From: "Henry Grabowski" To: "Susan Grabowski" Subject: http://www.drmcdougall.com/jan_feb98.html Date sent: Fri, 4 Sep 1998 07:07:52 -0400 McDougall Newsletter Jan/Feb 1998 HERBS IMPROVE THINKING A placebo-controlled, double-blind, randomized trial of an extract of gingko biloba for dementia by Pierre Bars in the October 22/29 1997 issue of the Journal of the American Medical Association found ginkgo biloba "...was safe and appears capable of stabilizing, and in a substantial number of cases, improving the cognitive performance and social functioning of demented patients for 6 months to 1 year." (JAMA 278:1327) The effects of gingko biloba on the patient's behavior were of sufficient magnitude to be recognized by the caregivers.  Both men and women 45 years and older with a diagnosis of dementia were give either the gingko biloba or a placebo.  These 202 people were followed for one year and evaluated with a variety of mental performance tests.  The tests given to evaluate mental function showed the group on gingko maintained its baseline status or improved slightly, while those in the placebo group showed worsening of their cognitive and social function over time.  The investigators felt the main function of this herb was to act as a free radical scavenger through its antioxidant properties. COMMENT: Dementia is common, affecting 4 million people in the United States and is a major cause of long-term disability in old-age.  It affects 2 percent of the population between ages 65 to 70 and 20 percent of people over the age of 80.  Most diseases causing dementia are due to loss of functioning brain tissue.  The symptoms depend upon which part of the brain is most affected.  Loss of cognitive functions such as language, perception and calculation would occur with loss of the cortical function (areas near the surface of the brain), whereas subcortical loss causes flattening of affect and disturbances of mood and motivation.  Memory is impaired in both types.  Alzheimer's disease and vascular disease are the cause of most cases of dementia.  Modern medicine has little more to offer than comforting words of sympathy for the patient and family. Gingko biloba is extracted from the leaves of cultivated maidenhair trees.  It is mentioned in traditional Chinese medicine and was used by the Chinese to treat asthma and bronchitis.   Much of the research on gingko biloba showing improvement in mental function in the young and elderly was initially published in the mid-1980s in Germany and France.  Gingko is licensed in Germany to treat cerebral dysfunction, with, for example, memory loss, dizziness, ringing in the ears, hearing loss, headaches, emotional instability with anxiety, and for intermittent claudication.   All trials but one showed positive effects of gingko compared to placebo for cerebral insufficiency (Lancet 340:1136, 1992).  Benefits appear 6 weeks to 3 months after initiating of therapy. Insufficient supply of blood to the legs caused by atherosclerosis results in pain with walking (intermittent claudication).  In one trial walking distance increased from 112 to 222 meters after 6 months of therapy (compared to 145 to 176 meters with placebo).  In most trials the dose is 120-160 mg per day in 3 divided doses.  Treatment must be for 4-6 weeks before any positive effects can be expected.  There are no serious side-effects.  In rare cases there has been reported mild stomach upset, headache, and allergic skin reactions. The exact mechanisms involved in improving mental function with gingko are unknown, however, gingko extracts contain multiple compounds which provide a variety of effects, such as decreasing inflammation, protection of the cell membranes, and improvement in the rate of transmission of information between nerve cells.   Since dementia is often due to decreased blood supply to the brain many investigators have believed the improvements seen are due to improved blood and oxygen supply to the brain tissues.  In addition to improvements in judged by mental function tests, abnormal EEG (electroencephalogram) tracing have improved, with the EEG returning to normal in some cases. Considering the consistent evidence that says it works and the fact that there are virtually no side effects, and the costs are reasonable, this self-administered herbal medication should be tried by anyone with problems due to low blood supply to the brain (cerebral insufficiency) and leg (intermittent claudication).     ----------------------------------------------------------------- ------- Check the accuracy of this information with your doctor before applying information in this newsletter to your health care. Don't change your diet or medication without your doctor's advice. Thank you! John McDougall, M.D. Call 1-800-570-1654 and order your copy of the January / February 1998  McDougall Newsletter. Or Better yet, subscribe, and keep these fact filled Newsletters coming every 2 months. http://www.drmcdougall.com/jan_feb98.html