November 28, 2012
Much confusion exists regarding the efficacy, or lack thereof, of ginkgo for the enhancement of memory. Recently a double-blind, placebo-controlled, randomized clinical trial assessed the utility of a standardized ginkgo biloba extract (GBE) in the treatment of Alzheimer’s dementia and vascular dementia. A daily dosage of 240 mg GBE standardized to 24 percent flavonoids and 6 percent lactones was compared to placebo in 410 people over 50 years old with physician-diagnosed mild to moderate dementia.
Each person had a caregiver to ensure compliance with the study and was followed over the 24 week study with a variety of validated questionnaires. Both cognitive performance (43 percent versus 23 percent) and quality of life (57 percent versus 39 percent) significantly improved in the GBE group compared to the placebo. Both the treatment group and the placebo group reported an approximately 40 percent chance of variable side-effects with the placebo group reporting a higher rate of severe side-effects. Results are both statistically, as well as clinically, very significant.
My commentary on this trial is meant to give you my anecdotal experience and approach to the use of GBE. First of all, yes, this is a proven herbal supplement with documented benefits in the treatment of mild dementia, memory loss affecting quality of life. This herb is safer, less expensive, and more proven than the drugs used for this condition and should be considered the standard of care in the first line treatment of dementia. My experience also emphasizes the importance of the Basic Nutritional Protocol (BNP –www.middlepathmedicine.com) in dramatically enhancing the effectiveness of GBE, and the importance of a caregiver in ensuring the compliance to any supplement routine as well as for validation of treatment effects.
Even more importantly for the people out there who are not demented but notice mild cognitive impairment (MCI), I have found that GBE works best in combination with other supportive herbs. My treatment of choice for both MCI as well as early dementias of varied etiologies is a supplement called Membrin, made by OrthoMolecular. This supplement combines 120 mg of standardized GBE, 30 mg of Vinpocetine, and 100 mcg of Huperzine alkaloids, taken as one capsule daily first thing in the AM on an empty stomach. It is beyond the scope of today’s article to discuss the other components other than to tell you I have found these herbs in combination definitely outperform GBE on its own. I further recommend a schedule of five days on and two days off as the body can habituate to the Huperzine component if holidays aren’t given.
So if you have any inclination that your memory could use some enhancement, I do encourage a trial of Membrin for a minimum of 3 months. Have a loved one work with you on remembering to take your supplements, both those Basic Nutritional Protocol and Membrin, and giving you feedback as often the caregivers notice more than the patient when it comes to this problem. Most importantly, know that there is proven, reliable help for those that suffer from memory impairment.
Gary E. Foresman, MD is Board Certified and Fellowship Trained in Internal Medicine, Functional, Anti-Aging and Regenerative Medicine, and a Fellow in Integrative Cancer Therapies. He is President of Middle Path Medicine in Arroyo Grande.
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