Is Ginkgo Biloba Beneficial for People with MS?

Ginkgo biloba supplements are made from the leaves of the Ginkgo biloba tree, one of the oldest tree species and arguably one of the most beautiful! These supplements are purported to be beneficial for many health conditions including: premenstrual syndrome, migraine headaches, macular degeneration, glucose intolerance, hemorrhoids, vertigo and multiple sclerosis. Many people with multiple sclerosis take the supplement believing it helps them with cognitive problems associated with the disease. Some of the phytochemical components of Ginkgo biloba act as antioxidants, others act to inhibit platelet-activating factor (PAF). PAF is a compound involved in blood clotting and inflammation, and so inhibiting it could reduce inflammation.

Ginkgo biloba and MS: Does the research support the claims?

Recent research suggests that Ginkgo biloba does not improve cognitive performance or disease course in people with multiple sclerosis. One review of over 30 clinical trials found “inconsistent and unreliable” evidence that it provides benefits for people with dementia or cognitive impairment. However, one small pilot study found that it exerted modest beneficial effects on select functional measures (eg, fatigue) among some individuals with MS.

At this time, the science doesn’t seem to back that up purported benefits for MS. If you are taking it and have not noticed a significant difference in how you feel you may consider saving your money. But if you are a Ginkgo devotee and feel as if you have had an improvement in one of the functional measures then good for you! Just read about the cautions and concerns listed below. And make sure that your healthcare team knows all of the supplements that you are taking.

Some cautions and concerns to be aware of:

• Like other dietary supplements, is not regulated by the FDA. Contents may vary by manufacturer.
• It may increase the risk of bleeding. People who have a blood clotting disorder, a history of seizures, a history or stroke or are at risk for a stroke should not take this supplement. In addition, it should be discontinued at least 36 hours prior to a surgery due to the increased risk of bleeding.
• Ginkgo biloba can interfere with some medications including Warfarin and other blood thinners, monoamine oxidase inhibitors (MAOI), antipsychotic medications or prochlorperazine, insulin, trazadone, non-steroidal anti-inflammatory drugs (NSAIDS).
• It may interfere with fertilization and conception.
• When purchasing, look for products that contain Ginkgo biloba leaf extract. The plant chemicals in the leaf extract are considerably more concentrated than in dried ginkgo leaf. Avoid products that contain ginkgolic acid, which can increase the risk of allergic reactions.
• It can cause some minor side effects such as stomach upset, headache, dizziness, constipation, forceful heartbeat, flatulence, diarrhea and allergic skin reactions.
• The researchers at ConsumerLab.com found that the prices of supplements range from 5 cents (Costco Trunature Ginkgo Biloba with Vinpocetine- 1 softgel twice daily)  to 34 cents (Natures Way Ginkgold- 1-2 tablets twice daily) for 120 mg of Ginkgo biloba extract. So if you are taking it, consider price as well.
• Consult a physician, pharmacist or registered dietitian before taking dietary supplements to prevent any unwanted interactions.

References:

• About Herbs. Memorial Sloan Kettering Cancer Center’s Guide to Botanicals, Supplements, Complimentary Therapies, and More  Accessed 5/7/15
• Birks J, Grimley Evans J. Ginkgo biloba for cognitive impairment and dementia. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD003120.
• ConsumerLab.com  Ginkgo biloba product review  5/7/15
• David Mantle, Richard M. Wilkins, and Muhamed Asim Gok. Comparison of Antioxidant Activity in Commercial Ginkgo biloba Preparations. The Journal of Alternative and Complementary Medicine. October 2003, 9(5): 625-629.
• Johnson SK, Diamond BJ, Rausch S, Kaufman M, Shiflett SC, Graves L. The effect of Ginkgo biloba on functional measures in multiple sclerosis: a pilot randomized controlled trial. Explore (NY). 2006 Jan;2(1):19-24.
• Lovera JF, Kim E, Heriza E, Fitzpatrick M, Hunziker J, Turner AP, Adams J, Stover T, Sangeorzan A, Sloan A, Howieson D, Wild K, Haselkorn J, Bourdette D. Ginkgo biloba does not improve cognitive function in MS: a randomized placebo-controlled trial. Neurology 2012 Sep 18;79(12):1278-84.