Ginkgo Biloba
Ginkgo biloba
TL;DR
Ginkgo biloba leaf extract improves blood flow and is used at 120–240 mg/day of standardised EGb 761, mainly for age-related cognitive complaints and tinnitus.
Ideal For
- Older adults with mild cognitive complaints
- People with tinnitus alongside cognitive symptoms
- Adults with intermittent claudication seeking adjunct support
Avoid If
- You take warfarin, DOACs or antiplatelet drugs
- You have a seizure disorder
- You have surgery scheduled within two weeks
- You are pregnant or breastfeeding
Frequently Asked Questions
Overview
Ginkgo biloba extract is made from the leaves of one of the oldest surviving tree species. Nearly all credible research uses a standardised extract — usually EGb 761 — containing about 24% flavone glycosides and 6% terpene lactones. Crude leaf powder is not equivalent, and unstandardised products cannot be assumed to behave the same way.
Evidence is genuinely mixed and depends on who is being treated. In people with existing cognitive impairment or dementia, 240 mg/day for 22–24 weeks produces small improvements in cognition and daily function in several trials and pooled analyses. In cognitively healthy adults hoping for a memory boost, large prevention trials such as GEM and GuidAge found no reduction in dementia incidence, and acute effects in young adults are unimpressive.
Beyond cognition, ginkgo has reasonable support in intermittent claudication and in tinnitus associated with cognitive decline, and mixed support in vertigo and normal-tension glaucoma. The bleeding-risk question deserves attention: pooled trials do not show increased bleeding events, but case reports exist and the drug-interaction profile with anticoagulants is real enough to warrant caution.
How It Works
- Flavone glycosides scavenge free radicals and protect neuronal membranes
- Terpene lactones antagonise platelet-activating factor, improving microcirculation
- Increases cerebral and peripheral blood flow without a large change in blood pressure
- Supports mitochondrial respiration in ageing neurons
- Modulates cholinergic and monoaminergic neurotransmission
Quick Facts
- May support memory
- Promotes circulation
- Antioxidant properties
- Traditional cognitive tonic
Benefits & Outcomes
Verbal Fluency
Ginkgo shows small effects in dementia populations and essentially none in healthy adults.
Sexual Arousal
Ginkgo is often suggested for SSRI-related sexual dysfunction, but controlled trials disappointed.
Cerebral Blood Flow
Ginkgo reliably increases measured cerebral perfusion; cognitive benefits are smaller and mostly seen in impaired populations.
Cognitive Function
Ginkgo helps modestly in diagnosed dementia at 240 mg/day, but produces no measurable cognitive gain in healthy adults.
Enhanced Memory Formation
Ginkgo does not improve memory in healthy adults, despite decades of marketing to the contrary.
Antioxidant Protection
Ginkgo flavonoids demonstrate antioxidant activity in laboratory and marker studies, but the clinical relevance is unclear.
Mental Clarity
There is no reliable evidence ginkgo sharpens focus or mental clarity in healthy people.
Health Concerns Addressed
Vertigo Disorder
Mixed. Comparable to a weakly evidenced comparator; irrelevant for BPPV, the most common cause.
Tinnitus
No. Large randomised trials and Cochrane review show no benefit for tinnitus.
Memory Loss
Not recommended for age-related forgetfulness. The best-quality evidence is negative, and it interacts with blood thinners.
Glaucoma
Small studies hinted at visual field benefit in normal-tension glaucoma, but the evidence is far too thin to act on and it never replaces pressure-lowering treatment.
Cognitive Decline
Standardised ginkgo (EGb 761) at 240 mg/day produces small symptomatic gains in diagnosed dementia, but it does not prevent cognitive decline in healthy older adults.
Supporting Research23 studies
Ginkgo biloba for cognitive enhancement in healthy individuals: a systematic review
Laws KR, Sweetnam H, Kondel TK
No reliable benefit of Ginkgo biloba was found on any cognitive domain in healthy people.
Ginkgo biloba for intermittent claudication
Nicolai SP, et al.
Overall, there is no evidence that Ginkgo biloba has a clinically significant benefit for patients with peripheral arterial disease.
Ginkgo biloba for cognitive impairment and dementia (updated review)
Cochrane Dementia and Cognitive Improvement Group
It remains uncertain whether Ginkgo is better than placebo for improving overall cognitive condition at six months; certainty of evidence was low to very low.
A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction
Kang BJ, Lee SJ, Kim MD +1 more
This study did not replicate a prior positive finding supporting the use of Ginkgo biloba for antidepressant, especially SSRI, induced sexual dysfunction
Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial
Snitz BE, O'Meara ES, Carlson MC +3 more
Compared with placebo, the use of G. biloba, 120 mg twice daily, did not result in less cognitive decline in older adults with normal cognition or with mild cognitive impairment.
Ginkgo biloba for prevention of dementia: a randomized controlled trial
DeKosky ST, et al
G. biloba at 120 mg twice a day was not effective in reducing either the overall incidence rate of dementia or AD incidence in elderly individuals with normal cognition or those with MCI.
Ginkgo biloba does not improve cognitive function in MS: a randomized placebo-controlled trial
Lovera JF, et al
Treatment with ginkgo 120 mg twice a day did not improve cognitive performance in persons with MS.
Is Ginkgo biloba a cognitive enhancer in healthy individuals? A meta-analysis
Laws KR
We report that G. biloba had no ascertainable positive effects on a range of targeted cognitive functions in healthy individuals.
Ginkgo biloba for cognition and verbal fluency: Cochrane systematic review
Birks J, Grimley Evans J
Evidence that ginkgo improves cognition, including verbal domains, was inconsistent and unreliable across trials
No significant effect of ginkgo biloba special extract EGb 761 in the treatment of primary Raynaud phenomenon: a randomized controlled trial
Bredie SJ, Jong MC
EGb 761 could not demonstrate a statistically significant reduction in clinically relevant symptoms compared with placebo.
Ginkgo biloba for tinnitus
There is uncertainty about the benefits and harms of Ginkgo biloba for the treatment of tinnitus when compared to placebo.
Ginkgo biloba and haemostasis: a systematic review of bleeding risk and platelet function
Kellermann AJ, Kloft C
Controlled trials found no consistent effect of ginkgo on platelet aggregation or bleeding time
Anticoagulant activity of select dietary supplements
Stanger MJ, Thompson LA, Young AJ
Ginkgo has documented antiplatelet activity and may increase bleeding risk when combined with anticoagulants.
Effect of Ginkgo biloba versus nifedipine on the frequency of Raynaud attacks: a randomized trial
Choi WS, Choi CJ, Kim KS
Both treatments reduced attack frequency, with nifedipine producing a greater reduction than Ginkgo biloba.
Ginkgo biloba extract EGb 761 in dizziness and tinnitus: a review of randomised trials
Sokolova L, Hoerr R, Mishchenko T
EGb 761 reduced vertigo severity and dizziness scores versus placebo.
Efficacy of Ginkgo biloba on parameters in glaucoma: A systematic review
Prinz J, Prokosch-Willing V, Wang X +3 more
This study aims to analyse the efficacy of GBE administration in patients with glaucoma and healthy volunteers.
Ginkgo biloba for cognitive impairment and dementia (Cochrane review)
Birks J, Grimley Evans J
The evidence that Ginkgo biloba has predictable and clinically significant benefit for people with dementia or cognitive impairment is inconsistent and unreliable.
Comparative effects of Bacopa monnieri and Ginkgo biloba on cognitive functions: A systematic review and network meta-analysis
Tiemtad P, et al.
Brahmi, particularly in high-dose formulations, shows promise as a cognitive enhancer compared to Ginkgo in healthy adults.
Acute cognitive effects of standardised Ginkgo biloba extract complexed with phosphatidylserine
Kennedy DO
Administration of GBE complexed with phosphatidylserine resulted both in improved secondary memory performance and significantly increased speed of memory task performance.
Effect of Ginkgo biloba extract (EGb 761) on the vasospastic response of mouse cutaneous arterioles to platelet activation
Stucker O
EGb 761, via an action on the thromboxane pathway, could be useful in treating Raynaud's phenomenon.
Long-term use of standardised Ginkgo biloba extract for the prevention of Alzheimer's disease (GuidAge): a randomised placebo-controlled trial
Vellas B, Coley N, Ousset PJ +3 more
Long-term use of standardised ginkgo biloba extract in this trial did not reduce the risk of progression to Alzheimer's disease compared with placebo.
Ginkgo biloba extract EGb761 in dementia: a meta-analysis of randomised controlled trials
Tan MS, Yu JT, Tan CC +3 more
EGb761 at 240 mg per day was able to stabilise or slow decline in cognition, function, behaviour and global change at 22-26 weeks in cognitive impairment and dementia.
Ginkgo biloba for tinnitus (Cochrane review)
Sereda M, Xia J, Scutt P +3 more
We found no evidence that Ginkgo biloba has a clinically important effect on tinnitus loudness or tinnitus symptom severity.
Safety Information
Potential Side Effects
Usually mild: headache, dizziness, palpitations and gastrointestinal upset. Allergic skin reactions occur in people sensitive to poison ivy relatives. Serious bleeding events are rare in trials but reported in case series.
Contraindications
Stop at least 14 days before surgery. Avoid with anticoagulant or antiplatelet therapy unless supervised. Avoid in epilepsy — ginkgotoxin in seeds, and possibly trace amounts in poor-quality extracts, can lower seizure threshold.
Drug Interactions
- Warfarin, DOACs and antiplatelet agents — potential additive bleeding risk
- Anticonvulsants — may reduce seizure control
- Efavirenz and some CYP-metabolised drugs — ginkgo can lower plasma levels
- SSRIs and MAOIs — theoretical serotonergic interaction
Pregnancy & Breastfeeding
Pregnancy: likely_unsafe
Breastfeeding: insufficient_data
Dosage Guidelines
Dosage Used in Studies
Consult healthcare provider
Best Time to Take
Morning, or split morning and evening
Best Form
Standardised EGb 761 extract (24/6), because it is what the clinical literature actually tested
Forms Compared
EGb 761 standardised extract
LI 1370 extract
Crude leaf powder
Food & Timing
With or without food; taking it with a meal reduces occasional stomach upset
Medical Disclaimer
The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.
Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.