GINKGO BILOBA
Source: Gale Encyclopedia of Alternative Medicine
By: Clare Hanrahan

Description
Ginkgo biloba, known as the maidenhair tree, is one of the oldest trees on Earth, once part of the flora of the Mesozoic period. The ginkgo tree is the only surviving species of the Ginkgoaceae family. This ancient deciduous tree may live for thousands of years. Ginkgo is indigenous to China, Japan, and Korea, but also thrived in North America and Europe prior to the Ice Age. This drastic climate change destroyed the wild ginkgo tree throughout much of the world. In China, ginkgo was cultivated in temple gardens as a sacred tree known as bai gou, thus assuring its survival there for over 200 million years. Ginkgo fossils found from the Permian period are identical to the living tree, which is sometimes called a living fossil.

Ginkgo trees may grow to 122 ft (37.2 m) tall and measure 4 ft (1.2 m) in girth. The female trees have a somewhat pointed shape at the top, like a pyramid. The male trees are broader at the crown. The bark of the ornamental ginkgo tree is rough and fissured and may be an ash to dark-brown in color. Distinctive, fan-shaped leaves with long stalks emerge from a sheath on the stem. Leaves are bright green in spring and summer, and turn to golden yellow in the fall. Ginkgo trees may take as long as 30 years to flower. Ginkgo is dioecious, with male and female flowers blooming on separate trees. Blossoms grow singly from the axils of the leaf. The female flowers appear at the end of a leafless branch. The yellow, plum-shaped fruits develop an unpleasant scent as they ripen. They contain an edible inner seed that is available in Asian country marketplaces. Ginkgo's longevity may be due, in part, to its remarkable resistance to disease, pollution, and insect damage. Ginkgo trees are part of the landscape plan in many urban areas throughout the world. Millions of ginkgo trees, grown for harvest of the medicinal leaves, are raised on plantations in the United States, France, South Korea, and Japan, and are exported to Europe for pharmaceutical processing.

General use
Ginkgo leaves, fresh or dry, and seeds, separated from the outer layer of the fruit, are used medicinally. Ginkgo has remarkable healing virtues that have been recorded as far back as 2800 B.C. in the oldest Chinese materia medica. Ginkgo seeds were traditionally served to guests along with alcohol drinks in Japan. An enzyme present in the ginkgo seed has been shown in clinical research to speed up alcohol metabolism in the body, underscoring the wisdom of this folk custom. The leaf extract has been used in Asia for thousands of years to treat allergies, asthma, and bronchitis. It is also valued in Chinese medicine as a heart tonic, helpful in the treatment of cardiac arrhythmia. Ginkgo was first introduced to Europe in 1730, and to North America in 1784 where it was planted as an exotic garden ornamental near Philadelphia. Ginkgo medicinal extracts are the primary prescription medicines used in France and Germany.

Ginkgo acts to increase blood flow throughout the body, particularly cerebral blood flow. It acts as a circulatory system tonic, stimulating greater tone in the venous system. The herb is a useful and proven remedy for numerous diseases caused by restricted blood flow. European physicians prescribe the extract for treatment of Raynaud's disease, a condition of impaired circulation to the fingers. It is also recommended to treat intermittent claudication, a circulatory condition that results in painful cramping of the calf muscles in the leg and impairs the ability to walk. German herbalists recommend ingesting the extract for treatment of leg ulcers, and large doses are used to treat varicose veins. Ginkgo is widely recommended in Europe for the treatment of stroke. The dried leaf extract may also act to prevent hemmorrhagic stroke by strengthening the blood capillaries throughout the body. In studies of patients with atherosclerotic clogging of the penile artery, long-term therapy with ginkgo extract has provided significant improvement in erectile function. Ginkgo extract also acts to eliminate damaging free-radicals in the body, and has been shown to be effective in treatment of premenstrual syndrome, relieving tender or painful breasts.

Ginkgo extract has proven benefits to elderly persons. This ancient herb acts to enhance oxygen utilization and thus improves memory, concentration, and other mental faculties. The herbal extract is used to treat Alzheimer's disease. It has been shown to have beneficial effect on the hippocampus, an area of the brain affected by Alzheimer's disease. The herbal extract has also been shown to significantly improve long-distance vision and may reverse damage to the retina of the eye. Studies have also confirmed its value in the treatment of depression in elderly persons. The ginkgo extract may provide relief for persons with headache, sinusitis, and vertigo. It may also help relieve chronic ringing in the ears known as tinnitus.

The active constituents in the ginkgo tree, known as ginkgolides, interfere with a blood protein known as the platelet activating factor, or PAF. Other phytochemicals in ginkgo include flavonoids, biflavonoides, proanthocyanidins, trilactonic diterpenes (including the ginkgolides A, B, C, and M), and bilabolide, a trilactonic sesquiterpene. The therapeutic effects of this herb have not been attributed to a single chemical constituent; rather, the medicinal benefits are due to the synergy between the various chemical constituents. The standardized extract of ginkgo must be taken consistently to be effective. A period of at least 12 weeks of use may be required before the beneficial results are evident.

Preparations
Ginkgo's active principles are dilute in the leaves. The herb must be processed to extract the active phytochemicals before it is medicinally useful. It would take an estimated 50 fresh ginkgo leaves to yield one standard dose of the extract. Dry extracts of the leaf, standardized to a potency of 24% flavone glycosides and 6% terpenes, are commercially available. A standard dose is 40 mg, three times daily, though dosages as high as 240 mg daily are sometimes indicated.

Ginkgo extracts are widely used in Europe where they are sold in prescription form or over the counter as an approved drug. This is not the case in the United States, where ginkgo extract is sold as a food supplement in tablet and capsule form.

Precautions
Ginkgo is generally safe and non-toxic in therapeutic dosages. Exceeding a daily dose of 240 mg of the dried extract may result in restlessness, diarrhea, and mild gastrointestinal disorders. Those on anticoagulants should have their doctor adjust their dose or should avoid ginkgo in order to avoid over-thinning their blood and hemorrhaging. Ginkgo should be avoided two days before and one to two weeks after surgery to avoid bleeding complications.

Side effects
Severe allergic skin reactions, similar to those caused by poison ivy, have been reported after contact with the fruit pulp of ginkgo. Eating even a small amount of the fruit has caused severe gastrointestinal irritation in some persons. People with persistent headaches should stop taking ginkgo. Some patients on medications for nervous system disease should avoid ginkgo. It can interact with some other medicines, but clinical information is still emerging.

Interactions
The chemically active ginkgolides present in the extract, specifically the ginkgolide B component, act to reduce the clotting time of blood and may interact with antithrombotic medicines, including aspirin
 

HOME