Ginkgo biloba is a living fossil, whose direct ancestor formed on Earth over 200 million years ago in a form that is still around today in many Polish parks, as well as thousands of kilometers from South-east China where it was endemic. The natural characteristics of Gingko have been used in traditional Chinese medicine from ancient times, and its extract are some of the most popular diet supplements.
The main resourcee used for producing extracts are the leaves, which contain large amounts of tarpenoids, such as bilobalide and ginkgolides, which are considered to be the main biologically active ingredients of the extract. Moreover, the leaves are rich in flavonoids (kaempferol, quercetin, isorhamnetin, rutin), as well as organic acids and polipropenole. A standardized extract obtained from dried leaves of ginkgo contains 24% glycosides flavonoids and at least 6% terpene lactones. 1 g of this extract is equivalent to 50 g of leaves.1
Ginkoglide B contained in the extract of Ginkgo biloba acts as an inhibitor of the platelet activating factor receptor, which reduces the risk of blood clots occuring in blood vessels. PAF, despite the fact that it increases presynaptic excretion of glutamine and has a positive effect on long-term synaptic strengthening, which plays a fundamental role in the processes of learning and memory, may also intensify the effects of nerve tissue damage after a stroke. That is why the antagonist effect of ginkoglide B on PAF produces a neuro-protective effect while kaempferol has a protective effect against neurotoxicity caused by an excess of NMDA receptor activity of glutamine binding.2–5 Additionally, it was shown that the compounds in ginkgo increase the expression of transthyretin- a protein capable of binding β-amyloid, which in turn is responsible for Alzheimer's disease.4
Despite the fact that a meta-analysis of scientific articles has shown that Gingko biloba extract does not have a significant influence on executive functions, memory and attention in adults; many individual reports have demonstrated a wide range of effects from substances contained in Ginkgo.5–9 One study has proven that sub-chronic usage of the extract increases dopaminergic, noradrenergic, and cholinergic transmission in the prefrontal cortex, which is considered to be the center for our superego and is responsible for complex cognitive and intellectual functions, especially working memory and executive functions (decision-making, planning, organization, learning from mistakes, goal-realization).8,9 Additionally, it has been shown that Gingko biloba reduces AChE activity in the hippocampus, which suggests a possible influence on long-term memory.10 It was also shown that Gingko extract can block the effects of can block the action of monoamine oxidase, which may be the basis for its anxiolytic and anti-depressant effets.7
120 to 160 mg per day, preferably three times a day of 40 mg with meals.11
Phosphatidylserine intensifies the effects of the standardized extract on cognitive functions.12
• Gingko extract in combination with fluoxetine (Prozac), St. John's Wort and other herbs can cause nervousness and agitation.11
• Anticoagulants, aspirin, ibuprofen, diclofenac, naproxen - combined with Gingko extract may increase the risk of bruising and bleeding.11
• Ginkgo extract may reduce the effect of alprazolam and anticonvulsants.11
• Ginkgo extract may affect the rate of metabolism of some drugs by liver enzymes. Contact your doctor if you are taking the following medicines: clozapine, fluvoksamin, haloperidol, imipramine, olanzapine, propranolol, theophylline, zileuton, zolmitriptan, amitriptyline, citalopram, diazepam, lansoprazole, omeprazole, warfarin, selekoksib, diclofenac, amitriptyline, codeine, donepezil, fentanyl, meperidine, methadone, metoprolol, tramadol, cyclosporine, estogeny, insulin and other.11
• Do not take Ginkgo extract with drugs that may increase the risk of seizures, such as anaesthetics, antijak anestetyki, antiarrhythmic drugs, antibiotics (penicillin, cephalosporin), antidepressants, antihistamines, immunosuppressants (cyclosporine), drugs, stimulants (methylphenidate), theophylline, and others.11
Ginkgo extract is considered safe; however, some minor side effects may occur- such as abdominal pain, headache, dizziness, constipation, heart palpitations, and allergic skin reactions. Additionally, it should be taken into account that Ginkgo dilutes the blood and reduce its ability to form blood clots, that is why there are concerns that the extract may increase the risk of bruising and bleeding to occur. A few individuals have experienced bleeding in the eye and brain, as well as an excessive bleeding during surgery.11
Gingko is most likely not safe for pregnant women as it may increase the amount of bleeding while giving birth. The extract has also not been sufficiently studied on breast-feeding women.11
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