Ginkgo biloba remains the most studied natural extract for its preventative effects on dementia. One study identified more than 1,142 scientific studies on Ginkgo biloba. Considering only the highest quality clinical studies (nine studies totaling 2,578 patients), the authors concluded that Ginkgo biloba extracts were superior to placebo for the prevention of cognitive decline and the maintenance of everyday abilities. These results are significant only for the youngest participants (NB whose average age is less than 75 years). This last point probably underlines that in order to prevent, you have to act early enough, but at 75, it is not too late.
In my first book (Live Young, Longer), I presented Ginkgo biloba as one of the important ingredients to consider for healthy longevity. I could not yet mention at the time that we had also discovered new modulators of primary aging during our research with Concordia University. These findings are now published in a scientific journal with a high impact in basic research on primary aging and patents have been filed. I will therefore be able to make the link between our research, the well-demonstrated health benefits of Ginkgo biloba, and its relevance in an aging context.
Let’s talk about quality above all
When talking about the health benefits of plants and plant extracts, it is always very important to talk about the quality of the raw material, especially in the case of Ginkgo biloba. It is considered the most counterfeit ingredient, exhibiting the highest rates of adulteration on the market. It could be the addition of external substances, the presence of contaminants, the use of the wrong plant or the wrong part of the plant. Often, even the manufacturer is not aware of the presence of an adulterated ingredient. Several scientific studies have shown irregularities in the concentration of standardized extracts marketed. For example, one review reports that out of 29 extracts tested, only four contained exactly the doses mentioned (25 were wrong; 86%).
For Ginkgo biloba, the active ingredients are extracted from the leaf. They are polyphenols from the group of flavone glycosides, terpenes, lactones, and proanthocyanidins. The most abundant would be the flavone glycosides, including quercetin and catechin. Lactone terpenes contain molecules unique to Ginkgo biloba, called Ginkgolides. Terpenoids, flavonoids, and anthocyanidins are known to be the active elements of this plant. Terpenoids are probably responsible for its unique health benefits. Quality extracts are standardized at 24% flavonoids and 6% terpenoids.
Buckwheat, soy, Ginkgo?
The problems of adulteration are very complex. For example, one of the flavones in Ginkgo biloba is rutin. The cheapest source of rutin on the market is buckwheat (Fagopyrum esculentum M). This allows an extract producer to add enough buckwheat extracts to their product to obtain 24% flavonoids. Will this product have the same properties as Ginkgo biloba? Probably not. The profile obtained by HPLC (high performance liquid chromatography) analysis will be practically the same! Soy isoflavones can also be used to defeat this standardization. The large variation in composition and quality of extracts on the market could also explain the variability of clinical results reported in the scientific literature.
For example, several meta-analyzes have concluded that Ginkgo biloba extracts are ineffective for tinnitus issues. Yet a meta-analysis, published in 2011, concluded that there is an obvious significant effect for tinnitus. These are standardized extracts of Ginkgo biloba. The study specifically highlights the effectiveness of EGb 761® extract. The author mentions that the two important factors are the quality of the studies considered and the quality of the extracts. Another example; if taking a Ginkgo biloba product that causes skin reactions such as rash or headache, it probably contains Ginkgolic acid (a manufacturing defect; it is of poor quality). Don’t take it anymore.
From yesterday to today
Ginkgo biloba is a large tree referred to as a living fossil, because it is the last unchanged representative of a family of trees that became extinct more than 300 million years ago. Dinosaurs have crossed paths with Ginkgoaceae. It can live more than 1,000 years and reach 40 meters in height. The leaf is mainly used for its antioxidant, neuroprotective, and vasodilator properties. Ginkgo biloba has been used in traditional medicine for centuries. It is one of the most widely used herbs for medicinal use around the world. A study carried out in Germany among people aged 60 to 94 reports that 66% of respondents consume dietary supplements. For Ginkgo biloba, 57% of users confirm having received the recommendation from their doctor.
When we consider doctors and pharmacists, they account for 73% of the reasons for the consumption by the elderly in Germany. Obviously, this is a very clear confirmation of the positive perceptions of the German medical profession towards the use of Ginkgo biloba. The German government recognizes the use of Ginkgo biloba for:
- Loss of memory and concentration, depression, tinnitus, dizziness and headaches associated with organic brain syndrome and all forms of dementia;
- Improved peripheral circulation in vascular occlusive syndromes, including intermittent claudication;
- Dizziness and tinnitus of vascular origin.
In the second article, we will talk about some clinical demonstrations of Ginkgo biloba, the results of research on its effects on aging (including some of our discoveries with Concordia University), its interactions with certain drugs and uses recommended by Health Canada for the product Vitoli® Memory and Cognitive Health, which contains it.
Other suggested readings:
- Guide to Dementia and Alzheimer’s Disease
- Alzheimer’s Disease and Healthy Lifestyles
- Cognitive Health and Aging
- Amieva et al, 2013. Ginkgo biloba extract and long-term cognitive decline: a 20-year follow-up population-based study. PLoS One. 8(1):e52755.
- Brondino et al, 2013. A Systematic Review and Meta-Analysis of Ginkgo biloba in Neuropsychiatric Disorders: From Ancient Tradition to Modern-Day Medicine. Evid Based Complement Alternat Med. 2013:915691.
- Budec et al, 2019. Verification of authenticity of Ginkgo biloba L. leaf extract and its products present on the Croatian market by analysis of quantity and ratio of Ginkgo flavone glycosides to terpene trilactones to the effect of unmasking counterfeit drug endangering patient health. Acta Clin Croat. 2019 Dec;58(4):672-692.
- Chan, P.C., Xia, Q., Fu, P.P. 2007. Ginkgo biloba leave extract: biological, medicinal, and toxicological effects. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2007 Jul-Sep;25(3):211-44.
- Duff et al, 2003. Quality Control Analyses for Ginkgo Extracts Require Analysis of Intact Flavonol Glycosides. J Food Drug Analysis. 11(2):102-7.
- Franke et al, 2014. The use of Ginkgo biloba in healthy elderly. Age (Dordr). Feb;36(1):435-44.
- Jiang et al, 2013. Ginkgo biloba extract for dementia: a systematic review. Shanghai Arch Psychiatry. Feb;25(1):10-21.
- Kennedy, D.O., Scholey, A.B., Wesnes, K.A. 2000. The dose-dependent cognitive effects of acute administration of Ginkgo biloba to healthy young volunteers. Psychopharmacology (Berl). Sep;151(4):416-23.
- Le Bars et al, 1997. A placébo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. (North America EGb Study Group). JAMA. 278:1327-32.
- Sarkar et al, 2020. Therapeutic promises of Ginkgolide A: A literature-based review. Biomed Pharmacother. 2020 Dec;132:110908.