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Ginkgo biloba

Ginkgo biloba is the most commonly ingested herb for brain health. While it may boost cognition in older populations, this effect is not very reliable or generalizable.

Our evidence-based analysis on ginkgo biloba features 298 unique references to scientific papers.

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Last Updated:

How to Take

Medical Disclaimer

Recommended dosage, active amounts, other details

Gingko biloba can be supplemented for cognitive enhancement, or to alleviate cognitive decline.

For cognitive enhancement, take 120-240mg, one to four hours before performance. To alleviate cognitive decline in older adults, take 40-120mg, three times a day.

The supplement form of Gingko biloba is also called EGb-761 extract. It should be a 50:1 concentrated extract.

Gingko biloba should be taken with meals.

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Human Effect Matrix

The Human Effect Matrix looks at human studies (it excludes animal and in vitro studies) to tell you what effects ginkgo biloba has on your body, and how strong these effects are.
Grade Level of Evidence
Robust research conducted with repeated double-blind clinical trials
Multiple studies where at least two are double-blind and placebo controlled
Single double-blind study or multiple cohort studies
Uncontrolled or observational studies only
Level of Evidence
? The amount of high quality evidence. The more evidence, the more we can trust the results.
Outcome Magnitude of effect
? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.
Consistency of research results
? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.
Notes
grade-a Notable High See all 11 studies
For usage of EGb-761 at 240-360mg daily as a therapeutic option in people who already are experiencing cognitive decline, then it appears to be reliably effective and comparable to 10mg Donepezil.
grade-a Minor High See all 12 studies
There appears to be a fairly reliable increase in short term memory and free recall associated with ginkgo supplementation in older individuals (55yrs or above) either with or without diagnosed neurodegenerative disease states.
grade-a Minor Very High See all 6 studies
There appears to be reduced symptoms of intermittent claudication with ginkgo supplementation, although it seems to vary significantly from one individual to another and despite some persons experiencing large benefit the overall 'net' benefit is relatively minor.
grade-b Notable Moderate See all 7 studies
There appears to be a quite potent yet quite unreliable reduction in symptoms of AMS when ginkgo is taken at 240mg daily for 1-5 days prior to a trip up a mountain. The reason for this variability is not known.
grade-b
Minor
- See all 7 studies
Ginkgo biloba has shown both vasodilatory effects (via nitric oxide metabolism) and some possible constrictive effects, depending on the context of supplementation.
grade-b Minor High See all 7 studies
Other parameters of cognition are differentially influenced by ginkgo, as facial recognition in those with dementia has noted improvement yet trip planning in middle-aged persons is unaffected.
grade-b Minor High See all 3 studies
An increase in ocular blood flow has been noted in instances of normal tension glaucoma as well as healthy controls, although a one-time oral dose is ineffective (at least two days supplementation is required)
grade-b Minor High See all 3 studies
An improvement in mood has been noted in persons with cerebral injury, but not in otherwise healthy middle aged persons.
grade-b Minor Very High See all 5 studies
Cognitive impairment that is associated with Alzheimer's appears to be significantly reduced with ginkgo supplementation.
grade-b - Very High See all 5 studies
Attentional focus and similar parameters (task switching) do not appear to be significantly influenced by ginkgo supplementation.
grade-b - Very High See all 7 studies
Despite the influence on blood flow and circulation, there does not appear to be a significant influence on blood pressure
grade-b - Very High See all 6 studies
No significant influence of ginkgo biloba supplementation on heart rate.
grade-b - Very High See all 3 studies
Despite the increase in ocular blood flow associated with repeated dosing of ginkgo biloba, there does not appear to be a significant modification of intraocular blood pressure in persons with normal IOP.
grade-b - Very High See all 4 studies
Although a potential benefit cannot be ruled out at this moment in time (the first pilot study showed promise and there are some responders), overall ginkgo does not appear to influence SSRI-induced sexual dysfunction in more well conducted trials.
grade-b - - See study
Although there is some scattered evidence to support the role of ginkgo in stroke recovery rates, the best evidence currently available does not find a significant therapeutic benefit.
grade-b - Very High See all 4 studies
There does not appear to be a significant and reliable therapeutic effect of ginkgo on tinnitus symptoms, although limited evidence suggests that if tinnitus is a side-effect of cognitive decline that it may be attenuated.
grade-b - Very High See all 3 studies
Despite the improvement in short term memory and recall, there does not appear to be a significant improvement in working memory.
grade-c Notable - See study
The 29.6% reduction in MPO concentrations following supplementation of 240mg EGb-761 in persons with metabolic syndrome was fairly notable.
grade-c Notable Moderate See 2 studies
In high risk individuals, the reduction has been noted to be 17.0+/-5.5%
grade-c Notable - See study
The study in diabetics noting a reduction in urinary albumin noted a near halving over 8 weeks with a low dose of ginkgo.
grade-c Minor - See study
Ginkgo appears to reduce symptoms of ADHD, but 80-120mg of the EGb-761 extract has been confirmed to be less potent than 20-30mg Ritalin
grade-c
Minor
- See 2 studies
Superoxide dismutase and glutathione have been noted to be increased with supplementation of ginkgo (240mg EGb-761) in persons with metabolic syndrome, while the abnormal elevation of these enzymes in schizophrenia is attenuated; essentially, a beneficial modulation appears to exist
grade-c Minor - See study
Prolonged supplementation of ginkgo biloba appears to confer anxiolytic effects in persons with generalized anxiety disorder. Anxiety in dementia may also be reduced secondary to treating the symptoms of dementia
grade-c Minor - See study
In high risk individuals, the reduction has been noted to be 23.4+/-7.9%
grade-c Minor - See study
In high risk subjects, supplementation of ginkgo biloba appeared to reduce atherosclerotic buildup relative to control at the standard supplemental dose.
grade-c Minor - See study
An increase in breast cancer risk has been noted to barely pass statistical significance in an analysis of cancer development in elderly persons (75 years or older) given EGb-761 daily for a median 6.1 years.
grade-c Minor - See study
A decrease in C-reactive protein is noted with supplementation of Ginkgo biloba
grade-c Minor - See study
One study to assess the effects of ginkgo biloba in cognition, which failed to improve alertness, noted an increase in self-reported calmness with 120mg (EGb-761)
grade-c Minor Very High See all 3 studies
There appears to be a significant improvement in blood flow to the middle and anterior cerebral arteries, although other arteries are unaffected.
grade-c Minor - See study
The increase in cortisol seen before a stress test is attenuated with supplementation of ginkgo, secondary to its anti-stress effects
grade-c Minor - See study
A slight decrease in urinary creatinine has been noted with ginkgo supplementation in diabetics with nephropathy
grade-c Minor - See study
There appears to be a reduction in general oxidation as assessed by biomarkers (reduced glutathione, etc.) associated with supplementation of ginkgo biloba
grade-c Minor - See study
A slight reduction in IL-6 has been reported in persons who are diagnosed with metabolic syndrome
grade-c Minor - See study
There is a small increase in microcirculation seen in elderly persons given ginkgo biloba, extending to both periphery and the liver. Benefits seem to be time dependent and greater at day 30 relative to day 10
grade-c Minor Very High See 2 studies
An increase in cGMP (downstream mediator of nitric oxide signalling) has been noted in high risk individuals alongside an increase in superoxide dismutase, to the degree of 27.7+/-8.3% and nitric oxide itself has been increased by up to 40% in persons with poor circulation.
grade-c Minor - See study
The study that investigated numerical working memory has noted an impairment associated with ginkgo relative to placebo
grade-c Minor - See study
In persons undergoing high altitude climbing, the reduced risk of AMD is associated with increased functional capacity of blood to carry oxygen.
grade-c Minor Very High See 2 studies
There appear to be reductions in the symptoms of PMS associated with ginkgo supplementation, the degree of reduction being reported at up to 23.68%
grade-c Minor - See study
Eye drops containing ginkgo biloba appear to be more effective than control in reducing symptoms of conjunctivitis (pink eye) after a month of treatment
grade-c Minor Very High See 2 studies
The number of errors seen in serial threes and serial sevens tasks appears to be reduced with acute supplementation of EGb-761
grade-c Minor Moderate See 2 studies
In older individuals, there appears to be an increase in processing speed without a sacrifice in accuracy
grade-c Minor - See 2 studies
Alongside improvements in general cognition in older individuals, an improvement in reaction time has been noted.
grade-c Minor - See study
There appears to be a significantly reduced risk of developing peripheral vascular diseases when using ginkgo biloba supplementation relative to placebo in older individuals
grade-c Minor - See study
An increase in serum BDNF has been confirmed in persons with schizophrenia and tardive dyskinesia only
grade-c Minor Very High See 2 studies
There may be an increase in sleep efficiency (reduced waking during the night) without any apparent enhancement of REM sleep, this seems to be related to the flavonoid portion
grade-c Minor - See study
There may be some anti-stress properties of ginkgo biloba supplementation when a single dose is taken prior to a stress test
grade-c Minor Moderate See all 4 studies
Symptoms of schizophrenia appear to be reduced with supplementation of ginkgo biloba (EGb-761 at 240-360mg daily), although all studies currently use ginkgo alongside standard antipsychotic therapy. It appears effective as an add-on
grade-c Minor - See study
Symptoms of tardive dyskinesia appear to be slightly reduced with supplementation of ginkgo biloba
grade-c Minor Very High See 2 studies
EGb-761 appears to be associated with skin repigmentation in persons suffering from vitiligo, although the degree of this effect is fairly modest
grade-c Minor - See study
Improvements have been noted in the visual field in persons with normal tension glaucoma, which is characterized by damage to this parameter. It is uncertain whether ginkgo increases visual acuity in otherwise healthy persons.
grade-c - - See study
No significant alterations are observed in apolipoprotein B concentrations
grade-c - - See study
In diabetics, ginkgo does not appear to significantly reduce blood glucose
grade-c - - See study
No significant influence on overall cancer risk associated with prolonged usage of EGb-761 in elderly individuals
grade-c - - See study
Supplementation of ginkgo does not appear to significantly influence depressive symptoms in older individuals
grade-c - Very High See 2 studies
Although ginkgo may have an acute therapeutic benefit, supplementation of ginkgo daily over the course of years in persons at risk for Alzheimer's does not appear to be too effective as a preventative supplement
grade-c - - See study
Similar to the inability of ginkgo biloba to influence Alzhiemer's disease occurrence, ginkgo does not appear to reduce the risk of developing dementia.
grade-c - - See study
The risk of myocardial infarction (as well as other heart conditions such as angina) does not appear to be significantly affected by ginkgo supplementation.
grade-c - - See study
The risk of stroke does not appear to be reduced with supplementation of 240mg EGb-761 in older individuals.
grade-c - Very High See 2 studies
The better conducted trial and parts of the preliminary evidence suggest no therapeutic benefit of ginkgo biloba in the treatment of autism
grade-c - - See study
Supplementation of ginkgo has failed to significantly benefit the cognition of persons with multiple sclerosis
grade-c - Very High See 2 studies
No significant influence of ginkgo biloba supplementation on the symptomology of Raynaud's Phenomenon
grade-c - Very High See 2 studies
No significant influence of supplemental ginkgo on verbal fluency even in persons with cognitive injuries.
grade-d Notable - See study
The lone study assessing the effects of topical application of 0.3% ginkgo flavonoids in a cream noted a 28% increase in skin moisture content over 28 days, a highly relevant increase.
grade-d Minor - See study
Skin smoothness/roughness is beneficially influenced with topical application of ginkgo flavonoids at 0.3%
grade-d Minor - See study
There appears to be a slight decrease in skin wrinkling following topical application of 0.3% ginkgo for 28 days

Studies Excluded from Consideration

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Things to Note

Also Known As

Tanakan, Tebonin, Rökan, Maidenhair, gingko

Do Not Confuse With

Pelargonium sidoides (EPs 7630)

Goes Well With

  • Phosphatidylserine (seems to enhance the efficacy of ginkgo biloba in youth, but limited evidence has a conflict of interest)

  • Panax Ginseng (exact synergism not known, but appears to be beneficial for quality of memory formation)

Caution Notice

Ginkgo is known to interact with drug metabolism enzymes

  • Ginkgo biloba may inhibit the CYP2B6 and CYP3A4 enzymes

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