Ginkgo Biloba Explained Simply

1. What It Is About

The tree is one of the oldest living tree species and is traditionally used in Chinese medicine. For research, a standardised extract is produced from the leaves, that is, a preparation with a consistent composition. The most frequently studied is the special extract EGb 761. It contains, among other things, flavonoids and terpene lactones — plant substances that are considered the active constituents. The extract is usually taken as a tablet, capsule or drops. Important for understanding the studies: Ginkgo extracts are not uniformly composed. Other preparations contain different amounts of the same or additional substances. Results obtained with EGb 761 therefore cannot be readily transferred to every Ginkgo product. Some of the constituents are only limitedly absorbed by the body. In basic studies, individual components are often investigated, not the whole extract.

2. What Studies Show

Ginkgo biloba is best studied in mild to moderate dementia. In a study with 216 patients over 24 weeks, participants received either the extract EGb 761 or a placebo without active ingredient. At the end, significantly more people in the Ginkgo group had performed better in at least two of three areas: in the overall clinical picture, in attention and memory, and in daily life 1. A second study compared EGb 761 with the drug donepezil and with a placebo over 24 weeks in people aged 50 to 80 years with mild to moderate Alzheimer’s dementia. Both active substances slowed the decline in mental performance to a similar extent, and both performed better than the placebo 2. In a third study with 410 participants over 24 weeks, the Ginkgo group improved more than the comparison group — both in cognitive tests and in behavioural abnormalities such as restlessness or irritability, which frequently occur in dementia 6. Reviews that summarise several studies reach a similar picture: in mild to moderate dementia there is a moderate advantage over placebo, especially in memory and attention 3 4. Regarding tolerability: the most common reports were gastrointestinal complaints, headaches and dizziness, mostly mild and transient. The number of people who discontinued treatment did not differ from the placebo comparison group 4. In healthy older people without memory problems, by contrast, no short-term benefit was observed: in a study with cognitively healthy older adults, performance in memory and attention tests did not differ from those on placebo 5.

3. What Remains Unclear

In mild cognitive impairment — a preliminary stage in which memory declines but daily life is still manageable — the results are inconsistent. Some studies suggest improvements, especially when Ginkgo was combined with another treatment; robust long-term data are still pending 7. The studies use different extracts, dosages and test procedures, which makes comparison difficult. Most positive results come from studies with EGb 761; other preparations less frequently performed clearly better than placebo. There are case reports regarding possible bleeding. In most of these cases additional risk factors were present, such as concurrent use of anticoagulants. A definite causal link cannot be inferred from this 9. Whether the processes observed in nematodes also play a role in humans remains open; corresponding studies are still pending 8.

4. What This Means in Everyday Life

The reported benefits concern a specific group: people with mild to moderate dementia who were predominantly treated with the standardised extract EGb 761. For healthy older people and for people with only mild memory impairment the studies say considerably less. Likewise, conclusions cannot be drawn from EGb 761 to other Ginkgo preparations because their composition differs. Anyone wishing to find out about a particular product will usually find in the study details only the tested extract, not the commercial preparation. The next points to clarify are long-term studies over more than one year, direct comparisons with other dementia medications over longer periods, and studies that examine whether progression of symptoms can be halted in mild cognitive impairment.

All Details with Study Numbers and Sources: detailed page on Ginkgo biloba. For Children: Ginkgo biloba for Children.