Ginkgo Biloba for Cognitive Function
Ginkgo helps modestly in diagnosed dementia at 240 mg/day, but produces no measurable cognitive gain in healthy adults.
Overview
Verdict
How It Works
Dosing & Protocol
Typical dose
- Recommended dose
- 240 mg/day of standardised ginkgo extract (EGb 761) in two divided doses with food, for at least 22-24 weeks
- Expected timeframe
- 22-24 weeks
Protocol
- form
- Standardised extract EGb 761 or equivalent (24% flavone glycosides, 6% terpene lactones, ginkgolic acid under 5 ppm) - every trial worth citing used this, and generic leaf products are not equivalent
- duration
- 22-24 weeks minimum - trials shorter than this show nothing
- co factor
- Take with food, morning and evening. Evidence is mixed, and the split is informative. In healthy adults seeking cognitive enhancement, trials are consistently negative. In people with diagnosed dementia or mild cognitive impairment, meta-analyses of EGb 761 at 240 mg/day for 22-24 weeks show small but statistically significant improvements in cognition and activities of daily living, comparable in size to modest pharmacological effects. For prevention, the large GEM and GuidAge trials found ginkgo did not prevent dementia. So: possibly modest help in established impairment, no benefit for prevention, and none for healthy cognition.
- titration
- Increase to 120 mg twice daily. 240 mg/day is the dose used in the trials that showed any effect; 120 mg/day is generally insufficient
- starting dose
- 60 mg twice daily with meals for two weeks to check tolerance
Evidence
What the studies say
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.
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 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.
Safety
Caveats
Progressive memory loss, difficulty with familiar tasks, getting lost or personality change needs medical assessment - reversible causes including B12 deficiency, hypothyroidism, depression, sleep apnoea, medication effects and normal pressure hydrocephalus are treatable, and delay costs the window in which they can be reversed. Ginkgo does not replace cholinesterase inhibitors or memantine where indicated. Safety ceiling: ginkgo has antiplatelet activity, with case reports of intracranial and post-surgical haemorrhage - avoid with warfarin, DOACs, aspirin, clopidogrel and NSAIDs, which is a common combination in this age group, and stop at least two weeks before surgery. It may lower the seizure threshold, so avoid in epilepsy. It induces CYP2C19 and can reduce omeprazole and antiepileptic levels, and interacts with efavirenz. Avoid in pregnancy, breastfeeding and children. Use only preparations with ginkgolic acid below 5 ppm.
Less likely to help if
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.