What is Ginkgo?

Ginkgo biloba is one of the oldest living tree species, often called a "living fossil" with a history spanning over centuries. The leaves contain active compounds used medicinally for thousands of years, particularly in traditional Chinese medicine.

Active Compounds:

• Flavonoids: Powerful antioxidants that protect cells from oxidative damage
• Terpenoids (Ginkgolides & Bilobalide): Improve blood flow and protect nerve cells
• Organic Acids: Support various metabolic processes

Standardized extracts typically contain 24% flavone glycosides and 6% terpene lactones, known as EGb 761 (the most researched form).

Primary Functions & Benefits

Essential Functions:

• Vasodilation: Improves blood circulation, especially to the brain
• Antioxidant Activity: Neutralizes free radicals and reduces oxidative stress
• Neuroprotection: Protects brain cells from damage
• Anti-Inflammatory: Reduces inflammation throughout the body
• Platelet Aggregation Inhibition: Prevents excessive blood clotting

Health Benefits:

• Enhances cognitive function and memory (particularly in older adults)
• May slow cognitive decline in dementia and Alzheimer's disease
• Reduces anxiety and improves mood
• Supports eye health and may help with macular degeneration
• Improves intermittent claudication (leg pain from poor circulation)
• May reduce symptoms of vertigo and tinnitus
• Enhances sexual function (especially antidepressant-induced dysfunction)
• Supports cardiovascular health
• May improve symptoms of PMS and menstrual discomfort
• Potentially reduces symptoms of psychiatric disorders

Recommended Daily Amounts

Standard Dosing:

• Cognitive Enhancement: 120-240 mg daily (divided doses)
• Memory Support: 120-160 mg daily
• Dementia/Alzheimer's: 240 mg daily
• Anxiety: 240-480 mg daily
• Intermittent Claudication: 120-160 mg daily
• Sexual Dysfunction: 60-240 mg daily
• Vertigo/Tinnitus: 120-160 mg daily

Forms & Concentrations:

• Standardized Extract (50:1): Most common and researched
• Capsules/Tablets: Easiest to dose accurately
• Liquid Extracts: Faster absorption but harder to standardize
• Tea: Less concentrated, requires larger amounts

Note: Most research uses standardized extracts (24% flavone glycosides, 6% terpene lactones)

Timing & Administration

Optimal Timing:

• Morning and afternoon doses preferred (avoid evening if it causes insomnia)
• Divided doses (2-3 times daily) for best results
• Effects typically appear after 4-6 weeks of consistent use
• Long-term use (months) often needed for maximum cognitive benefits

With or Without Food:

• Can be taken with or without food
• With food may reduce potential stomach upset
• Consistency matters more than timing with meals

Duration:

• Safe for long-term use (months to years)
• Most studies show continued benefits with ongoing use
• Some practitioners recommend periodic breaks (e.g., 2 weeks off every 3 months)

Synergistic Supplements

Take WITH Ginkgo:

• Panax Ginseng: Enhanced cognitive function and energy
• Bacopa Monnieri: Complementary memory and learning support
• Phosphatidylserine: Synergistic brain health benefits
• B Vitamins (especially B6, B9, B12): Support cognitive function
• Omega-3 Fatty Acids: Enhanced neuroprotection and brain health
• Acetyl-L-Carnitine: Improved mental energy and cognition
• Rhodiola Rosea: Combined stress reduction and mental performance

Beneficial Combinations:

• Nootropic stacks for cognitive enhancement
• Circulation-supporting supplements (CoQ10, L-arginine)
• Antioxidant combinations (vitamins C, E, alpha-lipoic acid)

Interactions & What NOT to Take

DO NOT Combine With:

• Blood Thinners: Warfarin, heparin, aspirin (increased bleeding risk)
• Antiplatelet Drugs: Clopidogrel (Plavix), ticlopidine
• NSAIDs: Ibuprofen, naproxen (increased bleeding risk)
• Anticoagulants: Any medication that prevents clotting
• SSRIs/MAOIs: May increase serotonin syndrome risk
• Seizure Medications: Ginkgo may lower seizure threshold

Use Extreme Caution With:

• Diabetes Medications: May affect blood sugar levels
• High Blood Pressure Medications: May alter effectiveness
• Alprazolam (Xanax): Ginkgo may reduce effectiveness
• Omeprazole (Prilosec): May alter drug metabolism
• Ibuprofen: Increased risk of bleeding when combined

Other Supplements to Avoid:

• High-dose Vitamin E: Increased bleeding risk
• Garlic supplements: Additive blood-thinning effects
• Ginger (high doses): Increased bleeding risk
• Saw Palmetto: May increase bleeding risk
• Fish Oil (high doses): Additive anticoagulant effects

Who Should Take Ginkgo Biloba

Ideal Candidates:

• Adults over 50 experiencing mild memory decline
• Individuals with early-stage dementia or Alzheimer's
• People with poor circulation or intermittent claudication
• Those experiencing tinnitus or vertigo
• Individuals with anxiety or mild depression
• People seeking cognitive enhancement and focus
• Those with age-related macular degeneration
• Individuals with sexual dysfunction (especially SSRI-related)
• People experiencing altitude sickness
• Those with peripheral artery disease

May Benefit:

• Students or professionals seeking mental performance
• Individuals with attention difficulties
• People with chronic fatigue affecting cognition
• Those recovering from stroke (under medical supervision)

Who Should AVOID or Use Caution

Absolute Contraindications:

• Bleeding Disorders: Hemophilia, von Willebrand disease
• Upcoming Surgery: Stop 2 weeks before any surgical procedure
• Active Bleeding: Any current bleeding condition
• Seizure Disorders: Epilepsy or history of seizures
• Pregnancy & Breastfeeding: Safety not established
• Children: Not recommended under 18 without medical guidance

Use Caution:

• Individuals taking blood-thinning medications
• People with diabetes (monitor blood sugar closely)
• Those with infertility issues (may affect fertility)
• Individuals with known ginkgo seed allergy
• People scheduled for dental procedures
• Those with gastric ulcers or GERD
• Individuals with schizophrenia or psychotic disorders

Deficiency Symptoms

Ginkgo biloba is not an essential nutrient, so true "deficiency" doesn't exist. However, individuals may experience conditions that ginkgo helps address:

Signs You Might Benefit:

• Mental fog or poor concentration
• Age-related memory decline
• Reduced circulation (cold hands/feet)
• Difficulty with complex mental tasks
• Poor word recall or verbal fluency
• Slow information processing
• Leg pain when walking (claudication)
• Persistent ringing in ears
• Visual disturbances from poor circulation
• Dizziness or balance issues

Conditions Associated With Potential Benefit:

• Mild cognitive impairment
• Vascular insufficiency
• Age-related sensory decline
• Chronic inflammation
• Oxidative stress conditions

Adverse Effects & Toxicity

Common Side Effects (Generally Mild):

• Headache (most common)
• Dizziness or lightheadedness
• Upset stomach or nausea
• Diarrhea or constipation
• Heart palpitations
• Skin irritation or allergic reactions
• Restlessness or insomnia

Serious Adverse Effects (Rare):

• Increased Bleeding Risk: Easy bruising, nosebleeds, bleeding gums
• Seizures: Very rare but documented
• Severe Allergic Reactions: Rash, itching, swelling, difficulty breathing
• Liver Toxicity: Extremely rare
• Severe Gastrointestinal Issues: Bleeding or severe upset

Toxicity Concerns:

• Ginkgotoxin: Found in seeds (not standardized leaf extracts)
• Ginkgolic Acids: Present in crude extracts, removed in quality supplements
• Standardized extracts are generally well-tolerated
• Doses up to 600 mg daily studied with acceptable safety profile

Warning Signs to Stop Use:

• Unusual bleeding or bruising
• Severe headaches or dizziness
• Seizure activity
• Allergic reaction symptoms
• Severe gastrointestinal distress
• Vision changes or eye pain

Special Considerations

Cognitive Enhancement:

• Effects are subtle and cumulative
• More effective for age-related decline than healthy young adults
• Requires consistent use for 6-12 weeks for full effects
• Not a "smart drug" but supports brain health over time

Circulation Improvement:

• Benefits most noticeable in those with existing circulation problems
• May take several weeks to months for maximum effect
• Particularly helpful for peripheral vascular conditions

Age-Related Factors:

• Elderly: Generally, most beneficial population
• Middle-Aged: May provide preventive cognitive benefits
• Young Adults: Limited evidence for cognitive enhancement in healthy individuals
• Children: Not recommended without medical supervision

Quality & Standardization:

• Choose standardized extracts (24/6 ratio)
• Look for EGb 761 or similar quality standards
• Avoid raw ginkgo seeds (toxic ginkgotoxin content)
• Third-party testing recommended (ConsumerLab, USP)
• Cheaper products may not contain therapeutic amounts

Absorption Factors:

• Well-absorbed orally
• Bioavailability varies by formulation
• Fat content in meals doesn't significantly affect absorption
• Standardized extracts provide consistent active compounds

Clinical Evidence

Strong Evidence For:

• Improving cognitive function in dementia
• Reducing intermittent claudication symptoms
• Improving quality of life in Alzheimer's patients
• Supporting circulation

Moderate Evidence For:

• Anxiety reduction
• Age-related memory improvement
• Tinnitus relief (mixed results)
• Sexual dysfunction improvement

Weak/Insufficient Evidence For:

• Preventing dementia in healthy adults
• ADHD treatment
• Multiple sclerosis symptoms
• Preventing altitude sickness

Summary & Key Takeaways

Ginkgo biloba is one of the most researched herbal supplements with particular benefits for cognitive function, circulation, and age-related decline. It works gradually and requires consistent use for weeks to months. The primary safety concern is increased bleeding risk, especially when combined with blood-thinning medications.

Bottom Line: Best suited for older adults experiencing mild cognitive decline or circulation issues. Choose standardized extracts (24% flavone glycosides, 6% terpene lactones), take 120-240 mg daily in divided doses, expect results after 4-6 weeks of consistent use, and avoid if taking blood thinners or have bleeding disorders. Always inform your healthcare provider before starting, especially if taking medications or planning surgery.