(Ginkgo biloba) is a well known herbal or natural medicine that is most
commonly thought to be useful for memory, prevention and/or treatment of
Alzheimer's related dementia, Raynaud's disease (or intermittent claudication),
erectile dysfunction, multiple sclerosis and tinnitus to name a few.1 The
wide variety of medical claims not only comes from anecdotal information, but
also stems from some studies. Furthermore, this variation in indications
is also due to the various proposed mechanisms of action for ginkgo, which
would have beneficial effects in each of these conditions.
active compounds found in ginkgo include flavonoids, bioflavonoids,
proanthocyanidins, and trilactonic diterpenes (ginkgolide A, B, C). The
majority of these components contribute to one or more of its pharmacodynamic
effects. The proposed mechanisms of action for ginkgo include the
there are other possibly mechanisms, these reflect the main mechanisms that
have some supporting pharmacodynamic data. Unfortunately, some of this
data is from animal or in-vitro analysis, thus making the extrapolation of
information into humans with supporting clinically relevant outcomes more
- National Institutes of Health. National Center for Complementary and
Alternative Medicine. Ginkgo. NCCAM Publicaton No. D290. July 2010.
- Chung KF, Dent G, McCusker M et al. Effect of a ginkgolide
mixture (BN 52063) in antagonising skin and platelet responses to
platelet activating factor in man. Lancet 1987;1(8527):248-51.
- Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997;336:1108.
- Koch E. Inhibition of platelet activating factor (PAF)-induced
aggregation of human thrombocytes by ginkgolides: considerations on
possible bleeding complications after oral intake of Ginkgo biloba
extracts. Phytomedicine 2005;12:10-6.
- Dorman DC, Cote LM, Buck WB. Effects of an extract of Gingko
biloba on bromethalin-induced cerebral lipid peroxidation and edema in
rats. Am J Vet Res 1992;53:138-42.
- Otamiri T, Tagesson C. Ginkgo biloba extract prevents mucosal
damage associated with small-intestinal ischaemia. Scand J
- Logani S, Chen MC, Tran T et al. Actions of Ginkgo Biloba related
to potential utility for the treatment of conditions involving cerebral
hypoxia. Life Sci 2000;67:1389-96.
- Barth SA, Inselmann G, Engemann R et al. Influences of Ginkgo
biloba on cyclosporin A induced lipid peroxidation in human liver
microsomes in comparison to vitamin E, glutathione and
N-acetylcysteine. Biochem Pharmacol 1991;41:1521-6.
- Duverger D, DeFeudis FV, Drieu K. Effects of repeated treatments
with an extract of Ginkgo biloba (EGb 761) on cerebral glucose
utilization in the rat: an autoradiographic study. Gen Pharmacol
- Wu Y, Li S, Cui W et al. Ginkgo biloba extract improves coronary
blood flow in healthy elderly adults: role of endothelium-dependent
vasodilation. Phytomedicine 2008;15:164-9.
- Liu HJ, Wang XL, Zhang L et al. Inhibitions of vascular
endothelial growth factor expression and foam cell formation by EGb 761,
a special extract of Ginkgo biloba, in oxidatively modified low-density
lipoprotein-induced human THP-1 monocytes cells. Phytomedicine
- Wada K, Ishigaki S, Ueda K et al. An antivitamin B6,
4'-methoxypyridoxine, from the seed of Ginkgo biloba L. Chem Pharm
- Arenz A, Klein M, Fiehe K et al. Occurrence of neurotoxic
4'-O-methylpyridoxine in Ginkgo biloba leaves, Ginkgo medications and
Japanese Ginkgo food. Planta Med 1996;62:548-51.
- Van Beek TA, Montoro P. Chemical analysis and quality control of
Ginkgo biloba leaves, extracts, and phytopharmaceuticals. J Chromatogr