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Information, effects, deficiency, dosage, side effects
Plant components of the ginkgo biloba have long been enjoyed as teas and snacks in East Asia and used as medicine against many different ailments. Standardised ginkgo biloba extracts from controlled production are also a recognised and low-side-effect supplement or alternative to traditional treatment methods in Europe. They are used, among other things, to improve memory function, treat circulatory disorders and prevent and treat migraine attacks.
The Ginkgo (botanical name: Ginkgo Biloba, alternative spelling: Ginko) is a tree species from China that belongs to the class of the Ginkgoopsida within the seed plants. It is the only recent species of the ginkgo family. All other representatives of this group of plants are extinct, but there are numerous fossil finds that document the common origin.
The gingko tree, which is planted worldwide today - mostly as an ornamental tree - long presented biologists with a classification problem due to its uniqueness and therefore occupies a special position within the biological system and taxonomy. Although it forms leaves, it is classified in the biological system because of its ovules to the conifers - the so-called conifers.
A young ginkgo tree can be recognised by its slender, straight growing trunk, from which branches branch off at irregular intervals. The overall appearance is pyramid-shaped, the branches ascending. Older trees from around 25 years of age grow horizontally and often form mighty tree tops.
Branches and twigs appear less symmetrical because the tips of the long branches can grow into new branches. Old trees often have two main shoots, which are usually of different strengths. Sometimes the ginkgo biloba also forms secondary stems growing out of the root system.
Ginkgo trees reach a height of up to 40 m and a circumference of up to 9 m. The trunk diameter is usually between 1 and 4 m. The trees are also characterised by their extreme longevity: they can reach an age of over 1000 years.
Ginkgo trees are wind pollinators, so it is not necessary for insects to transmit the pollen for reproduction. There are male and female, rarely also oogamous plants. Usually male and female plants are planted alternately to facilitate pollination.
The leaves of the ginkgo tree are fan-like and separated in the middle by a narrow bulge, which is where the name Ginkgo Biloba comes from - 'bilobus' means two-lobed. They are used as the only parts of the plant in pharmaceutical preparations such as capsules, teas and tinctures. Their processing into medicines has a very long tradition in classical Chinese medicine.
The original distribution area of Ginkgo Biloba is East Asia. At the beginning of the 18th century, it came to Europe on trade routes from Japan, where it has been cultivated as an ornamental plant since then. It was also widely used in the United States and South America. The oldest ginkgo trees can be found today in their area of origin China, where some specimens up to 5000 years old exist.
Since the tree species itself is highly cultivated at its place of origin, it has long been discussed among botanists whether natural populations of the Ginkgo Biloba are still present. This question has now been settled: DNA analyses in the mid-2000s showed that individual ginkgo biloba stocks in southwest China - mainly in the Chongqing province - show a significantly higher genetic variability than stocks in other parts of the country, where the tree has been grown as a crop for centuries. High genetic variability is a marker for natural occurrence in biology.
In addition to the genetic, ecological, and cultural references to naturally occurring ginkgo stocks can also be found. In Chongqing and in the neighbouring province of Guizhou, several small stocks of ginkgo trees have been discovered, which can either be regarded as independent groups within the surrounding natural forests or as remains of former larger populations that have lost contact with their original forest.
However, ginkgo planting and the consumption of ginkgo seeds have no tradition in the population of the Guizhou Province. The cultivation of ginkgo trees only started there around 1980 and therefore does not offer an explanation for the numerous, sometimes very large trees that can be found in the region. There are also no ginkgo trees growing near temples, which is an indication of human cultivation.
Wild gingko trees also show some features from a botanical point of view, by which they can be distinguished from cultivated plantings. Thus, the gender ratio is largely balanced within naturally occurring populations - there are approximately the same number of female and male plants. Wild ginkgo trees grow scattered between other plants, while cultivated plants mostly exist as isolated stocks.
And finally, wild ginkgos have a different growth form than their cultivated counterparts: In contrast to them, they usually only have a single trunk and very few branches close to the ground - an indication of the direct growth from a seed.
In East Asia, the fruits, flowers, and leaves of the ginkgo tree have been used as food and as a cure for over two millennia. This is also one of the reasons why cultivated populations consist largely of female plants - only these contain the edible kernels also known as nuts in their seeds. In Europe and the USA, the ginkgo kernel could not prevail as a food due to its unpleasant smell.
Especially in Japan, the nuts are cooked in various dishes or eaten grilled as a snack with a glass of sake. They are only used as medicinal products in traditional Chinese medicine, but not in other pharmaceutical preparations. It has been shown that the ingestion of large amounts can lead to symptoms of intoxication due to the active ingredient 4-methoxypyridoxine.
The term traditional Chinese medicine (TCM) encompasses historical East Asian medicine from the 1st millennium BC to its current theory and practical application. Today it is very popular as an alternative treatment method in large parts of Europe and North America. In scientific medicine, however, most of the concepts and methods of TCM are not recognised due to poor or insufficient evidence.
In addition to acupuncture, which aims to achieve a healing effect through needles, and the moxibustion - the heating of these points for the same purpose - the so-called Chinese drug therapy. In addition to the use of medicinal plants, diet and exercise, which are grouped together in our own therapy systems, play an important role.
In Chinese drug therapy, which is the most important pillar of TCM, the proportion of herbal active ingredients is very high. Almost all components of the plants have traditionally been processed, most often into so-called decoctions (decoction or watery extract). In contemporary Chinese medicine, the active ingredients are offered individually or in combination with others as capsules, granules, or concentrates.
Formulations containing components of the Ginkgo Biloba have been used to treat a wide range of ailments: stomach and intestinal complaints, infection and poisoning, asthmatic complaints, and cough are just as important as the use of the agent for thinning the blood or for menstrual cramps. Today, Ginkgo Biloba extracts are also used in traditional Chinese medicine mainly for the treatment of disorders of the brain function and to improve memory performance.
Active ingredients in ginkgo biloba, which are contained in food supplements or medicinal products today, are obtained exclusively from the leaves of the ginkgo tree. Its main components are flavonoids, diterpene lactones (ginkgolides), bilobalide, ginkgolic acids, and ginkgotoxins. Not all of these ingredients have desired effects, which is why preparations made from ginkgo biloba ingredients are usually made in several enrichment and depletion steps.
The most important active ingredients of the ginkgo leaf are the diterpene lactones of the tree, which are also known as ginkgo solids. Five different ginkgolides are known: A, B, C, J and M, of which ginkgolides A and B in particular are said to have an effect on inhibiting inflammatory messenger substances.
The flavonoids contained are largely kaempferol, quercetin, and isorhamnetin. Kaempferol is a phytoestrogen that is also found in red grapes, grapefruits, and other plants. It is said to have anti-inflammatory as well as cardio- and neuroprotective effects.
Quercetin is found in many types of fruits and vegetables, but is partly destroyed by the preparation. It has a high antioxidant potential and acts as a radical scavenger. It also inhibits the enzyme xanthine oxidase, which contributes to the development of gout.
Isorhamnetin is a glycoside and metabolite of quercetin. It also has an antioxidant effect. An anti-carcinogenic effect by promoting the apoptosis of cancer cells, similar to other metabolites of flavonoids, is currently being discussed.
The main effect of the flavonoids, which as secondary metabolites of many plants cause their different colors, is their function as a radical scavenger in the human body. Radical scavengers or antioxidants are chemical compounds that have the ability to neutralise reactive radicals - e.g. atoms or molecules that can cause damage due to their high reactivity.
Another important active ingredient is bilobalide, which arises from a similar biosynthetic pathway as ginkgolides. In addition to its antioxidative properties, it also has a vasodilatory effect that is initiated by the release of nitrogen oxide.
The main effects of ginkgo biloba preparations are therefore:
Based on the documented effects, preparations containing ingredients derived from ginkgo biloba are classified by the WHO as anti-dementia drugs. These are active ingredients or medicinal products that are used to treat brain disorders such as problems with concentration, impaired thinking ability, or memory disorders.
Dietary supplements and medications, the effects of which are based on ingredients of the ginkgo biloba, are available in different dosage forms. Common application forms are dried, powdered leaves from which extracts, capsules, tablets, and teas are made. There are great differences in the type and quantity of the ingredients contained in the products offered. However, for the safe and effective use of ginkgo products, it is essential that active ingredients and quantities are exactly known.
The leaves of the ginkgo biloba are those components of the plant that have the highest content of active ingredients. They form the basis for all preparations that are offered today as food supplements or medicines based on ginkgo. The planting and cultivation of the trees, the harvesting of the leaves and the subsequent processing are mostly carried out on professional ginkgo plantations.
Regular pruning drives the plants out at ground level - this makes harvesting the leaves easier with special machines and ensures much higher yields than in the case of uncontrolled growth. Harvest time is from the beginning to the middle of July - at this point the active ingredient content in the leaves is at its highest. In a few smaller companies, the leaves are also harvested by hand. The effort is much higher and the products are accordingly more expensive.
After the harvest, the leaves are dried in a particularly gentle process so that the ingredients are preserved as completely as possible. The leaves are then finely ground under strict quality control and the so-called extraction process follows. Its result is the basis of all recognised remedies from ginkgo biloba leaves: the ginkgo extract.
The processing of ginkgo biloba into tea also has a very long tradition in China. Both the leaves and the crushed and boiled seeds were used. For the production of ginkgo biloba tea, the dried leaves are roughly cut and processed into tea blends with different levels of ginkgo. Gingko teas - like all other preparations of the plant - are said to have many health effects, but in many cases these promises cannot be kept by the products.
Since teas and tea preparations are usually classified as food and manufacturers of these products are therefore not allowed to make health-related promises, descriptions that suggest that these teas have a health-promoting effect should be treated with caution. Of course, there is nothing wrong with consuming tea preparations with ingredients from ginkgo biloba as a luxury food.
Ginkgoo biloba containing teas usually have a slightly bitter taste. For this reason, they are often offered in mixtures with sweet and fruity plant based ingredients or can be combined with other teas. Sweetening with honey or sugar is also an option to neutralise the slightly bitter taste.
Caution should be held especially when preparing self-made ginkgo teas from uncontrolled sources or when consuming very large quantities: These often contain large amounts of the actually undesirable ginkgo acids as well as tannins and methylpyridoxine (MPD), which are removed during the production of the extracts.
Ginkgolic acids are lipophilic substances and therefore hardly soluble in water. After a long brewing period and probably in connection with other substances, however, these should still pass into the tea mixture to a large extent - in any case, high amounts have been detected in infusions. It is known from drug evaluation that a high proportion of ginkgolic acids can have harmful effects on health.
The Federal Institute for Risk Assessment comes to the conclusion that the data on the toxicity of tea infusions with ginkgo biloba components are not sufficient to be able to provide a reliable assessment. As a result, teas and tea blends containing ginkgo biloba should not be consumed in excessive amounts and not for therapeutic purposes.
Ginkgo biloba extracts contain the active ingredients found in medicine and supplements called ginkgo biloba.
In order for a ginkgo extract, which was produced by acetone-water extraction, to comply with the provisions of the European Pharmacopoeia or the German Medicine Act, it must have the following active ingredient profile:
A so-called Ginkgo standard extract, which is officially called EGb 761, contains an average of 24% flavone glycosides (mainly quercetin, kaempferol and isorhanmnetin) and 6% terpene lactones (thereof 2.8-3.4% ginkgolides A, B and C and 2.6-3.2% bilobalide).
Extracts that have been produced according to these standardised specifications can be classified as harmless to the health, provided that the respective recommendations for dosing are followed.
In order to achieve an optimal active ingredient profile, Ginkgo Biloba extracts are freed from undesirable ingredients during the manufacturing process and enriched with the flavone glycosides and terpene lactones responsible for the positive effects. Extracts are available from many different manufacturers.
Ginkgo biloba capsules also contain the active ingredients of the extract. Their advantage is that, unlike dry extracts, they are easier to dose. In addition to this, the capsule offers a certain protection of the ingredients and enables a delayed release of the active ingredients.
Ginkgo biloba capsules are usually available with an active ingredient content of 100 mg.
The most common form of ginkgo biloba administration as a finished medicinal product for therapeutic or preventive purposes is the tablet form as well as the capsule form. Tablets have the advantage of being easy to dose, as they are available in many different quantities. In the usual preparations, ginkgo biloba tablets contain between 40 and 500 mg of the active ingredient.
There are numerous other products on the market that contain active ingredients of ginkgo biloba and advertise with a drug-like effect. Examples include creams and ointments that promise blood circulation, shampoos, essential oils, and drops as an extract or homeopathic tincture. For most of these preparations, however, there is no scientifically proven evidence. They should therefore not be used for treatment purposes without thinking about it.
There are no general dosage recommendations, since an effective dose always depends on the purpose of the intake, the type of disease and some individual factors. However, recommendations from Commission E of the Federal Institute for Drugs and Medical Devices are available for very specific indications and only for the dry extract which is extracted with acetone water. Commission E is a sovereign and independent scientific admission authority responsible for the testing of herbal medicinal products.
The areas of application for which recommendations are available are as follows:
Various neurological and psychiatric disorders are summarised under the term dementia, which are initially characterised by the progressive loss of cognitive abilities. In the later course of the disease there are personality changes, loss of everyday competence and severe restrictions in motor skills, memory, and linguistic expressions.
The causes of the development of dementia are only clear for some forms of the disease, for others there are still no clear results. Treatment options depend on the cause and progress of the disease. In some cases - especially at the beginning of the disease - the symptoms of the brain disorder are at least partially reversible or the development can be delayed.
A distinction is made between primary and secondary dementia. In the former, the symptoms of the disease are always caused by brain changes and are considered to be non-reversible. Secondary dementia, for example caused by injuries or alcohol abuse, are partially reversible.
The WHO counts dementia among organic mental disorders and classifies them as follows:
However, it is controversial whether any organ-related performance disorder should already be classified as dementia. Classic symptoms such as memory and thinking disorders are part of the normal aging process and therefore do not necessarily have to be defined as pathological. However, old age is the biggest risk factor for the development of dementia.
The most common form of dementia is the so-called Alzheimer's dementia, from which more than 60% of those affected suffer from. This is a primary dementia, which, in addition to the symptoms already described, is characterised by behavioural problems and various neuropsychiatric symptoms. Alzheimer's dementia is characterised primarily by microscopic deposits (so-called plaques) in the brain.
Other factors that promote dementia include obesity, cardiovascular disease, diabetes mellitus, depression, kidney failure, and smoking. Many of these diseases are related to metabolic processes that damage blood vessels, nerve and brain cells. The result is reduced blood flow to the brain, which is partly responsible for the typical symptoms of the described dementia.
Data from several clinical studies are available on the effects of drugs with the active ingredients of the ginkgo biloba extract in dementia diseases. They do not come to a uniform result. In summary, it can be said that standardised ginkgo biloba preparations, due to their ability to trap oxygen radicals and promote blood circulation, can at least minimise some risk factors for dementia.
In any case, a meta-analysis from 2015 came to the conclusion that the preventive administration of ginkgo biloba extract does not cause any undesirable side effects compared to the placebo group. Treatment of Alzheimer's patients has shown that early administration of ginkgo biloba extract in combination with a cholinesterase inhibitor and memantine can reduce dementia symptoms and delay hospitalisations.
One speaks of arterial circulatory disorders if the blood flow in one or more arteries of the body is restricted for various reasons. The blood then no longer reaches the region of the body to be supplied, which leads to different symptoms in the supply areas of the affected artery. Vascular occlusions caused by arteriosclerosis are often the cause of circulatory disorders.
Vascular stenoses are found, for example, in peripheral arterial diseases (PAD) and in coronary heart diseases (CHD). In pAD, vessels of the leg, but more rarely also of the arms, are usually stenosed (narrowed) and completely close as the disease progresses. It is assumed that about 10% of the population is affected by PAD from the age of 50.
In the initial stages, the disease is often asymptomatic and is only discovered by chance - an indication of a PAD can be a missing foot pulse, for example. Men are affected about four times more often than women. Since sufferers feel pain at longer walking distances at a later stage of the disease and therefore have to stop more often, the disease is also known as a 'window shopper's disease'.
Coronary artery disease is an arteriosclerotic narrowing that narrows the coronary arteries. The coronary stenosis leads to circulatory disorders of the heart muscle, which are either 'silent' or may be noticeable through angina pectoris. The seizure-like pain that characterises angina pectoris arises from inadequate blood flow to the heart.
The brain can also be affected by an arterial circulatory disorder: this is called cerebral artery sclerosis. A lack of blood flow to the brain can lead to a large number of reversible or irreversible consequential damages: progressive cognitive deficits, dizziness, neurological failures, and strokes (ischemic insults) occur most frequently.
The most important risk factors for arterial circulatory disorders are smoking, high blood pressure and metabolic diseases such as diabetes mellitus, increased lipid levels (hyperlipidemia), obesity and the metabolic syndrome.
Ginkgo biloba extracts are approved for the prevention and therapy of arterial occlusive disease and some other indications from the spectrum of circulatory disorders. The mechanism of action of the ginkgo biloba for these indications is based on the promotion of blood circulation through the release of nitrogen oxide (NO). The active ingredients responsible for this are bilobalid and quernceptin.
Nitric oxide has a vasodilatory effect - this means that it enlarges the vessels and thus improves blood flow. The flavonoids contained in the ginkgo extracts also neutralise free radicals that can cause vascular damage.
Dizziness (medical term: vertigo) is not a disease of its own, but a symptom that can occur in a variety of diseases. It is characterised by a disturbance in the sense of balance, which makes you feel like everything is turning or swaying. Sometimes this feeling is accompanied by nausea or vomiting.
A dizziness is caused by contradicting information that the sensory organs send to the brain. This information can be of a visual nature, transmitted via the organ of balance in the ear or conveyed by sensors in muscles, tendons, and joints - so-called proprioceptors or position sensors.
The brain then tries to process and balance this contradictory information. This misinterpretation does not result in normal adjustments of the position to the environment and ineffective attempts to stay balanced - this countermeasure creates dizziness.
There are many possible causes of dizziness. They are often harmless - for example, people who suffer from low blood pressure are often affected by dizziness. However, dizziness caused by circulatory disorders in the brain is common and less harmless. Other possible triggers are poisoning, trauma, visual disturbances, cardiac arrhythmia, arterial hypertension, or tension in the cervical spine.
Dizziness can manifest itself differently: Depending on the type of symptoms, a distinction is made between systematic dizziness (spinning dizziness, staggering dizziness) and unsystematic dizziness (gait insecurity). Dizziness associated with drowsiness occurs especially in old age. For an effective treatment, the cause of the vertigo must always be determined first and then the underlying disease must be treated.
If vascular diseases and a consequent reduced blood flow to the brain are the cause of a balance disorder, an additional treatment with ginkgo extract is a possible therapy option. A review of several randomised, placebo-controlled double-blind studies confirmed positive effects. Therefore, there is convincing evidence of the effectiveness of these preparations.
The mechanisms of action of the reduction in dizziness due to the administration of standardised ginkgo biloba extract are not fully clarified. The proven circulation-promoting effects of the ginkgo biloba, its property as a radical scavenger and the cognitively activating effects likely play a role.
Tinnitus is a permanently or regularly recurring, unpleasant noise in the ear that arises without an external sound source. A distinction is made between objective tinnitus, which can also be heard or measured by the examiner, and subjective tinnitus, which can only be heard by those affected.
Objective tinnitus is often based on arterial flow arteries, vascular malformations or tension in the middle ear muscles and is most likely perceived as a tick. Subjective tinnitus, on the other hand, is most often triggered by noise pollution (continuous noise, bang trauma). Other possible causes include diseases of the inner ear, otitis media, muscle tension in the area of the cervical spine, and damage to the sense of hearing due to medication.
Another subdivision can be made according to the duration of the noises. In up to three months, one speaks of an acute ear noise, longer-lasting sounds are called chronic tinnitus. Especially with the chronic form of tinnitus, the suffering for those affected can be considerable.
Most patients experience the sounds as extremely disturbing and stressful. The level of exposure depends not only on the duration, but also on the type and intensity of the noise. They are perceived very differently depending on the individual and described, for example, as a whistling, humming, ringing, rustling, crackling, or hissing noise.
Unfortunately, there are only a few effective drug options available to treat tinnitus. For this reason, people suffering from a chronic form of the disease are often advised to get used to the sounds with the help of desensitisation, habitual or cognitive behaviour therapy.
The acute form of tinnitus, on the other hand, is treated, among other things, with blood circulation-promoting agents. It also has a better chance of healing spontaneously or at least improving. Ginkgo biloba preparations that comply with the regulations for medicinal products have been shown to promote blood circulation and are therefore used in alternative medicine to treat tinnitus.
However, the scientific evidence for this treatment option is not sufficient to make a conclusive statement about the effectiveness of tinnitus therapy with preparations from ginkgo biloba. A comprehensive analysis of existing data and studies on this topic brought contradictory results and is therefore not suitable for a general recommendation.
In any case, patients who developed tinnitus for the first time did not benefit from taking ginkgo biloba. There was a somewhat more favourable outcome in the group of sufferers who also suffered from dementia or Alzheimer's disease: They showed a slight but statistically significant reduction in the tinnitus symptoms.
Headaches and migraines are among the most common symptoms of the nervous system. Almost everyone has been affected before. As banal, short-term, quickly disappearing headache attacks appear at first glance - the disease can lead to a considerable reduction in the quality of life. This is especially true if the attacks become chronic or the pain intensity is particularly high.
Headaches differ in their intensity, the way they appear, and the quality of pain. Basically, they can be divided into migraines, tension headaches, and cluster headaches. A further subdivision is made into primary and secondary headache: while in the former the pain itself defines the disease and the cause is unclear, secondary headache is always the side effect of another disease.
Many different events can be considered as the cause of secondary headache. Neurological, internal and ENT causes, trauma, poisoning from medication or food, but also psychogenic factors play a role in the development of pain.
Patients who are affected by migraines are subject to a particularly high level of suffering. Migraines are characterised by attack-like, very pain-intensive, often pulsating and up to three-day headache attacks, which lead to a strong feeling of illness due to their unpleasant side effects. The most common of these are nausea, vomiting, and a greatly increased sensitivity to light and noise.
The classic form of migraines is often accompanied by a so-called 'aura'. This is understood to mean neurological deficits, which usually only last for a short time and disappear completely after the attack has ended. They can occur in the form of visual field failures followed by flashes of light. These symptoms are thought to be caused by a circulatory disorder in one of the brain's main vessels, the posterior cerebral artery.
Migraines are mainly treated with pain relievers. In the case of very strong forms of the course, special medications - so-called triptans - are available that narrow the blood vessels in the brain and inhibit inflammation. Beta-blockers, calcium antagonists and various anti-epileptics are mainly used to prevent seizures.
Medicinal products containing the active ingredients of ginkgo biloba are also used to prevent and treat headache attacks. Several clinical studies confirm its effectiveness in preventing the migraine attack and as a therapeutic measure in the acute attack. However, further examinations with a higher number of participants are necessary to ensure that these results are sufficiently confirmed.
Depression is a serious mental illness, the main characteristics of which are depressed mood, listlessness, lack of interest and joy. It should not be confused with the normal sadness, but rather characterised by a general 'feeling of numbness'.
In contrast to depressive moods, clinically manifest depression does not go away on its own, but always requires treatment. They show very complex clinical pictures with a variety of symptoms. In addition to mild depressive episodes, moderate to severe depressive symptoms with or without a psychotic component can occur.
It has not yet been sufficiently clarified whether ginkgo biloba can contribute to improving symptoms in depressed patients, in addition to adequate medicinal and psycho-therapeutic treatment. However, the effectiveness of ginkgo biloba on diseases from the neuropsychiatric spectrum has been investigated more intensively in recent years. It turned out that not all patient groups seem to benefit equally from this.
An improvement in depressive symptoms was found especially in older patients who also suffered from mild cognitive disorders. On the other hand, there is insufficient evidence whether the use of ginkgo biloba has a positive effect on the mood and symptoms of younger patients with classic depression or the seasonal variant, winter depression.
A positive effect of the ginkgo biloba ingredients on inflammatory diseases of the respiratory tract, such as bronchial asthma, is consistently claimed. However, sufficient evidence of efficacy cannot be found because there are not enough clinical studies.
While potency disorders (technically speaking: erectile dysfunction) often has a psychological component in younger people and generally only exists temporarily, organic causes are more common in older people. In addition to smoking, risk factors include an increased blood pressure, long-standing or inadequately well-managed diabetes and increased blood lipid levels.
The long-term consequences of these diseases are arterial or venous circulatory disorders, which in turn can cause a lack of blood supply or excessive blood drainage from the erectile tissue. Other possible organic causes are mostly neurological or hormonal. Some medications, especially psychotropic drugs, can also be used as triggers for erectile dysfunctions.
If circulatory disorders are the cause of an erectile dysfunction, a treatment with ginkgo biloba preparations seems obvious, since the promotion of blood circulation for these preparations has been scientifically proven. However, there is insufficient evidence for this effect. The few clinical studies that were carried out on this question mainly examined the erectile dysfunction caused by taking psychotropic drugs and did not show any statistically significant connections.
Medicinal preparations and food supplements that contain active ingredients of ginkgo biloba can interact with other substances to different degrees. Therefore, some active ingredients should never be taken with ginkgo biloba at the same time, while others should be used with caution. If in doubt, medical advice should always be sought.
Strong interactions - should not be taken together with ginkgo biloba: All anticoagulants and medications that also inhibit blood clotting, such as aspirin, ibuprofen, diclofenac.
Moderate interactions - ginkgo biloba should only be used with these with caution: Certain antidepressants, diabetes medication, anticonvulsants.
There is normally no risk of overdosing on ginkgo biloba, provided that only controlled, standardised products are taken and dosage regulations are followed. Caution should be exercised when consuming untreated parts of plants that may contain unknown amounts of ginkgo toxins.
Side effects occur very rarely in connection with ginkgo biloba preparations from controlled cultivation and standardised processing. If there is an intolerance to one or more of the active ingredients in ginkgo biloba, allergic reactions can occur. Teas and tea blends, the active ingredient content of which is not known, can cause side effects due to the ginkgolic acids they contain.
Possible side effects, which can also occur when taking the recommended amounts, are gastrointestinal complaints such as bloating, cramps and heartburn. Headache, dizziness and a general feeling of discomfort have also been described.
A rare but potentially dangerous side effect is triggered by the so-called ginkgo toxin. This is mainly found in the seeds of the plant and to a lesser extent in the leaves. It is an anti-vitamin that is chemically similar to vitamin B6.
Poisoning with ginkgo toxins is rare and has only been described in isolated cases. Affected were mainly children who ate ginkgo seeds. They can lead to cramps, epileptic seizures and loss of consciousness.
In pregnancy, ginkgo biloba is contraindicated for safe use due to insufficient data.
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