Ginkgo

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• QCan ginkgo biloba really benefit your brain?

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  A Dr. Mehmet Oz, MD , Cardiology (Cardiovascular Disease), answered

  Many people believe that the supplement gingko biloba improves brain function by increasing blood flow and thinning your blood-for both minimal cognitive impairments and Alzheimer's patients. But all the recent data shows that gingko offers no better protection from the effects of aging than a placebo.

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• QShould I take ginkgo biloba to improve or protect my memory?

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  A Dr. Michael Roizen, MD , Internal Medicine, answered

  If you want to. Though there are no large studies to support its use, there's some promise that this very commonly used supplement is effective in helping improve cognition. It can also thin the blood, which can be helpful in folks with blood vessel disease but dangerous for those with clotting disorders or anticipating surgery. Because it's considered a safe antioxidant supplement, we're comfortable with you trying 120 milligrams daily to see if it has any positive effects.
• QWhat do I need to know about ginkgo biloba and ginseng?

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  A Dr. Michael Roizen, MD , Internal Medicine, answered

  Two herbs that patients ask us about more than any others are ginkgo biloba and ginseng. I lump them together here because I almost always hit them in combination when I have this talk with patients.
  
  Ginkgo biloba comes from the leaves and seeds of the Chinese ginkgo tree, and many people think it can boost memory, lower blood pressure, and even reverse aging. Ginseng is a root that's taken as an energy booster, and some people also believe it can strengthen the immune system.
  
  Do they work? Patients want a definitive answer. So we give them one: Try the supplements, and if they work for you, then yes, they work.
  
  There are plenty of studies on these herbs, but their results are contradictory. Most of the evidence for them comes from personal testimonials and anecdotes. It's often impossible to know what's really in a bottle of ginkgo biloba or ginseng based on the label—because labels lie (and the law allows them to lie!). What one supplement manufacturer calls "ginseng" is what another may call "garbage."
  
  And even if the pills genuinely contain these herbs, their potency can vary greatly. It can even depend on the time of year the herbs were harvested. Hunting for the little US Pharmocopiea "P" on the label will help ensure at least some consistency.
• QWhat side effects does Ginkgo Biloba cause?

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  A Dr. Michael Roizen, MD , Internal Medicine, answered

  Ginkgo biloba is an herb that comes from the Chinese ginkgo tree. It appears to be another of many possible antioxidants found in fruits and vegetables. A known side effect of ginkgo biloba is an antiplatelet effect (it inhibits the ability of platelets to clump together and cause blood clotting), which does not appear to be significant for most patients.

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• QShould I let my doctor know if I am taking gingko biloba?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  It is always a good idea to consult your doctor before taking any nutritional supplements, especially if you receive prescription medications or other treatments for medical conditions. Your doctor may be aware of additional drug interactions or risks associated with gingko biloba that are unique to your case. Your doctor may also recommend other ways to treat your medical condition.
  
  
• QWhat is the maximum daily dosage for ginkgo biloba?

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  A RealAge answered

  Ginkgo biloba is available in a variety of product types. The recommended daily dose of Ginkgo biloba is a total of 120 to 240 milligrams divided into two to three doses.
  
  The time limitations for using Ginkgo biloba correspond to the condition:
  

  • Gingko should be used for at least eight weeks if treating impaired memory. Gingko may be used for more than three months if there is evidence of continued effectiveness.
  • For disorders of blood vessels in the general circulatory system, the recommended use of ginkgo is at least six weeks.
  • For vertigo or tinnitus, use should be limited to six to eight weeks, unless there is evidence of continued effectiveness.
• QWhat should I avoid while taking ginkgo biloba?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  While taking gingko biloba, avoid certain drugs that may adversely interact with this supplement. These include blood thinners (anticoagulants and antiplatelets), seizure drugs, blood pressure medications (such as iltiazem, nifedipine, and verapamil), and trazodone. Ask your doctor about breastfeeding or becoming pregnant while taking gingko biloba.

• QHow should I take ginkgo biloba?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Gingko biloba comes in the form of teas, liquids, colas, capsules, extracts, sprays, bars and tablets. Follow all instructions and warnings on the package of your gingko biloba. Taking gingko biloba with food and a full glass of water will help your body absorb this supplement. Do not take gingko biloba with any medications that may interact with it, especially blood thinners and seizure drugs.
  
  
• QWho should not take ginkgo biloba?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Do not take gingko biloba if you know you are allergic to it. Do not take garlic if you take blood-thinning medications - such as aspirin, NSAIDs, or anticoagulants - or for two weeks before surgery, due to an increased danger from bleeding. Also avoid gingko biloba if you receive seizure medications, such as phenytoin (Dilantin), carbamazepine (Tegretol), and phenobarbital. Because mental impairments could be serious, never treat them without the advice of your doctor.

• QCan I take ginkgo biloba and ginseng if I take BP medicine?

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  A MDLIVE answered

  You should discuss this with your doctor, especially the specialist prescribing the blood pressure medication if not your primary care doctor. Herbal medications such as gingko and ginseng can react unfavorably with some medications. There are many blood pressure medications on the market and it is likely you may be on other medications for other conditions (such as cholesterol or diabetes) as well. Whenever you take prescription medications, the doctor and/or pharmacist check your list of known medications for any potential dangerous reactions or need for dose adjustment. Taking non-prescription medications like herbals can complicate things and so you should check with your doctor on this. This is another reason to keep your doctors informed of ALL your medications whether that particular doctor prescribed it or not. Further, you should get all your prescriptions from one pharmacy or pharmacy chain so that the pharmacist can double-check your medications.