Ginkgo Biloba
An ancient tree extract with one core mechanism: improved blood flow, especially to the brain. Best evidence is in mild cognitive impairment and dementia.
Moderate evidence for cognitive function in mild dementia / MCI (improved daily living, cognitive testing). Moderate for intermittent claudication (improved walking distance), tinnitus, vertigo. Weak for general memory enhancement in healthy adults. Effects: 8–12 weeks.
Ginkgo biloba leaf extract is one of the most-studied herbal supplements in the West, especially in Germany where it's a registered drug for cognitive impairment. The standardised extract EGb 761 (Tebonin / Tanakan) contains flavonoid glycosides and terpene lactones that improve microcirculation, reduce platelet aggregation, and have antioxidant effects. Best evidence is in mild-to-moderate cognitive impairment, dementia symptoms, intermittent claudication, and tinnitus. Less impressive in healthy adults seeking 'memory boost' — the effect is too modest to feel acutely.
- Form
- EGb 761 (Tebonin / Tanakan) — the standardised German extract used in most trials. Standardised to 24% flavonoid glycosides + 6% terpene lactones.
- Dose
- 120–240 mg/day. Trials use 120 mg twice daily.
- Timing
- With food. AM and PM split.
- Schedule
- Daily. Effects accumulate over 8–12 weeks.
- Side effects
- Generally well-tolerated. Headache, GI upset, dizziness. Rare allergic skin reactions.
- Interactions
- Anticoagulants and antiplatelets — additive blood-thinning; case reports of bleeding (including intracranial). Don't combine with high-dose ginkgo. SSRIs, MAOIs — possible additive serotonergic effects. Seizure medications — ginkgo may lower seizure threshold (high-dose).
- Contraindications
- Bleeding disorders. Pre-surgery (stop 7–14 days before). On anticoagulants. Epilepsy / seizure disorders (high doses). Pregnancy.
- Lab markers
- Cognitive testing (MMSE, MoCA) for objective tracking in MCI / dementia. PT/INR if on warfarin.
- Food sources
- Ginkgo seeds (银杏 in TCM) are edible after cooking — but the leaves contain the supplemental compounds, not the seeds, and leaves aren't eaten directly.
Pairs with
Panax ginseng (synergistic cognitive support — classic combo). Phosphatidylserine, citicoline (cognitive stack). Omega-3 DHA.
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