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Ginkgo (Ginkgo biloba) is the oldest surviving species of tree and is often referred to as "the living fossil". Based on fossil records, it probably originated during the Permian period about 250 million years ago. That Gingko is the only living species of its family speaks to its hardiness. To explore the characteristics, medicinal uses and prescribing considerations of this herb in more detail, check out the references indicated., 
- Common Names: Gingko, Maidenhair tree
- Family: Ginkgoaceae
- Habitat: Ginkgo can be found in South China and is rare or extinct in the wild. It is cultivated from monastery gardens.
- Parts Used: Leaves (root is used in China)
- Constituents: flavonoids, terpenoids
- Medicinal Actions: antioxidant, nerve protective, increases peripheral circulation (in small and medium arteries), bronchodilator, analgesic, anti-PAF, antitussive, cognition enhancing, tissue perfusion enhancing
The medicinal properities of Ginkgo were first recorded around 2800 BC. In Chinese folk medicine the leaf was used as an antitussive, antiasthmatic, and anodyne. In Europe, it is one of the most widely prescribed medications for the treatment of cognitive deficiency.
Gingko is one of the most researched herbal medications.
- reduced cerebral vascular circulation (cerebral vascular insufficiency), poor memory, dementia, cerebral arteriosclerosis, vertigo from poor circulation, emotionally labile, Alzheimer's disease (Gingko will only help if memory loss is due to cerebral vascular insufficiency not from heavy metal toxicity)
- Other Conditions
The information provided is intended to augment the treatment from a naturopathic doctor or other trained medical professional. Although most herbs are generally safe, it is recommended that you avoid self-prescribing especially when there is an underlying ongoing medical condition, if you are on any prescription medications or if you are pregnant or breastfeeding.
Formulations and Preparation
- Tincture - 1-30 drops three times daily
- Fluid extract - 1-20 drops three times daily
- Standardized extract - (24% flavoglycoside), 120-150mg daily to twice daily or 40-60mg three times daily
- Raw herb - 300mg daily
- Generally regarded as safe.
- Side-effects are extremely infrequent but can include gastrointestinal disturbances and headache and very rarely spontaneous bleeding.
- Pregnancy - use with caution
- Drug-Herb Interactions. Because of the antiplatelet activating factor properties Gingko should not be used with anticoagulant medications (e.g. blood thinners, clotting factor replacements, acetylsalicylic acid, ibuprofen, fish oils, vitamin E) as this may increase the risk of spontaneous bleeding.
- Anesthesia General - Interaction likely but uncertain occurrence and unclear implications; Possible increase in sleeping time. Mechanism is not known (significance is unclear, inadequate data).
- Antiplatelet Thromboprophylactics - Potential or theoretical adverse interaction of uncertain severity; Theoretical additive antiplatelet activity (significance not established, likely overstated). Gingko may allow lower dose of drug, reducing drug adverse effects. Avoid or Monitor INR.
- Cisplatin and Related Platinum Chemotherapy Compounds - Beneficial or supportive interaction with professional management, prevention or reduction of drug adverse effect; Gingko may help reduce platinum drug toxicities (neural and renal).
- Cyclosporine - Beneficial or supportive interaction with professional management, prevention or reduction of drug adverse effect; Gingko may help reduce PAF-mediated drug nephrotoxicity. Potentially important for allograft patients.
- Doxorubicin and Related Anthracycline Chemotherapy - Potential or theoretical beneficial or supportive interaction with professional management, prevention or reduction of drug adverse effects; Gingko protects against and reduces drug-induced cardiotoxicity through multiple mechanisms. Pretreat, co-administer, and continue herb postchemotherapy.
- Fluorouracil - Interaction possible but uncertain occurrence and unclear implications; Suggested additive therapeutic effect caused by increase in drug disposition by circulating effects of Gingko. Professional advice mandatory.
- Fluoxetine and Related Selective Serotonin Reuptake Inhibitor Antidepressants (SSRIs) - Beneficial or supportive interaction with professional management, prevention or reduction of drug adverse effect; Gingko reduces sexual dysfunction adverse effects (including erectile dysfunction) of drug through multiple mechanisms. May have additive antidepressant effect.
- Gentamicin and Related Aminoglycoside Antibiotics - Potential or theoretical beneficial or supportive interaction with professional management, prevention or reduction of drug adverse effect; Gingko may reduce drug induced ototoxicity through neuroprotective and neuroreparative mechanisms.
- Haloperidol and Related Antipsychotics - Potential or theoretical beneficial or supportive interaction with professional management, prevention or reduction in drug adverse effects; Gingko may reduce drug-induced tardive dyskinesia adverse effects through neuroprotective and neuroreparative actions.
- Surgery - Potentially harmful or serious adverse interaction - AVOID, bimodal or variable interaction with professional management, potential or theoretical beneficial or supportive interaction with professional management. Gingko may decrease hemostasis via antiplatelet effects pre-surgically. Anti-ischemic and neuroparative post-surgically. Stop Gingko 1 week pre-surgery and adopt post-surgically if indicated.
- Trazodone - Avoid until further data is available.
- Warfarin and Related Oral Vitamin K Antagonist Anticoagulants - Potential or theoretical adverse interaction of uncertain severity - AVOID; Theoretical additive effects on hemostasis caused by potential platelet inhibition (inadequate data, incidence and significance is not known, general risk is overstated). Audit elderly populations for undisclosed herb use. If co-administered, maintain regime, monitor INR. Hold if INR supratherapeutic or signs of abnormal bleeding occur.
- Boon Heather, Smith Michael (2009) 55 Most Common Medicinal Herbs: The Complete Natural Medicine Guide Second Edition Institute of Naturopathic Education and Research, CCNM Toronto.
- Godfrey Anthony, Saunders Paul, Barlow Kerry, Gowan Matt (2011) Principles and Practices of Naturopathic Botanical Medicine, Advanced Botanical Medicine. V3 CCNM Press, Toronto.
- Li GH, Lei XX, Yi YM, Xu BL, Wang HP, Du J (Sep 2008) Studies on the effect of Ginkgo biloba extracts on NF-kappaB pathway. Zhong Yao Cai;31(9):1357-60. PMID: 19180958.
- Stargrove Mitchell Bebell, Treasure Jonathan, McKee Dwight L (2008) Herb, Nutrient and Drug Interactions: Clinical Implications and Therapeutic Strategies.
- Brinker Francis (1997) Herbal Contraindications and Drug Interactions: Plus Herbal Adjuncts With Medicines, 4th Edition Eclectic Medical Publications.