Ginkgo biloba:
Reality vs Popular Delusion
1. Are ginkgo pills or tablets any good?
ConsumerLab.com of White Plains, New York, an independent lab which tests various "health" products currently on the market, found in 2003 only two out of nine products passed minimal requirements for a quality product. In accordance with FDA standards (or lack thereof), such products are sold as commodities, not medicines, so are not obligated to meet any standard of quality required for medicines.So whether or not there were any actual health benefits to self-medicating with these products, your "odds" of happening on a quality preparation are not good.
2. But if I got randomly lucky & accidentally obtained a quality product, would there be health benefits for vascular disease as so often advertised?
The most hopeful studies suggest a moderate & temporary relief value might exist in limited & specific cases of vascular illness, but other studies show that it has no such effect at all. So it is either worthless, or very slightly benificial, but never strongly benificial, & never lastingly benificial.It may or may not assist bloodflow so that, for example, leg-pain from hardened arteries would experience a slight relief, with an associative degree of relief to the heart muscle; such is the theoretical possibility at least.
The effect, if any, has not been entirely ruled out, but if present is so subtle as to be immeasurable, rendering even the most favorable doubleblind studies inconclusive. A cup of coffee would have a more definitive impact on bloodflow than does ginkgo biloba.
3. But doesn't ginkgo biloba contain antioxidants? And aren't antioxidants generally benificial?
Yes, & this is the "yes" upon which so many false claims are founded. The "best" or "truest" claims that might be made for ginkgo could be made for strawberry jam, but when the claims are being made, no one ever mentions that strawberry jam would work even better. If the antioxidants in ginkgo were as easily accessible through ingestion as are the antioxidants in fruits & vegetables, it could be said that ginkgo is as benificial as fruits & vegetables. But they're not, so it's not. Eat plenty of fruits, berries, & veggies, if you want the best "natural" daily dose of antioxidants.4. Does ginkgo improve memory or decrease senility as many vendors claim?
No. Paul R. Solomon of Williams College conducted a doubleblind study of 260 individuals age 60 or older, half receiving ginkgo, half receiving a placebo, followed by standardized tests for learning, memory, concentration, & attention. Those using ginkgo fared no better than the control group taking a placebo. The findings were that there was no benefit to cognitive function. Another study (Jorm et al, 2004) conducted at the Australian National University's Center for Mental Health Research discovered only 2.8% of 2,551 elderly subjects reported even subjective benifit from taking ginkgo, vitamin E, bacopa, or Vitamin B. But when subjected to actual tests for memory performance, anxiety, depression, & physical health, there was no objective improvement.Virtually all studies that indicate a possibility of improved memory or improved mood were either interviews reliant on subjectivity of the volunteer, or lacked a parallel control group with placebo. One of the most hopeful studies (Trick et al, 2004) included both errors of research design. The study had for its control group a cluster of volunteers who took nothing at all; this would prove only that people who thought they were taking something for a given purpose have a small improvement over people who know they are taking nothing. The study concluded there was a demonstrable improvement on the the "self-assessed performance of the tasks of everyday living." The key word here is "self-assessed." Everything looks much cheerier with neither doubleb-blind placebo controls nor objective testing! But of course this is the sort of meaningless "evidence" that permits promoters & vendors to lie their asses off about efficacy.
The theory had been that ginkgo as a stimulant might increase bloodflow to extremities & to the brain. Therefore ginkgo should have at least temporary effects on brain activity similar to a cup of coffee, though much milder than would coffee, the chemical component bilobalide having been thought possibly to function much like caffeine. Doubleblind studies, alas, put this one to rest; it has no effect on cognitive function.
5. Does it cure Alzheimer's disease?
Absolutely not. A randomized, doubleblind, controlled study conducted by Von Donegan et al (2001) ran trials of 214 long-term care residents who had documented memory impairment, treated with ginkgo or placebo for 24 weeks. The study concluded there were no improvements in cognition or any other positive effects. The best thing the study was able to document was a lack of statistically significant diletarious effects, so ginkgo did nothing helpful, & nothing harmful.The study also analyzed how it could be that a few older studies hinted at greater possibilities, & it appeared that the difference was in the sampling base. The Von Donegan study took their sampling from care fascilities were the environment was controlled with few unpredictable factors, whereas other studies' sample base were outpatient or community-based inadequate controls for variables. I would add that several studies have relied heavily on subjective self-evaluation rather than objective memory & performance tests. The more objective a study is designed to be, the clearer it becomes that ginkgo has no objective value in treating senility of any kind.
6. I read an article that claimed ginkgo corrected erectile dysfunction for half of all men who took it, & improved sexual response for ninety percent of all women who took it. Does it really improve sex drive?
And the moon is made of cheese. If there were a mild relief for pain by temporarily increasing blood flow in individuals with arterial disease, more physical activity might be possible, including sex. If it improves mental outlook of someone mildly depressed, even if only on the basis of the placebo effect, that too might increase interest in sex. These are big "ifs." As to the science, the doubleblind studies, alas, indicate it is ineffective at increasing sexual function, & is not at all effective as a treatment for sexual dysfunction.7. Does it correct tinnitus, hearing loss, macular degeneration, or blindness as often promised?
It does not. A 1994 German study often cited as the best evidence for gingko assisting hearing problems actually concluded the expected percentage of spontaneous recovery was all that was observed. The evidence for assistance to vision loss is worse still, & usually based on the idea that ginkgo probably improves blood circulation therefore it must help visual acuity, a nice hypothesis but not one that has been lent credence by proper controlled studies.8. Does it cure cancer as often asserted?
Certainly not. Though the claim is frequently made that ginkgo treats gastric cancer, prostate cancer, & many other cancers, the claims are fraudulant. The American Cancer Society has warned that no study for ginkgo has ever shown value in human cancer treatment.9. But isn't it at least a good diet aid for losing weight?
It is not. Rumor of sundry herbs being a weight-loss aids is affixed randomly to commercial products because so many people are dieting for so much of their lives, making this claim a most profitable ruse. Of course, if you did happen to eat nothing but ginkgo leaves for a week, you'd sure as hell lose weight, same as if you ate peanut shells or oakleaves or anything else practically indigestible.10. But for minor complaints like soar throat, smoker's cough, or the common cold, it's very useful, right?
Sorry, no. Most minor complaints are things people will naturally recover from & then be tempted to credit whatever treatment they tried. That's why doubleblind studies are the real evidence, & for ginkgo, efficacy has been found to be no greater than a placebo.12. Surely it has been helping my asthma?
No. Asthma can be a major illness. Relying on herbal remedies is foolhardy & dangerous.13. Oh, I know, it improves balance & corrects vertigo, doesn't it?
Not to any noticeable degree. In doubleblind studies it is reported equally to cause dizziness, although likewise to no significant degree.14. I've heard it's good for altitude sickness, is it true?
Used during airplane flights, mountain climbing, or a drive to Denver, it has a positive effect on altitutude sickness equivalent to that of a placebo. In other words, if you think it helped, it helped; if you're unsure, then it didn't. Ginkgo has no inate ability to arrest altitude sickness.15. Everyone tells me it's good for depression. Any reason I should doubt them?
It has about an equal chance of being a mood destablizer as it does of being an antidepressant. Typical of doubleblind clinical trials, Lingaerde et al, 1999, found ginkgo extracts to be worthless for preventing or curing winter onset of depression.16. Does it correct Attention Deficite Disorder or hyperactivity in children as several pop-articles promise?
It does not. Medicating children without a physician's guidance should be regarded as child abuse.17. Well golly gee, if so few of these claims have any truth to them, then why is it so popular as a medicine?
The same reason Jesus is popular. People want to believe. Faith can be a beautiful & enriching hobby. But wherever it promotes bigotry or causes people to risk their health, it is not to be condoned.18. I see by the labels that there is no actual promise of medicinal value, that it is a food supplement only. Does that mean my ginkgo pills are at least nutritious?
Not really. They're made from leaves. Cattle can digest leaf matter because they have four stomachs & don't mind farting up a storm & can eat for hours at a go. Humans are not ruminants so do not process ground up leaves & twigs with any fascility.19. If there were one thing you would consider an intelligent use of gingko, what would it be?
Garden landscaping. They are beautiful, beautiful trees.20. Who are the majority of the customers for gingko remedies?
At one time or another nearly everyone will have used an alternative remedy of some kind, so everyone is a potential customer, & a potential victim, of the herbal industry. But of the population that most commonly self-medicates with herbal remedies, women far outnumber men, & a disproportionately high percentage of these women are also on psychoactive medications.21. Whether or not it has the specific medicinal benifit I am dreaming of, are there any risks or side-effects from trying it anyway?
Yes. The American Society for Reproductive Medicine warns that ginkgo is one of the herbs (St. John's wort & echinacea are others) that negatively impact fertility, so that couples attempting to get pregnant should not use it.It may cause restlessness, interferring with sleep patterns, with associative negative impact on health. It can cause headaches. It may cause gastrointestinal distress including vomiting or diarrhea.
There are a host of additional health risks, but in most cases the threat of harm is no greater or lesser than the possibility of health benifit. The one good thing you can say about herbs that have little or no health value, they also have a low rate of side-effects. The stronger the medicinal value, the more worrisome the side-effects are apt to be. As ginkgo's health benifits are not especially potent, neither is it high on the list of particularly dangerous herbs. But even the slight possibility of mild relief for pain from vascular disease involves a process that bares with it an equal or greater risk of side-effects.
It may for instance be dangerous for anyone with a clotting disorder. It is apt to be dangerous used with any anticoagulant/blood thinner, including household aspirin. It could be life-threatening if a surgeon has not been forwarned of a patient's self-medicating habit.
It can be dangerous taken with any anti-inflammatory prescription medication. It may negate the effectiveness of prescription medications, worsening illness because the actual meds will be rendered ineffective. It is absolutely essential a doctor be informed if you are self-medicating whether with booze, cocaine, other legal or illegal drugs, including herbs.
Many people are embarrassed to admit to a doctor if they are hophead, speedfreak, or herb swiller, but these things must be told to your family physician. Always consult a qualified M.D. before self-medicating with anything, so that at the very least your complaints as well as your self-medicating are on record.
20. My doctor just doesn't take my ailments seriously, & I swear to God ginkgo has helped me more than any physician ever has. Whatcha got to say about that, chump?
For hypochondriacs with vague or imaginary complaints, herbs are as good as anything, the placebo effect being quite real. But genuinely sick people take greater risks. The gravest & most recurring tragedy associated with self-medicating with herbs is the manner by which so many individuals who did have treatable illnesses relied on herbal remedies until their disease had progressed beyond treatability.