is used for the treatment of numerous conditions, many which are under scientific investigation. Available evidence demonstrates ginkgo's efficacy in the management of intermittent claudication, Alzheimer's/multi-infarct dementia, and "cerebral insufficiency" (a syndrome thought to be secondary to atherosclerotic disease, characterized by impaired concentration, confusion, decreased physical performance, fatigue, headache, dizziness, depression, and anxiety).

Although not definitive, there is promising early evidence favoring use of ginkgo for memory enhancement in healthy subjects, altitude (mountain) sickness, symptoms of premenstrual syndrome (PMS), and reduction of chemotherapy-induced end-organ vascular damage.

Although still controversial, a recent large trial has shifted the evidence against the use of ginkgo for tinnitus.

The herb is generally well tolerated, but due to multiple case reports of bleeding, should be used cautiously in patients on anti-coagulant therapy, with known coagulopathy, or prior to some surgical or dental procedures.

Evidence

Claudication (painful legs from clogged arteries): Numerous studies suggest thatGinkgo bilobataken by mouth causes small improvements in claudication symptoms (leg pain with exercise or at rest due to clogged arteries). However, ginkgo may not be as helpful for this condition as exercise therapy or prescription drugs. Additional evidence is needed.
Grade: A

Dementia (multi-infarct and Alzheimer's type): The scientific literature overall does suggest that ginkgo benefits people with early stage Alzheimer's disease and multi-infarct dementia, and may be as helpful as acetylcholinesterase inhibitor drugs such as donepezil (Aricept®). Well-designed research comparing ginkgo to prescription drug therapies is needed.
Grade: A

Cerebral insufficiency: Multiple clinical trials have evaluated ginkgo for a syndrome called "cerebral insufficiency." This condition, more commonly diagnosed in Europe than the United States, may include poor concentration, confusion, absent-mindedness, decreased physical performance, fatigue, headache, dizziness, depression, and anxiety. It is believed that cerebral insufficiency is caused by decreased blood flow to the brain due to clogged blood vessels. Some research reports benefits of ginkgo in patients with these symptoms, but most have been poorly designed without reliable results. Better studies are needed before a strong recommendation can be made.
Grade: B

Acute hemorrhoidal attacks: In early study ginkgo was shown to be effective in the treatment of patients with acute hemorrhoidal attacks. Further research is needed to confirm these results.
Grade: C

Age-associated memory impairment (AAMI): Age-associated memory impairment (AAMI) is a non-specific syndrome, which may be caused by early Alzheimer's disease or multi-infarct dementia (conditions for which ginkgo has been shown to have benefit). There is preliminary research showing small improvements in memory and other brain functions in patients with AAMI, although some studies disagree. Overall, there is currently not enough clear evidence to recommend for or against ginkgo for this condition.
Grade: C

Altitude (mountain) sickness: A small amount of poorly designed research reports benefits of ginkgo for the treatment of altitude (mountain) sickness. Additional study is needed before a recommendation can be made.
Grade: C

Chemotherapy side effects reduction: In limited human study, ginkgo has been examined in addition to 5-fluorouracil (5-FU) in the treatment of pancreatic and colorectal cancer, to measure possible benefits on side effects. At this time, there is not conclusive evidence in this area.
Grade: C

Deafness (cochlear): Preliminary clinical study has been conducted on the effect of ginkgo in chronic cochleovestibular disorders. Further research is needed before a recommendation can be made.
Grade: C

Depression and seasonal affective disorder (SAD): Preliminary study of seasonal affective disorder (SAD) suggests that ginkgo is not effective in preventing the development of winter depression. Other research in elderly patients with depression shows possible minor benefits. Overall, there is not enough evidence to form a clear conclusion.
Grade: C

Gastric cancer: Ginkgo bilobaexocarp polysaccharides (GBEP) capsule preparation has been studied for upper digestive tract malignant tumors of middle and late stage with positive results. However, further research is needed before a recommendation can be made.
Grade: C

Glaucoma: Several small human studies report ginkgo may be associated with mild increases in blood flow to the eyes, vision and intraocular pressure. Well-designed research is needed before a recommendation can be made.
Grade: C

Macular degeneration: Preliminary research suggests that ginkgo may improve eye blood flow, although it remains unclear if macular degeneration is significantly affected by ginkgo. More research is needed in this area before a conclusion can be drawn.
Grade: C

Memory enhancement (in healthy people): It remains unclear if ginkgo is effective. Further well-designed research is needed as existing study results conflict.
Grade: C

Multiple sclerosis: Based on laboratory study, it has been suggested that ginkgo may provide benefit in multiple sclerosis (MS). Human research is limited to several small studies, which have not found consistent benefit. Additional research is needed before a recommendation can be made.
Grade: C

Premenstrual syndrome (PMS): Initial study in women with premenstrual syndrome or breast discomfort suggests that ginkgo may relieve symptoms including emotional upset. Further well-designed research is needed before a recommendation can be made.
Grade: C

Pulmonary interstitial fibrosis: Based on early study, ginkgo may be effective in treating pulmonary interstitial fibrosis. Further research is needed to confirm these results.
Grade: C

Quality of life: Early studies suggest that ginkgo may aid in quality of life. More randomized controlled trials are needed before a conclusion can be made.
Grade: C

Raynaud's disease: Results from one clinical trial suggest thatGinkgo bilobamay be effective in reducing the number of Raynaud's attacks in patients suffering from Raynaud's disease. In order to confirm these results, further clinical trials are required.
Grade: C

Retinopathy (diabetes mellitus type II): Early study suggestsGinkgo bilobaextract may offer benefit to individuals with retinopathy. Further clinical trials are required to determine efficacy.
Grade: C

Ringing in the ears (tinnitus): There is conflicting research regarding the use of ginkgo for tinnitus. Additional well-designed research is needed in order to resolve this controversy.
Grade: C

Sexual dysfunction: Ginkgo has been used and studied for the treatment of sexual dysfunction in men and women. In general, studies are small and not well designed. Additional research is needed before a recommendation can be made.
Grade: C

Stroke: Laboratory studies suggest that ginkgo may be helpful immediately following strokes because of possible antioxidant or blood vessel effects. However, initial study of ginkgo in people having strokes found no benefits. Further research is needed in this area.
Grade: C

Vertigo : A small amount of poorly designed research reports benefits of ginkgo for the treatment of vertigo. Additional study is needed before a recommendation can be made.
Grade: C

Vitiligo: Early study using oralGinkgo bilobaextract reports that ginkgo appears to arrest the progression of this disease. Better-designed studies are needed to confirm these results.
Grade: C

Cocaine dependence: One small study reports no benefit of ginkgo for cocaine independence.
Grade: D

Mental performance (after eating): The results of one study investigating the effect ofGinkgo bilobaon post-prandial mental alertness are unclear. Ginkgo may benefit some but not all endpoints. Further clinical trials are required before recommendations can be made.
Grade: D

Mood and cognition in post-menopausal women: Based on early study of chronic administration, Gincosan appears to have no beneficial effects on mood, anxiety, or sleepiness in post-menopausal women.
Grade: D