Materia Medica

Ginkgo biloba ‘“A Clinical Study in Geriatrics

Last modified on September 8th, 2012

Hafeezullah Baig
Written by Hafeezullah Baig

Ginkgo biloba is recognised throughout the world as a beneficial medicine for the problems associated with aging. It has a record of curing many geriatric problems since early in human history and is a clinical remedy in Homoeopathy. An attempt is made to verify the clinical symptoms and add a few more. An extensive proving is needed to bring out many more beneficial utilities of the drug. The present study proved that 1X is more effective than mother tincture. The recommended dose is 1 tab (250 mg) twice daily and tapered slowly and stopped after considerable improvement.

MATERIAL AND METHODS

STUDY DESIGN: An observational clinical study was conducted at the Drug Standardisation Unit, Hyderabad, under the Central Council of Research in Homoeopathy to ascertain the clinical utility of Ginkgo biloba (GB) in geriatric problems.

  • After considering the inclusion criteria, the cases are selected for study.
  • A complete case taking is made highlighting geriatric problems in anatomical manner.
  • Complete blood picture; complete urine examination; fasting blood sugar; post lunch blood sugar; total cholesterol; blood urea; serum creatinine tests were conducted at entry and as when required till the study was over.
  • Allopathic medication for diabetes and hypertension were allowed to continue.
  • No other homoeopathic medicine was given in all the enrolled cases for a period of one year of the study.
  • Improvement assessment was initiated after 1 month of the use of GB(Q ,1X).
  • Not improved cases were dropped from the study.
  • Improved cases were continued with GB (Q or 1X) and or followed up till next 11 months or earlier depending upon the improvement of the geriatric problems.
  • Final assessment was made by compiling the data.

PARTICIPANTS: 30 geriatric subjects were selected from the OPD, in age group 60-74 years belonging to both sexes (M-19, F-21)

INCLUSION CRITERIA:

  • Age above 60 years and below 75 years
  • Suffering from common geriatric problems in less intensity
  • Well controlled individuals with diabetes mellitus or hypertension under allopathic medication

EXCLUSION CRITERIA:

  • Age below 60 years and above 75 years
  • Individuals with uncontrolled diabetes mellitus or hypertension under allopathic medication.
  • Those suffering from any serious systemic illnesses.
  • Those suffering from psychiatric problems and taking allopathic medication.
  • Individuals using anti coagulants or anti depressants.

SELECTION OF MEDICINE: All selected cases are randomly given GB Q or 1X (10 cases Q and 20 cases 1X)

POTENCY, DOSAGE AND REPETITION: GB Q was given in 10 drops doses twice daily in half cup of drinking water. GB 1X was given in 1 tab (250mg) twice daily. The same dosage was continued if improvement was mild. If improvement was marked the dosage was gradually tapered and stopped.

OUT COME ASSESSMENTS: the improvement is assessed after 1 month of use of GB (Q or 1X) in the following way:

  • If a patient did not improve in any of the geriatric problems he was suffering with, that case is considered as not improved and was dropped from the study.
  • If patient improves in one or more geriatric problems, then such case is considered as improved and further follow up is made.
  • The same dosage of medicine was continued till the patient markedly improved.
  • Once marked improvement is observed in the geriatric problems, then the dosage is slowly tapered and then stopped.
  • After 1 year of follow up the improvement status is tabulated in an anatomical manner starting from mind and ending with modalities i.e. from above downwards

RESULT: Out of 30 cases selected for study, 10 were given Q and 20 1X. The outcome result showed that 2 cases have improved by Q out of 10 cases and 17 cases with 1X out of 20, in various geriatric problems (see table -II).

2 cases had Hb less than 10g % and on treatment have improved by 1X; Out of 4 diabetic patients 2 have improved in their sugar level with 1X; 5 cases have increased pus cell in urine with urinary problems. 3 have improved with 1X and 1 case with Q; 4 cases had albumin in urine before treatment and 2 have improved with2X; Systolic and diastolic pressure was considerably decreased by 1X in 2 cases; 2 cases each with diabetic and hypertensive retinopathy showed improvement clinically (see table -III).

The minimum duration of treatment followed in Q and 1X was 1 month where as maximum duration of treatment followed in Q was 3 months and 1X was up to 1 year.

DISCUSSION: Ginko Biloba remains as a clinical remedy in homoeopathy. A small proving was carried out in 1993 by E.A. Maury and his team with the mother tincture and 6c potency, bringing out few fractional proving data. A large stock of clinical symptoms from various sources revealed a broad utility for the drug1-7. Extensive clinical trials have been conducted in which people took standardized GBE at doses of 120mg -240mg daily for up to 1 year without any side effects8-10. The present study verified the same with GB1X used in doses of 250mg -500mg for 1 year.

As cautioned in the study by De.Smet PA11, our study has excluded the cases who are under treatment with anti coagulants. Hahnemann suggested trituration as the superior method for preparing homoeopathic medicine in aphorism 271 of 6th edition of organon of medicine and the same was demonstrated in our study.

CONCLUSION : It is demonstrated from the clinical study that people suffering with disorders like loss of mental alertness, difficulty in concentration, heaviness of head, disturbed vision and hearing, paresthesia of the palms and soles, fissures and cracks in skin, angular stomatitis, cramps in calf muscles, impotency etc. are found to be immensely benefited with GB1X, by virtue of the drug increasing blood flow to brain and other parts of the body thereby delivering the required nutrients and oxygen to every cell. Further, it may also be considered in organ transplanted individuals to bring functional harmony

Table – I

Symbolic resemblance

S.NoGingko biloba treeGingko biloba patient
1In the East it is considered a symbol of longevity, hope, resilience and peace. Has a tendency to live long and hence a great hope for relatives and friends; they leap back with normal activities by taking this drug. By and large they are peace loving persons.
2The tree is grown by Chinese monks in temple gardensBasically these patients are from orthodox families and highly principled. They spend much time in religious gatherings.
3Shimenawas or cords of rice straw are tied around trunk of the tree to fend of evil spiritsPatients due to their orthodox nature tie thread on arms and neck to the needed person for keeping away from evil spirits
4Leaves which are fan-shaped have been prized for their beauty , hence copied by artist and heralded in literature Patients are beautiful with joyful look, hence considered geriatric model.
5In China it is a tradition that grandfathers plant the trees for their grandsons Generally these patients are under the care of grand children due to the longevity of their life.
6It is a national tree of China and its leaf is used in the logos of the city of Tokyo and Osaka University.As an oldest member of the family he blesses on all occasions his grand children, thereby becoming an important person. All invitations and other write-ups are on his name.
7The female Gingko produces oval orange fruit which produce rancid butter smell and hence male plants are planted in the urban area rather than the female plantBasically due to the non adjusting nature with grand children and bad smell due to incontinence of urine she is not accepted by the grand children.
8Fossil record of these trees indicate that it grows primarily in disturbed environment along stream and leveesThese patient have history of living in disturbed environment such as after losing life partner , children, friends, relatives, and also property, and wealth.
9Gingko’s tenacity may be seen in Hiroshima, Japan when due to an atom bomb explosion all plants were destroyed , but Gingko though charred, survived and very soon became healthy again Due to the process of aging there is decrease in blood supply and O2 tension and it leads to onset of impaired function of brain, kidney, lungs etc. Added to this is suppressed emotion, stressful life due to loss of mate, children, friends relatives etc; non adjustment problem , unfulfilment of desired things and also due to loss in business, wealth etc, patient becomes depressed and soon becomes normal and gains health by simple counselling and medication.
10It can withstand harsh condition and rarely suffers from disease Though leading life in stressful way and with dissatisfactory living under the care of grand children they suffer with no major illness.
11In China children are not allowed to eat cooked seeds due to their toxic nature.It is rarely employed for the children in their any problems
12Late reproductive maturity: it takes the plant 40-50 years to matureGinkgo helps in the individual having late marriage at 40 plus with erectile dysfunction, impotency, Oligospermia and no desire for sex
13The bark is fireproof and regenerates quickly though charredGinkgo helps to increase circulation, prevent capillary fragility, helps collagen formation and create fibroblasts for making skin healthy. and young.

Table -II

Improvement assessment of Ginkgo biloba.

S.NoSigns and SymptomsTotal No. of Cases PrescribedTotal No. of Cases Improved
Q1XQ1X
Mind
Short term memory loss2403
loss of mental alertness1504
Difficulty in concentration2806
forget fullness of name, time, date, day, appointments and events1202
Fearful dreams, dreams of robbers0202
Dreams of wars, death, falling from a height0101
Postponement attitude1403
Ailments from suppressed anger/ emotion1403
Religious 24
Morose, dull and sadness1414
over sensitiveness 0101
Cross1504
fearful mood1504
confusion making mistakes in speaking, writing and reading1504
weeping tendency0302
tearful mood0302
Loquacity0202
raises late from bed, dislike to brush teeth and attend to daily activities including taking bath1202
imagine every thing is unreal1100
delusion being old1100
criticizes others and himself1101
Avoids people and also conversion1202
Head
Heaviness in frontal region1101
pain in nose, supra orbital region and temples right

headache with vertigo

0202
Headache with tears < cold, open air0101
Headache> rest1101
Eye
Lachrymation ? during headache0101
pressing pain in eyeballs esp. looking upwards and to the rt. Side with dim vision0202
Useful in diabetic retinopathy0202
Useful in hypertensive retinopathy0202
neuralgia over the rt. eye0202
Nose
Nose blockage during cold1202
running nose < early morning1202
EAR
Reduced hearing 1202
blocking of both ears0302
Tinnitus1312
MOUTH
Aphthous ulcers with burning0101
excessive salivation or dryness of mouth, coated tongue esp. towards base, angular stomatitis0101
FACE
neuralgic pain in Rt.of the face, cracks and fissures in lips0101
herpetic eruptions around mouth0101
THROAT
Burning sore throat0101
dryness of throat1101
difficulty in swallowing0101
swelling of the parotids0100
STOMACH
Anorexia with slight discomfort in epigastrium with nausea and eructation1212
ABDOMEN
Fullness of abdomen1202
discomfort in hypogastrium0101
cramping, griping pain in hypochondria0202
CHEST
Constrictive pain in pericardium radiating to left arm with numbness0202
RESPIRATION
Cough with dyspnoea and difficult expectoration of the mucus0202
BACK & EXTREMITIES
Stiffness of neck and back with crackling sounds on movement1303
bruised pain in lumbar region as if beaten1212
trembling of both hands and legs 0101
icy coldness of both feet1312
cramps in calf muscles3826
numbness of part laid on1212
Paresthesia of palms and soles2816
URO-GENITAL ORGANS
Oliguria1202
Diuretic1212
pain in urethra before and during urination1312
Incontinence of urine2413
impotency0202
prostatic enlargement2302
discharge of prostatic fluid0101
SKIN
Dryness of skin with cracks & fissures1504
herpetic eruptions with itching0101
SLEEP
Sleep disturbance between 2-3 AM1303
gets up late in the morning with un-refreshed sleep1303
Dreams of animals, insects, dead bodies , floods, robbers etc0202
GENERALITIES
Easily fatigue mentally and physically3616
desires company13
likes stimulants like tea, coffee1303
RELATIONSHIP
Gingko biloba leaves contains allergen urushiols which is similar to poison Ivy hence used as antidote0202
MODALITIESTotal No. of Cases
Morning <13
2-3 AM <13
Walking <13
cold open air <12
Drinking <02
looking up and to the right <02
pressure >12
rest >13
Warmth >03
Tea, coffee >13
MIASM
tubercular miasm1020
DOSEAGE Total No. of Cases PrescribedTotal No. of Cases Improved
Q1XQ1X
recommended dose (10 drops b.id)1 tab (250mg) b.id
1020
Duration of treatment 217
Minimum 1 month 1 month
Maximum 3 month1 year

Table -III response to treatment: laboratory and clinical parameters

S. NoLaboratory parametersAt entryAt completionImproved cases by GB
Q1X
1Hb g%Min : 9

Mix : 13

Min : 11

Mix : 13.5

2
2FBS in mg/dlMin : 123

Mix : 172

Min : 110

Mix :140

2
3PPBS in mg/dlMin : 170

Mix : 230

Min : 160

Mix : 210

2
4Pus cell in Urine Min : 2-3/HPF

Mix : plenty /HPF

Min : 1-2/HPF

Mix : 6-8/HPF

13
5Albumin in UrineMin : Trace

Mix : ++

Min : nil

Mix : +

2
6B.Psystolic Min : 140

Mix : 160

Min : 130

Mix : 150

2
DiastolicMin : 90

Mix : 100

Min : 88

Mix : 94

2

Note: not mentioned parameters maybe consider normal before and after treatment

About the Ginko

The Ginkgo tree is the only living representative of the division- Ginkgophyta, comprising the single class Ginkgoopsida, order Ginkgoales, family Ginkgoaceae, genus Ginkgo and species biloba is the only extant species within this group. It is one of the best-known examples of a living fossil, because no species other than G. Biloba of Ginkgoales are known from the fossil record after the Pliocene. The tree normally reaches a height of 20-35 m. It is the national tree of China. It belongs to the era when dinosaurs existed 213 million years ago. The extinction of the dinosaurs as potential seed dispersers influenced their decline, according to fossil records. About 7 million years ago the Ginkgo disappeared from the fossil record of North America. It was gone from Europe from about 2.5 million years ago. The tree was widely cultivated and introduced, since an early in human history. It has various uses as a food and traditional medicine. It was once widespread throughout the world, but currently occurs in the wild only in the northwest of Zhejiang province in the Tianmu Shan mountain reserve in eastern China. Even its status as a naturally occurring species there is questionable.

The Ginko withstands harsh conditions and rarely suffers from disease. It’s tenacity may be seen in Hiroshima, Japan, where six trees from the 1945 atom bomb explosion were among the few living things in the area to survive the disaster. Though charred very badly, it grew healthy and was still alive. Its wood is insect resistant which makes it a long lived specimen. Male plants produce small pollen cones with sporophylls each bearing two microsporangia spirally arranged around a central axis. Female plants do not produce cones. Two ovules are formed at the end of a stalk, and after pollination, one or both develop into seeds. The seed is 1.5-2 cm long. Its fleshy outer layer is light yellow-brown, soft, and fruit-like. The seed has the size and appearance of a small apricot when mature and a silvery bloom on the fruit, hence called Ginkgo meaning “Silver apricot”. It is also popularly known as “Maidenhair tree” due to the leaves, which resemble some of the pinnae of the Maidenhair fern, which are fan shaped with a split in the middle, hence named biloba. The nut-like gametophytes inside the seeds are considered as traditional Chinese food, particularly served at special occasions like weddings and the Chinese New Year. Some people are sensitive to the chemicals in the sarcotesta, the outer fleshy coating. Hence the seeds are handled with care by wearing disposable glows while preparing for consumption.

Extracts of Ginkgo leaves contain flavonoid glycosides and terpenoids (ginkgolides, bilobalides) and have been used pharmaceutically. Ginkgo supplements are usually taken in the range of 40-200 mg per day. Although Chinese herbal medicine has used both the ginkgo leaf and seed for thousands of years, modern research has focused on the standardized Ginkgo biloba extract (GBE), which is prepared from the green leaves, as done also in Homoeopathy. This standardized extract is highly concentrated and seems to be clinically more effective.


Ginkgo extract may have three effects on the human body: improvement in blood flow (including microcirculation in small capillaries) to most tissues and organs; protection against oxidative cell damage from free radicals; and blockage of many of the effects of platelet-activating factor (platelet aggregation, blood clotting) that are related to the development of a number of cardiovascular, renal, respiratory and central nervous system disorders.

Ginkgo is found to have nootropic properties and is mainly used as memory and concentration enhancer. Studies have revealed prolye endopeptidase (PEP) activities are significantly higher in Alzheimer’s patients. Ginkgo exhibited inhibition of PEP suggestive of its role in learning and memory processes, major depression and senile dementia. Ginkgo is also used for intermittent claudication. The World Health Organization reports its clinical use in cerebrovascular insufficiency, peripheral arterial occlusive diseases.

Ginkgo eases the symptoms of tinnitus, benefits in multiple sclerosis and arrests the development of vitiligo. Ginkgo may have undesirable effects, especially for individuals using anticoagulants, antidepressants and during pregnancy, hence should be avoided. When any side effects like gastrointestinal discomfort, nausea, vomiting, diarrhoea, headaches, dizziness, heart palpitations, and restlessness occurs then medicine should be stopped immediately.

Clinical utility of Gingko biloba as a geriatric remedy

It is a remedy to increase blood flow to the brain and other parts of the body, thereby improving the delivery of necessary nutrients and oxygen to every cell. It increases metabolic efficiency, regulates neurotransmitters, and controls the transformation of cholesterol to plaque, associated with the hardening of arteries and relaxing constricted blood vessels.

REFERENCES:

  1. Universal Repertory By Dr.Roger Van Zandvoort
  2. Encylopaedia of Homoeopathic Pharmacopoeia By Dr.Verma and Dr.Vaid
  3. Dictionary of Homoeopathic Materia Medica By O.A.Julian.
  4. Oriental herbal Medicine,Vol -I, San Francisco, by Dr.Yu Min Chan.
  5. Chinese Herbal Medicine Materia Medica, by Lilian Lai Bensky.
  6. Plant Medica Vol.70, by Jung-Han Lee et.al;
  7. Encyclopedia of Medicinal plants by Andrew Chevallier & Dorlin Kindersley
  8. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group. By Le Bars PL,et.al JAMA. 1997 Oct 22-29;278(16):1327-32.
  9. Ginkgo for memory enhancement: a randomized controlled trial. By Solomon PR, et.al. JAMA. 2002 Aug 21;288(7):835-40.
  10. Effectiveness of Ginkgo biloba in treating tinnitus: double blind, placebo controlled trial. By Drew S, Davies E. BMJ. 2001 Jan 13;322(7278):73.
  11. Herbal remedies. By De Smet PA.N Engl J Medorrhinum 2002 Dec 19;347(25):2046-56.

About the author

Hafeezullah Baig

Hafeezullah Baig

Dr. Hafeezullah Baig M.D. has worked in the Central Council for Research in Homoeopathy for the past 24 years. He completed assigned projects viz. Osteo arthritis, Filariasis, Amoebiasis, Hypertension, Epilepsy, Diabetes mellitus, Geriatric problems, Diabetic nephropathy, and Influenza-like illness. He is currently working as Asst. Director at the Drug Standardisation Unit, Hyderabad. Dr. Baig was a resource person in a number of seminars/ conferences/Continuing Medical Education programs etc.

21 Comments

  • Dr sahib Salam i have gone through your study article,its realy wonderful work done by you and your team.My mother haviing age of 70 years gets fits while asleep once or twice in a month.These fits have the symptoms resemblance with epilapsy but she never got fits while awakening.Can we use Ginkgo biloba for her.Secondly what medicine do you recommend for a patient having ,hypertention,heart arteries blocked(stented).The patient once suffered from MI second grade.

    regards
    Dr afzal

    • Dear Afzal,
      Your mother aged 70 years getting fits during sleep only, requires drugs like Opium, Silicea , Bufo, Cuprum met , Lachesis …, depending on the signs and symptoms. You can use gingko biloba 1x as add on medicine, provided if she is not in use of any anti coagulants or anti depressants in her medication. For the patient suffering from hypertention, heart arteries blocked (stented) or any cardiopathies, the same precaution is followed.

  • Ginkgo biloba is alomost not known medicine and, therefore, very seldomly used …. This is a detailed study and is very good and useful article… Perhaps, there is a need to chck its effectiveness at higher potencies like 30c and 200c.

  • thnx. Dr.Hfiz..
    G.Biloba was proven homeopathically by you? n how can we get it? it is not listed in hpthy lists. do u distribute it now arround?thnx

    • Dear bassam hns,
      Thank you very much for your comments

      Ginkgo biloba(G.B) was not proven homeopathically by me. A small proving was carried out in 1993 by E.A. Maury and his team with the mother tincture and 6c potency, bringing out few fractional proving data. An attempt is made by me to verify the clinical symptoms and add a few more signs and symptoms which had benefitted the geriatric problems with the use of G.B in my observational study. An extensive proving is needed to bring out many more beneficial utilities of the drug.
      You can get G.B from homoeo stores. I have use Willmar schwabe India pvt.ltd product in my study.

  • It is highly appreciable of having this article; i am using for high cholestrol and high blood pressure persons, who are in extensively tension profession like one in market trading and other person as General Manager of firm having 1800 employees. Both have much relaxed symptoms after G.B. Q for 3 months, daily 10drops twice a day in 10ml drinking water.
    This article publication and reproving gave a morale boom and strength to all Homeopaths. Thanks Dr. Hafeezullah Baig M.D and Hpathy. Hope many more such reprovings will come.

    • Dear Nittur Guruprasad ;
      Thank you very much for your appreciation. I suggest you to use GB 1X instead of GB Q and see the difference. I have used for more than 1 Year with out any physiological proving in few patients. GB plant contains minerals like calcium, Phosphate, Silica, Magnesium, zinc, iron etc. which are not soluble in water or ethyl alcohol hence mother tincture lacks of these ingredients.

  • Dr Hafeezullah,

    Adaab.I have found your article on GB an excellent piece of Research. I am treating my wife with Homoeopathic medicines for conditions of Parkinson disease.Since she is having Nystagmus also , I believe that she suffeing from MS as well. I had used GB mother tincture also but it did not benefit much. Now I definitely want to ue GB1X. In this connection kindly advise me as to how many drops GB1X will be approximately equal to 250mg.

    Narinder Singh
    Jaipur

  • Respected Dr.Hafeezullah
    Tremendous work and very useful experiments about potency.i appreciate u in all aspect of your research work

  • Hi Dr. Hafeezullah, congratulations for this excellent work. Were the Q and the 1X prepared for you? Thanks a lot. Best regards.
    Ramon

  • Namaste Dr.
    My husband (60 years old)had cholestrol problem and had angiography done, they found some blockage and inserted one stent, as precaution, (the blockage was more than 60%)
    He is on statin and blood thinner medicines now.
    My question to you is :
    Can I use GB 1X for him?
    Last week, he was diagnosed with Essential tremors as well. No medicine is prescribed as yet. They are waiting for blood report for vitamin deficiency, MRI etc.
    Thank you very much for your time and help.

  • Thanks to Baig sab for making such a valueble information public for the benefit of vast majority of patients with bood disorders with this single remedy.

    In my Clinical practice it is highly useful to those who have blood stasis (slow circulation) symptoms like dull, drowsy, forgetfulness,
    boold clots, subcutaneous purpura, endometriosis, lumps or clots during menstruation, Raynaud’s syndrome, hemorrhoids and varicose veins, some tumors and growths, a darkening of the complexion of skin, tongue and nails,
    It is giving benefit to Low BP patinets (like Ginseng) and issues related to Low BP in Dabetic peripheral vascular disease, in complications from stroke and skull injuries.

    Please memember that it increases blood flow to the brain, eyes, ears and extreemities.

    It is very useful to those who have more platelet counts.

    It can be compared with Carbo veg, Gelsemium, Ginseng, china, conium,
    sepia, Plb Met

    Thanks
    Naga.
    Hyderbad

  • ITS GOOD ARTICLE AND PROVING OF GINKOBA….I M USING IT IN 1X SINCE LONG IN THE CASES OF STROKE,HYPERTENSION AND ALL TYPES OF CLOT IN THE BRAIN …SO IF ANY ONE HAD SAME EXPERIENCS PLZ SHARE HERE.

  • Dear, I have use ginkgo biloba on my patients . I found very good result in high cholesterol and high blood pressure.

  • Dr. Baig
    This was indeed a very informative paper/article.
    My mother aged 71 has recently been diagnosed with “Diffused Cerebral Atrophy-Age Related” as per her CT Scan – Head results.
    She also has been painfully suffering with paresthesia of soles.
    She also takes regular medicines for controlling high BP & Diabetes.
    I am very keen on giving her GB 1X after reading the above article/ paper. For your consultations.
    Warm Regards
    Uday Narain
    Lucknow

  • Dear Dr. Sahib. Kindly let me know if the GB can be given to a cancer patient of second stage with other homeopathic medicines as its properties include production of new cells and improvement of circulation. (cancerous cells have spread in the entire tummy)

    With thanks and regards,

    Naima

  • Dear Dr Hafeez Sb,
    kindly advise that can we gave GB 1X to thalassemia patient to improve red cells & decrease iron or level the iron in his body.
    kindly advised in detail & oblige.

    Regards,
    Nasir Iqbal

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