Ginkgo Supplements
Description
The Ginkgo biloba tree has been called "the doyen of trees," because of its antiquity. It is believed to pre-date the ice age. Individual trees are believed capable of living 2000 to 4000 years, and some in existance are dated to over a 1000 years. It is the sole remaining species of the so-called Ginkgophyte botanical division which, according to fossil records, once flourished on the earth. Hence, Ginkgo is also often called "a living fossil."
The tree is basically native to China and Japan (though there is evidence it was native to Europe at some ancient date), but has been extensively cultivated throughout the world due to its hardy nature. Ginkgo biloba is remarkably resistant to all kinds of pollution, virus and fungi. It has a unique history, unique life cycle, and extremely unique biochemistry.
Asian cultures have used the kernel of Ginkgo medicinally for hundreds of years. The body of folklore surrounding this practice is quite extensive. However, the modern Western use of ginkgo is limited exclusively to the leaf. Since very little folk medicine has had a chance to develop concerning the leaf (the use of which began seriously as recently as the early 1970's), current use of Ginkgo is an anomaly in herbal medicine, being almost completely without a body of historical experiential data upon which to build an experimental science. It is almost as if the modern scientific body of information on Ginkgo sprang up overnight.
Ginkgo biloba extract is a complex product or compound, whose method of preparation has become very well-defined and exacting (there are, however, just a few labs in the world with the capability and know-how to do it). The green leaves of the tree are usually harvested from trees growing in plantations in South Korea, Japan and France. Growing, harvesting and extracting are perfectly standardized and controlled, insuring all undesirable substances are eliminated and certain levels of active constituents are obtained.
Method of Action
Active constituents in Ginkgo leaves are flavoglycosides (heterosides), and quercetin, as found in the leaf. These constituents should not be isolated, but should be present in a concentrated extract. Such an extract would be expected to contain about 24% flavoglycosides and 10% quercetin (which is itself a flavonoid). The use of whole leaf is of little efficacy. The product is only effective when extracted and concentrated. In addition to the guaranteed potency constituents, a substantial amount of pharmacologically active terpene derivatives (ginkgolides and bilobalides) should also be present.
Cerebral vascular effects
In a typical pre-clinical study using standard pharmacological procedures, microscopic particles are injected into the carotid artery of rats to mimic arterial blockage. The administration of ginkgo biloba successfully protects the animals against the destructive effects of this procedure. Under the influence of Ginkgo, increased levels of glucose and ATP occur, which helps to maintain energy levels within individual cells. In the above procedures following the injection of microspheres, there is usually a period of several hours characterized by a hypertensive burst, during which time considerable damage is done to the blood-brain barrier (that physiological system preventing toxic substances from entering the brain mass from the surrounding blood vessels). The damage begins with just small molecules passing the barrier, but progresses until increasingly larger substances cross over.
In later stages, considerable swelling (edema) of cerebral tissues becomes evident. The administration of Ginkgo during the initial stages prevents the later stages by stabilizing the membranes involved in the blood-brain barrier. Other studies have shown stabilization takes place through direct action on the ionic potential across the membranes and indirectly, through action on intracellular (mitochondrial) respiration. These actions result in diminution of cerebral edema and essentially complete restoration of function.
Cerebral edema is one of the most common complications of advancing age. It is profoundly important Ginkgo biloba is able to inhibit the occurrence of cerebral edema and eliminate its neurological consequences.
Alzheimer's disease
Research on the possible affects of Ginkgo in patients suffering from Alzheimer's disease and other age-related cognitive disorders is currently underway, and preliminary discussions are extremely promising.
In reviewing the available research, one scientist concluded Ginkgo extract showed exceptional promise as the drug of choice "in all types of dementia, and even in patients suffering from cognitive disorders secondary to depression, because of its beneficial effects on mood. Of special concern are people who are just beginning to experience deterioration in their cognitive function. Ginkgo biloba extract might delay deterioration and enable these subjects to maintain a normal life and escape institutionalization.
In addition, Ginkgo biloba extract appears to be a safe drug, being well tolerated, even in doses many times higher than those usually recommended.
Free radical inhibitor
Ginkgo demonstrates an ability to neutralize free radicals. That free radicals are directly implicated in the aging process as well as in many other debilitating conditions, is a reason why medical science is always in search of new and better ways to neutralize or destroy these pathological agents.
Since oxygen is the major source of free radicals, oxygen scavengers are among the best substances used to prevent the formation of free radicals.
The flavonoids of Ginkgo, including quercetin, are extremely potent oxygen scavengers. Possessing a particular affinity for the central nervous system as well as the adrenal and thyroid glands, Ginkgo is ideally suited for use in protecting the heart, blood vessels, and brain against the destructive influence of free radicals.
Free radical inhibition by Ginkgo has been reported in a number of petri dish models. Ginkgo not only destroys existing free radicals, but also inactivates their formation, and inhibits membrane lipid peroxidation (a destructive effect for which free radicals are partly responsible). Finally, through its anti-radical activity, Ginkgo exerts a stimulant effect on the biosynthesis of prostanoids (substances which, among other things, are capable of dilating blood vessels, thereby contributing to the prevention of high blood pressure).
Ginkgo significantly prevents the onset and severity of visual impairment due to diabetes, probably because of its effect on free radicals.
Ginkgo significantly improves long distance visual acuity in human patients suffering from senile macular degeneration (macula refers to an opacity of the pupil occurring in the elderly). Free oxygenated radicals are thought to be the cause of this condition.
Ginkgo has displayed a protective effect against argon laser blast-induced lesions of retinal cells. Such lesions are partly related to the production of free radicals in a fairly complex manner. The investigators concluded pretreatment with Ginkgo, by capturing the free radicals, prevented significant tissue damage.
Mental and behavioral effects
In a 12 week study, elderly patients expressing no particular complaint were selected to receive Ginkgo (120mg) or placebo on a daily basis. EEG readings were taken daily and certain behavioral and psychometric tasks were engaged in. The Ginkgo produced definite improvements in alertness measures in persons in whom there was room for improvement but induced no change in the persons whose initial performance was already at a high level. In comparison to controls, the experimental subjects showed a substantial increase in vigilance as measured by simple reaction time tests and multiple choice reaction tests. These results contrasted somewhat with results obtained in an early trial in which healthy young girls improved significantly on a memory test after ingesting 600 mg of Ginkgo. The general implication of these studies is Ginkgo increases the rate of information processing at neuronal levels, not only in geriatric persons with deteriorating mental function but perhaps also in healthy young individuals.
In another study, 8 healthy female volunteers were administered variable doses of Ginkgo one hour before being subjected to a battery of tests, including critical flicker fusion (when do two flickers look like one), choice reaction time, subjective rating scale, and the Sternberg memory scanning test (a measure of short term memory). A 600 mg dose produced significant differences in scores on the Sternberg test; the first 3 measures were not affected.
These results differentiate Ginkgo from sedative and stimulant drugs (which would affect the first 3 tests) and suggest a selective effect of Ginkgo on the memory process. Keep in mind these tests took place just one hour following the administration of the compound. This quick acting effect, when placed in context with the longer periods required for the vascular action, suggest a whole continuum of properties attributable to this herb.
Utilizing the EEG, one study determined the effects of Ginkgo in 3 pathological animals models, in young healthy volunteers and in elderly people with dementia disorders. It was found the EEG tracings correlated well with the psychometric tests employed. The results confirmed those of other clinical trials and especially highlighted the ability of Ginkgo to enhance alertness in the human subjects.
Not many long term studies have had a chance to be conducted, given the short history of Ginkgo research, but one such study was recently reported. Using 166 patients, researchers tracked the effects of Ginkgo on a battery of behavioral, clinical and physiological measures (such as those discussed elsewhere) of cerebral disorders due to aging. Differences between control and treatment groups became clearly apparent after just three months. Over the ensuing months, the differences increased - a dramatic demonstration of benefits available from the use of Ginkgo extract.
Neurotransmitters
Pretreatment with Ginkgo significantly increases blood flow to the brain, and, perhaps more critically, it also produces a significant rise in dopamine synthesis, a neurotransmitter critical to the transfer of information and electrochemical impulses between nerves and other nerves, and between nerves and muscles, glands, organs, blood vessels and other structures of the body.
Studies on the contractile action of Ginkgo on isolated rabbit aorta have found this action is probably due to the ability of the substance to stimulate the release of still other neurotransmitters: the catecholamines, namely epinephrine and norepinephrine.
Because of its capacity to release catecholamines, Ginkgo could affect the functioning of the entire network of catecholaminergic, glandular, cardiovascular and nervous systems of the body (perhaps the most extensive network upon which depends the most important functions of life). Ginkgo exerts a specific effect on the noradrenergic system (noradrenergic is the name of the nervous system depending primarily on the presence of norepinephrine), as well as on beta-receptors. Beta receptor sites, when activated, produce among other things dilation of airways in the lung, and dilation of peripheral blood vessels - i.e., those going to muscles, etc. The best description of the effect of Ginkgo on the noradrenergic system is "reactivation."
In the aging process, this system especially in the brain, begins to lose vigor; associated symptoms of memory loss, speech defects, and decrease in alertness appear. By reactivating the noradrenergic system of the cerebral cortex, Ginkgo promises to be an important substance in the prevention of premature aging.
Ginkgo also affects the cholinergic aspect of the nervous system. The decline in function of this system is also implicated in the aging process and the onset of dementia. Using rats as a model of this condition, researchers have found the oral administration of Ginkgo significantly increases population of appropriate cholinergic receptor sites in the brain. Rather than having a direct effect on transmitter substances, in this case the compound works by proliferating sites that can be activated by cholinergic neurotransmitters. The end result is the same: revitalization of decreasingly effective cerebral tissue.
Pain reduction
Ginkgo is used to treat vascular disturbances of the inner ear
Both structural and function disturbances of the inner ear have been successfully treated with Ginkgo. These problems all stem from some underlying vascular defect.
In one study Ginkgo was given to patients suffering from hearing loss due to old age (presbyacusia), patients with persistent ringing in the ears, and patients with vertigo. Improved hearing was experienced by 40% of the presbyacusia patients; those who didn't respond were assumed to have irreversible lesions of the sensory structures of the inner ear. Most of those patients with ringing in the ear experienced significant improvement within 10-20 days. The action of Ginkgo on cerebral circulation resulted in swift and complete disappearance of vertigo. The researcher concludes his study with the admonition to use Ginkgo not only for treatment, but also for prevention of otorhinolaryngeal problems.
Similar results were obtained by various other investigators
An 88% success rate was obtained in one study involving 49 patients suffering variously from hearing loss, ringing, vertigo and labyrinthine syndrome. The consensus of such studies is Ginkgo is highly recommended in neurosensory diseases of the inner ear of vascular origin which manifest themselves by ringing the ear, vertigo and headache.
Severe cochleovestibular disturbances with a vascular component are subject to amelioration by Ginkgo is reported in a recent study. In deafness of long standing, the results were poor, but even then about half of such cases definite improvement was seen. Such results are truly remarkable. In recent deafness, following head injuries or sonic damage, the results were very good in more than 60% of the cases. Ringing in the ear improvement significantly even in very severe cases at a rate of 74%.
Almost all patients with vertigo reported significant improvement.
In one study devoted explicitly to vertigo, 70 patients were given Ginkgo or placebo over a 3 month period. The effectiveness of the Ginkgo on the intensity, frequency and duration of the disorder was statistically significant. At the end of the trial, 47% of the patients receiving Ginkgo were completely free of their symptoms (18% of the placebo group recovered). Other studies have essentially replicated the findings of this one.
Platelet aggregation
Ginkgo has an inhibitory effect on blood platelet aggregation, meaning it effectively reduces the tendency of blood components to stick together; therefore, it reduces the tendency for dangerous clots or thrombi to form in veins and arteries. The ability to inhibit blood clotting implies, of course, Ginkgo is probably an effective agent in the prevention of coronary thrombosis and in recovery from strokes and heart attacks, etc.
Vascular effects
Ginkgo exerts considerable anti-spasmodic or sedative effects, and has excellent restorative effect on the nervous system26. Over one hundred patients with organic and neurological angiopathy, as well as ten healthy volunteers, were observed for changes in several physiological parameters resulting from exercise, after using Ginkgo. It was concluded Ginkgo treatment should be considered in any case of central and peripheral vascular disease. Interestingly, they also found Ginkgo should be an effective treatment for diabetic angiopathy as it decreases the consumption of insulin.
In persons recovering from thrombosis (blood clot in artery of heart), it was found Ginkgo lowered blood pressure and dilated peripheral blood vessels, including the capillaries.
Ginkgo has been found to affect the microcirculation of the conjunctiva in elderly patients suffering from disturbances in cerebral blood supply.
These studies have found a consistent increase in capillary and venous blood flow to the head resulting from decreased resistance to flow. The reduction in flow was not accompanied by hypotension or any appreciable variations in blood pressure.
Some observers view the action of Ginkgo on venous tone as a regulation rather than as a simple increase, since the herbal extract corrects venular spasms often occurring in elderly, often arteriosclerotic, patients. The regulatory action makes ginkgo a unique product - at one and the same time able to combat disturbances resulting from vascular spasm, and able, with the same efficiency, to restore tone and circulation in areas subject to vasomotor paralysis.
It has also been found the use of Ginkgo Biloba avoids another common complication caused by the more orthodox hypotensive medications: it increases peripheral blood flow without sacrificing cerebral circulation.
A common side-effect of standard peripheral vaso-dilators is blood tends to accumulate in the expanded vessels rather than circulate to the veins feeding the central nervous system, whose supporting vascular micro-structure is not affected by the drug. Ginkgo avoids this complication by simultaneously increasing blood flow to the periphery and to the brain.
With 20 patients between the ages of 62 and 86 years serving as subjects, a 1977 study attempted to discover the effect of very low doses of Ginkgo, administered over a two week period. All subjects were experiencing a lack of adequate blood supply to the brain (cerebral circulatory insufficiency) due to age and arteriosclerosis. The expectation of the investigators was combination of age, health of subjects, and the low dosage, would preclude any kind of spectacular results. Yet, of 20 subjects, 15 responded dramatically with much improved cerebral hemodynamics.
In a six month long study in patients with peripheral arterial insufficiency, Ginkgo was able to produce significant improvement in all experimental measures, including measures of ability to walk long distances without pain, and on blood flow to the legs. The experimenters describe the results as not only statistically significant, but as clinically remarkable.
Administered to patients with Parkinson's disease secondary to cerebral arteriosclerosis, Ginkgo increased blood supply to the brain and improved its nutritional status. The latter finding has not been investigated thoroughly. It crops up now and again, usually as a by-product of a study, rather than as the subject proper of the study.
Many other studies of improved vascular flow could be reviewed here. Instead, we will summarize some of the more important results as follows (over 95% of the following studies were double-blind placebo controlled trials):
65% successful treatment of 30 patients with focal or diffuse cerebral vascular disease.
80% successful treatment of 47 patients with cerebral circulatory insufficiency, measured as improvement in mental functioning, EEG parameters, and cerebral angiogram. This study was a good demonstration of the potential benefit of Ginkgo in the treatment of disease with both neural and circulatory components.
80% success rate in 60 patients with chronic cerebral insufficiencies measured by improvement in functional symptoms such as vertigo, headache, etc.
Successful treatment of 60 patients with cerebral insufficiency as measured by ECG, EEG, computer tomography of the skull, and psychological tests.
92% success rate in patients with cerebrovascular insufficiency in which all pathological findings disappeared after 18 days of treatment.
80% success in treating headache and lesser percent success in case of migraine, though still highly significant considering subjects had complained of migraine for a long time and had already received other treatments - authors conclude Ginkgo should be considered as one of the most effective drugs against migraine. 23 of 30 cases of dystrophy following venous insufficiency and is a complication of varicose disease or postphlebitic disease - successfully treated.
40% success in the treatment of 49 elderly patients with peripheral arteriopathy (arterial insufficiency of lower limbs), some with angiopathy complicating senile diabetes mellitus, as measured by improvement in general psychophysical performance and in capacity to adapt to the environment.
72% success in the treatment of chronic vasculopathies normally treated with vasodilators which unfortunately end by lowering vascular tone rather than restoring it; Ginkgo acts by toning the arterioles to produce the vasodilator effect.
82% success in study similar to one above, as measured by maximum walking distance, oscillometric index, mean blood pressure, plethysmography and systolic blood pressure. Successful treatment of 21 patients with the very severe and rapidly disabling vascular disease of the lower limbs called chronic arterial obliteration, as measured both instrumentally and functionally; recommendation made G.B.E. be used for all patients with this disease unless surgery was impending.
Proctology
Patients suffering from acute and chronic hemorrhoids have received great relief from the use of Ginkgo. One early study reported good or very good results in 86% of several dozen patients with hemorrhoids in a more or less advanced stage. The compound was particularly effective in individuals with congestive conditions and bleeding. Ginkgo appears to have less effect on fissures, but is very good at relieving pain and stopping rectal bleeding.
Therapeutic Approaches
GBE has gained widespread acceptance as an exceptional therapeutic agent in : Alzheimer’s disease, asthma, circulatory disorders, depression, dizziness, free radical scavenging (also termed “anti-aging”), hearing loss, hemorrhoids, impotence, macular degeneration, migraines, pain syndromes associated with diabetic neuropathy, retinopathy, strokes, tinnitus and vertigo.
Capsule
Twice daily. 60mg (containing 14.4mg (24%) flavoglycosides, of which 6m or 10% should be quercetin and other flavonoids).
Drops
40 mg three or four times a day (160 mgs total).
Toxicity Factors
Some people have reported severe reactions from the ginkgo fruit pulp. However, standardized extracts from the leaves are the commercially available form.
Before Ginkgo was ever approved for human consumption it had been extensively tested for potential side effects. Virtually none were found.
Some people have reported mild gastrointestinal upset, headache or skin rash probably allergic in nature, but that's it. Even doses many times in excess of the recommended therapeutic amount have not produced significant toxicity.
One long term study was carried out to determine if very large doses of Ginkgo had any influence on delicate endocrine balances. The results of all hormonal and blood assays were negative.
In a 1988 study, Dr. Stalliecken found that only 33 of 8,505 patients experienced side effects.
Since GBE is compatible with other medications, it should prove useful in combination therapy, which is often essential for older populations, many of whom will have the indication of cerebrovascular insufficiency, together with other ailments and multiple prescription drugs.
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