The Ginkgo tree (Ginkgo biloba) is still found growing wild in China, the only species remaining from an ancient genus that originated in the Jurassic period. It is a tall tree which has fan-shaped leaves that turn yellow in Autumn, and edible nuts that are toxic if eaten in quantity, especially when raw.

Ginkgo has been used as a medicine for millennia and is regarded as particularly good for supporting the elderly due to its stimulating effect on the circulation. Constituents in this herb cause the dilation of capillaries which increases the flow of oxygen and nutrients to the extremities and the brain. They also inhibit clotting, dampen inflammation, and reduce oxidative stress, an impressive suite of activities valuable in supporting healthy aging, mental exertion, physical performance (VO2max, blood anti-oxidant levels¹), and a range of pathological conditions. These include dementia, stroke, sexual dysfunction, Raynaud syndrome, Meniere’s disease, as well as acute mental fatigue and poor memory caused by prolonged study.²

The term dementia covers several conditions that afflict the elderly including Alzheimer’s disease and vascular dementia (stroke). These conditions produce progressive impairments in thought, memory, language, living skills and other behaviours. Such symptoms affect the patient’s quality of life and cause distress to caregivers, and while there is no cure, any improvement or slowing of decline is advantageous, keeping the patient out of a nursing home as long as possible. To this end a Ginkgo extract (EGB 761) has been shown to be significantly better than placebo in reducing behavioural and psychological symptoms of dementia.³

In the case of Alzheimer’s disease we find significant changes in the brain at the molecular level taking place early in the disease: oxidative damage and the formation of tau proteins; Aβ proteins clumping to form plaques; formation of neurofibrillary tangles; and chronic inflammation. Ginkgo meets this challenge with several neuroprotective effects including antioxidant, anti-neuroinflammatory, and anti-apoptotic activity, as well as protecting against neurotoxicity caused by plaque aggregation, and tau protein phosphorylation.⁴

Of course we look to other interventions when treating dementia in tandem with Ginkgo, a markedly different approach to conventional medicine which relies on cholinesterase inhibitors. These interventions may be the use of focussed supplements, or an improved diet of wholefoods rich in a range of vitamins, minerals, polyphenols and fatty acids. Of particular efficacy are vitamins C, E, B and D, selenium, iron, zinc, omega-3 fats, as well as the avoidance of trans fats, refined sugars, aluminium and fluoride. Other useful herbs are turmeric, bacopa, withania, cinnamon and green tea which points to a holistic approach including social involvement and exercise.^4–7

In the case of acute ischemic stroke, Ginkgo can immediately protect against reperfusion injury as well as keep oxygen and nutrient flow at optimum levels to aid recovery. It does this by reducing oedema, inflammatory cell injury, endoplasmic reticulum stress and other metabolic disturbances that result in neuronal cell death. A recent metanalysis of 12 clinical trials involving stroke patients did indeed find that Ginkgo biloba extract was associated with an improvement in neurological function, and ‘activities of daily living.’^8,9

Another common problem of aging is degenerative diseases of the eye due to circulatory problems, ischemia, poor oxygen supply, and oxidative stress. These conditions are glaucoma, macular degeneration, diabetic retinopathy and cataract formation, all of which can potentially be ameliorated by treatment with Ginkgo extract.^2,10,11

The fact that Ginkgo can inhibit clotting is the reason it, as well as garlic and ginger, is sometimes contraindicated with warfarin administration, a common medication given to the elderly. Fortunately none of these herbs significantly affects the pharmacokinetics, pharmacodynamics of warfarin at recommended doses.¹²

A version of this Article appears in the 2021 eBook edition of Wholefoods And Common medicinal Herbs.

Disclaimer: this article is intended for the purpose of general education only, and is not a substitute for a diagnosis, treatment advice, or a prescription given in a consultation with a qualified physician.

References:

1.         Sadowska-Krępa E, Kłapcińska B, Pokora I, Domaszewski P, Kempa K, Podgórski T. Effects of Six-Week Ginkgo biloba Supplementation on Aerobic Performance, Blood Pro/Antioxidant Balance, and Serum Brain-Derived Neurotrophic Factor in Physically Active Men. Nutrients 2017;9.

2.         Labkovich M, Jacobs EB, Bhargava S, Pasquale LR, Ritch R. Ginkgo Biloba Extract in Ophthalmic and Systemic Disease, With a Focus on Normal-Tension Glaucoma. Asia Pac J Ophthalmol (Phila) 2020;9:215–25.

3.         Savaskan E, Mueller H, Hoerr R, von Gunten A, Gauthier S. Treatment effects of Ginkgo biloba extract EGb 761® on the spectrum of behavioral and psychological symptoms of dementia: meta-analysis of randomized controlled trials. Int Psychogeriatr 2018;30:285–93.

4.         Sharma A, Kumar Y. Nature’s Derivative(s) as Alternative Anti-Alzheimer’s Disease Treatments. J Alzheimers Dis Rep 2019;3:279–97.

5.         Hu N, Yu J-T, Tan L, Wang Y-L, Sun L, Tan L. Nutrition and the risk of Alzheimer’s disease. Biomed Res Int 2013;2013:524820.

6.         Goschorska M, Baranowska-Bosiacka I, Gutowska I, Metryka E, Skórka-Majewicz M, Chlubek D. Potential Role of Fluoride in the Etiopathogenesis of Alzheimer’s Disease. Int J Mol Sci 2018;19.

7.         Frisardi V, Solfrizzi V, Capurso C, et al. Aluminum in the diet and Alzheimer’s disease: from current epidemiology to possible disease-modifying treatment. J Alzheimers Dis 2010;20:17–30.

8.         Chong PZ, Ng HY, Tai JT, Lee SWH. Efficacy and Safety of Ginkgo biloba in Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Am J Chin Med 2020;48:513–34.

9.         Feng Z, Sun Q, Chen W, Bai Y, Hu D, Xie X. The neuroprotective mechanisms of ginkgolides and bilobalide in cerebral ischemic injury: a literature review. Mol Med 2019;25:57.

10.       Park JW, Kwon HJ, Chung WS, Kim CY, Seong GJ. Short-term effects of Ginkgo biloba extract on peripapillary retinal blood flow in normal tension glaucoma. Korean J Ophthalmol 2011;25:323–8.

11.       Evans JR. Ginkgo biloba extract for age-related macular degeneration. Cochrane Database Syst Rev 2013;CD001775.

12.       Choi S, Oh D-S, Jerng UM. A systematic review of the pharmacokinetic and pharmacodynamic interactions of herbal medicine with warfarin. PLoS One 2017;12:e0182794.