Indications

Benefits likely associated with improved circulation, and reduced oxidative stress and antiplatelet activity.

Cardiovascular
• conditions with impaired circulation:
- cerebrovascular insufficiency
- peripheral arterial occlusive diseases
- intermittent claudication
- Raynaud's disease
- venous insufficiency
• thrombosis (prevention)
• hemorrhoids
• lymphedema

CNS
• poor cognition, related to poor circulation
• neurodegenerative disorders
• senility
• dementia
• Alzheimer's disease - research suggests it may not be effective
• multiple sclerosis
• vertigo
• tinnitus (secondary to vascular complications)
• anxiety (elderly)
• depression
• multiple sclerosis (MS)
• autism

Respiratory
• asthma

Immune
• vitiligo

Opthalmic
• macular degeneration
• glaucoma

Reproduction
• erectile dysfunction - due to vascular causes

Actions

• Nootropic
• Neuroprotective
• Antiinflammatory
• Antithrombotic
• Antiasthmatic
• Vasodilator
• Antidepressant

Constituents

• Diterpene Lactones (E.g. Ginkgolides)
• Sesquiterpenes Lactones (E.g. Bilobalides)
• Flavonoids

Posology

• Tincture (1:4): 1-3 ml tid
• Standardized extract (24% flavoglycoside; 8% Terpenes): 60-120 mg bid

Safety

Side effects (rare): increased bleeding, gastrointestinal complaints, headaches.

Caution: Bleeding disorders (PAF inactivation by ginkgolides significantly thins the blood). Sensitivity to Toxicodendron spp. (e.g. poison oak, poison ivy, poison sumac) and/or develop rashes to mangoes may develop urushiol-induced contact dermatitis.

Interactions

• Anticoagulants (e.g. coumadin) • known to interaction
• Drug metabolism • known to inhibit specific P450 that metabolize drugs.
• Antidepressants • caution may interact with MAO-Is and SSRIs.

References

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Barnes J, Anderson LA, Phillipson JD. Herbal Medicines, 3rd ed. London: Pharmaceutical Press, 2007.

Bone K. Principles and Practice of Phytotherapy. Edinburgh: Churchill Livingstone, 2000.

Bone K. A Clinical Guide to Blending Liquid Herbs: Herbal Formulations for the Individual Patient. St Louis, MO: Churchill Livingstone, 2003.

Brinker F. The Toxicology of Botanical Medicines, 3rd ed. Sandy, Oregon: Eclectic Medical Publications, 2000.

Felter HW, Lloyd JU. King's American Dispensatory. 1898. http://www.ibiblio.org/herbmed/eclectic/kings/main.html. Accessed: August 19, 2006.

Hoffman D. Medical Herbalism. Rochester, Vermont: Healing Arts Press, 2003.

Weiss RF. Herbal Medicine. Beaconsfield, England: Beaconsfield Publishers Ltd, 1988.

Williamson EM, ed. Major Herbs of Ayurveda. Edinburgh: Churchill Livingstone, 2002