THE UNIVERSITY OF NEW SOUTH WALES

SCHOOL OF BIOTECHNOLOGY AND BIOMOLECULAR SCIENCES

GENS6013 PLANTS AND PEOPLE: MURDER, MAGIC AND MEDICINE

HERBAL MEDICINE ASSIGNMENT — 2008

Step 1
Students are required to find a substantial advertisement or brochure that deals with the use of a
plant to treat a recognised medical condition or disease as a herbal remedy. This does not include
nutritional conditions nor a specific form of alternative medicine such as homeopathy or
acupuncture. A good source of material are pharmacies, health food shops and some magazines.

THE ORIGINAL ARTICLE MUST BE SUBMITTED AS PART OF YOUR REPORT AND SHOULD NOT COME
FROM THE INTERNET OR WWW.

Step 2
Use the INTERNET to find an appropriate amount of further information and/or claims about the
herbal treatment, for example a 'home page'.

Step 3
You then need to find scientific or other valid articles that attempt to establish whether or not the
herbal treatment actually works or is beneficial. Your choice in Steps 1 and 2 will to some extent be
influenced by what you can find in this category. Do not use the WWW as your primary source of
scientific information unless it is the full text of a scientific article, but you can use it as a source of
supplementary information (or mis-information).

Step 4
A written critique of the original article and the WWW claims for your plant with respect to the
medical condition, using the "evidence" that you have found in Step 3. Your answer should include
comment on the language (words) used in the herbal claims, the way the herbal information is
presented, the validity of the actual scientific evidence and any claims or counterclaims regarding
the so called 'hard evidence'.

Your written critique should be typewritten if possible (word processor; double spaced; single side
of the page) and up to 1500 words in length. Evidence (References) should be properly cited in a
bibliography including WWW addresses at the end of your report. In some cases it may be
appropriate to attach them to your assignment.

This assignment is worth 25% of the assessment for this course.

Marks will be awarded for the "relevancy" of your submitted article, the nature, value and reliability
of your evidence for and against, and the quality of your written analysis of all the information you
present.

The declaration sheet (see the back of this sheet), properly filled in and signed, must be attached to
the front of your assignment.

Please submit your declaration sheet and report securely stapled together.

The assignment is due into the BABS Student Office (Room 103 Biol Sci Bldg) on Friday 24th
October 2008 (Week 12) at 4:00 PM.
Ian McFarlane
Course Co-ordinator
4th September, 2008
 THE UNIVERSITY OF NEW SOUTH WALES
SCHOOL OF BIOTECHNOLOGY AND BIOMOLECULAR SCIENCES

GENS6013 PLANTS AND PEOPLE: MURDER, MAGIC AND MEDICINE

2008

HERBAL MEDICINE ASSIGNMENT

DECLARATION SHEET

STUDENT NAME:

STUDENT NUMBER:

FACULTY:

COURSE:

DECLARATION

I have read the information concerning Academic Misconduct in the Course Structure
handout (page 4).

This assignment is the product of my own individual efforts.

Signed: Date:
Bacopa
(Bacopa monnieri)

Plant Part Used

Leaf

Introduction Back to Top

The leaf of bacopa, or water hyssop, has been used in the Indian
medical system of Ayurveda since the 6th century A.D. to help
improve mental performance. It is also considered the foremost
tonic for the nervous system in Ayurvedic medicine. It has been
used traditionally for epilepsy, mental illness, and to improve
memory and mental capacities. Today, scientists think bacopa
contains compounds that may enhance nerve impulse
transmission, thereby strengthening memory and general
cognition.

Reported Uses Back to Top

Modern studies may lend credence to what Ayurvedic
practitioners have known for centuries about bacopa's ability to
enhance mental function. One
such study suggested that bacopa Interactions
may increase learning ability in Drug/Herb Interactions
laboratory animals. Other studies Calcium channel blockers
on humans suggest bacopa may
improve intellectual activity in children. In adults, bacopa may
be effective in reducing anxiety and increasing energy. This
effect, scientists suggest, may lead to improved memory and
mental performance.(1) Other human studies have supported
these findings.(2, 3)
In addition to these memory and mental performance enhancing
effects, bacopa may function as an antioxidant in the body. More
specifically, it may reduce oxidation of fats in the blood stream,
which is a common risk factor for the development
cardiovascular diseases.(4)

Finally, a study conducted in the 1960s suggested that bacopa

may be useful in improving the symptoms and occurrence of
epileptic seizures.(5) A more recent study confirmed
improvement in memory and mental performance problems
generally experienced in patients with epilepsy taking certain
anti-seizure medications.(6)

Dosage Info Back to Top

Most Common
Dosage Range Dosage Standardization
50-150mg 100mg The most current
(standardized (standardized available medical
extract), 3 times a extract), 2 times a and scientific
day. day. literature indicates
that this dietary
supplement should
be standardized to
20% bacosides A
and B per dose.

*Standardization represents the complete body of information and controls that

serve to enhance the batch to batch consistency of a botanical product, including
 but not limited to the presence of a marker compound at a defined level or within
a defined range.(7)

Toxicities & Precautions Back to Top

Be sure to tell your pharmacist, doctor, or other health care
providers about any dietary supplements you are taking. There
may be a potential for interactions or side effects.
General
This dietary supplement is considered safe when used in
accordance with proper dosing guidelines.
Pregnancy/Breast-Feeding
To date, the medical literature has not reported any adverse
effects related to fetal development during pregnancy or to
infants who are breast-fed. Yet little is known about the use of
this dietary supplement while pregnant or breast-feeding.
Therefore, it is recommended that you inform your healthcare
practitioner of any dietary supplements you are using while
pregnant or breast-feeding.
Age Limitations
To date, the medical literature has not reported any adverse
effects specifically related to the use of this dietary supplement
in children. Since young children may have undiagnosed allergies
or medical conditions, this dietary supplement should not be
used in children under 10 years of age unless recommended by a
physician.

Footnotes Back to Top

1
Kidd PM. A Review of Nutrients and Botanicals in the
Integrative Management of Cognitive Dysfunction. Altern Med
Rev. Jun1999;4(3):144-61.
View Abstract
2
Stough C, Lloyd J, Clarke J, Downey LA, Hutchison CW,
Rodgers T, et al. The chronic effects of an extract of Bacopa
monniera (Brahmi) on cognitive function in healthy human
subjects. Psychopharmacology (Berl). Aug2001;156(4):481-4.
View Abstract
3
Roodenrys S, Booth D, Bulzomi S, Phipps A, Micallef C, Smoker
J. Chronic effects of Brahmi (Bacopa monnieri) on human
memory. Neuropsychopharmacology. Aug2002;27(2):279-81.
View Abstract
4
Tripathi YB, et al. Bacopa monniera Linn. As An Antioxidant:
Mechanism of Action. Indian J Exp Biol. Jun1996;34(6):523-26.
View Abstract
5
Mukherjee GD, et al. Clinical Trial on Brahmi. I. J Exp Med Sci.
1966;10(1):5-11.
6
Vohora D, Pal SN, Pillai KK. Protection from Phenytoin-induced
Cognitive Deficit by Bacopa monniera, A Reputed Indian
Nootropic Plant. J Ethnopharmacol. Aug2000;71(3):383-390.
View Abstract
7
American Herbal Products Association. Use of Marker
Compounds in Manufacturing and Labeling Botanically Derived
Dietary Supplements. Silver Spring, MD: American Herbal
Products Association; 2001.
Copyright © 2000-2008 NHIOnDemand, LLC All rights
reserved. www.nhiondemand.com
This information is educational in context and is not to be used to
diagnose, treat or cure any disease. Please consult your licensed
health care practitioner before using this or any medical
information.
http://content.nhiondemand.com/psv/monoAll-style.asp?
objID=100165&ctype=ds&mtyp=1

Ginkgo
(Ginkgo biloba)
Plant Part Used
Leaf

Introduction Back to Top

Ginkgo is among the oldest living plant species on earth and has
been used extensively as a medicinal agent worldwide for
centuries. Today, it is the most frequently prescribed medicinal
herb in Europe. Ginkgo has been the subject of hundreds of
scientific studies that have reported positive effects in a wide
range of health areas. The remedy has been popularized for its
use in the support of mental function. There are many other,
less publicized, applications. The leaf of the ginkgo tree is used
to derive a standardized extract.

Reported Uses Back to Top

Ginkgo has been extensively Interactions
researched for its possible
benefits to the elderly. Studies Drug/Herb Interactions
indicate ginkgo has the ability to Anticoagulant medications
increase circulation which can lead Nonsteroidal anti-inflammatory
to enhanced memory. (1, 2) This medications (NSAIDs)
effect can in turn delay the onset MAO inhibitors
of Alzheimers and reduce the Antiplatelet medications
effects of senile dementia,
tinnitus, and vertigo.(3, 4, 5, 6) Studies indicate that ginkgo's
support of healthy brain function is related to its ability to
increase blood flow to the brain, thus improving delivery of
nutrients and disposal of waste products.(7)
The effectiveness of ginkgo in treating dementia is debated.
Numerous studies have been completed evaluating numerous
patients with various types of demetia, including Alzheimer's
disease. These studies have had very differing results. In a study
involving over 200 patients, a standardized ginkgo preparation
(40mg three times a day) was compared to placebo. The ginkgo
was reported safe and capable of stabilizing and improving
mental and social functioning for up to a year.(8) Another trial
involving over 200 patients, compared the same ginkgo
preparation with placebo and reported no advantage with the
gingko when used for 24 weeks.(9) A third trial compared 115
people over 60 years old using ginkgo to 115 people over 60
years old using placebo. The study evaluated these participants
using 15 different tests for memory and learning. The results of
this study showed no improvement in the tests for both the
ginkgo and the placebo group.(10)

Four commonly used medications for dementia (tacrine,

donepezil, rivastigmine, and metrifonate) were compared to a
standardized ginkgo extract and a placebo for their use in
Alzheimer's disease. The authors concluded that second-
generation cholinesterase inhibitors (donepezil, rivastigmine, and
metrifonate) and the standardized ginkgo extract should be
considered equally effective in the treatment of mild to moderate
Alzheimer's disease.(11)

Because of its effects on the circulatory system, ginkgo may also

ease the leg pain that arises from intermittent claudication and
similar disorders.(12, 13) One study even found that ginkgo
performed as well as a leading prescription medication for
treating intermittent claudication.

Ginkgo's ability to support healthy circulation and brain function

has applications in younger populations as well. Disorders it may
improve include diabetes and various circulatory conditions
including cyanosis and Raynaud's Syndrome.(14)

Ginkgo has also been used to treat impotence, especially when

associated with antidepressant therapy.(15, 16) Ginkgo may also
be involved in a chemical process that reduces the potential for
clot formation in the blood by inhibiting platelet activating factor
(PAF).(17) Scientists think this function, along with a potential
ability to dilate blood vessels, accounts for its record of use in
treating asthma in China for thousands of years.

Finally, ginkgo is an antioxidant, giving it the ability to help rid

the body of free radicals and thus lessen the risk of chronic
degenerative diseases.(18) Also due to the antioxidant activity of
ginkgo, it may help treat macular degeneration(19) and decrease
the damaging effects of radiation, chemotherapy,(20) and certain
medications.(21)

Dosage Info Back to Top

Most Common
Dosage Range Dosage Standardization
40-80mg 40mg (standardized The most current
(standardized extract), 3 times a available medical
extract), 3 times a day. and scientific
day. literature indicates
that this dietary
supplement should
be standardized to
24% ginkgo
flavoglycosides and
6% triterpenes per
dose; also
standardized to 27%
flavoglycosides 7%
triterpenes per dose.

*Standardization represents the complete body of information and controls that

serve to enhance the batch to batch consistency of a botanical product, including
but not limited to the presence of a marker compound at a defined level or within
a defined range.(22)

Toxicities & Precautions Back to Top

Be sure to tell your pharmacist, doctor, or other health care
providers about any dietary supplements you are taking. There
may be a potential for interactions or side effects.
General
This dietary supplement is considered safe when used in
accordance with proper dosing guidelines.
Fresh seeds of the ginkgo tree should not be eaten because they
may be toxic.

If you are planning to have any type of surgery or dental work,

stop using this dietary supplement for at least 14 days prior to
the procedure.(23)

Allergy
Some individuals experience an allergic skin reaction when
taking this dietary supplement. Although extremely rare, call
your doctor or seek medical attention if you have fast or
irregular breathing, skin rash, hives or itching.(24)
Health Conditions
If you have a bleeding disorder, talk to your doctor before taking
this dietary supplement.(25)
Side Effects
Side effects are possible with any dietary supplement. Although
extremely rare, this dietary supplement may cause
gastrointestinal distress or headache.(26) Tell your doctor if
these side effects become severe or do not go away.
Pregnancy/Breast-Feeding
To date, the medical literature has not reported any adverse
effects related to fetal development during pregnancy or to
infants who are breast-fed. Yet limited information exists
regarding the use of this dietary supplement while pregnant or
breast-feeding. Therefore, it is recommended that you inform
your healthcare practitioner of any dietary supplements you are
using while pregnant or breast-feeding.(27, 28)
Age Limitations
To date, the medical literature has not reported any adverse
effects specifically related to the use of this dietary supplement
in children. Since young children may have undiagnosed allergies
or medical conditions, this dietary supplement should not be
used in children under 10 years of age unless recommended by a
physician.

Footnotes Back to Top

1
Kleijnen J, et al. Ginkgo biloba for Cerebral Insufficiency. Br J
Clin Pharm. 1992;34:352-58.
View Abstract
2
Kleijnen J, et al. Ginkgo biloba. Lancet. 1992;340(8828):1136-
39.
3
Maurer K, et al. Clinical Efficacy of Ginkgo biloba Special Extract
EGb 761 in Dementia of the Alzheimer Type. J Psychiatr Res.
1997;31(6):645-55.
View Abstract
4
Kanowski S, et al. 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;29:47-56.
View Abstract
5
Meyer B. Multicenter Randomized Double-blind Drug versus
Placebo Study of Ginkgo biloba Extract in the Treatment of
Tinnitus. Presse Med. 1986;15:1562-64.
View Abstract
6
Odawara M, et al. Ginkgo biloba. Neurology. 1997;48(3):789-
90.
7
Ernst E. Ginkgo biloba in the Treatment of Intermittent
Claudication. A Critical Review. Fortschritte der Medizin.
1996;114(8):85-87.
View Abstract
8
Le Bars PL, Katz MM, Berman N, et al. A Placebo-controlled,
Double-blind, Randomized Trial of an Extract of Ginkgo biloba for
Dementia. North American EGb Study Group. JAMA.
Oct1997;278(16):1327-32.
View Abstract
9
Van Dongen MC, van Rossum E, Kessels AG, et al. 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. Oct2000;48(10):1183-94.
View Abstract
10
Solomon PR, Adams F, Silver A, Zimmer J, DeVeaux R. Ginkgo
for memory enhancement: a randomized controlled trial. JAMA.
Aug2002;288(7):835-40.
View Abstract
11
Wettstein A. Cholinesterase Inhibitors and Gingko Extracts--
Are They Comparable in the Treatment of Dementia?
Comparison of Published Placebo-controlled Efficacy Studies of at
Least Six Months' Duration. Phytomedicine. Jan2000;6(6):393-
401.
View Abstract
12
Kleijnen J, et al. Ginkgo biloba. Lancet. 1992;340(8828):1136-
 39.
13
De Felice M, Gallo P, Masotti G. Current Therapy of Peripheral
Obstructive Arterial Disease. The Non-surgical Approach.
Angiology. 1990;41:1-11.
View Abstract
14
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.
View Abstract
Cohen AJ, et al. Ginkgo biloba for Antidepressant-induced
15

Sexual Dysfunction. J Sex Marital Ther. 1998;24(2):139-43.

View Abstract
16
Sikora R, et al. Ginkgo biloba Extract in the Therapy of Erectile
Dysfunction. J Urol. 1989;141:188A.
17
Braquet P. Anti-anaphylactic Properties of BN 52021: A Potent
Platelet Activating Factor Antagonist. Advances in Experimental
Medicine and Biology. 1987;215:215-33.
18
Hu B, Sun S, Mei G, Chen L, Tong E. Protective effects of
Ginkgo biloba extract on rats during cerebral
ischemia/reperfusion. Chin Med J (Engl). Sep2002;115(9):1316-
20.
View Abstract
19
Lebuisson DA, et al. Treatment of Senile Macular Degeneration
with Ginkgo biloba Extract. A Preliminary Double-blind Drug vs.
Placebo Study. Presse Med. Sep1986;15(31):1556-58.
View Abstract
20
Inselmann G, Blohmer A, Kottny W, et al. Modification of
Cisplatin-induced Renal P-aminohippurate Uptake Alteration and
Lipid Peroxidation by Thiols, Ginkgo biloba Extract, Deferoxamine
and Torbafylline. Nephron. 1995;70(4):425-9.
View Abstract
21
Barth SA, Inselmann G, Engemann R, et al. Influences of
Ginkgo biloba on Cyclosporin A Induced Lipid Peroxidation in
Human Liver Microsomes in Comparison to Vitamin E,
Glutathione and N-acetylcysteine. Biochem Pharmacol.
May1991;41(10):1521-6.
View Abstract
22
American Herbal Products Association. Use of Marker
Compounds in Manufacturing and Labeling Botanically Derived
Dietary Supplements. Silver Spring, MD: American Herbal
Products Association; 2001.
23
Pribitkin ED. Herbal therapy: what every facial plastic surgeon
must know. Arch Facial Plast Surg. Apr2001;3(2):127-32.
24
PDR for Herbal Medicines, 2nd ed. Montvale, NJ: Medical
Economics Company; 2000:344.
25
Behrman: Nelson Textbook of Pediatrics, 16th ed. W B
Saunders Company; 2000:2304.
26
Odawara M, et al. Ginkgo biloba. Neurology. 1997;48(3):789-
90.
27
Ondrizek RR, Chan PJ, Patton WC, King A. An alternative
medicine study of herbal effects on the penetration of zona-free
hamster oocytes and the integrity of sperm deoxyribonucleic
acid. Fertil Steril. Mar1999;71(3):517-22.
View Abstract
28
Dugoua JJ, Mills E, Perri D, et al. Safety and efficacy of ginkgo
(Ginkgo biloba) during pregnancy and lactation. Can J Clin
Pharmacol. Oct 2006;13(3):e277-84.
View Abstract
http://content.nhiondemand.com/psv/monoAll-style.asp?
objID=100060&ctype=ds&mtyp=1

Differential cognitive effects of Ginkgo biloba after acute and chronic treatment in healthy
young volunteers.

Psychopharmacology (Berl). 2005 May;179(2):437-46. Epub 2005 Mar

 Elsabagh S, Hartley DE, Ali O, Williamson EM, File SE.

Psychopharmacology Research Unit, Centre for Neuroscience, Hodgkin Building, King's College
London, Guy's Campus, London, SE1 1UL, UK. sarah.elsabagh@kcl.ac.uk

RATIONALE: Acute doses of Ginkgo biloba have been shown to improve attention and
memory in young, healthy participants, but there has been a lack of investigation into
possible effects on executive function. In addition, only one study has investigated the
effects of chronic treatment in young volunteers. OBJECTIVES: This study was conducted
to compare the effects of ginkgo after acute and chronic treatment on tests of attention,
memory and executive function in healthy university students. METHODS: Using a
placebo-controlled double-blind design, in experiment 1, 52 students were randomly
allocated to receive a single dose of ginkgo (120 mg, n=26) or placebo (n=26), and
were tested 4 h later. In experiment 2, 40 students were randomly allocated to receive
ginkgo (120 mg/day; n=20) or placebo (n=20) for a 6-week period and were tested at
baseline and after 6 weeks of treatment. In both experiments, participants underwent
tests of sustained attention, episodic and working memory, mental flexibility and
planning, and completed mood rating scales. RESULTS: The acute dose of ginkgo
significantly improved performance on the sustained-attention task and pattern-
recognition memory task; however, there were no effects on working memory, planning,
mental flexibility or mood. After 6 weeks of treatment, there were no significant effects
of ginkgo on mood or any of the cognitive tests. CONCLUSIONS: In line with the
literature, after acute administration ginkgo improved performance in tests of attention
and memory. However, there were no effects after 6 weeks, suggesting that tolerance
develops to the effects in young, healthy participants.

PMID: 15739076 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/15739076

Ginkgo
Keywords: fossil tree, alzheimer's, cognitive decline, leg pain, vascular function

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© Steven Foster

On this page

• Introduction
• What It Is Used For
• How It Is Used
• What the Science Says
• Side Effects and Cautions
• Sources
• For More Information
Introduction
This fact sheet provides basic information about the herbA plant or part of a plant used for its flavor, scent, or potential
therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots. ginkgo--common names, uses,
potential side effects, and resources for more information. The ginkgo tree is one of the oldest types of trees in the world.
Ginkgo seeds have been used in traditional Chinese medicine for thousands of years, and cooked seeds are
occasionally eaten.

Common Names—ginkgo, Ginkgo biloba, fossil tree, maidenhair tree, Japanese silver apricot, baiguo, bai guo ye, kew
tree, yinhsing (yin-hsing)

Latin Name—Ginkgo biloba

Top

What It Is Used For

• Ginkgo leaf extract has been used to treat a variety of ailments and conditions, including asthma, bronchitis,
fatigue, and tinnitus (ringing or roaring sounds in the ears).
• Today, people use ginkgo leaf extracts hoping to improve memory; to treat or help prevent Alzheimer's disease
and other types of dementia; to decrease intermittent claudication (leg pain caused by narrowing arteries); and to
treat sexual dysfunction, multiple sclerosis, tinnitus, and other health conditions.

How It Is Used
Extracts are usually taken from the ginkgo leaf and are used to make tablets, capsules, or teas. Occasionally, ginkgo
extracts are used in skin products.

Top

What the Science Says

• Numerous studies of ginkgo have been done for a variety of conditions. Some promising results have been seen
for Alzheimer's disease/dementia and intermittent claudication, among others, but larger, well-designed research
studies are needed.
• Some smaller studies for memory enhancement have had promising results, but a trial sponsored by the
National Institute on Aging of more than 200 healthy adults over age 60 found that ginkgo taken for 6 weeks did not
improve memory.
• NCCAM is conducting a large clinical trial of ginkgo with more than 3,000 volunteers. The aim is to see if the
herb prevents the onset of dementia and, specifically, Alzheimer's disease; slows cognitive decline and functional
disability (for example, inability to prepare meals); reduces the incidence of cardiovascular disease; and decreases
the rate of premature death.
• Other NCCAM-funded research includes studies on ginkgo for asthma, symptoms of multiple sclerosis, vascular
function (intermittent claudication), cognitive decline, sexual dysfunction due to antidepressants, and insulin
resistance. NCCAM is also looking at potential interactions between ginkgo and prescription drugs.

Side Effects and Cautions

• Side effects of ginkgo may include headache, nausea, gastrointestinal upset, diarrhea, dizziness, or allergic skin
reactions. More severe allergic reactions have occasionally been reported.
• There are some data to suggest that ginkgo can increase bleeding risk, so people who take anticoagulant drugs,
have bleeding disorders, or have scheduled surgery or dental procedures should use caution and talk to a health
care provider if using ginkgo.
• Uncooked ginkgo seeds contain a chemical known as ginkgotoxin, which can cause seizures. Consuming large
quantities of seeds over time can cause death. Ginkgo leaf and ginkgo leaf extracts appear to contain little
ginkgotoxin.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full
picture of what you do to manage your health. This will help ensure coordinated and safe care.
Top
Sources
• Solomon PR, Adams F, Silver A, et al. Ginkgo for memory enhancement: a randomized controlled trial. Journal
of the American Medical Association. 2002;288(7):835–840.

• Ginkgo biloba. In: Coates P, Blackman M, Cragg G, et al., eds. Encyclopedia of Dietary Supplements. New
York, NY: Marcel Dekker; 2005:249–257.

• Ginkgo. Natural Medicines Comprehensive Database Web site. Accessed on July 2, 2007.

• Ginkgo (Ginkgo biloba L.). Natural Standard Database Web site. Accessed on June 28, 2007.

• Ginkgo biloba leaf extract. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded
Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:359–366.

• De Smet PA. Herbal remedies. New England Journal of Medicine. 2002;347(25):2046–2056.

Top

For More Information

• What's in the Bottle? An Introduction to Dietary Supplements
• Herbal Supplements: Consider Safety, Too
NCCAM Clearinghouse
Toll-free in the U.S.: 1-888-644-6226
TTY (for deaf and hard-of-hearing callers): 1-866-464-3615
E-mail: info@nccam.nih.gov

CAM on PubMed
Web site: nccam.nih.gov/camonpubmed/

NIH Office of Dietary Supplements

Web site: ods.od.nih.gov

NIH National Library of Medicine's MedlinePlus

Ginkgo Listing: www.nlm.nih.gov/medlineplus/druginfo/natural/patient-ginkgo.html

http://nccam.nih.gov/health/ginkgo/
Ginkgo biloba

Also listed as: Fossil tree; Kew tree; Maiden hair tree; Ginkgo biloba
• Overview

• Plant Description

• What's It Made Of?

• Medicinal Uses and Indications

• Available Forms

• How to Take It

• Precautions

• Possible Interactions

• Supporting Research

Overview
Ginkgo ( Ginkgo biloba ) is one of the oldest living tree species and its leaves are among the most
extensively studied botanicals in use today. Unlike many other medicinal herbs, ginkgo leaves are
not frequently used in their crude state, but rather, in the form of a concentrated, standardized
ginkgo biloba extract (GBE). In Europe and the United States, ginkgo supplements are among the
best-selling herbal medications and it consistently ranks as a top medicine prescribed in France and
Germany.
Ginkgo has been used in traditional medicine to treat circulatory disorders and enhance memory.
Scientific studies throughout the years lend support to these traditional uses. Emerging evidence
suggests that GBE may be particularly effective in treating ailments associated with decreased blood
flow to the brain, particularly in elderly individuals. Laboratory studies have shown that GBE
improves blood circulation by dilating blood vessels and reducing the stickiness of blood platelets.
Ginkgo leaves also contain two types of chemicals (flavonoids and terpenoids) believed to have
potent antioxidant properties. Antioxidants are substances that scavenge free radicals -- damaging
compounds in the body that alter cell membranes, tamper with DNA, and even cause cell death.
Free radicals occur naturally in the body, but environmental toxins (including ultraviolet light,
radiation, cigarette smoking, and air pollution) can also increase the number of these damaging
particles. Free radicals are believed to contribute to a number of health problems including heart
disease and cancer as well as Alzheimer's disease and other forms of dementia. Antioxidants such as
those found in ginkgo can neutralize free radicals and may reduce or even help prevent some of the
damage they cause.

Plant Description
Ginkgo biloba is the oldest living tree species. A single tree can live as long as 1,000 years and
grow to a height of 120 feet. It has short branches with fan-shaped leaves and inedible fruits that
produce a strong odor. The fruit contains an inner seed, and there has been a report of a human
poisoning from ingesting the seed.
Although Chinese herbal medicine has used both the ginkgo leaf and seed for centuries, modern
research has focused on the standardized Ginkgo biloba extract (GBE), which is prepared from the
dried green leaves. This standardized extract is highly concentrated and seems to be clinically more
effective in treating health problems (particularly circulatory ailments) than the non-standardized
leaf alone.

What's It Made Of?

More than 40 components isolated from the ginkgo tree have been identified, but only two are
believed to be responsible for the herb's beneficial effects in humans -- flavonoids and terpenoids.
Flavonoids (such as quercetin and rutin) have potent antioxidant effects. Laboratory and animal
studies have shown that flavonoids protect the nerves, heart muscle, blood vessels, and retina from
damage. Terpenoids (such as ginkgolides) improve blood flow by dilating blood vessels and
reducing the stickiness of platelets.

Medicinal Uses and Indications

Based on studies conducted in laboratories, animals, and humans, many health care professionals
may recommend ginkgo for the following health problems:
Dementia and Alzheimer's Disease
Ginkgo is widely used in Europe for treating dementia. It use is primarily due to its ability to
improve blood flow to the brain and because of its antioxidant properties. The evidence that ginkgo
may improve thinking, learning, and memory in people with Alzheimer's disease (AD) has been
highly promising.
Clinical studies suggest that ginkgo may provide the following benefits for people with AD:
• Improvement in thinking, learning, and memory (cognitive function)
 • Improvement in activities of daily living

• Improvement in social behavior

• Fewer feelings of depression

Several studies have found that ginkgo may be as effective as leading AD medications in delaying
the symptoms of dementia in people with this debilitating condition. In addition, ginkgo is
sometimes used preventively because it may delay the onset of AD in someone who is at risk for
this type of dementia (for example, family history).
Eye problems
The flavonoids found in ginkgo may help halt or lessen some retinal problems (that is, problems to
the back part of the eye). Retinal damage has a number of potential causes, including diabetes and
macular degeneration. Macular degeneration (often called age-related macular degeneration or
ARMD) is a progressive, degenerative eye disease that tends to affect older adults and is the number
one cause of blindness in the United States. Studies suggest that gingko may help preserve vision in
those with ARMD.
Intermittent Claudication
Because ginkgo is reported to improve blood flow, this herb has been studied in people with
intermittent claudication (pain caused by inadequate blood flow to the legs). People with
intermittent claudication have difficulty walking without suffering extreme pain. An analysis of
eight published studies revealed that people taking ginkgo tend to walk roughly 34 meters farther
than those taking placebo. In fact, ginkgo has been shown to be as effective as a leading medication
in improving pain-free walking distance. However, regular walking exercises are more beneficial
than ginkgo in improving walking distance.
Memory Impairment
Ginkgo is widely touted as a "brain herb." Researchers recently reviewed all of the high-quality
published studies on ginkgo and mild memory impairment (in other words, people without
Alzheimer's or other form of dementia), and concluded that ginkgo was significantly more effective
than placebo in enhancing memory and cognitive function. Ginkgo is commonly added to nutrition
bars, soft drinks, and fruit smoothies to boost memory and enhance cognitive performance, although
there is debate over whether the small amounts of ginkgo found in these products are effective.
Tinnitus
Given that nerve damage and certain blood vessel disorders can lead to tinnitus (the perception of
ringing, hissing, or other sound in the ears or head when no external sound is present), some
researchers have investigated whether ginkgo relieves symptoms of this hearing disorder. Although
the quality of most studies was poor, the reviewers concluded that ginkgo moderately relieves the
loudness of the tinnitus sound. However, a well-designed study including 1,121 people with tinnitus
found that ginkgo (given 3 times daily for 3 months) was no more effective than placebo in
relieving symptoms of tinnitus. Given these conflicting findings, the therapeutic value of ginkgo for
tinnitus remains uncertain. In general, tinnitus is a very difficult problem to treat.
Other uses
In addition to these health problems, health care professionals may also recommend ginkgo for a
variety of other ailments, including altitude sickness, asthma, depression, disorientation, headaches,
high blood pressure, erectile dysfunction, and vertigo.
• A clinical study found that a standardized ginkgo extract may reduce the side effects of
menopause as well as risk factors for osteoporosis and cardiovascular disease. Women are becoming
more reluctant to use pharmaceutical hormone replacement therapy (HRT) due to its undesirable side
effects, such as irregular bleeding and an increased risk of breast cancer. Several human studies have
reported that a standardized ginkgo extract has estrogenic activity and might be suitable as an
alternative to HRT.
 • A standardized ginkgo extract was reported to significantly improve functional measures (such as
coordination, energy level, strength, mental performance, mood, and sensation) in 22 individuals with
multiple sclerosis (MS).

Available Forms
• Standardized extracts containing 24 - 32% flavonoids (also known as flavone glycosides or
heterosides) and 6 - 12% terpenoids (triterpene lactones)

• Capsules

• Tablets

• Liquid extracts (tinctures, fluid extracts, glycerites)

• Dried leaf for teas

How to Take It
Pediatric
Ginkgo is not routinely used in children by the medical community. Therefore, it is not currently
recommended to use ginkgo in children under 12.
Adult
Initial results often take 4 - 6 weeks, but should continue to accumulate beyond that period.
Memory impairment and cardiovascular function: Generally, 120 mg daily in divided doses,
standardized to contain 24 - 32% flavone glycosides (flavonoids or heterosides) and 6 - 12%
triterpene lactones (terpenoids). If more serious dementia or Alzheimer's disease is present, up to
240 mg daily, in 2 or 3 divided doses, may be necessary.

Precautions
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs,
however, contain components that can trigger side effects and interact with other herbs,
supplements, or medications. For these reasons, herbs should be taken with care, under the
supervision of a health care provider qualified in the field of botanical medicine.
GBE is considered to be safe, and side effects are rare. In a few cases, gastrointestinal upset,
headaches, skin reactions, and dizziness were reported.
Because gingko decreases platelet aggregation (stickiness), there is some concern that it may
increase risk of intracranial (brain) hemorrhage. In fact, there have been several reports of bleeding
complications associated with ginkgo use. However, it is not clear whether ginkgo or another factor
(such as the combination of ginkgo and blood-thinning medications including aspirin and non-
steroidal anti-inflammatory agents such as ibuprofen) caused the bleeding complications. One
human study found that a ginkgo extract significantly prolonged bleeding time when given along
with cilostazol (Pletal), a commonly used medication that inhibits platelet aggregation.
Pregnant and breastfeeding women should avoid using ginkgo preparations. In addition, ginkgo use
should be discontinued at least 36 hours prior to surgery due to the risk of bleeding complications.
Do not ingest Ginkgo biloba fruit or seed.
Possible Interactions
Ginkgo may alter the metabolism and effectiveness of some prescription and non-prescription
medications. If you are being treated with any of the following medications, you should not use
ginkgo without first talking to your health care provider:
Anticonvulsant medications -- High doses of ginkgo could decrease the effectiveness of
anticonvulsant therapy, such as carbamazepine (Tegretol) or valproic acid (Depakote), in controlling
seizures.
Antidepressant medications -- Taking ginkgo along with selective serotonin reuptake inhibitor
(SSRIs) antidepressants -- including fluoxetin (Prozac), sertraline (Zoloft), paroxetine (Paxil), and
escitalopram (Lexapro) -- may cause serotonin syndrome. This condition is characterized by
rigidity, tachycardia (fast heart rate), hyperthermia (high body temperature), restlessness, and
diaphoresis (sweating). Ginkgo may enhance the effects (both good and bad) of antidepressant
medications known as MAOIs, such as phenelzine (Nardil).
Antihypertensive medications -- Ginkgo may decrease blood pressure, so use of ginkgo along with
prescription antihypertensive medications should be monitored by a health care provider. There has
been a report of an interaction between ginkgo and nifedipine (Procardia), a calcium channel
blocking drug used for blood pressure and arrhythmias.
Blood-thinning medications -- Ginkgo has blood-thinning properties and therefore should not be
used if you are taking anticoagulant (blood-thinning) medications, such as aspirin, clopidogrel
(Plavix), dipyridamole (Persantine), heparin, ticlopidine (Ticlid), or warfarin (Coumadin). There has
been bleeding in the brain reported when using a ginkgo product and ibuprofen (Advil), a non-
steroidal antiinflammatory drug (NSAID).
Blood sugar lowering medications -- Ginkgo was reported to increase insulin levels in healthy
subjects and to decrease insulin levels in diabetic patients. Use ginkgo supplements under the
supervision of a health care provider if you are diabetic and taking insulin or oral blood sugar
lowering drugs.
Cylosporine -- Ginkgo biloba may help protect the cells of the body during treatment with the
immunosuppressive (decreases immunity) drug cyclosporine.
Thiazide diuretics -- Although there has been one literature report of increased blood pressure
associated with the use of ginkgo during treatment with thiazide diuretics, this interaction has not
been verified by clinical trials. Nevertheless, you should consult with your health care provider
before using ginkgo if you are taking thiazide diuretics.
Trazodone -- There has been a report of an adverse interaction between ginkgo and trazodone
(Desyrel), an antidepressant medication that resulted in an elderly patient going into a coma.

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• Review Date: 1/26/2007

• Reviewed By: Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D.
Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ.
Review provided by VeriMed Healthcare Network.

http://www.umm.edu/altmed/articles/ginkgo-biloba-000247.htm

Ginkgo (Ginkgo biloba L.)

Contents of this page:

• Background • Safety

• Synonyms • Interactions

• Evidence • Methodology Ginkgo

• Dosing • Selected references

BackgroundReturn to top
Ginkgo biloba has been used medicinally for thousands of years. Today, it is one of the
top selling herbs in the United States.
Ginkgo is used for the treatment of numerous conditions, many of which are under
scientific investigation. Available evidence demonstrates ginkgo's efficacy in the
management of intermittent claudication, Alzheimer's/multi-infarct dementia, and
"cerebral insufficiency" (a syndrome thought to be secondary to atherosclerotic disease,
characterized by impaired concentration, confusion, decreased physical performance,
fatigue, headache, dizziness, depression, and anxiety).
Although not definitive, there is promising early evidence favoring the use of ginkgo for
memory enhancement in healthy subjects, altitude (mountain) sickness, symptoms of
premenstrual syndrome (PMS), and reduction of chemotherapy-induced end-organ
vascular damage.
Although still controversial, a recent large trial has shifted the evidence against the use
of ginkgo for tinnitus.
The herb is generally well tolerated, but due to multiple case reports of bleeding, should
be used cautiously in patients on anticoagulant therapy, with known coagulopathy, or
prior to some surgical or dental procedures.

SynonymsReturn to top
Adiantifolia, AKL1, arbre aux quarante écus, ArginMax®, bai guo ye, baiguo, BioGinkgo®,
Blackmores Ginkgo Brahmi ( Bacopa monniera ), BN-52063, duck foot tree, EGb, EGb
761, Elefantenohr, Eun-haeng, facherblattbaum, Fossil tree, GBE, GBE 24, GBX, gin-nan,
ginan, Gincosan®, Ginexin Remind®, Gingopret®, Ginkai®, ginkgo balm, Ginkgo biloba
blätter, Ginkgo biloba exocarp polysaccharides (GBEP), Ginkgo folium, Ginkgo Go®,
Ginkgo Phytosome®, Ginkgo Powder®, Ginkgoaceae (family), ginkgoblätter, ginkgogink,
ginkgold, Ginkgold®, ginkgopower, Ginkopur®, ginkyo, Herbal vX®, icho, ityo,
 Japanbaum, Japanese silver apricot, kew tree, kung sun shu, LI 1370, maidenhair tree,
noyer du Japon, oriental plum tree, pei kuo, pei-wen, Pterophyllus, Pterophyllus
salisburiensis , Rokan, Rö Kan®, salisburia, Salisburia adiantifolia , Salisburia
macrophylla , Seredin, silver apricot, sophium, tanakan, tanakene, tebofortan, tebonin,
tempeltrae, temple balm, tramisal, valverde, vasan, vital, ya chio, yin-guo, yin-hsing.

EvidenceReturn to top
These uses have been tested in humans or animals. Safety and effectiveness have not always
been proven. Some of these conditions are potentially serious, and should be evaluated by a
qualified healthcare provider.

Uses based on scientific evidence Grade*

Claudication (painful legs from clogged

arteries)
Numerous studies suggest that Ginkgo biloba
taken by mouth causes small improvements in
claudication symptoms (leg pain with exercise or A
at rest due to clogged arteries). However, ginkgo
may not be as helpful for this condition as exercise
therapy or prescription drugs. Additional evidence
is needed.

Dementia (multi-infarct and Alzheimer's

type)
The scientific literature overall does suggest that
ginkgo benefits people with early stage
Alzheimer's disease and multi-infarct dementia, A
and may be as helpful as acetylcholinesterase
inhibitor drugs such as donepezil (Aricept®). Well-
designed research comparing ginkgo to
prescription drug therapies is needed.

Cerebral insufficiency
Multiple clinical trials have evaluated ginkgo for a
syndrome called "cerebral insufficiency." This
condition, more commonly diagnosed in Europe
than the United States, may include poor
concentration, confusion, absent-mindedness,
decreased physical performance, fatigue,
headache, dizziness, depression, and anxiety. It is B
believed that cerebral insufficiency is caused by
decreased blood flow to the brain due to clogged
blood vessels. Some research reports benefits of
ginkgo in patients with these symptoms, but most
have been poorly designed without reliable
results. Better studies are needed before a strong
recommendation can be made.

Acute hemorrhoidal attacks C

In early study ginkgo was shown to be effective in
the treatment of patients with acute hemorrhoidal
attacks. Further research is needed to confirm
these results.

Age-associated memory impairment (AAMI)

Age-associated memory impairment (AAMI) is a
non-specific syndrome, which may be caused by
early Alzheimer's disease or multi-infarct dementia
(conditions for which ginkgo has been shown to
have benefit). There is preliminary research C
showing small improvements in memory and other
brain functions in patients with AAMI, although
some studies disagree. Overall, there is currently
not enough clear evidence to recommend for or
against ginkgo for this condition.

Altitude (mountain) sickness

A small amount of poorly designed research
reports benefits of ginkgo for the treatment of C
altitude (mountain) sickness. Additional study is
needed before a recommendation can be made.

Cardiovascular disease
Animal and limited human data suggest a role in
C
heart blood flow. More research is needed in this
area.

Chemotherapy side effects reduction

In limited human study, ginkgo has been
examined in addition to 5-fluorouracil (5-FU) in the
treatment of pancreatic and colorectal cancer, to C
measure possible benefits on side effects. At this
time, there is a lack of conclusive evidence in this
area.

Cognition
It remains unclear if ginkgo is effective for
cognition improvement. Further well-designed C
research is needed as existing study reports
conflicting evidence.

Deafness (cochlear)
Preliminary clinical study has been conducted on
the effect of ginkgo in chronic cochleovestibular C
disorders. Further research is needed before a
recommendation can be made.

Depression and seasonal affective disorder C

(SAD)
Preliminary study of seasonal affective disorder
(SAD) suggests that ginkgo is not effective in
preventing the development of winter depression.
Other research in elderly patients with depression
shows possible minor benefits. Overall, there is not
enough evidence to form a clear conclusion.

Gastric cancer
Ginkgo biloba exocarp polysaccharides (GBEP)
capsule preparation has been studied for upper
digestive tract malignant tumors of middle and C
late stage with positive results. However, further
research is needed before a recommendation can
be made.

Glaucoma
It is not clear if ginkgo may improve intraocular
pressure and blood flow in patients with glaucoma.
C
Some study results conflict or have not been
significant. Further research is needed before a
recommendation can be made.

Graves' disease
Ginkgo may decrease damage to cells caused by
C
radioiodine therapy in patients with Graves'
disease. Further study is needed.

Macular degeneration
Preliminary research suggests that ginkgo may
improve eye blood flow, although it remains
C
unclear if macular degeneration is significantly
affected by ginkgo. More research is needed in
this area before a conclusion can be drawn.

Memory enhancement (in healthy people)

It remains unclear if ginkgo is effective. Further
C
well-designed research is needed as existing study
results conflict.

Multiple sclerosis
Based on laboratory study, it has been suggested
that ginkgo may provide benefit in multiple
sclerosis (MS). Human research is limited to C
several small studies, which have not found
consistent benefit. Additional research is needed
before a recommendation can be made.

Premenstrual syndrome (PMS)

Initial study in women with premenstrual
syndrome or breast discomfort suggests that
C
ginkgo may relieve symptoms including emotional
upset. Further well-designed research is needed
before a recommendation can be made.
Pulmonary interstitial fibrosis
Based on early study, ginkgo may be effective in
C
treating pulmonary interstitial fibrosis. Further
research is needed to confirm these results.

Quality of life
Early studies suggest that ginkgo may aid in
C
quality of life. More randomized controlled trials
are needed before a conclusion can be made.

Raynaud's disease
Results from one clinical trial suggest that Ginkgo
biloba may be effective in reducing the number of
C
Raynaud's attacks in patients suffering from
Raynaud's disease. In order to confirm these
results, further clinical trials are required.

Retinopathy (diabetes mellitus type 2)

Early study suggests Ginkgo biloba extract may
offer benefit to individuals with retinopathy. C
Further clinical trials are required to determine
efficacy.

Ringing in the ears (tinnitus)

There is conflicting research regarding the use of
ginkgo for tinnitus. Additional well-designed C
research is needed in order to resolve this
controversy.

Sexual dysfunction
Ginkgo has been used and studied for the
treatment of sexual dysfunction in men and
C
women. In general, studies are small and not well
designed. Additional research is needed before a
recommendation can be made.

Stroke
Laboratory studies suggest that ginkgo may be
helpful immediately following strokes because of
possible antioxidant or blood vessel effects. C
However, initial study of ginkgo in people having
strokes found a lack of benefit. Further research is
needed in this area.

Vertigo
A small amount of poorly designed research
reports benefits of ginkgo for the treatment of C
vertigo. Additional study is needed before a
recommendation can be made.

Vitiligo C
 Early study using oral Ginkgo biloba extract
reports that ginkgo appears to arrest the
progression of this disease. Better-designed
studies are needed to confirm these results.

Cocaine dependence
One small study reports no benefit of ginkgo for D
cocaine independence.

Mental performance (after eating)

The results of one study investigating the effect of
Ginkgo biloba on post-prandial mental alertness
D
are unclear. Ginkgo may benefit some but not all
endpoints. Further clinical trials are required
before recommendations can be made.

Mood and cognition in post-menopausal

women
Based on early study of chronic administration,
D
Gincosan® appears to have no beneficial effects
on mood, anxiety, or sleepiness in post-
menopausal women.

*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.
Grading rationale

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been
thoroughly tested in humans, and safety and effectiveness have not always been proven.
Some of these conditions are potentially serious, and should be evaluated by a qualified
healthcare provider.
Acidosis, aging, alcoholism, allergies, angina, anti-bacterial, anti-fungal, anti-inflammatory,
antioxidant, anti-parasitic, anti-rheumatic, anti-tumor, anxiety, asthma, attention deficit
hyperactivity disorder, autoimmune disorders, bladder disorders, blood vessel disorders, blood
clots, body fat reducer (cellulite), brain damage, breast disease, breast tenderness, bronchial
asthma, bronchitis, cancer, cataracts, chest pain, chilblains (inflammation of toes, fingers, ears,
or face with exposure to cold), chronic rhinitis, cochleovestibular impairment (vascular
vestibular disorders, vestibular organ peripheral lesion syndrome), colorectal cancer,
congestive heart failure, cough, cyanosis, degenerative diseases (prevention), dermatitis,
diabetes, diabetic nerve damage (neuropathy), digestion, dizziness, dysentery (bloody
diarrhea), eczema, edema, encephalopathy (circulatory), fatigue, fibromyalgia, freckle-
removing, genitourinary disorders, headache, heart attack, hepatitis B, high cholesterol, high
blood pressure, hypoxia (lack of oxygen), immunomodulator, insomnia, labor induction,
menstrual pain, migraine, mouth cancer, respiratory tract illnesses, scabies (ginkgo cream),
schizophrenia, seizures, sepsis, skin sores (ginkgo cream), spermicide, swelling, traumatic brain
injury, ulcer (trophic lesions), ulcerative colitis, vaginal dryness, varicose veins, vision (color).
DosingReturn to top
The below doses are based on scientific research, publications, traditional use, or expert
opinion. Many herbs and supplements have not been thoroughly tested, and safety and
effectiveness may not be proven. Brands may be made differently, with variable ingredients,
even within the same brand. The below doses may not apply to all products. You should read
product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old)

80 to 240 milligrams of a 50:1 standardized leaf extract taken daily by mouth in 2 to 3
divided doses has been used and studied (standardized to 24% to 25% ginkgo flavone
glycosides and 6% terpine lactones). Other forms used include tea (bags usually contain
30 milligrams of extract), 3 to 6 milliliters of 40 milligrams per milliliter extract daily in
three divided doses, and "fortified" foods. Ginkgo seeds are potentially toxic and should
be avoided. The German ginkgo product Tebonin®, given through the veins (IV), was
removed from the German market due to significant side effects.
Children (under 18 years old)
There is not enough scientific evidence to recommend use of ginkgo in children.

SafetyReturn to top
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There
is no guarantee of strength, purity or safety of products, and effects may vary. You should
always read product labels. If you have a medical condition, or are taking other drugs, herbs, or
supplements, you should speak with a qualified healthcare provider before starting a new
therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies
Allergy/hypersensitivity to Ginkgo biloba or members of the Ginkgoaceae family may
occur. A severe reaction called Stevens-Johnson syndrome, which includes skin blistering
and sloughing-off, has been reported with use of a combination product. There may be
cross-sensitivity to ginkgo in people allergic to urusiols (mango rind, sumac, poison ivy,
poison oak, cashews), and an allergic cross-reaction has been reported in a person
allergic to poison ivy.
Side Effects and Warnings
Overall, ginkgo leaf extract (used in most commercial products) appears to be well
tolerated in most healthy adults at recommended doses for up to six months. Minor
symptoms including headache, nausea, and intestinal complaints have been reported.
Bleeding has been associated with the use of ginkgo taken by mouth, and caution is
advised in patients with bleeding disorders or taking drugs/herbs/supplements that may
increase the risk of bleeding. Dosing adjustments may be necessary. Ginkgo should be
stopped prior to some surgical or dental procedures. Reports of bleeding range from
nose bleeds to life-threatening bleeding in several case reports. In some of these reports,
ginkgo has been used with other agents that may also cause bleeding.
Eating the seeds is potentially deadly, due to risk of tonic-clonic seizures and loss of
consciousness.
Based on human study, ginkgo may theoretically affect insulin and blood sugar levels.
Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs,
herbs, or supplements that affect blood sugar. Serum glucose levels may need to be
monitored by a healthcare professional, and medication adjustments may be necessary.
There have been uncommon reports of dizziness, stomach upset, diarrhea, vomiting,
muscle weakness, loss of muscle tone, restlessness, racing heart, rash, and irritation
around the mouth with the use of ginkgo. There is a case report of "coma" in an elderly
Alzheimer's patient taking trazodone and ginkgo, although it is not clear that ginkgo was
 the cause. Based on laboratory and human research, ginkgo may decrease blood
pressure, although there is one report of ginkgo possibly raising blood pressure in a
person taking a thiazide diuretic ("water pill"). Based on theory, high concentrations of
ginkgo may reduce male and female fertility. Contamination with the drug colchicine has
been found in commercial preparations of Ginkgo biloba.
Ginkgo may affect the outcome of electroconvulsive therapy (ECT). Adverse effects on
the eyes have also been reported.
Pregnancy and Breastfeeding
Use of ginkgo is not recommended during pregnancy and breastfeeding due to lack of
reliable scientific study in this area. The risk of bleeding associated with ginkgo may be
dangerous during pregnancy.

InteractionsReturn to top
Most herbs and supplements have not been thoroughly tested for interactions with other herbs,
supplements, drugs, or foods. The interactions listed below are based on reports in scientific
publications, laboratory experiments, or traditional use. You should always read product labels.
If you have a medical condition, or are taking other drugs, herbs, or supplements, you should
speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Overall, controlled trials of ginkgo report few adverse effects and good tolerance, with
rates of complications similar to placebo. However, use of ginkgo with drugs that may
cause bleeding may further increase the risk of bleeding, based on multiple case reports
of spontaneous bleeding in patients using ginkgo alone, with warfarin (Coumadin®), or
with aspirin. One case report documents a possible increase in bleeding risk with
ticlodipine (Ticlid®) and ginkgo. Examples of drugs that may increase the risk of
bleeding include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®)
or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-
inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®,
Aleve®). However, not all studies agree with the existence of this risk, and it is not clear
if particular types of patients may be at greater risk.
Based on preliminary research, ginkgo may affect insulin and blood sugar levels. Caution
is advised when using medications that may also lower blood sugar. Patients taking
drugs for diabetes by mouth or insulin should be monitored closely by a qualified
healthcare professional. Medication adjustments may be necessary.
Ginkgo has been found to decrease blood pressure in healthy volunteers, although some
studies disagree. Theoretically, ginkgo may add to the effects of medications that also
lower blood pressure, although raised blood pressure has been reported in a patient
taking a thiazide diuretic ("water pill") with ginkgo. It has been suggested that Ginkgo
biloba leaf extract (GBE) and nifedipine should not be ingested at the same time.
Monoamine oxidase (MAO) inhibition by ginkgo was reported in one animal study, but
has not been confirmed in humans. In theory, if taken with MAOI drugs, such as
isocarboxazid (Marplan®), phenelzine (Nardil®), or tranylcypromine (Parnate®), additive
effects and side effects may occur. Based on laboratory research, ginkgo may also add to
the effects of SSRI antidepressants such as sertraline (Zoloft®), with an increased risk of
causing serotonin syndrome, a condition characterized by stiff muscles, fast heart rate,
hyperthermia, restlessness, and sweating.
Based on human use, ginkgo may decrease side effects of antipsychotic drugs, although
scientific information in this area is limited. There is a case report of "coma" in an elderly
Alzheimer's patient taking trazodone and ginkgo, although it is not clear that this
reaction was due to ginkgo. In theory, ginkgo may increase the actions of drugs used for
 erectile dysfunction such as sildenafil (Viagra®).
There may be a risk of seizure when taking ginkgo, particularly in people with a history of
seizure disorder. Although most reports of seizures have been due to eating ginkgo
seeds (not leaf extract which is found in most products), an animal study found that the
anti-seizure properties of sodium valproate or carbamazepine were reduced by giving
ginkgo. In theory, drugs such as donepezil (Aricept®) and tacrine (Cognex®) may have
an additive effect when used at the same time as ginkgo, potentially increasing
cholinergic effects (such as salivation and urination).
5-fluorouracil induced side effects and cyclosporine kidney toxicity may in theory be
improved by ginkgo, although evidence is not conclusive in these areas. Colchicine has
been found in commercial preparations of ginkgo, and may increase blood
concentrations in patients using colchicine.
Ginkgo may alter the way the liver breaks down certain drugs.
Interactions with Herbs and Dietary Supplements
Use of ginkgo with herbs or supplements that may cause bleeding may increase the risk
of bleeding, although some studies disagree. Several cases of bleeding have been
reported with the use of garlic, and two cases with saw palmetto. Numerous other agents
may theoretically increase the risk of bleeding, although this has not been proven in
most cases.
Ginkgo has been found to decrease blood pressure in healthy volunteers, although some
studies disagree. Theoretically, ginkgo may have additive effects when used with herbs
or supplements that also decrease blood pressure. However, high blood pressure was
reported in a patient taking a thiazide diuretic ("water pill") plus ginkgo. Although it
remains unclear if ginkgo has clinically significant effects on blood pressure, caution may
be warranted when ginkgo is used with other agents that affect blood pressure.
Based on human study, ginkgo may theoretically affect insulin and lower blood sugar
levels. Caution is advised when using herbs or supplements that may also affect blood
sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Effects on monoamine oxidase (inhibition) by ginkgo are reported in animals but not
confirmed in humans. In theory, ginkgo may add to the side effects of herbs or
supplements that also inhibit monoamine oxidase, such as 5-HTP (5-Hydroxytryptophan).
Based on laboratory research, ginkgo may add to the effects of herbs or supplements
that affect levels of serotonin in the blood or brain, and could increase the risk of
serotonin syndrome (a condition characterized by muscle stiffness, increased heart rate,
hyperthermia, restlessness, and sweating).
Ginkgo may increase the actions of agents used for erectile dysfunction, including
yohimbe.
Ginkgo may alter the way the liver breaks down herbs and supplements.

Methodology Return to top

This information is based on a professional level monograph edited and peer-reviewed by
contributors to the Natural Standard Research Collaboration (www.naturalstandard.com):
Tracee Rae Abrams, PharmD (University of Rhode Island); E-P Barrette, MD (Case
Western Reserve University School of Medicine); Ethan Basch, MD (Memorial Sloan-
Kettering Cancer Center); Samuel Basch, MD (Mt. Sinai Medical Center); Julie Conquer,
PhD (RGB Consulting); Dawn Costa, BA, BS (Natural Standard Research Collaboration);
Paul Hammerness, MD (Harvard Medical School); Jenna Hollenstein, MS, RD (Natural
Standard Research Collaboration); David Kroll, PhD (Duke University); George Papaliodis,
MD (Massachusetts Eye and Ear Infirmary); Michael Smith, ND, MRPharmS (Canadian
 College of Naturopathic Medicine); Philippe Szapary, MD (University of Pennsylvania);
Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine
Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern
University); Wendy Weissner, BA (Natural Standard Research Collaboration).
Methodology details

Selected references Return to top

1. Birks J, Grimley Evans J. Ginkgo biloba for cognitive impairment and dementia. Cochrane Database Syst Rev
2007 Apr 18;(2):CD003120.

2. Carlson JJ, Farquhar JW, DiNucci E, et al. 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.

3. Hilton M, Stuart E. Ginkgo biloba for tinnitus. Cochrane Database Syst Rev 2004;(2):CD003852.

4. 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;11(1):155-160.

5. Kampman K, Majewska MD, Tourian K, et al. A pilot trial of piracetam and ginkgo biloba for the treatment of
cocaine dependence. Addict Behav 2003;28(3):437-448.

6. Kohler 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;15(4):303-309.

7. Lovera J, Bagert B, Smoot K, et al. Ginkgo biloba for the improvement of cognitive performance in multiple
sclerosis: a randomized, placebo-controlled trial. Mult Scler 2007 Apr;13(3):376-85.

8. Mazza M, Capuano A, Bria P, et al. 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.

9. Napryeyenko O, Borzenko I; GINDEM-NP Study Group. Ginkgo biloba special extract in dementia with
neuropsychiatric features. A randomised, placebo-controlled, double-blind clinical trial. Arzneimittelforschung
2007;57(1):4-11.

10. Robertson SM, Davey RT, Voell J, et al. Effect of Ginkgo biloba extract on lopinavir, midazolam and
fexofenadine pharmacokinetics in healthy subjects. Curr Med Res Opin 2008 Feb;24(2):591-9.

11. Thomas M, Sheran J, Smith N, et al. AKL1, a botanical mixture for the treatment of asthma: a randomised,
double-blind, placebo-controlled, cross-over study. BMC Pulm Med. 2007 Mar 20;7:4.

12. Van Dongen M, van Rossum E, Kessels A, et al. Ginkgo for elderly people with dementia and age-associated
memory impairment: a randomized clinical trial. J Clin Epidemiol 2003;56(4):367-376.

13. Wang J, Zhou S, Bronks R, et al. Supervised exercise training combined with ginkgo biloba treatment for
patients with peripheral arterial disease. Clin Rehabil 2007 Jul;21(7):579-86.

14. Wolf HR. Does Ginkgo biloba special extract EGb 761 provide additional effects on coagulation and bleeding
when added to acetylsalicylic acid 500 mg daily? Drugs R D 2006;7(3):163-72.

15. Zeng X, Liu M, Yang Y, et al. Ginkgo biloba for acute ischaemic stroke. Cochrane Database Syst Rev 2005 Oct
19;(4):CD003691.

March 01, 2008.

This evidence-based monograph was prepared by the Natural Standard Research

Collaboration. The information provided should not be used during any medical

emergency or for the diagnosis or treatment of any medical condition. Talk to your health

care provider before taking any prescription or over the counter drugs (including any

herbal medicines or supplements) or following any treatment or regimen. Copyright©

2008 Natural Standard (www.naturalstandard.com). All Rights Reserved.

http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-ginkgo.html

Bacopa
Memory Enhancing Herb With Anti-Anxiety Action
 Bacopa is a great neurotonic, immuno-modulator, adaptogen, tranquilizing,
memory and learning enhancing, cerebral activator, anti-ulcer,
antispasmodic, anti-asthmatic ayurvedic herb. Other benefits are anti-
allergic, free radicals scavenging effect and as herbal supplement in Epilepsy, anxiety and
depression.

Know its beneficial actions on brain, memory, mental deficiency, Alzheimer's disease, learning
skills, anxiety, depression, stress, epileps and ADHD children.

The Effects Of Bacopa Monnieri Approved By Clinical Research Trials

Bacopa Effects On Brain Functions:

In a double blind randomized placebo controlled research study in Australia, at University of
Wollongong, this ayurvedic botanical was found to be effective in tests for retention of new
information.

In another similar study mentioned in Neuropsychopharmacology (Aug.2002), its effects were

documented for several weeks and various memory functions were tested with levels of
anxiety. The study revealed the same - B. monnieri decreases the rate of forgetting of
newly acquired information, verbal learning rate and memory consolidation.

In yet another study, the chronic (3 weeks to 12 weeks) administration of B. monnieri showed
significant improvement in speed of visual information processing by IT task, learning
rate and memory consolidation as compared to placebo. There was improvement in
higher order cognitive functions that depend on memory, learning and environmental factors.

However the single dose of this medicinal herb doesn't show any improvement in cognitive or
memory functions. The dosage in the above two studies was 300 mg of B. monnieri extracts
daily.

Triterpenoid saponins and Bacosides of B. monnieri play key role for enhancing nerve
impulse transmission. Bacosides support the repair of damaged neurons by enhancing
kinase activity, neuronal synthesis, restoration and regeneration of synaptic activity resulting
in nerve impulse transmission. These effects make it a wonderful nerve tonic or nerve
nourishing agent as against the neuroleptic drugs that modulate the behavior.

In a study on this its effects on children, it showed significant improvement in exploratory

drive, improved perceptual image of patterns and increased perceptual organization
and reasoning ability.

During International Brain Research Conference in Australia 1996, CDRI scientists presented
that B. monnieri reduced the time to learn specific task to six days while the control
group took ten days to learn the same task.

BACK TO TOP

Bacopa In Mild To Moderate Mental Deficiency:

B. monnieri was tested on men with mild to moderate mental deficiency. 172 persons received
B. monnieri 500 mg of extract thrice a day while 114 persons received placebo for one year. At
the end of study, there was improvement in concentration ability, memory span, and
overall mental performance in individuals taking the extract as compared with
placebo group.

There was improvement in the performance of school children with poor educational
performance.

Alzheimer's Disease And Bacopa:

Loss of cholinergic activity in hippocampus was the primary cause of Alzheimer's disease. B.
monnieri showed important antioxidant activity in many brain parts like hippocampus,
striatum and frontal cortex. Further studies showed its protective effect against DNA
damage in astrocytes and fibroblast cells. All this suggest its important role in Alzheimer's and
at least it could be useful in checking the progression of this disease to some extent.

BACK TO TOP

Bacopa In Epilepsy:
Despite its mention as anti-epilepsy role it was found to exert this effect only on very high
doses over long periods. The dose near LD50 showed effect against seizures. Research in
India found hersaponin to exert some anticonvulsant effect. So it could better be used as an
adjuvant in treatment of Epilepsy.

Anti-epilepsy drugs as Phenytoin have some side effects as cognitive impairment.

Simultaneous administration of this botanical with phenytoin improved acquisition and
retention of memory. B. monnieri extracts have corrective effect on phenytoin induced
cognitive deficit.

Bacopa Improving Learning Skills:

In this research trial, the animals were trained in T maze. One group wasn't given any
medicine, second group was given Diazepam and third, fourth and fifth group received this
ayurvedic herb. After 10 days there was comparable memory and learning enhancement
in the group treated with B. monnieri. Biochemical studies found the Serotonin content of
B. monnieri groups to be more compared to control group and the other group.

All the anti-depressants - SSRI's, Tricyclic antidepressants and MAO inhibitors produce two
effects - the augmentation of the effect of Norepinephrine and Seotonin by blocking their
intracellular depletion. It is not clear how B. monnieri produced this effect of increasing
Serotonin content. But in future as the understanding of these neurochemicals would grow,
B. monnieri might emerge as the standard and natural treatment for anxiety and depression.

BACK TO TOP

Bacopa In Stress:
In this study on rats, B. monniera showed the potential to be effective in stress. The response
had been better in the group that was pretreated for one week with 20 to 40
mg/kg/daily of it even before exposing to stress.

The level of Hsp70 increases in brain as a response to stress. After giving B. monnieri for
seven days, and then giving stress to animals, the Hsp70 was found in lower concentration in
animals pretreated with Bacopa.

The two P450 enzymes respond differently to B. monnieri. These two enzymes EROD &
PROD levels in pretreated rats were found more even before exposure to stress. Thus B.
monnieri primed the brain for stress by stockpiling these useful enzymes even before
stressful conditions. Our susceptibility to stress could be lowered by using this medicinal
herb.

The SOD interpretation was difficult. Researchers concluded as "B. monnieri helps in coping
with combined hypoxic, hypothermic and immobilization stress that could lead to onslaught of
free radicals." Thanks to this ayurvedic herb for all such beneficial effects without asking any
recognition.

Bacopa For Anxiety:

Research on rats as models of clinical anxiety showed the anxiolytic activity of its extracts
with 25 percent bacosides as comparable to Lorazepam. Plus there were no side effects
of Lorazepam, like amnesia. Rather there was memory enhancing effect.

Another one month study on diagnosed anxiety neurosis patients, with syrup of this medicinal
herb equivalent to 12 gm of crude powder, found significant reduction in anxiety symptoms,
level of disability and fatigue. There was additional increase in immediate memory, decreased
respiratory rate and decreased SBP or systolic blood pressure.
 BACK TO TOP

Bacopa For Depression:

The B. monnieri extract in the dose of 20 to 40 mg per kg was given once daily for five days
and it was found comparable to standard anti-depressant drug Imipramine in anti-
depressant activity in rodent animals.

Bacopa Potentiating Barbiturate Action:

Epilepsy patients who are taking Barbiturates can benefit from B. monnieri. It may potentiate
the effect of Barbiturates so they are needed in lower dosage. Plus there would be relief
from other side effects like behavioral abnormalities, diminution of intelligence, impairment of
learning and memory, hyperactivity in children and mental confusion in older patients.

Bacopa & ADD Hyperactive Children:

Another double blind study at BRD Medical College, at Gorakhpur, India, on children with ADHD
(Attention Deficit Disorder) showed benefit after 12 weeks of B. monnieri use in sentence
repetition, logical memory and paired associated learning tasks. The children were given the
test four weeks after the B. monnieri had been withdrawn and it affirms its lasting effect.

Bacopa
GABAergic Action Of Bacopa:
Monniera
Researchers believe that, among its other mechanisms, Bacopa
meditates the GABAergic system. Gamma-aminobutyric acid is an
inhibitory neurotransmitter that has been shown to possess
anticonvulsive, antinociceptive (prevention of pain due to
hypersensitive nerve endings), locomotor, and sedative effects.

Use Bacopa For:

1. Memory Enhancing.

2. Aid In Learning Skills.

3. Stress, Anxiety and Depression.

(Click Image)

4. Children with ADHD.

5. Visit Bacopa related pages on this site to get more information about this herbal
supplement.

6. You can take one tablet twice or thrice a day or as suggested by qualified herbalist. Each
tablet contains 225 mg of extract standardized for 20 % of Bacosides (A+B).
http://www.holistic-herbalist.com/bacopa.html

1: Neuropsychopharmacology. 2002 Aug;27(2):279-81. Links

Chronic effects of Brahmi (Bacopa monnieri) on human memory.

Roodenrys S, Booth D, Bulzomi S, Phipps A, Micallef C, Smoker J.

Department of Psychology, University of Wollongong, Woolongong, Australia.

steven_roodenrys@uow.edu.au

A study is reported on the effects of Brahmi (Bacopa monniera) on human memory.

Seventy-six adults aged between 40 and 65 years took part in a double-blind
randomized, placebo control study in which various memory functions were tested and
 levels of anxiety measured. There were three testing sessions: one prior to the trial, one
after three months on the trial, and one six weeks after the completion of the trial. The
results show a significant effect of the Brahmi on a test for the retention of new
information. Follow-up tests showed that the rate of learning was unaffected, suggesting
that Brahmi decreases the rate of forgetting of newly acquired information. Tasks
assessing attention, verbal and visual short-term memory and the retrieval of pre-
experimental knowledge were unaffected. Questionnaire measures of everyday memory
function and anxiety levels were also unaffected.

PMID: 12093601 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/12093601

Bacopa plant by Ray Sahelian, M.D. - Bacopa Monnieri Information

Bacopa supplement information

Plus: Mind Power Rx with Bacopa - for healthy brain function
Bacopa monnieri is an Ayurvedic herb used in India for memory, epilepsy, and as a
mild sedative. Bacopa commonly grows in marshy areas throughout India. Studies
show that bacopa has strong antioxidant properties, protects mental function in
those with epilepsy who take the drug phenytion, while a study on rats showed
bacopa administration improves learning skills. I have seen Bacopa monnieri also
spelled as Bacopa monniera but I have been informed that bacopa monnieri is the
correct spelling.
What's in Bacopa herb?
Two saponins, designated as bacopaside I and II, are found in Bacopa monniera.
Additional phytochemicals betulinic acid, wogonin and oroxindin have been isolated
from the aerial parts of Bacopa monniera. Bacopa also has the flavonoids apigenin
and luteolin.

Bacopa Extract, 225 mg, 120 Tablets - Planetary Formulas

Bacopa has been revered for centuries in the Ayurvedic herbal
tradition of India to enhance clear thinking and support memory
function. Studies have shown that Bacopa supports learning
and memory in humans. In animal models, Bacopa monnieri
provides antioxidant protection for critical memory centers and
helps to reduce the effects of stress on the brain. Traditional
application suggests that Bacopa has a direct effect on
improving brain functions, increasing concentration, and in
promoting memory functions. Bacosides play a protective role in the synaptic
functions of the nerves in the hippocampus, the seat of memory. Nerve impulses are
transmitted across the synapses and their degeneration is believed to contribute to
impaired memory and cognition.

Click here to buy Bacopa Monnieri, Mind Power Rx,

Eyesight Rx, or to sign up to a Free Newsletter
Subscribe to a FREE Supplement Research Update
newsletter. Twice a month you will receive an email with a
review of several studies on various supplements and
natural medicine topics, and their practical interpretation by
Ray Sahelian, M.D. We will discuss bacopa research when
available.
Bacopa Monnieri Supplement Facts
Amount Per Serving
Calcium - 100 mg - 10%DV
Bacopa whole plant extract - 450 mg* (20% bacosides A+B)

* Bacopa monnieri daily value not established.

Mind Power Rx with Bacopa extract - Formulated by Ray Sahelian, M.D.
Mind Power Rx is a sophisticated cognitive formula with bacopa and a
dozen brain herbs and nutrients. It combines a delicate balance of brain
circulation agents and neurotransmitter precursors with powerful
natural brain chemicals that support healthy:
Memory and Mood
Mental clarity
Concentration
Alertness & Focus
Why buy all the individual herbs and nutrients separately -- at great expense -- when
you can buy this excellent combination? The herbs in Mind Power Rx include:
Ashwagandha, Bacopa monnieri, Fo-Ti, Ginkgo biloba, Ginseng, Gotu Kola, Mucuna
pruriens, Reishi, and Rhodiola. The nutrients and vitamins in Mind Power Rx
include Acetyl-l-carnitine, Carnitine, Carnosine, Choline, DMAE, Inositol,
Methylcobalamin, Pantothenic acid, Trimethylglycine, Tyrosine, and Vinpocetine.
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Bacopa: Ayurvedic memory herb

Researchers at the Department of Psychology, University of Wollongong, in
Australia, studied the effects of Bacopa on human memory. Seventy-six adults aged
between 40 and 65 years took part in a double-blind randomized, placebo control
study in which various memory functions were tested and levels of anxiety
measured. There were three testing sessions: one prior to the trial, one after three
months on the trial, and one six weeks after the completion of the trial. The results
showed a significant effect of bacopa monniera on a test for the retention of new
information. Follow-up tests showed that the rate of learning was unaffected,
suggesting that bacopa decreases the rate of forgetting of newly acquired
information.

Bacopa dosage
The usual dosage of bacopa is 100 mg of the extract once or twice daily. It appears
that bacopa works better when taken a few days in a row rather than just once.

Additional benefits of bacopa extract

Bacopa moniera has antioxidant properties. One rodent study indicates bacopa to
have some potential in helping protect the stomach from ulcer formation.
Bacopa side effects
Long term side effects are currently not fully known. As with most herbs, it's best to
take breaks from use.

Bacopa Human Research Update

Chronic effects of Brahmi (Bacopa monniera) on human memory.
Neuropsychopharmacology. 2002 Aug;27(2):279-81.
A study is reported on the effects of Brahmi (Bacopa monniera) on human memory.
Seventy-six adults aged between 40 and 65 years took part in a double-blind
randomized, placebo control study in which various memory functions were tested
and levels of anxiety measured. There were three testing sessions: one prior to the
trial, one after three months on the trial, and one six weeks after the completion of
the trial. The results show a significant effect of the Bacopa monniera on a test for
the retention of new information. Follow-up tests showed that the rate of learning
was unaffected, suggesting that Bacopa monniera decreases the rate of forgetting
of newly acquired information. Tasks assessing attention, verbal and visual short-
term memory and the retrieval of pre-experimental knowledge were unaffected.

The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function

in healthy human subjects.
Psychopharmacology (Berl) 2001 Aug;156(4):481-4
Extracts of Bacopa monniera have been reported to exert cognitive enhancing
effects in animals. However, the effects on human cognition are inconclusive. The
current study examined the chronic effects of an extract of bacopa on cognitive
function in healthy human subjects. The study was a double-blind placebo-
controlled independent-group design in which subjects were randomly allocated to
one of two treatment conditions, bacopa (300 mg) or placebo. Neuropsychological
testing was conducted pre-(baseline) and at 5 and 12 weeks post drug
administration. RESULTS: Bacopa significantly improved speed of visual
information processing measured by the IT task, learning rate and memory
consolidation compared to placebo, with maximal effects evident after 12 weeks.
CONCLUSIONS: These findings suggest that Bacopa monniera may improve higher
order cognitive processes that are critically dependent on the input of information
from our environment such as learning and memory.

The acute effects of an extract of Bacopa monniera (Brahmi) on cognitive function in

healthy normal subjects.
Hum Psychopharmacol. 2001 Jun;16(4):345-351.
The Ayurvedic medicine Bacopa monniera (Brahmi) has been shown to exert
cognitive enhancing effects in animals. The current study examined the acute
effects of an extract of Bacopa monniera on cognitive function in normal healthy
human subjects. Subjects were randomly allocated to one of two treatment
conditions, Bacopa monniera (300 mg) or placebo. Neuropsychological testing was
conducted before and 2 hours after drug administration. No significant changes
were found on any of the tests. The findings suggest that Bacopa monniera, at least
for the dose administered, has no acute effects on cognitive functioning in normal
healthy subjects.

Bacopa Animal Research Update

Adaptogenic effect of Bacopa monniera (Brahmi).
Pharmacol Biochem Behav. 2003 Jul;75(4):823-30.
We report the investigations on the adaptogenic property of a standardized extract
of Bacopa monniera against acute and chronic stress (CS) models in rats. Panax
root powder (Panax quinquefolium) was taken as a standard. Male rats exposed to
immobilization stress for 150 min once only for acute and for seven consecutive
days in CS, were fed with Bacopa monniera or Panax root powder daily for 3 days in
acute and for 7 days in CS, 45 min prior to each exposure of stress. Rats were
sacrificed immediately after stress, the blood was collected, and the plasma was
separated out for biochemical estimation. Adrenals, spleen, and thymus were
dissected for organ weight and stomach for ulcer score. Acute exposure
significantly increased the ulcer index, adrenal gland weight, plasma glucose, liver
enzymes, but significantly decreased the spleen weight. Pretreatment with Bacopa
monniera po significantly reduced the acute state-induced increase in the ulcer
index, adrenal gland weight, plasma glucose, AST, and CK. A Bacopa monniera
dose of 80 mg/kg po significantly reversed the acute state-induced changes in
adrenal gland weight, spleen weight, plasma glucose, ALT, and AST. Pretreatment
with low dose of Bacopa monniera extract at 40 mg/kg significantly reversed
changes in ulcer index and plasma AST only, whereas the pretreatment with higher
dose significantly reversed CS-induced changes in ulcer index, adrenal gland
weight, CK, and AST. Panax root powder significantly reversed CS-induced increase
in ulcer index, adrenal gland weight, CK, and AST. On the basis of our result, it is
concluded that the standardized extract of Bacopa monniera possesses a potent
adaptogenic activity.

Effect of Bacopa monniera and Azadirachta indica on gastric ulceration and healing
in experimental NIDDM rats.
Indian J Exp Biol. 2004 Apr;42(4):389-97.
Gastric ulcers were induced in normal /NIDDM rats by various physical and chemical
agents and duodenal ulcer were induced by cysteamine. Ulcer healing activity was
studied in gastric ulcers induced by acetic acid and HCI. The result indicated that in
both, normal and NIDDM rats, Bacopa monniera extract did not show any significant
effect on blood glucose level, while Azadirachta indica significantly decreased it.
However, both Bacopa monniera extract and Azadirachta showed significant anti-
ulcer and ulcer-healing activities in normal and NIDDM rats. Further, the present
results also indicated that the ulcer protective effects of Bacopa monniera extract
was more pronounced in non-diabetic, while that of Azadirachta was more in NIDDM
rats. The anti-ulcer and ulcer-healing activities of Bacopa monniera extract and
Azadirachta may be due to their effects on various mucosal offensive and defensive
factors, and correction of blood sugar level by Azadirachta may help to have more
ulcer protective effect in NIDDM rats.

Antidepressant activity of standardized extract of Bacopa monniera in experimental

models of depression in rats.
Phytomedicine. 2002 Apr;9(3):207-11.
Bacopa monniera is a commonly used Ayurvedic drug for mental disorders. The
standardized bacopa extract was reported earlier to have significant anti-oxidant
effect, anxiolytic activity and improve memory retention in Alzheimer's disease.
Presently, the standardized methanolic extract of Bacopa monniera (bacoside A)
was investigated for potential antidepressant activity in rodent models of
depression. The effect was compared with the standard antidepressant drug
imipramine. The bacopa monnieri extract when given in the dose of 20 and 40
mg/kg, orally once daily for 5 days was found to have significant antidepressant
activity in forced swim and learned helplessness models of depression and was
comparable to that of imipramine.

Bacopa Laboratory Studies

Quantitative determination of the major saponin mixture bacoside A in Bacopa
monnieri by HPLC.
Phytochem Anal. 2005 Jan-Feb;16(1):24-9.
Bacoside A, the putative bioactive component of the Indian medicinal plant Bacopa
monnieri, was found to be a mixture of saponins with bacoside A3 (1), bacopaside II
(2), jujubogenin isomer of bacopasaponin C (3) and bacopasaponin C (4) as major
constituents. An HPLC method together with an optimised extraction procedure was
developed for the estimation of 1-4 in B. monnieri to enable standardisation of the
latter. Two common flavonoids, luteolin and apigenin, were present in all samples of
Bacopa monnieri.
Phytotoxic and antimicrobial constituents of Bacopa monnieri and Holmskioldia
sanguinea.
Phytother Res. 2004 Feb;18(2):114-7.
The phytochemicals betulinic acid (1), wogonin (2) and oroxindin (3) isolated from
the aerial parts of Bacopa monnieri and Holmskioldia sanguinea showed significant
antifungal activity against the two fungi Alternaria alternata and Fusarium
fusiformis.

Free radical scavenging capacity and protective effect of Bacopa monniera on DNA
damage.
Phytother Res. 2003 Sep;17(8):870-5.
Bacopa monniera is an Ayurvedic medicine, clinically used for memory enhancing,
epilepsy, insomnia and as a mild sedative. In this work, the free radical scavenging
capacity of a methanol extract of Bacopa monniera and the effect on DNA cleavage
induced by H2O2 UV-photolysis was investigated. In addition, we examined whether
Bacopa monniera extract is capable of reducing the hydrogen peroxide-induced
cytotoxicity and DNA damage in human non-immortalized fibroblasts. Bacopa
monniera showed a dose-dependent free radical scavenging capacity and a
protective effect on DNA cleavage. The antioxidant capacity of Bacopa monniera
may explain, at least in part, the reported antistress, immunomodulatory, cognition-
facilitating, antiinflammatory and antiaging effects produced by it in experimental
animals and in clinical situations and may justify further investigation of its other
beneficial properties. Moreover, this experimental evidence suggests that because
of its antioxidant activity, Bacopa monniera may be useful in the treatment of human
pathologies in which free radical production plays a key role.
In vitro evaluation of Bacopa monniera on anti-Helicobacter pylori activity and
accumulation of prostaglandins.
Phytomedicine. 2003;10(6-7):523-7.
Bacopa monniera is an Indian tratidional medicine widely used to improve
intellectual functions. Earlier, we had reported the prophylactic and curative effects
of standardized extract of Bacopa monniera in various gastric ulcer models. The
effect was due to augmentation of the defensive mucosal factors like increase in
mucin secretion, life span of mucosal cells and gastric antioxidant effect rather than
on the offensive acid-pepsin secretion. The present study includes evaluation of
standardized Bacopa monniera on other contributing factors towards ulcerogenesis.
Bacopa monniera showed anti-Helicobacter pylori activity in vitro and increased in
vitro of prostanoids (PGE and PGI2) in human colonic mucosal incubates. It may be
concluded that these factors may contribute to antiulcerogenic activity of Bacopa
monniera.

Broncho-vasodilatory activity of fractions and pure constituents isolated from

Bacopa monniera.
J Ethnopharmacol. 2003 May;86(1):27-35.
The present study demonstrates that various fractions and sub-fractions isolated
from Bacopa monniera produced significant inhibition of carbachol-induced
bronchoconstriction, hypotension and bradycardia in anaesthetized rats. Overall
bioassay-directed fractionation of Bacopa monniera improved the bronchodilatory
activity in various fractions and compound 1 (2-219x) in anaesthetized rats. In vitro,
the KCl-induced contraction was equally inhibited by crude Bacopa monniera
extract, petroleum ether and methanol fractions on trachea suggesting
bronchodilatory activity remained the same in fractions. On pulmonary artery
petroleum ether, dichloromethane and methanol fractions produced 2-2.6 times
more vasodilatation compared to crude extract of Bacopa monniera. Thus, it may be
concluded that various fractions derived from Bacopa monniera possess broncho-
vasodilatory activity, which is attributed mainly to inhibition of calcium ions.

Bacopasides III-V: three new triterpenoid glycosides from Bacopa monniera.

Chem Pharm Bull (Tokyo). 2003 Feb;51(2):215-7.
Three new saponins, designated as bacopasides III, IV and V have been isolated
from Bacopa monniera

Antistress effects of bacosides of Bacopa monnieri

Phytother Res. 2002 Nov;16(7):639-45.
The antistress effect of bacosides of Brahmi (Bacopa monnieri) was -studied in
adult male Sprague Dawley rats by administering oral doses of 20 and 40 mg/kg for
7 consecutive days. In half of the animals treated with 20 or 40 mg/kg of bacopa,
stress was given 2 h after the last dose. Stress was also administered to the animals
treated with distilled water alone. Bacopa, at both doses, did not induce a significant
change in the expression of Hsp70 in any brain region studied while stress alone
produced a significant increase in the Hsp70 expression in all the brain regions. A
significant decrease in the activity of superoxide dismutase (SOD) was evident in
the hippocampus with the lower dose of Bacopa and in animals given stress alone,
while an increase in the activity of SOD was observed in the brain regions with the
higher dose of Bacopa. An increase in the activity of cytochrome P450 (P450)
dependent 7-pentoxyresorufin-o-dealkylase (PROD) and 7-ethoxyresorufin-o-
deethylase (EROD) was observed in all the brain regions after exposure to stress
alone and with both doses of Bacopa although the magnitude of induction of P450
expression was less with a higher dose of Bacopa. Interestingly, stress when given
to the animals pretreated with Bacopa for 7 days resulted in a decrease in Hsp70
expression in all the brain regions with a significant decrease occurring only in the
hippocampus. Likewise the activity of SOD was found to be further reduced in all
the brain regions in the animals treated with the lower dose of Bacopa followed by
stress. However, when stress was given to the animals pretreated with the higher
dose of Bacopa, a significant increase in the enzyme activity was observed in the
cerebral cortex and in the rest of the brain while the activity of SOD was reduced to
a much greater extent in the cerebellum and in the hippocampus. Likewise, the
activity of P450 enzymes was found to be restored to almost control levels in the
animals given stress and pretreated with the higher dose of Bacopa, while a lesser
degree of induction, compared with animals treated with Bacopa or stress alone,
was observed in the animals pretreated with the lower dose of Bacopa and given
stress. The data indicate that Bacopa has potential to modulate the activities of
Hsp70, P450 and SOD thereby possibly allowing the brain to be prepared to act
under adverse conditions such as stress.
http://www.raysahelian.com/bacopa.html

Bacopa monnieri

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Coastal Waterhyssop
 Scientific classification
Kingdo Plantae
m:
Division: Magnoliophyta
Class: Magnoliopsida
Order: Lamiales
Family: Scrophulariace
ae
Genus: Bacopa
Species: B. monnieri
Binomial name
Bacopa monnieri
L. Pennell[1]
Synonyms
Bacopa monniera
Bramia monnieri (L.) Pennell
Gratiola monnieria L.
Herpestes monnieria (L.) Kunth
Herpestis fauriei H.Lev.
Herpestis monniera
Herpestris monnieria
Lysimachia monnieri L.
Moniera euneifolia
Bacopa monnieri is a perennial, creeping herb whose habitat includes wetlands and muddy shores.
Common names include Coastal Waterhyssop and brahmi. But brahmi is also the Ayurvedic
name given to Centella asiatica and other herbs, and while B. monnieri is often simply called
"water hyssop" or "waterhyssop", this actually can refer to any species of Bacopa. This plant is
also sometimes called thyme-leafed gratiola.
Contents
[hide]
• 1 Description

• 2 Ecology

• 3 Uses

o 3.1
Medicine
 o 3.2 Kitchen

• 4 See also

• 5 References

• 6 External links

[edit] Description
The leaves of this plant are succulent and relatively thick. Leaves are oblanceolate and are arranged
oppositely on the stem. The flowers are small and white, with four or five petals. Its ability to grow
in water makes it a popular aquarium plant. It can even grow in slightly brackish conditions.
Propagation is often achieved through cuttings.
[edit] Ecology
It commonly grows in marshy areas throughout India, Nepal, Sri Lanka, China, Taiwan, and
Vietnam, and is also found in Florida and other southern states of the USA where it can be grown in
damp conditions by the pond or bog garden.
[edit] Uses

[edit] Medicine
This plant has a number of uses in Ayurveda. It is a traditional treatment for epilepsy and asthma.[2]
Laboratory studies on rats indicate that extracts of the plant improve memory capacity and motor
learning ability.[2] Studies in humans show that an extract of the plant has antianxiety effects.[2] It is
listed as a nootropic, a drug that enhances cognitive ability. In India, this plant has also been used
traditionally to consecrate newborn babies in the belief that it will open the gateway of intelligence.
Recent studies suggest bacopa may improve intellectual activity.[3][4] It has antioxidant properties,
reducing oxidation of fats in the bloodstream.[2]

[edit] Kitchen
It is used in Vietnamese cuisine, where it is called rau đắng. It is used in cháo cá, a variety of rice
congee made with fish and nấm tràm mushrooms.
http://en.wikipedia.org/wiki/Bacopa_monnieri