By Dr.Glenn Rothfeld, MD DBMA

The leaves, are fan-like, the [female] species of fruit smells awful when ripe, and it’s called “The living fossil” because of its age (found in 200 million year old fossils). But gingko biloba is more than just a tree. It’s a billion dollar business, and a possible hope for millions worldwide. In Germany alone, ginkgo biloba prescriptions (it is prescribed by doctors in Germany) retailed at $280 million in U.S. dollars, according to a report of 1994. One German manufacturer, Schwabe, sold almost $2 billion U.S. dollars worth of Ginkgo biloba extract worldwide in 1993.

What makes ginkgo so attractive is its ability to increase cerebral blood flow as well as blood flow to other areas in the body. Gingko biloba extract (GBE) has been extensively studied, and it has a number of positive effects on dementia, both due to poor circulation and due to Alzheimer’s disease. It is known to contain unique types of molecules called ginkgolides. These molecules block a substance in the body called platelet activating factor (PAF). PAF is a chemical messenger which is involved in inflammation, constriction of blood vessels, increased clotting in the circulation, and (probably) loss of cerebral function in dementia. Also, like many other plant substances, GBE is a potent antioxidant, and oxidation damage contributes to loss of brain function in the elderly.

There are over 50 double-blind studies showing the effectiveness of GBE in cerebral insufficiency, and several that show positive effects in (early) Alzheimer’s Disease. GBE seems to improve mental function at younger ages as well, shown by a number of clinical studies of memory and alertness. It has been tried successfully against other medications for cerebral function, and an 1992 article in Lancet (Kleijnen and Knipschild) stated unequivocally that the research supporting the use of GBE is on par with the research supporting most accepted medications.

The anti-inflammatory and antioxidant effects of GBE also make it a possible choice in asthma, allergy, and eczema, and it has been studied in the retinopathy of diabetes, in cardiac ischemia, and in peripheral vascular problems. Two studies have shown successful treatment of impotence, even in men unresponsive to papaverine injections. The dose of almost all studies has been standardized, so searching for the right GBE involves looking at the label. It should say 24% ginkgoflavonglycosides, and is usually given 40 mg three times a day. The most recent Alzheimer’s study used a double dosage, which may be necessary in this condition. Treatment of conditions with GBE should continue for three to six months, before full effects can be assessed. There are few side effects with ginkgo biloba, but headaches, dizziness and stomach upset can occur, especially at the higher dose.

So why isn’t GBE more popular in the U.S.? First, there has been a bias here against medicines which do not have only one ingredient, and phytomedicines have many different substances, with different effects, contained in the herb. Second, the FDA has been slow to allow phytomedicines into the U.S. market. This is changing with the 1994 passage of the Dietary Supplement Health and Education Act (DSHEA), which will eventually allow for a way to bring these phytomedicines into the market appropriately. The Food and Dietary Supplement Consumer Information Act of 1995, introduced into the House by Reps. Pallone of New Jersey and Hastert of Illinois, will hopefully pass and further this goal. Finally, U.S. doctors, and their training programs, must become aware of the wisdom inherent in many of the older remedies, especially, Ginkgo biloba, the world’s oldest tree.