Ginkgo biloba

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

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).

There is promising early evidence favouring 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.

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.

Claudication (painful legs from clogged arteries)

Numerous studies suggest that Ginkgo biloba taken 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. Preliminary research comparing ginkgo to pentoxifylline (Trental®) has not provided clear answers. Most studies have used 120 milligrams of ginkgo per day, divided into two to three doses, for up to six months. Additional evidence is needed from well-designed studies comparing or combining ginkgo with drug and exercise therapies.

Dementia (multi-infarct and Alzheimer's type)

Many human and laboratory studies have examined the use of ginkgo for dementia. Most research has not been well designed. Despite these deficiencies, the scientific literature overall does suggest that ginkgo (120 to 240 milligrams daily) 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.

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.

Sexual dysfunction

Ginkgo has been used and studied for the treatment of sexual dysfunction in men and women. Ginkgo may be effective in the treatment of erectile dysfunction, based on human and animal studies that show blood vessel relaxant properties, which may improve blood flow in the penis to achieve an erection. Ginkgo has also been reported in limited human study to treat sexual dysfunction in men and women caused by antidepressant drugs, such as fluoxetine (Prozac®), although other study results disagree. In general, studies are small and not well designed. Additional research is needed before a recommendation can be made.

http://www.mayoclinic.com/health/ginkgo-biloba/NS_patient-ginkgo