The benefits of “Ginkgo Biloba Extract”

The benefits of “Ginkgo Biloba Extract”

Ginkgo biloba is one of the oldest living species on the planet. The leaves and seeds of this plant have been used for medicinal purposes in China for centuries, initially being used for asthma and problems in the digestive system. In Europe and the USA, they have been sold since the sixties, and now they represent one of the most popular phytotherapeutic products in the world^[1].

In the early 1970s, Dr. Willmar Schwabe Pharmaceuticals (Karlsruhe, Germany) effectively developed a method for the extraction and standardization of ginkgo biloba extract preparation and produced highly concentrated and stable extract from ginkgo biloba leaves. The standardized extract of ginkgo biloba leaves contains 6% terpenoids (in which 3.1% are ginkgolides A, B, C, and J and 2.9% is bilobalide), 24% flavonoid glycosides (containing quercetin, kaempferol, isorhamnetin etc.), and 5–10% organic acids^[2].

The active compounds for ginkgo biloba extract is flavonoids and terpenoids. The content of flavonoids promotes blood circulation, especially cerebral blood circulation. Therefore, it is used in disorders such as Alzheimer’s disease and memory loss that are caused by decreased blood flow. In addition, the extract also has antioxidant^[3] and neuroprotective properties^[2]. 

Ginkgo Biloba Extracts Properties.

• Dementia and Alzheimer’s disease.

The rapid aging of the global population is resulting in an increasing prevalence of mild cognitive impairment, dementia, and Alzheimer’s disease. Age is a key risk factor for these diseases; after the age of 65 years, the prevalence of dementia doubles every five years. It is higher among women than men, largely because women tend to live longer^[4].

There are studies performed that the positive effect of ginkgo biloba extract has been reported on Alzheimer’s disease, memory enhancement, dementia of vascular origin, and cognitive disorders. The extract modifies the cerebral blood flow and may help to reduce fatigue and inattention^[2]. But some studies of ginkgo biloba extract have not been demonstrated to prevent the progression of dementia. However, several studies showed that ginkgo biloba extract encourage efficacy in terms of improvement in cognition, behavior, and ability to maintain activities of daily living in patients with dementia or Alzheimer’s disease, as well as reducing caregiver burden^[4].

• Age-related macular degeneration (AMD).

Age-related macular degeneration (AMD) is a condition affecting the central area of the retina (the back of the eye). The retina can deteriorate with age and some people get lesions that lead to loss of central vision. Vascular factors and oxidative damage are two potential mechanisms in the pathology of the disease. Ginkgo biloba extract contains two constituents (flavonoids and terpenoids) which have antioxidant properties. It is believed these may help to slow down the progression of AMD through several mechanisms of action including increased blood flow, inhibiting platelet-activating factor, and prevention of membrane damage caused by free radicals^[5]. 

• Glaucoma.

Glaucoma is the leading cause of irreversible visual impairment and blindness. Although the mechanism of glaucoma is still largely unknown, oxidative stress, optic nerve ischemia, and neuroinflammation were found to be a certain role in the development of glaucomatous optic nerve degeneration. It has been suggested that ginkgo biloba extract may protect tissue against free radical damage like other antioxidants such as vitamin C and E. However, unlike the others, the extract acts at the level of organelles by stabilizing the mitochondria due to abnormal mitochondrial changes can lead to glaucoma^[6].   

Ginkgo biloba extract was also found to have vasodilatory properties that could improve coronary and peripheral circulation that could improve blood viscosity^[6]. Moreover, it was associated with positive effects on the improvement of deteriorated visual field in patients with open-angle glaucoma^[7]. Due to its antioxidant, vasoregulatory, and anti-inflammatory benefits, ginkgo biloba extract is considered a neuroprotective agent and improve the vision of people with glaucoma^[6].

• Oxidative stress.

Oxidative stress is caused by destructive and progressive modifications in one or more body tissues, leading to dysfunction of organs, premature aging, and sometimes disease and death. Stress exposure, radiation, infections, and smoke exposure cause significant damage, inducing alterations in DNA, can lead to several oxidative disorders such as cardiovascular diseases and cancer. It is possible that the usage of ginkgo biloba extract may delay this process^[1].

Ginkgo biloba extract has antioxidant properties since it regulates the expression of antioxidant enzymes positively and reduces reactive oxygen and nitrogen species. It also exhibits anti-inflammatory properties, inhibits the expression of pro-inflammatory cytokines, such as IL-1, IL-6, and TNF-α so it minimizes the risk factors for diseases that are caused by the oxidative stress process^[1].

Warnings, Interactions, and Adverse Effects of Ginkgo Biloba Extract.

The most important clinical problem with ginkgo biloba is caused by its inhibition of the platelet-activating factor, so the use of ginkgo in conjunction with warfarin, aspirin, or other antiplatelet agents should be consulted with a specialist. Ginkgo biloba is generally well tolerated, with side effects being rare, usually mild, and including nausea, vomiting, diarrhea, headaches, dizziness, palpitations, restlessness, weakness, or skin rashes. Although no studies have been performed to support any restrictions on the use of ginkgo during pregnancy or lactation, it seems careful not to administer ginkgo in the absence of any data^[8].

References.

1. Achete de Souza G, de Marqui SV, Matias JN, Guiguer EL, Barbalho SM. Effects of Ginkgo biloba on Diseases Related to Oxidative Stress. Planta Medica. [Internet]. 2020 [cited 2022 Jan 6]; 86: 376-86. Available from: http://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-1109-3405
2. Singh SK, Srivastav S, Castellani RJ, Plascencia-Villa G, Perry G. Neuroprotective and Antioxidant Effect of Ginkgo Biloba Extract Against AD and Other Neurological Disorders. Neurotherapeutics. [Internet]. 2019 [cited 2022 Jan 6]; 16: 666-74. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694352/
3. Sellami M, Slimeni O, Pokrywka A, Kuvačić G, D Hayes L, Milic M, Padulo J. Herbal medicine for sports: a review. Journal of the International Society of Sports Nutrition. [Internet]. 2018 [cited 2022 Jan 6]; 15: 1-14. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856322/
4. Kandiah N, Ong PA, Yuda T, Ng LL, Mamun K, Merchant RA, et al. Treatment of dementia and mild cognitive impairment with or without cerebrovascular disease: Expert consensus on the use of Ginkgo biloba extract, EGb 761^®. CNS Neuroscience & Therapeutics. [Internet]. 2018 [cited 2022 Jan 6]; 25: 288-98. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488894/
5. Evans J. Ginkgo biloba extract for age-related macular degeneration (Review). Cochrane Database of Systematic Reviews. [Internet]. 2013 [cited 2022 Jan 7]; 1-15. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061350/
6. Ige M, Liu J. Herbal Medicines in Glaucoma Treatment. Yale Journal of Biology and Medicine. [Internet]. 2020 [cited 2022 Jan 7]; 93: 347-53. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309662/
7. Bungau S, Abdel-Daim MM, Tit DM, Ghanem E, Sato S, Maruyama-Inoue M, et al. Health Benefits of Polyphenols and Carotenoids in Age-Related Eye Diseases (Review). Oxidative Medicine and Cellular Longevity. [Internet]. 2019 [cited 2022 Jan 7]; 1-22. Available from:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390265/
8. Sierpina VS, Wollschlaeger B, Blumenthal M. Ginkgo Biloba. Complementary and Alternative Medicine. [Internet]. 2003 [cited 2022 Jan 7]; 68: 923-6. Available from : http://www.aafp.org/afp/2003/0901/p923.html