Ginkgo Supplement

Updated | 2021-12-02

Written and reviewed by the NatureClaim Team


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Ginkgo


Overview of Ginkgo

Scientific Name: Ginkgo biloba


Order: Ginkgoales


Family: Ginkgoaceae


Considered a living fossil. The leaves of ginkgo are used for medicine. Supplements containing ginkgo leaves should contain at least 24% flavone glycosides (or ginkgo glycosides) and 6% terpene lactones (or ginkgolides-bilobalide), the proposed active compounds. Most human clinical trials with ginkgo have been done with a standardized extract called EGb761. Ginkgo is sometimes misspelled as gingko or ginko.



Evidence

Strong:

insufficient information

Good:

  • Cognitive Ability, no effect on brain tumor, chemotherapy, MS, or post-menopausal patients [1-38]
    • Ginkgo appears to increase blood flow to the brain; though mainly short-term affects
    • Ginkgo with dang shen (Codonopsis pilosula), royal jelly / ginseng, phosphatidylserine, or ginseng alone may be more effective; however, ginkgo with Bacopa may NOT be effective
  • Schizophrenia, including a combination of ginkgo with olanzapine or haloperidol [39-43]

Promising:

  • Glaucoma, including a combination of ginkgo and bilberry [44-48]
  • Microcirculation (potentially due to ginkgo's antioxidant properties) [49-52]
  • Migraines, ginkgo with coenzyme-Q 10 / vitamin B2 or magnesium seems to be effective [53-56]
  • Peripheral Artery Disease [57-64]
  • Vertigo, one study found that a homeopathic product might be slightly better than ginkgo [65-67]

Conflicting (Unclear):

  • Alzheimer’s, ginkgo with royal jelly or donepezil may be more effective [68-80]
    • A large (3,069 participants) study, the Ginkgo Evaluation of Memory (GEM) Study, found that ginkgo was not effective at treating Alzheimer’s in individuals 75 and older
  • Anti-Platelet Aggregation, ginkgo with ticlopidine, and ginkgo for people with diabetes may be more effective [89-95]
  • Cardiovascular Disease/Coronary Artery Disease [96-104]
  • Dementia, ginkgo with royal jelly / ginseng may be more effective [105-120]
    • The same large (3,069 participants) study, the Ginkgo Evaluation of Memory (GEM) Study, also found that ginkgo was not effective at treating dementia in individuals 75 and older

Limited Evidence:

  • Anti-Thyroid Cancer Genotoxicity from Radioiodine Therapy [130-131]
  • Anxiety/Stress [132-133]
  • Cold Exposure [134]
  • Colon Cancer, ginkgo with 5-flurourcacil [135]
  • Diabetes [136]
  • Diabetic Nephropathy, including patients undergoing dialysis [137-138]
  • Dyslexia [139]
  • Endurance, ginkgo in combination with Rhodiola crenulata [140]
  • Gastric Cancer (ginkgo fruit skin) [141]
  • Lowers Cholesterol [142]
  • Meniere’s Disease [143]
  • Mild Cognitive Impairment (MCI) [144-146]
  • Mood, ginkgo with ginseng may be more effective [147-148]
  • Multiple Sclerosis (MS), less fatigue [149]
  • Nasal Spray for Post-viral Loss of Smell [150]
  • Neurofibromatosis Type 1 [151]
  • Pancreatic Cancer, ginkgo with 5-flurourcacil [152]
  • Piles, ginkgo in combination with ginseng or troxerutin / heptaminol [153-154]
  • Premenstrual Syndrome (PMS) [155]
  • Post-Traumatic Child with Dyskinesia [156]
  • Radiation [157-158]
  • Raynaud Phenomenon [159-161]
  • Sexual Health, including people on anti-depressant drugs [162-166]
  • Skin Damage from Breast Radiotherapy, ginkgo with aloe [167]
  • Sleep [168-169]
  • Sudden Deafness [170-171]
  • Tardive Dyskinesia, including those who have Schizophrenia [172-173]
  • Topical Treatment of Allergic Reactions [174-175]
  • Venous Disorder, ginkgo with troxerutin / heptaminol [176]
  • Vitiligo [177-178]
  • Wrinkle Cream [179]

No Evidence:


No Clinical Research:

All other conditions.


Side Effects
Side effects may include:
  • Diarrhea
  • Dizziness
  • Gas
  • Gastrointestinal Discomfort
  • Headache
  • Heart Palpitations
  • Nausea
  • Skin Irritation
Precautions and Adverse Events:
  • Avoid if you have had a history of nosebleeds, seizures, allergic reactions to ginkgo, are epileptic, have hypertension are planning a surgical operation, or after a surgical operation. Ginkgo can increase and prolong bleeding. Contact a licensed healthcare practitioner, if you had a seizure, changes in blood pressure, and have unusual bleeding or bruising while taking ginkgo.
  • Do NOT eat ginkgo nuts and fruits, especially young children and infants. Ginkgo nuts and fruits contain an anti-vitamin B6 neurotoxin.
    • Boiling ginkgo nuts and fruits first may remove the toxic compounds.
    • Ginkgo nuts and fruits can cause contact dermatitis.
    • Symptoms associated with ginkgo nut and fruit allergic reactions may include: intense itching, edema, papules, and pustules; usually subsiding within 7-10 days.
    • Ginkgo nuts and fruits can cause seizures and even death.
    • Symptoms associated with ginkgo nut poisoning may include: convulsions, vomiting, and nausea.
  • A few cases of bleeding occurred due to ginkgo use, including iris bleeding, bleeding after liver transplant, cerebral hemorrhaging, and bleeding after postoperative laparoscopic cholecystectomy.
  • Although some have reported that ginkgo does not cause a higher risk of bleeding, many more have reported that ginkgo does cause a higher risk bleeding or increased bleeding time.
  • Although withdrawn, do not inject ginkgo because it may causes allergic reactions, changes in blood pressure, circulatory disturbances, and inflammation of the veins.
  • Hypersensitive reactions of ginkgo supplements may consist of spasms and cramps and, in cases of acute toxicity, atonia and adynamia.
  • A case of someone with glucose-6-phosphate dehydrogenase (G6PD) deficiency developed acute hemolytic anemia.
  • A rare case of acute generalised exanthematous pustulosis (AGEP) occurred after someone took ginkgo.
  • Applying ginkgo extracts to the skin or mucus membranes may cause irritation and blistering.
  • Ginkgo supplements should not contain 5ppm (mcg/g) of ginkgolic acids, a known allergen.
  • Chronic ginkgo use caused cerebral bleeding and a case of retrobulbar hemorrhage.
  • Ginkgo caused epileptic seizures in people who had their seizures under control.
  • A case of Stevens-Johnson syndrome (SJS) occurred while someone took ginkgo.
  • There was a case of ventricular arrhythmias associated with ginkgo.
  • Avoid ginkgo at least 2 weeks before surgery.
  • Pollen from ginkgo is a strong allergen.
[196-222]


Pregnant or Nursing

Do NOT use ginkgo around labor, it may prolong bleeding after birth. Overall, there is not enough research on the use of supplements containing ginkgo during pregnancy and breast-feeding, so consult a licensed healthcare practitioner before use or avoid use. However, based on expert opinion, ginkgo should NOT be taken during pregnancy and breast-feeding. Ginkgo may be toxic to oocytes. [196-222]



Interactions

Major:

  • A ginkgo/St. John’s wort combination with Buspirone and Fluoxetine caused a case of hypomania; though this may have been due to the presence of St. John’s wort
  • A fatal seizure occurred when ginkgo was combined with Depakote and Dilantin
  • Ginkgo combined with Trazodone caused a coma
  • Anti-Coagulant/Anti-Platelet Drugs
  • Anti-Consultants/Anti-Epileptics
  • Anti-Thrombolytic Agents
  • Aspirin
  • Buspirone
  • Cilostazol
  • Clopidogrel
  • Depakote (Valproic Acid)
  • Dilantin
  • Dipyridamole
  • Diuretics
  • Fluoxetine
  • Heparin
  • Ibuprofen
  • Naproxen
  • Non-steroidal Anti-Inflammatory Drugs (NSAIDs)
  • Phenytoin
  • Risperidone
  • Rofecoxib
  • Schizophrenia Drugs
  • Selective Serotonin Reuptake Inhibitors
  • Thiazide Diuretics
  • Ticlopidine
  • Trazodone
  • Warfarin
[223-239]

Moderate:

  • Alprazolam
  • Anti-Hypertensives
  • Benzodiazepines
  • Cyclosporine
  • Digoxin
  • Drugs changed by Cytochrome P450s (CYPs) in the liver
  • Haloperidol
  • Midazolam
  • Nifedipine
  • Omeprazole
  • Propranolol
  • Proton Pump Inhibitors
  • Ritonavir
  • Sulfonylureas
  • Tolbutamide
[223-239]

Potential:

  • Insulin
  • Efavirenz
  • Monoamine Oxidase Inhibitors (MAOIs)
  • Nicardipine
  • Papaverine
  • Theophylline
  • Ginkgo may NOT interact with Metformin
[223-239]


Dosage

Ginkgo is not a "drug", the best doses have not been thoroughly established. Make sure to follow the specific product instructions and take as directed on the label, or consult a licensed healthcare practitioner before use.





References

1. Allain H, Raoul P, Lieury A, LeCoz F, Gandon JM, d'Arbigny P. Effect of two doses of ginkgo biloba extract (EGb 761) on the dual-coding test in elderly subjects. Clin Ther. 1993 May-Jun;15(3):549-58. 2. Amen DG, Taylor DV, Ojala K, Kaur J, Willeumier K. Effects of brain-directed nutrients on cerebral blood flow and neuropsychological testing: a randomized, double-blind, placebo-controlled, crossover trial. Adv Mind Body Med. 2013 Spring;27(2):24-33. 3. Attia A, Rapp SR, Case LD, D'Agostino R, Lesser G, Naughton M, McMullen K, Rosdhal R, Shaw EG. Phase II study of Ginkgo biloba in irradiated brain tumor patients: effect on cognitive function, quality of life, and mood. J Neurooncol. 2012 Sep;109(2):357-63. 4. Barton DL, Burger K, Novotny PJ, Fitch TR, Kohli S, Soori G, Wilwerding MB, Sloan JA, Kottschade LA, Rowland KM Jr, Dakhil SR, Nikcevich DA, Loprinzi CL. The use of Ginkgo biloba for the prevention of chemotherapy-related cognitive dysfunction in women receiving adjuvant treatment for breast cancer, N00C9. Support Care Cancer. 2013 Apr;21(4):1185-92. 5. Carlson JJ, Farquhar JW, DiNucci E, Ausserer L, Zehnder J, Miller D, Berra K, Hagerty L, Haskell WL. Safety and efficacy of a ginkgo biloba-containing dietary supplement on cognitive function, quality of life, and platelet function in healthy, cognitively intact older adults. J Am Diet Assoc. 2007 Mar;107(3):422-32. 6. Cieza A, Maier P, Pöppel E. Effects of Ginkgo biloba on mental functioning in healthy volunteers. Arch Med Res. 2003 Sep-Oct;34(5):373-81. 7. Dimpfel W, Kler A, Kriesl E, Lehnfeld R, Keplinger-Dimpfel IK. Neurophysiological characterization of a functionally active drink containing extracts of ginkgo and ginseng by source density analysis of the human EEG. Nutr Neurosci. 2006 Oct-Dec;9(5-6):213-24. 8. Dodge HH, Zitzelberger T, Oken BS, Howieson D, Kaye J. A randomized placebo-controlled trial of Ginkgo biloba for the prevention of cognitive decline. Neurology. 2008 May 6;70(19 Pt 2):1809-17. 9. Elsabagh S, Hartley DE, Ali O, Williamson EM, File SE. Differential cognitive effects of Ginkgo biloba after acute and chronic treatment in healthy young volunteers. Psychopharmacology (Berl). 2005 May;179(2):437-46. 10. Elsabagh S, Hartley DE, File SE. Limited cognitive benefits in Stage +2 postmenopausal women after 6 weeks of treatment with Ginkgo biloba. J Psychopharmacol. 2005 Mar;19(2):173-81. 11. Hartley DE, Elsabagh S, File SE. Gincosan (a combination of Ginkgo biloba and Panax ginseng): the effects on mood and cognition of 6 and 12 weeks' treatment in post-menopausal women. Nutr Neurosci. 2004 Oct-Dec;7(5-6):325-33. 12. Hartley DE, Heinze L, Elsabagh S, File SE. Effects on cognition and mood in postmenopausal women of 1-week treatment with Ginkgo biloba. Pharmacol Biochem Behav. 2003 Jun;75(3):711-20. 13. Herrschaft H, Nacu A, Likhachev S, Sholomov I, Hoerr R, Schlaefke S. Ginkgo biloba extract EGb 761® in dementia with neuropsychiatric features: a randomised, placebo-controlled trial to confirm the efficacy and safety of a daily dose of 240 mg. J Psychiatr Res. 2012 Jun;46(6):716-23. 14. Ihl R, Tribanek M, Bachinskaya N; GOTADAY Study Group. Efficacy and tolerability of a once daily formulation of Ginkgo biloba extract EGb 761® in Alzheimer's disease and vascular dementia: results from a randomised controlled trial. Pharmacopsychiatry. 2012 Mar;45(2):41-6. 15. Kaschel R. Specific memory effects of Ginkgo biloba extract EGb 761 in middle-aged healthy volunteers. Phytomedicine. 2011 Nov 15;18(14):1202-7. 16. Kennedy DO, Haskell CF, Mauri PL, Scholey AB. Acute cognitive effects of standardised Ginkgo biloba extract complexed with phosphatidylserine. Hum Psychopharmacol. 2007 Jun;22(4):199-210. 17. Kennedy DO, Jackson PA, Haskell CF, Scholey AB. Modulation of cognitive performance following single doses of 120 mg Ginkgo biloba extract administered to healthy young volunteers. Hum Psychopharmacol. 2007 Dec;22(8):559-66. 18. Kennedy DO, Scholey AB, Wesnes KA. The dose-dependent cognitive effects of acute administration of Ginkgo biloba to healthy young volunteers. Psychopharmacology (Berl). 2000 Sep;151(4):416-23. 19. Kennedy DO, Scholey AB, Wesnes KA. Differential, dose dependent changes in cognitive performance following acute administration of a Ginkgo biloba/Panax ginseng combination to healthy young volunteers. Nutr Neurosci. 2001;4(5):399-412. 20. Kennedy DO, Scholey AB, Wesnes KA. Modulation of cognition and mood following administration of single doses of Ginkgo biloba, ginseng, and a ginkgo/ginseng combination to healthy young adults. Physiol Behav. 2002 Apr 15;75(5):739-51. 21. Lovera J, Bagert B, Smoot K, Morris CD, Frank R, Bogardus K, Wild K, Oken B, Whitham R, Bourdette D. Ginkgo biloba for the improvement of cognitive performance in multiple sclerosis: a randomized, placebo-controlled trial. Mult Scler. 2007 Apr;13(3):376-85. 22. Lovera JF, Kim E, Heriza E, Fitzpatrick M, Hunziker J, Turner AP, Adams J, Stover T, Sangeorzan A, Sloan A, Howieson D, Wild K, Haselkorn J, Bourdette D. Ginkgo biloba does not improve cognitive function in MS: a randomized placebo-controlled trial. Neurology. 2012 Sep 18;79(12):1278-84. 23. Mix JA, Crews WD Jr. An examination of the efficacy of Ginkgo biloba extract EGb761 on the neuropsychologic functioning of cognitively intact older adults. J Altern Complement Med. 2000 Jun;6(3):219-29. 24. Mix JA, Crews WD Jr. A double-blind, placebo-controlled, randomized trial of Ginkgo biloba extract EGb 761 in a sample of cognitively intact older adults: neuropsychological findings. Hum Psychopharmacol. 2002 Aug;17(6):267-77. 25. Nathan PJ, Ricketts E, Wesnes K, Mrazek L, Greville W, Stough C. The acute nootropic effects of Ginkgo biloba in healthy older human subjects: a preliminary investigation. Hum Psychopharmacol. 2002 Jan;17(1):45-9. 26. Nathan PJ, Tanner S, Lloyd J, Harrison B, Curran L, Oliver C, Stough C. Effects of a combined extract of Ginkgo biloba and Bacopa monniera on cognitive function in healthy humans. Hum Psychopharmacol. 2004 Mar;19(2):91-6. 27. Rai GS, Shovlin C, Wesnes KA. A double-blind, placebo controlled study of Ginkgo biloba extract ('tanakan') in elderly outpatients with mild to moderate memory impairment. Curr Med Res Opin. 1991;12(6):350-5. 28. Rigney U, Kimber S, Hindmarch I. The effects of acute doses of standardized Ginkgo biloba extract on memory and psychomotor performance in volunteers. Phytother Res. 1999 Aug;13(5):408-15. 29. Santos RF, Galduróz JC, Barbieri A, Castiglioni ML, Ytaya LY, Bueno OF. Cognitive performance, SPECT, and blood viscosity in elderly non-demented people using Ginkgo biloba. Pharmacopsychiatry. 2003 Jul;36(4):127-33. 30. Scholey AB, Kennedy DO. Acute, dose-dependent cognitive effects of Ginkgo biloba, Panax ginseng and their combination in healthy young volunteers: differential interactions with cognitive demand. Hum Psychopharmacol. 2002 Jan;17(1):35-44. 31. Singh B, Song H, Liu XD, Hardy M, Liu GZ, Vinjamury SP, Martirosian CD. Dangshen (Codonopsis pilosula) and Bai guo (Gingko biloba) enhance learning and memory. Altern Ther Health Med. 2004 Jul-Aug;10(4):52-6. 32. Snitz BE, O'Meara ES, Carlson MC, Arnold AM, Ives DG, Rapp SR, Saxton J, Lopez OL, Dunn LO, Sink KM, DeKosky ST; Ginkgo Evaluation of Memory (GEM) Study Investigators. Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial. JAMA. 2009 Dec 23;302(24):2663-70. 33. Solomon PR, Adams F, Silver A, Zimmer J, DeVeaux R. Ginkgo for memory enhancement: a randomized controlled trial. JAMA. 2002 Aug 21;288(7):835-40. 34. Stough C, Clarke J, Lloyd J, Nathan PJ. Neuropsychological changes after 30-day Ginkgo biloba administration in healthy participants. Int J Neuropsychopharmacol. 2001 Jun;4(2):131-4. 35. Wesnes KA, Faleni RA, Hefting NR, Hoogsteen G, Houben JJ, Jenkins E, Jonkman JH, Leonard J, Petrini O, van Lier JJ. The cognitive, subjective, and physical effects of a ginkgo biloba/panax ginseng combination in healthy volunteers with neurasthenic complaints. Psychopharmacol Bull. 1997;33(4):677-83. 36. Wesnes KA, Ward T, McGinty A, Petrini O. The memory enhancing effects of a Ginkgo biloba/Panax ginseng combination in healthy middle-aged volunteers. Psychopharmacology (Berl). 2000 Nov;152(4):353-61. 37. Yakoot M, Salem A, Helmy S. Effect of Memo®, a natural formula combination, on Mini-Mental State Examination scores in patients with mild cognitive impairment. Clin Interv Aging. 2013;8:975-81. 38. Zhang SJ, Xue ZY. Effect of Western medicine therapy assisted by Ginkgo biloba tablet on vascular cognitive impairment of none dementia. Asian Pac J Trop Med. 2012 Aug;5(8):661-4. doi: 10.1016/S1995-7645(12)60135-7. 39. Atmaca M, Tezcan E, Kuloglu M, Ustundag B, Kirtas O. The effect of extract of ginkgo biloba addition to olanzapine on therapeutic effect and antioxidant enzyme levels in patients with schizophrenia. Psychiatry Clin Neurosci. 2005 Dec;59(6):652-6. 40. Zhang XY, Zhou DF, Cao LY, Wu GY. The effects of Ginkgo biloba extract added to haloperidol on peripheral T cell subsets in drug-free schizophrenia: a double-blind, placebo-controlled trial. Psychopharmacology (Berl). 2006 Sep;188(1):12-7. 41. Zhang XY, Zhou DF, Su JM, Zhang PY. The effect of extract of ginkgo biloba added to haloperidol on superoxide dismutase in inpatients with chronic schizophrenia. J Clin Psychopharmacol. 2001 Feb;21(1):85-8. 42. Zhang XY, Zhou DF, Zhang PY, Wu GY, Su JM, Cao LY. A double-blind, placebo-controlled trial of extract of Ginkgo biloba added to haloperidol in treatment-resistant patients with schizophrenia. J Clin Psychiatry. 2001 Nov;62(11):878-83. 43. Zhou D, Zhang X, Su J, Nan Z, Cui Y, Liu J, Guan Z, Zhang P, Shen Y. The effects of classic antipsychotic haloperidol plus the extract of ginkgo biloba on superoxide dismutase in patients with chronic refractory schizophrenia. Chin Med J (Engl). 1999 Dec;112(12):1093-6. 44. Chung HS, Harris A, Kristinsson JK, Ciulla TA, Kagemann C, Ritch R. Ginkgo biloba extract increases ocular blood flow velocity. J Ocul Pharmacol Ther. 1999 Jun;15(3):233-40. 45. Park JW, Kwon HJ, Chung WS, Kim CY, Seong GJ. Short-term effects of Ginkgo biloba extract on peripapillary retinal blood flow in normal tension glaucoma. Korean J Ophthalmol. 2011 Oct;25(5):323-8. 46. Quaranta L, Bettelli S, Uva MG, Semeraro F, Turano R, Gandolfo E. Effect of Ginkgo biloba extract on preexisting visual field damage in normal tension glaucoma. Ophthalmology. 2003 Feb;110(2):359-62; discussion 362-4. 47. Shim SH, Kim JM, Choi CY, Kim CY, Park KH. Ginkgo biloba extract and bilberry anthocyanins improve visual function in patients with normal tension glaucoma. J Med Food. 2012 Sep;15(9):818-23. 48. Wimpissinger B, Berisha F, Garhoefer G, Polak K, Schmetterer L. Influence of Ginkgo biloba on ocular blood flow. Acta Ophthalmol Scand. 2007 Jun;85(4):445-9. 49. Jung F, Mrowietz C, Kiesewetter H, Wenzel E. Effect of Ginkgo biloba on fluidity of blood and peripheral microcirculation in volunteers. Arzneimittelforschung. 1990 May;40(5):589-93. 50. Mantle D, Wilkins RM, Gok MA. Comparison of antioxidant activity in commercial Ginkgo biloba preparations. J Altern Complement Med. 2003 Oct;9(5):625-9. 51. Pietri S, Séguin JR, d'Arbigny P, Drieu K, Culcasi M. Ginkgo biloba extract (EGb 761) pretreatment limits free radical-induced oxidative stress in patients undergoing coronary bypass surgery. Cardiovasc Drugs Ther. 1997 Apr;11(2):121-31. 52. Suter A, Niemer W, Klopp R. A new ginkgo fresh plant extract increases microcirculation and radical scavenging activity in elderly patients. Adv Ther. 2011 Dec;28(12):1078-88. 53. Allais G, D'Andrea G, Maggio M, Benedetto C. The efficacy of ginkgolide B in the acute treatment of migraine aura: an open preliminary trial. Neurol Sci. 2013 May;34 Suppl 1:S161-3. 54. D'Andrea G, Bussone G, Allais G, Aguggia M, D'Onofrio F, Maggio M, Moschiano F, Saracco MG, Terzi MG, Petretta V, Benedetto C. Efficacy of Ginkgolide B in the prophylaxis of migraine with aura. Neurol Sci. 2009 May;30 Suppl 1:S121-4. 55. Esposito M, Carotenuto M. Ginkgolide B complex efficacy for brief prophylaxis of migraine in school-aged children: an open-label study. Neurol Sci. 2011 Feb;32(1):79-81. doi: 10.1007/s10072-010-0411-5. 56. Usai S, Grazzi L, Bussone G. Gingkolide B as migraine preventive treatment in young age: results at 1-year follow-up. Neurol Sci. 2011 May;32 Suppl 1:S197-9. 57. Bauer U. 6-month double-blind randomised clinical trial of Ginkgo biloba extract versus placebo in two parallel groups in patients suffering from peripheral arterial insufficiency. Arzneimittelforschung. 1984;34(6):716-20. 58. Gardner CD, Taylor-Piliae RE, Kiazand A, Nicholus J, Rigby AJ, Farquhar JW. Effect of Ginkgo biloba (EGb 761) on treadmill walking time among adults with peripheral artery disease: a randomized clinical trial. J Cardiopulm Rehabil Prev. 2008 Jul-Aug;28(4):258-65. 59. Li AL, Shi YD, Landsmann B, Schanowski-Bouvier P, Dikta G, Bauer U, Artmann GM. Hemorheology and walking of peripheral arterial occlusive diseases patients during treatment with Ginkgo biloba extract. Zhongguo Yao Li Xue Bao. 1998 Sep;19(5):417-21. 60. Mouren X, Caillard P, Schwartz F. Study of the antiischemic action of EGb 761 in the treatment of peripheral arterial occlusive disease by TcPo2 determination. Angiology. 1994 Jun;45(6):413-7. 61. Peters H, Kieser M, Hölscher U. Demonstration of the efficacy of ginkgo biloba special extract EGb 761 on intermittent claudication--a placebo-controlled, double-blind multicenter trial. Vasa. 1998 May;27(2):106-10. 62. Schweizer J, Hautmann C. Comparison of two dosages of ginkgo biloba extract EGb 761 in patients with peripheral arterial occlusive disease Fontaine's stage IIb. A randomised, double-blind, multicentric clinical trial. Arzneimittelforschung. 1999 Nov;49(11):900-4. 63. Thomson GJ, Vohra RK, Carr MH, Walker MG. A clinical trial of Gingkco Biloba Extract in patients with intermittent claudication. Int Angiol. 1990 Apr-Jun;9(2):75-8. 64. Wang J, Zhou S, Bronks R, Graham J, Myers S. Supervised exercise training combined with ginkgo biloba treatment for patients with peripheral arterial disease. Clin Rehabil. 2007 Jul;21(7):579-86. 65. Cesarani A, Meloni F, Alpini D, Barozzi S, Verderio L, et al. Ginkgo biloba (EGb 761) in the treatment of equilibrium disorders. Adv Ther. 1998 Sep-Oct;15(5):291-304. 66. Issing W, Klein P, Weiser M. The homeopathic preparation Vertigoheel versus Ginkgo biloba in the treatment of vertigo in an elderly population: a double-blinded, randomized, controlled clinical trial. J Altern Complement Med. 2005 Feb;11(1):155-60. 67. Schneider D, Schneider L, Shulman A, Claussen CF, Just E, et al. Gingko biloba (Rökan) therapy in tinnitus patients and measurable interactions between tinnitus and vestibular disturbances. Int Tinnitus J. 2000;6(1):56-62. 68. Bettermann K, Arnold AM, Williamson J, Rapp S, Sink K, Toole JF, Carlson MC, Yasar S, Dekosky S, Burke GL. Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study. J Stroke Cerebrovasc Dis. 2012 Aug;21(6):436-44. 69. Cornelli U. Treatment of Alzheimer's disease with a cholinesterase inhibitor combined with antioxidants. Neurodegener Dis. 2010;7(1-3):193-202. 70. DeKosky ST, Williamson JD, Fitzpatrick AL, Kronmal RA, Ives DG, Saxton JA, Lopez OL, Burke G, Carlson MC, Fried LP, Kuller LH, Robbins JA, Tracy RP, Woolard NF, Dunn L, Snitz BE, Nahin RL, Furberg CD; Ginkgo Evaluation of Memory (GEM) Study Investigators. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA. 2008 Nov 19;300(19):2253-62. 71. Guo S, Hernandez L, Wasiak R, Gaudig M. Modelling the clinical and economic implications of galantamine in the treatment of mild-to-moderate Alzheimer's disease in Germany. J Med Econ. 2010;13(4):641-54. 72. Kanowski S, Herrmann WM, Stephan K, Wierich W, Hörr R. Proof of efficacy of the ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Pharmacopsychiatry. 1996 Mar;29(2):47-56. 73. Le Bars PL. Response patterns of EGb 761 in Alzheimer's disease: influence of neuropsychological profiles. Pharmacopsychiatry. 2003 Jun;36 Suppl 1:S50-5. 74. Maurer K, Ihl R, Dierks T, Frölich L. Clinical efficacy of Ginkgo biloba special extract EGb 761 in dementia of the Alzheimer type. J Psychiatr Res. 1997 Nov-Dec;31(6):645-55. 75. Mazza M, Capuano A, Bria P, Mazza S. Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer's dementia in a randomized placebo-controlled double-blind study. Eur J Neurol. 2006 Sep;13(9):981-5. 76. Schneider LS, DeKosky ST, Farlow MR, Tariot PN, Hoerr R, Kieser M. A randomized, double-blind, placebo-controlled trial of two doses of Ginkgo biloba extract in dementia of the Alzheimer's type. Curr Alzheimer Res. 2005 Dec;2(5):541-51. 77. Vellas B, Coley N, Ousset PJ, Berrut G, Dartigues JF, Dubois B, Grandjean H, Pasquier F, Piette F, Robert P, Touchon J, Garnier P, Mathiex-Fortunet H, Andrieu S; GuidAge Study Group. Long-term use of standardised Ginkgo biloba extract for the prevention of Alzheimer's disease (GuidAge): a randomised placebo-controlled trial. Lancet Neurol. 2012 Oct;11(10):851-9. doi: 10.1016/S1474-4422(12)70206-5. 78. Yakoot M, Salem A, Helmy S. Effect of Memo®, a natural formula combination, on Mini-Mental State Examination scores in patients with mild cognitive impairment. Clin Interv Aging. 2013;8:975-81. 79. Yancheva S, Ihl R, Nikolova G, Panayotov P, Schlaefke S, Hoerr R; GINDON Study Group. Ginkgo biloba extract EGb 761(R), donepezil or both combined in the treatment of Alzheimer's disease with neuropsychiatric features: a randomised, double-blind, exploratory trial. Aging Ment Health. 2009 Mar;13(2):183-90. 80. Yasar S, Xia J, Yao W, Furberg CD, Xue QL, Mercado CI, Fitzpatrick AL, Fried LP, Kawas CH, Sink KM, Williamson JD, DeKosky ST, Carlson MC; Ginkgo Evaluation of Memory (GEM) Study Investigators. Antihypertensive drugs decrease risk of Alzheimer disease: Ginkgo Evaluation of Memory Study. Neurology. 2013 Sep 3;81(10):896-903. 81. Chow T, Browne V, Heileson HL, Wallace D, Anholm J, Green SM. Ginkgo biloba and acetazolamide prophylaxis for acute mountain sickness: a randomized, placebo-controlled trial. Arch Intern Med. 2005 Feb 14;165(3):296-301. 82. Gertsch JH, Basnyat B, Johnson EW, Onopa J, Holck PS. Randomised, double blind, placebo controlled comparison of ginkgo biloba and acetazolamide for prevention of acute mountain sickness among Himalayan trekkers: the prevention of high altitude illness trial (PHAIT). BMJ. 2004 Apr 3;328(7443):797. 83. Gertsch JH, Seto TB, Mor J, Onopa J. Ginkgo biloba for the prevention of severe acute mountain sickness (AMS) starting one day before rapid ascent. High Alt Med Biol. 2002 Spring;3(1):29-37. 84. Jowers C, Shih R, James J, Deloughery TG, Holden WE. Effects of Ginkgo biloba on exhaled nasal nitric oxide during normobaric hypoxia in humans. High Alt Med Biol. 2004 Winter;5(4):445-9. 85. Ke T, Wang J, Swenson ER, Zhang X, Hu Y, Chen Y, Liu M, Zhang W, Zhao F, Shen X, Yang Q, Chen J, Luo W. Effect of acetazolamide and gingko biloba on the human pulmonary vascular response to an acute altitude ascent. High Alt Med Biol. 2013 Jun;14(2):162-7. 86. Leadbetter G, Keyes LE, Maakestad KM, Olson S, Tissot van Patot MC, Hackett PH. Ginkgo biloba does--and does not--prevent acute mountain sickness. Wilderness Environ Med. 2009 Spring;20(1):66-71. 87. Moraga FA, Flores A, Serra J, Esnaola C, Barriento C. Ginkgo biloba decreases acute mountain sickness in people ascending to high altitude at Ollagüe (3696 m) in northern Chile. Wilderness Environ Med. 2007 Winter;18(4):251-7. Erratum in: Wilderness Environ Med. 2008 Spring;19(1):51. 88. Roncin JP, Schwartz F, D'Arbigny P. EGb 761 in control of acute mountain sickness and vascular reactivity to cold exposure. Aviat Space Environ Med. 1996 May;67(5):445-52. 89. Bal Dit Sollier C, Caplain H, Drouet L. No alteration in platelet function or coagulation induced by EGb761 in a controlled study. Clin Lab Haematol. 2003 Aug;25(4):251-3. 90. Galduróz JC, Antunes HK, Santos RF. Gender- and age-related variations in blood viscosity in normal volunteers: a study of the effects of extract of Allium sativum and Ginkgo biloba. Phytomedicine. 2007 Aug;14(7-8):447-51. 91. Hong JM, Shin DH, Lim YA, Lee JS, Joo IS. Ticlopidine with Ginkgo Biloba extract: a feasible combination for patients with acute cerebral ischemia. Thromb Res. 2013 Apr;131(4):e147-53. 92. Köhler S, Funk P, Kieser M. Influence of a 7-day treatment with Ginkgo biloba special extract EGb 761 on bleeding time and coagulation: a randomized, placebo-controlled, double-blind study in healthy volunteers. Blood Coagul Fibrinolysis. 2004 Jun;15(4):303-9. 93. Kudolo GB, Delaney D, Blodgett J. Short-term oral ingestion of Ginkgo biloba extract (EGb 761) reduces malondialdehyde levels in washed platelets of type 2 diabetic subjects. Diabetes Res Clin Pract. 2005 Apr;68(1):29-38. 94. Kudolo GB, Wang W, Elrod R, Barrientos J, Haase A, Blodgett J. Short-term ingestion of Ginkgo biloba extract does not alter whole body insulin sensitivity in non-diabetic, pre-diabetic or type 2 diabetic subjects--a randomized double-blind placebo-controlled crossover study. Clin Nutr. 2006 Feb;25(1):123-34. 95. Santos RF, Galduróz JC, Barbieri A, Castiglioni ML, Ytaya LY, Bueno OF. Cognitive performance, SPECT, and blood viscosity in elderly non-demented people using Ginkgo biloba. Pharmacopsychiatry. 2003 Jul;36(4):127-33. 96. Boelsma E, Lamers RJ, Hendriks HF, van Nesselrooij JH, Roza L. Evidence of the regulatory effect of Ginkgo biloba extract on skin blood flow and study of its effects on urinary metabolites in healthy humans. Planta Med. 2004 Nov;70(11):1052-7. 97. Brinkley TE, Lovato JF, Arnold AM, Furberg CD, Kuller LH, et al. Effect of Ginkgo biloba on blood pressure and incidence of hypertension in elderly men and women. Am J Hypertens. 2010 May;23(5):528-33. 98. Jezova D, Duncko R, Lassanova M, Kriska M, Moncek F. Reduction of rise in blood pressure and cortisol release during stress by Ginkgo biloba extract (EGb 761) in healthy volunteers. J Physiol Pharmacol. 2002 Sep;53(3):337-48. 99. Kalus JS, Piotrowski AA, Fortier CR, Liu X, Kluger J, White CM. Hemodynamic and electrocardiographic effects of short-term Ginkgo biloba. Ann Pharmacother. 2003 Mar;37(3):345-9. 100. Kuller LH, Ives DG, Fitzpatrick AL, Carlson MC, Mercado C, Lopez OL, Burke GL, Furberg CD, DeKosky ST; Ginkgo Evaluation of Memory Study Investigators. Does Ginkgo biloba reduce the risk of cardiovascular events? Circ Cardiovasc Qual Outcomes. 2010 Jan;3(1):41-7. doi: 10.1161/CIRCOUTCOMES.109.871640. Epub 2009 Nov 24. 101. Siegel G, Schäfer P, Winkler K, Malmsten M. Ginkgo biloba (EGb 761) in arteriosclerosis prophylaxis. Wien Med Wochenschr. 2007;157(13-14):288-94. 102. Wu Y, Li S, Cui W, Zu X, Du J, Wang F. Ginkgo biloba extract improves coronary blood flow in healthy elderly adults: role of endothelium-dependent vasodilation. Phytomedicine. 2008 Mar;15(3):164-9. 103. Wu Y, Li S, Cui W, Zu X, Wang F, Du J. Ginkgo biloba extract improves coronary blood flow in patients with coronary artery disease: role of endothelium-dependent vasodilation. Planta Med. 2007 Jun;73(7):624-8. 104. Wu YZ, Li SQ, Zu XG, Du J, Wang FF. Ginkgo biloba extract improves coronary artery circulation in patients with coronary artery disease: contribution of plasma nitric oxide and endothelin-1. Phytother Res. 2008 Jun;22(6):734-9. 105. Bettermann K, Arnold AM, Williamson J, Rapp S, Sink K, Toole JF, Carlson MC, Yasar S, Dekosky S, Burke GL. Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study. J Stroke Cerebrovasc Dis. 2012 Aug;21(6):436-44. 106. DeKosky ST, Williamson JD, Fitzpatrick AL, Kronmal RA, Ives DG, Saxton JA, Lopez OL, Burke G, Carlson MC, Fried LP, Kuller LH, Robbins JA, Tracy RP, Woolard NF, Dunn L, Snitz BE, Nahin RL, Furberg CD; Ginkgo Evaluation of Memory (GEM) Study Investigators. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA. 2008 Nov 19;300(19):2253-62. 107. Ihl R, Bachinskaya N, Korczyn AD, Vakhapova V, Tribanek M, Hoerr R, Napryeyenko O; GOTADAY Study Group. Efficacy and safety of a once-daily formulation of Ginkgo biloba extract EGb 761 in dementia with neuropsychiatric features: a randomized controlled trial. Int J Geriatr Psychiatry. 2011 Nov;26(11):1186-94. 108. Ihl R, Tribanek M, Bachinskaya N. Baseline neuropsychiatric symptoms are effect modifiers in Ginkgo biloba extract (EGb 761®) treatment of dementia with neuropsychiatric features. Retrospective data analyses of a randomized controlled trial. J Neurol Sci. 2010 Dec 15;299(1-2):184-7. 109. Kanowski S, Herrmann WM, Stephan K, Wierich W, Hörr R. Proof of efficacy of the ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Pharmacopsychiatry. 1996 Mar;29(2):47-56. 110. Kanowski S, Hoerr R. Ginkgo biloba extract EGb 761 in dementia: intent-to-treat analyses of a 24-week, multi-center, double-blind, placebo-controlled, randomized trial. Pharmacopsychiatry. 2003 Nov;36(6):297-303. 111. Le Bars PL, Katz MM, Berman N, Itil TM, Freedman AM, Schatzberg AF. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group. JAMA. 1997 Oct 22-29;278(16):1327-32. 112. Le Bars PL, Kieser M, Itil KZ. A 26-week analysis of a double-blind, placebo-controlled trial of the ginkgo biloba extract EGb 761 in dementia. Dement Geriatr Cogn Disord. 2000 Jul-Aug;11(4):230-7. 113. Le Bars PL, Velasco FM, Ferguson JM, Dessain EC, Kieser M, Hoerr R. Influence of the severity of cognitive impairment on the effect of the Gnkgo biloba extract EGb 761 in Alzheimer's disease. Neuropsychobiology. 2002;45(1):19-26. 114. Maurer K, Ihl R, Dierks T, Frölich L. Clinical efficacy of Ginkgo biloba special extract EGb 761 in dementia of the Alzheimer type. J Psychiatr Res. 1997 Nov-Dec;31(6):645-55. 115. McCarney R, Fisher P, Iliffe S, van Haselen R, Griffin M, van der Meulen J, Warner J. Ginkgo biloba for mild to moderate dementia in a community setting: a pragmatic, randomised, parallel-group, double-blind, placebo-controlled trial. Int J Geriatr Psychiatry. 2008 Dec;23(12):1222-30. 116. Nasab NM, Bahrammi MA, Nikpour MR, Rahim F, Naghibis SN. Efficacy of rivastigmine in comparison to ginkgo for treating Alzheimer's dementia. J Pak Med Assoc. 2012 Jul;62(7):677-80. 117. Snitz BE, Weissfeld LA, Lopez OL, Kuller LH, Saxton J, Singhabahu DM, Klunk WE, Mathis CA, Price JC, Ives DG, Cohen AD, McDade E, Dekosky ST. Cognitive trajectories associated with β-amyloid deposition in the oldest-old without dementia. Neurology. 2013 Apr 9;80(15):1378-84. 118. van Dongen M, van Rossum E, Kessels A, Sielhorst H, Knipschild P. The efficacy of ginkgo for elderly people with dementia and age-associated memory impairment: new results of a randomized clinical trial. J Am Geriatr Soc. 2000 Oct;48(10):1183-94. 119. van Dongen M, van Rossum E, Kessels A, Sielhorst H, Knipschild P. Ginkgo for elderly people with dementia and age-associated memory impairment: a randomized clinical trial. J Clin Epidemiol. 2003 Apr;56(4):367-76. 120. Yakoot M, Salem A, Helmy S. Effect of Memo®, a natural formula combination, on Mini-Mental State Examination scores in patients with mild cognitive impairment. Clin Interv Aging. 2013;8:975-81. 121. Burns NR, Bryan J, Nettelbeck T. Ginkgo biloba: no robust effect on cognitive abilities or mood in healthy young or older adults. Hum Psychopharmacol. 2006 Jan;21(1):27-37. 122. Kennedy DO, Scholey AB, Wesnes KA. Modulation of cognition and mood following administration of single doses of Ginkgo biloba, ginseng, and a ginkgo/ginseng combination to healthy young adults. Physiol Behav. 2002 Apr 15;75(5):739-51. 123. Mix JA, Crews WD Jr. A double-blind, placebo-controlled, randomized trial of Ginkgo biloba extract EGb 761 in a sample of cognitively intact older adults: neuropsychological findings. Hum Psychopharmacol. 2002 Aug;17(6):267-77. 124. Moulton PL, Boyko LN, Fitzpatrick JL, Petros TV. The effect of Ginkgo biloba on memory in healthy male volunteers. Physiol Behav. 2001 Jul;73(4):659-65. Erratum in: Physiol Behav 2002 Apr 15;75(5):773. 125. Persson J, Bringlöv E, Nilsson LG, Nyberg L. The memory-enhancing effects of Ginseng and Ginkgo biloba in healthy volunteers. Psychopharmacology (Berl). 2004 Apr;172(4):430-4. 126. Rai GS, Shovlin C, Wesnes KA. A double-blind, placebo controlled study of Ginkgo biloba extract ('tanakan') in elderly outpatients with mild to moderate memory impairment. Curr Med Res Opin. 1991;12(6):350-5. 127. Stough C, Clarke J, Lloyd J, Nathan PJ. Neuropsychological changes after 30-day Ginkgo biloba administration in healthy participants. Int J Neuropsychopharmacol. 2001 Jun;4(2):131-4. 128. Subhan Z, Hindmarch I. The psychopharmacological effects of Ginkgo biloba extract in normal healthy volunteers. Int J Clin Pharmacol Res. 1984;4(2):89-93. 129. Yasar S, Lin FM, Fried LP, Kawas CH, Sink KM, DeKosky ST, Carlson MC; Ginkgo Evaluation of Memory (GEM) Study Investigators. Diuretic use is associated with better learning and memory in older adults in the Ginkgo Evaluation of Memory Study. Alzheimers Dement. 2012 May;8(3):188-95. 130. Dardano A, Ballardin M, Caraccio N, Boni G, Traino C, et al. The effect of Ginkgo biloba extract on genotoxic damage in patients with differentiated thyroid carcinoma receiving thyroid remnant ablation with iodine-131. Thyroid. 2012 Mar;22(3):318-24. 131. Dardano A, Ballardin M, Ferdeghini M, Lazzeri E, Traino C, et al. Anticlastogenic effect of Ginkgo biloba extract in Graves' disease patients receiving radioiodine therapy. J Clin Endocrinol Metab. 2007 Nov;92(11):4286-9. 132. Jezova D, Duncko R, Lassanova M, Kriska M, Moncek F. Reduction of rise in blood pressure and cortisol release during stress by Ginkgo biloba extract (EGb 761) in healthy volunteers. J Physiol Pharmacol. 2002 Sep;53(3):337-48. 133. Woelk H, Arnoldt KH, Kieser M, Hoerr R. Ginkgo biloba special extract EGb 761 in generalized anxiety disorder and adjustment disorder with anxious mood: a randomized, double-blind, placebo-controlled trial. J Psychiatr Res. 2007 Sep;41(6):472-80. 134. Roncin JP, Schwartz F, D'Arbigny P. EGb 761 in control of acute mountain sickness and vascular reactivity to cold exposure. Aviat Space Environ Med. 1996 May;67(5):445-52. 135. Hauns B, Häring B, Köhler S, Mross K, Unger C. Phase II study of combined 5-fluorouracil/Ginkgo biloba extract (GBE 761 ONC) therapy in 5-fluorouracil pretreated patients with advanced colorectal cancer. Phytother Res. 2001 Feb;15(1):34-8. 136. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol. 2001 Jun;41(6):600-11. 137. Kim SH, Lee EK, Chang JW, Min WK, Chi HS, et al. Effects of Ginkgo biloba on haemostatic factors and inflammation in chronic peritoneal dialysis patients. Phytother Res. 2005 Jun;19(6):546-8. 138. Li XS, Zheng WY, Lou SX, Lu XW, Ye SH. Effect of Ginkgo leaf extract on vascular endothelial function in patients with early stage diabetic nephropathy. Chin J Integr Med. 2009 Feb;15(1):26-9. 139. Donfrancesco R, Ferrante L. Ginkgo biloba in dyslexia: a pilot study. Phytomedicine. 2007 Jun;14(6):367-70. 140. Zhang ZJ, Tong Y, Zou J, Chen PJ, Yu DH. Dietary supplement with a combination of Rhodiola crenulata and Ginkgo biloba enhances the endurance performance in healthy volunteers. Chin J Integr Med. 2009 Jun;15(3):177-83. 141. Xu AH, Chen HS, Sun BC, Xiang XR, Chu YF, et al. Therapeutic mechanism of Ginkgo biloba exocarp polysaccharides on gastric cancer. World J Gastroenterol. 2003 Nov;9(11):2424-7. 142. Xie ZQ, Liang G, Zhang L, Wang Q, Qu Y, et al. Molecular mechanisms underlying the cholesterol-lowering effect of Ginkgo biloba extract in hepatocytes: a comparative study with lovastatin. Acta Pharmacol Sin. 2009 Sep;30(9):1262-75. 143. Choung YH, Park K, Kim CH, Kim HJ, Kim K. Rare cases of Ménière's disease in children. J Laryngol Otol. 2006 Apr;120(4):343-52. 144. Bettermann K, Arnold AM, Williamson J, Rapp S, Sink K, et al. Statins, risk of dementia, and cognitive function: secondary analysis of the ginkgo evaluation of memory study. J Stroke Cerebrovasc Dis. 2012 Aug;21(6):436-44. 145. DeKosky ST, Williamson JD, Fitzpatrick AL, Kronmal RA, Ives DG, et al. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA. 2008 Nov 19;300(19):2253-62. 146. Mathis CA, Kuller LH, Klunk WE, Snitz BE, Price JC, et al. In vivo assessment of amyloid-β deposition in nondemented very elderly subjects. Ann Neurol. 2013 Jun;73(6):751-61. 147. Trick L, Boyle J, Hindmarch I. The effects of Ginkgo biloba extract (LI 1370) supplementation and discontinuation on activities of daily living and mood in free living older volunteers. Phytother Res. 2004 Jul;18(7):531-7. 148. Wesnes KA, Faleni RA, Hefting NR, Hoogsteen G, Houben JJ, et al. The cognitive, subjective, and physical effects of a Ginkgo biloba/Panax ginseng combination in healthy volunteers with neurasthenic complaints. Psychopharmacol Bull. 1997;33(4):677-83. 149. Johnson SK, Diamond BJ, Rausch S, Kaufman M, Shiflett SC, et al. The effect of Ginkgo biloba on functional measures in multiple sclerosis: a pilot randomized controlled trial. Explore (NY). 2006 Jan;2(1):19-24. 150. Seo BS, Lee HJ, Mo JH, Lee CH, Rhee CS, et al. Treatment of postviral olfactory loss with glucocorticoids, Ginkgo biloba, and mometasone nasal spray. Arch Otolaryngol Head Neck Surg. 2009 Oct;135(10):1000-4. 151. Carotenuto M, Esposito M. Nutraceuticals safety and efficacy in migraine without aura in a population of children affected by neurofibromatosis type I. Neurol Sci. 2013 Nov;34(11):1905-9. 152. Hauns B, Häring B, Köhler S, Mross K, Robben-Bathe P, et al. Phase II study with 5-fluorouracil and ginkgo biloba extract (GBE 761 ONC) in patients with pancreatic cancer. Arzneimittelforschung. 1999 Dec;49(12):1030-4. 153. Kiesewetter H, Jung F, Mrowietz C, Wenzel E. Hemorrheological and circulatory effects of Gincosan. Int J Clin Pharmacol Ther Toxicol. 1992 Mar;30(3):97-102. 154. Sumboonnanonda K, Lertsithichai P. Clinical study of the Ginko biloba--Troxerutin-Heptaminol Hce in the treatment of acute hemorrhoidal attacks. J Med Assoc Thai. 2004 Feb;87(2):137-42. 155. Ozgoli G, Selselei EA, Mojab F, Majd HA. A randomized, placebo-controlled trial of Ginkgo biloba L in treatment of premenstrual syndrome. J Altern Complement Med. 2009 Aug;15(8):845-51. 156. Zhao Y, Jin HM, Sun LP, Jiang F, Zhang T, et al. Organized intrasylvian subarachnoid hematoma in post-traumatic child with dyskinesia for 8 years: a case report and review of the literature. Childs Nerv Syst. 2009 Jul;25(7):881-7. 157. Emerit I, Arutyunyan R, Oganesian N, Levy A, Cernjavsky L, et al. Radiation-induced clastogenic factors: anticlastogenic effect of Ginkgo biloba extract. Free Radic Biol Med. 1995 Jun;18(6):985-91. 158. Emerit I, Oganesian N, Sarkisian T, Arutyunyan R, Pogosian A, et al. Clastogenic factors in the plasma of Chernobyl accident recovery workers: anticlastogenic effect of Ginkgo biloba extract. Radiat Res. 1995 Nov;144(2):198-205. 159. Bredie SJ, Jong MC. No significant effect of ginkgo biloba special extract EGb 761 in the treatment of primary Raynaud phenomenon: a randomized controlled trial. J Cardiovasc Pharmacol. 2012 Mar;59(3):215-21. 160. Choi WS, Choi CJ, Kim KS, Lee JH, Song CH, et al. To compare the efficacy and safety of nifedipine sustained release with Ginkgo biloba extract to treat patients with primary Raynaud's phenomenon in South Korea; Korean Raynaud study (KOARA study). Clin Rheumatol. 2009 May;28(5):553-9. 161. Muir AH, Robb R, McLaren M, Daly F, Belch JJ. The use of Ginkgo biloba in Raynaud's disease: a double-blind placebo-controlled trial. Vasc Med. 2002;7(4):265-7. 162. Kang BJ, Lee SJ, Kim MD, Cho MJ. A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction. Hum Psychopharmacol. 2002 Aug;17(6):279-84. 163. Meston CM, Rellini AH, Telch MJ. Short- and long-term effects of Ginkgo biloba extract on sexual dysfunction in women. Arch Sex Behav. 2008 Aug;37(4):530-47. 164. Stephenson KR, Meston CM. Differentiating components of sexual well-being in women: are sexual satisfaction and sexual distress independent constructs? J Sex Med. 2010 Jul;7(7):2458-68. 165. Stephenson KR, Rellini AH, Meston CM. Relationship satisfaction as a predictor of treatment response during cognitive behavioral sex therapy. Arch Sex Behav. 2013 Jan;42(1):143-52. 166. Wheatley D. Triple-blind, placebo-controlled trial of Ginkgo biloba in sexual dysfunction due to antidepressant drugs. Hum Psychopharmacol. 2004 Dec;19(8):545-8. 167. Di Franco R, Sammarco E, Calvanese MG, De Natale F, Falivene S, et al. Preventing the acute skin side effects in patients treated with radiotherapy for breast cancer: the use of corneometry in order to evaluate the protective effect of moisturizing creams. Radiat Oncol. 2013 Mar 12;8:57. 168. Hemmeter U, Annen B, Bischof R, Brüderlin U, Hatzinger M, et al. Polysomnographic effects of adjuvant ginkgo biloba therapy in patients with major depression medicated with trimipramine. Pharmacopsychiatry. 2001 Mar;34(2):50-9. 169. Murray BJ, Cowen PJ, Sharpley AL. The effect of Li 1370, extract of Ginkgo biloba, on REM sleep in humans. Pharmacopsychiatry. 2001 Jul;34(4):155-7. 170. Burschka MA, Hassan HA, Reineke T, van Bebber L, Caird DM, et al. Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients. Eur Arch Otorhinolaryngol. 2001 Jul;258(5):213-9. 171. Reisser CH, Weidauer H. Ginkgo biloba extract EGb 761 or pentoxifylline for the treatment of sudden deafness: a randomized, reference-controlled, double-blind study. Acta Otolaryngol. 2001 Jul;121(5):579-84. 172. Zhang WF, Tan YL, Zhang XY, Chan RC, Wu HR, et al. Extract of Ginkgo biloba treatment for tardive dyskinesia in schizophrenia: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2011 May;72(5):615-21. 173. Zhang XY, Zhang WF, Zhou DF, Chen da C, Xiu MH, et al. Brain-derived neurotrophic factor levels and its Val66Met gene polymorphism predict tardive dyskinesia treatment response to Ginkgo biloba. Biol Psychiatry. 2012 Oct 15;72(8):700-6. 174. Castelli D, Colin L, Camel E, Ries G. Pretreatment of skin with a Ginkgo biloba extract/sodium carboxymethyl-beta-1,3-glucan formulation appears to inhibit the elicitation of allergic contact dermatitis in man. Contact Dermatitis. 1998 Mar;38(3):123-6. 175. Russo V, Stella A, Appezzati L, Barone A, Stagni E, et al. Clinical efficacy of a Ginkgo biloba extract in the topical treatment of allergic conjunctivitis. Eur J Ophthalmol. 2009 May-Jun;19(3):331-6. 176. Janssens D, Michiels C, Guillaume G, Cuisinier B, Louagie Y, et al. Increase in circulating endothelial cells in patients with primary chronic venous insufficiency: protective effect of Ginkor Fort in a randomized double-blind, placebo-controlled clinical trial. J Cardiovasc Pharmacol. 1999 Jan;33(1):7-11. 177. Parsad D, Pandhi R, Juneja A. Effectiveness of oral Ginkgo biloba in treating limited, slowly spreading vitiligo. Clin Exp Dermatol. 2003 May;28(3):285-7. 178. Szczurko O, Shear N, Taddio A, Boon H. Ginkgo biloba for the treatment of vitilgo vulgaris: an open label pilot clinical trial. BMC Complement Altern Med. 2011 Mar 15;11:21. 179. Chuarienthong P, Lourith N, Leelapornpisid P. Clinical efficacy comparison of anti-wrinkle cosmetics containing herbal flavonoids. Int J Cosmet Sci. 2010 Apr;32(2):99-106. 180. Salehi B, Imani R, Mohammadi MR, Fallah J, Mohammadi M, et al. Ginkgo biloba for attention-deficit/hyperactivity disorder in children and adolescents: a double blind, randomized controlled trial. Prog Neuropsychopharmacol Biol Psychiatry. 2010 Feb 1;34(1):76-80. 181. Mattes RD, Pawlik MK. Effects of Ginkgo biloba on alertness and chemosensory function in healthy adults. Hum Psychopharmacol. 2004 Mar;19(2):81-90. 182. Hasanzadeh E, Mohammadi MR, Ghanizadeh A, Rezazadeh SA, Tabrizi M, et al. A double-blind placebo controlled trial of Ginkgo biloba added to risperidone in patients with autistic disorders. Child Psychiatry Hum Dev. 2012 Oct;43(5):674-82. 183. Brinkley TE, Lovato JF, Arnold AM, Furberg CD, Kuller LH, et al. Effect of Ginkgo biloba on blood pressure and incidence of hypertension in elderly men and women. Am J Hypertens. 2010 May;23(5):528-33. 184. Lis-Balchin M. Parallel placebo-controlled clinical study of a mixture of herbs sold as a remedy for cellulite. Phytother Res. 1999 Nov;13(7):627-9. 185. Kampman K, Majewska MD, Tourian K, Dackis C, Cornish J, et al. A pilot trial of piracetam and ginkgo biloba for the treatment of cocaine dependence. Addict Behav. 2003 Apr;28(3):437-48. 186. Siegel G, Schäfer P, Winkler K, Malmsten M. Ginkgo biloba (EGb 761) in arteriosclerosis prophylaxis. Wien Med Wochenschr. 2007;157(13-14):288-94. 187. Garg RK, Nag D, Agrawal A. A double blind placebo controlled trial of ginkgo biloba extract in acute cerebral ischaemia. J Assoc Physicians India. 1995 Nov;43(11):760-3. 188. Canis M, Olzowy B, Welz C, Suckfüll M, Stelter K. Simvastatin and Ginkgo biloba in the treatment of subacute tinnitus: a retrospective study of 94 patients. Am J Otolaryngol. 2011 Jan-Feb;32(1):19-23. 189. Drew S, Davies E. Effectiveness of Ginkgo biloba in treating tinnitus: double blind, placebo controlled trial. BMJ. 2001 Jan 13;322(7278):73. 190. Hahn A, Radkova L, Achiemere G, Klement V, Alpini D, Strouhal J. Multimodal therapy for chronic tinnitus. Int Tinnitus J. 2008;14(1):69-72. 191. Han SS, Nam EC, Won JY, Lee KU, Chun W, Choi HK, Levine RA. Clonazepam quiets tinnitus: a randomised crossover study with Ginkgo biloba. J Neurol Neurosurg Psychiatry. 2012 Aug;83(8):821-7. 192. Holgers KM, Axelsson A, Pringle I. Ginkgo biloba extract for the treatment of tinnitus. Audiology. 1994 Mar-Apr;33(2):85-92. 193. Morgenstern C, Biermann E. The efficacy of Ginkgo special extract EGb 761 in patients with tinnitus. Int J Clin Pharmacol Ther. 2002 May;40(5):188-97. 194. Rejali D, Sivakumar A, Balaji N. Ginkgo biloba does not benefit patients with tinnitus: a randomized placebo-controlled double-blind trial and meta-analysis of randomized trials. Clin Otolaryngol Allied Sci. 2004 Jun;29(3):226-31. 195. Lingaerde O, Føreland AR, Magnusson A. Can winter depression be prevented by Ginkgo biloba extract? A placebo-controlled trial. Acta Psychiatr Scand. 1999 Jul;100(1):62-6. 196. Bebbington A, Kulkarni R, Roberts P. Ginkgo biloba: persistent bleeding after total hip arthroplasty caused by herbal self-medication. J Arthroplasty. 2005 Jan;20(1):125-6. 197. Benjamin J, Muir T, Briggs K, Pentland B. A case of cerebral haemorrhage-can Ginkgo biloba be implicated? Postgrad Med J. 2001 Feb;77(904):112-3. 198. Bent S, Goldberg H, Padula A, Avins AL. Spontaneous bleeding associated with ginkgo biloba: a case report and systematic review of the literature: a case report and systematic review of the literature. J Gen Intern Med. 2005 Jul;20(7):657-61. 199. Cianfrocca C, Pelliccia F, Auriti A, Santini M. Ginkgo biloba-induced frequent ventricular arrhythmia. Ital Heart J. 2002 Nov;3(11):689-91. 200. DerMarderosian A, Beutler JA. The review of natural products: the most complete source of natural product information. 7th ed. St. Louis, MO, USA: Wolters Kluwer Health; 2012. 201. Dugoua JJ, Mills E, Perri D, Koren G. Safety and efficacy of ginkgo (Ginkgo biloba) during pregnancy and lactation. Can J Clin Pharmacol. 2006 Fall;13(3):e277-84. 202. Ernst E. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Ann Intern Med. 2002 Jan 1;136(1):42-53. 203. Fessenden JM, Wittenborn W, Clarke L. Gingko biloba: a case report of herbal medicine and bleeding postoperatively from a laparoscopic cholecystectomy. Am Surg. 2001 Jan;67(1):33-5. 204. Fetrow CW, Avila JR. The complete guide to herbal medicines. Spring House, PA, USA: Springhouse Corporation; 2000. 205. Fong KC, Kinnear PE. Retrobulbar haemorrhage associated with chronic Gingko biloba ingestion. Postgrad Med J. 2003 Sep;79(935):531-2. 206. Fujisawa M, Hori Y, Nakajima M, Shimada K, Yoshikawa H, Wada K. Gas chromatography-mass spectrometry analysis of 4-O-methylpyridoxine (MPN) in the serum of patients with ginkgo seed poisoning. J Anal Toxicol. 2002 Apr;26(3):138-43. 207. Gold JL, Laxer DA, Dergal JM, Lanctôt KL, Rochon PA. Herbal-drug therapy interactions: a focus on dementia. Curr Opin Clin Nutr Metab Care. 2001 Jan;4(1):29-34. 208. Granger AS. Ginkgo biloba precipitating epileptic seizures. Age Ageing. 2001 Nov;30(6):523-5. 209. Gruenwald J, Brendler T, Jaenicke C, editors. PDR for herbal medicines. 4th ed. Montvale, NJ, USA: Thomson Healthcare; 2007. 210. Hasegawa S, Oda Y, Ichiyama T, Hori Y, Furukawa S. Ginkgo nut intoxication in a 2-year-old male. Pediatr Neurol. 2006 Oct;35(4):275-6. 211. Hauser D, Gayowski T, Singh N. Bleeding complications precipitated by unrecognized Gingko biloba use after liver transplantation. Transpl Int. 2002 Jul;15(7):377-9. 212. Hermann R, von Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med. 2012 Sep;78(13):1458-77. 213. Kajiyama Y, Fujii K, Takeuchi H, Manabe Y. Ginkgo seed poisoning. Pediatrics. 2002 Feb;109(2):325-7. 214. Kellermann AJ, Kloft C. Is there a risk of bleeding associated with standardized Ginkgo biloba extract therapy? A systematic review and meta-analysis. Pharmacotherapy. 2011 May;31(5):490-502. 215. Kupiec T, Raj V. Fatal seizures due to potential herb-drug interactions with Ginkgo biloba. J Anal Toxicol. 2005 Oct;29(7):755-8. 216. Lai SW, Chen JH, Kao WY. Acute hemolytic anemia in glucose-6-phosphate dehydrogenase deficiency complicated by Ginkgo biloba. Acta Haematol. 2013;130(4):288-90. 217. Miwa H, Iijima M, Tanaka S, Mizuno Y. Generalized convulsions after consuming a large amount of gingko nuts. Epilepsia. 2001 Feb;42(2):280-1. 218. Pedroso JL, Henriques Aquino CC, Escórcio Bezerra ML, Baiense RF, Suarez MM, Dutra LA, Braga-Neto P, Povoas Barsottini OG. Ginkgo biloba and cerebral bleeding: a case report and critical review. Neurologist. 2011 Mar;17(2):89-90. 219. Pennisi RS. Acute generalised exanthematous pustulosis induced by the herbal remedy Ginkgo biloba. Med J Aust. 2006 Jun 5;184(11):583-4. 220. Silva BM, Hosman AE, Devlin HL, Shovlin CL. Lifestyle and dietary influences on nosebleed severity in hereditary hemorrhagic telangiectasia. Laryngoscope. 2013 May;123(5):1092-9. 221. Tomb RR, Foussereau J, Sell Y. Mini-epidemic of contact dermatitis from ginkgo tree fruit (Ginkgo biloba L.). Contact Dermatitis. 1988 Oct;19(4):281-3. 222. Werneke U, Turner T, Priebe S. Complementary medicines in psychiatry: review of effectiveness and safety. Br J Psychiatry. 2006 Feb;188:109-21. 223. Abad MJ, Bedoya LM, Bermejo P. An update on drug interactions with the herbal medicine Ginkgo biloba. Curr Drug Metab. 2010 Feb;11(2):171-81. 224. DerMarderosian A, Beutler JA. The review of natural products: the most complete source of natural product information. 7th ed. St. Louis, MO, USA: Wolters Kluwer Health; 2012. 225. Evans V. Herbs and the brain: friend or foe? The effects of ginkgo and garlic on warfarin use. J Neurosci Nurs. 2000 Aug;32(4):229-32. 226. Fetrow CW, Avila JR. The complete guide to herbal medicines. Spring House, PA, USA: Springhouse Corporation; 2000. 227. Gold JL, Laxer DA, Dergal JM, Lanctôt KL, Rochon PA. Herbal-drug therapy interactions: a focus on dementia. Curr Opin Clin Nutr Metab Care. 2001 Jan;4(1):29-34. 228. Gruenwald J, Brendler T, Jaenicke C, editors. PDR for herbal medicines. 4th ed. Montvale, NJ, USA: Thomson Healthcare; 2007. 229. Hermann R, von Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med. 2012 Sep;78(13):1458-77. 230. Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs. 2001;61(15):2163-75. 231. Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs. 2009;69(13):1777-98. 232. Kudolo GB, Wang W, Javors M, Blodgett J. The effect of the ingestion of Ginkgo biloba extract (EGb 761) on the pharmacokinetics of metformin in non-diabetic and type 2 diabetic subjects--a double blind placebo-controlled, crossover study. Clin Nutr. 2006 Aug;25(4):606-16. 233. Kupiec T, Raj V. Fatal seizures due to potential herb-drug interactions with Ginkgo biloba. J Anal Toxicol. 2005 Oct;29(7):755-8. 234. Naccarato M, Yoong D, Gough K. A potential drug-herbal interaction between Ginkgo biloba and efavirenz. J Int Assoc Physicians AIDS Care (Chic). 2012 Mar-Apr;11(2):98-100. 235. Spinella M, Eaton LA. Hypomania induced by herbal and pharmaceutical psychotropic medicines following mild traumatic brain injury. Brain Inj. 2002 Apr;16(4):359-67. 236. Tsai HH, Lin HW, Simon Pickard A, Tsai HY, Mahady GB. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Pract. 2012 Nov;66(11):1056-78. 237. Ulbricht C, Chao W, Costa D, Rusie-Seamon E, Weissner W, Woods J. Clinical evidence of herb-drug interactions: a systematic review by the natural standard research collaboration. Curr Drug Metab. 2008 Dec;9(10):1063-120. 238. Vaes LP, Chyka PA. Interactions of warfarin with garlic, ginger, ginkgo, or ginseng: nature of the evidence. Ann Pharmacother. 2000 Dec;34(12):1478-82. 239. Werneke U, Turner T, Priebe S. Complementary medicines in psychiatry: review of effectiveness and safety. Br J Psychiatry. 2006 Feb;188:109-21. 240. Afendi FM, Okada T, Yamazaki M, Hirai-Morita A, Nakamura Y, Nakamura K, Ikeda S, Takahashi H, Altaf-Ul-Amin M, Darusman LK, Saito K, Kanaya S. KNApSAcK family databases: integrated metabolite-plant species databases for multifaceted plant research. Plant Cell Physiol. 2012 Feb;53(2):e1.