Ginkgo
Useful mainly for older adults with existing mild cognitive impairment or peripheral artery walking pain, using a standardized extract.
Quick decision guide
May help most
Older adults with existing mild cognitive impairment or peripheral artery walking pain, using a standardized extract
Common dosing range
120–240 mg/day standardized extract, split
When to expect effects
Weeks (4–6 weeks to plateau)
Watch out for
Increased bleeding risk, especially with anticoagulant or antiplatelet drugs
What is it
Ginkgo (Ginkgo biloba) is a unique tree species native to China, with a fossil record dating back over 200 million years. Its fan-shaped leaves are used in herbal medicine, primarily as standardized extracts containing flavone glycosides (typically 24 percent) and terpene lactones (typically 6 percent).
Is it worth it for you?
Use this as a quick fit check, not a diagnosis.
Worth considering if…
Probably skip if…
Evidence at a glance
| Goal | Effect | Best fit | Time |
|---|---|---|---|
dementia and mild cognitive impairment Limited Evidence | Modest, inconsistent | Older adults with existing mild cognitive impairment or early Alzheimer's using EGb 761 at ~240 mg/day | Weeks to months |
intermittent claudication Limited Evidence | Small increase in walking distance | People with peripheral artery disease and exertional leg pain | Weeks |
vertigo and dizziness Limited Evidence | Modest | Adults with vestibular vertigo | Weeks |
cognitive function in healthy adults Mixed Evidence | None reliably demonstrated | No clearly benefiting healthy group identified | Not established |
tinnitus Mixed Evidence | Small, inconsistent | Adults with tinnitus, possibly those whose tinnitus accompanies cognitive decline | Weeks |
dementia and mild cognitive impairment
- Effect
- Modest, inconsistent
- Best fit
- Older adults with existing mild cognitive impairment or early Alzheimer's using EGb 761 at ~240 mg/day
- Time
- Weeks to months
intermittent claudication
- Effect
- Small increase in walking distance
- Best fit
- People with peripheral artery disease and exertional leg pain
- Time
- Weeks
vertigo and dizziness
- Effect
- Modest
- Best fit
- Adults with vestibular vertigo
- Time
- Weeks
cognitive function in healthy adults
- Effect
- None reliably demonstrated
- Best fit
- No clearly benefiting healthy group identified
- Time
- Not established
tinnitus
- Effect
- Small, inconsistent
- Best fit
- Adults with tinnitus, possibly those whose tinnitus accompanies cognitive decline
- Time
- Weeks
Evidence for 5 uses
AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.
dementia and mild cognitive impairment
Disease adjunctSmaller trials of the standardized extract EGb 761 at 240 mg/day report modest improvement in patients with existing mild cognitive impairment or early Alzheimer's. The large GEM trial (3,069 older adults over 6 years) found no reduction in dementia incidence, and the Cochrane review judged the overall evidence inconsistent and unreliable.
Bottom line: A modest, unreliable adjunct in established cognitive impairment, not a prevention strategy.
Evidence is mixed
Small symptomatic trials are positive while the largest prevention trial and Cochrane review are negative, so the picture is genuinely mixed.
intermittent claudication
Disease adjunctTrials and meta-analyses of ginkgo in intermittent claudication show a small increase in pain-free walking distance versus placebo. The effect is modest and supervised exercise remains first-line.
Bottom line: A modest add-on for claudication walking distance, not a substitute for exercise therapy.
vertigo and dizziness
Supplement benefitA few controlled trials report that standardized ginkgo extract reduces vertigo symptom frequency and intensity, in some comparisons performing similarly to betahistine. Evidence is limited in size and quantity.
Bottom line: Limited evidence suggests modest help for vertigo symptoms.
cognitive function in healthy adults
Supplement benefitControlled trials in cognitively healthy adults have not shown consistent improvement in memory or attention. Positive findings are small, short, and not reproduced in larger studies.
Bottom line: No reliable cognitive boost in healthy people.
tinnitus
Supplement benefitEvidence for ginkgo in tinnitus is mixed: some trials report modest reductions in perceived loudness or distress while others show no benefit over placebo. Any effect is small.
Bottom line: Worth a time-limited trial for bothersome tinnitus, but results are unreliable.
Evidence is mixed
Trial results conflict, with several showing no separation from placebo.
How it works
How to take it
What to track
3 commercial forms
Compare the main delivery options and what they’re best suited for.
EGb 761 (standardized ginkgo extract)
The reference standardized extract. Tebonin and Tanakan are common brand names internationally.
Standardized to 24 percent flavone glycosides and 6 percent terpene lactones; the form used in most positive trials.
Generic standardized ginkgo (24/6)
Most consumer products. Look for the 24/6 standardization marker and certifications for quality.
Matches EGb 761 specification; quality varies by manufacturer.
Whole leaf ginkgo (unstandardized)
Less reliable and potentially more allergenic. Standardized extracts are preferred.
Variable bioactive content; may contain higher ginkgolic acid levels.
Safety
Know the common side effects, key cautions, and who should avoid it.
Common side effects
Serious risks
Bleeding, including rare intracranial hemorrhage
Seizures from raw ginkgo seeds
Who should avoid it
- People on anticoagulants or antiplatelet drugs
- People with bleeding disorders
- People with seizure disorders
- Anyone within 1–2 weeks of surgery
Pregnancy & breastfeeding
Avoid in pregnancy and breastfeeding due to limited safety data and bleeding concerns.
Interactions
Additive bleeding risk; case reports of serious hemorrhage
Additive bleeding risk via platelet-activating factor inhibition
May lower drug levels and reduce seizure control
May lower blood sugar, compounding hypoglycemia risk
Ginkgo can alter levels of drugs cleared by these enzymes
Documented interactions
Evidence-graded pair pages with sources, dosing notes, and timing guidance — a complement to the narrative section above.
Warnings (6)
+ phenytoin
highGinkgo biloba can induce CYP2C19, an enzyme involved in clearing phenytoin, which may lower phenytoin blood levels and raise the risk of breakthrough seizures. A published fatal case report described subtherapeutic phenytoin and valproate levels in a patient who had been self-administering ginkgo. Ginkgo also carries its own seizure-related signal. If you take phenytoin, avoid ginkgo and review any supplement changes with your doctor or pharmacist.
+ ibuprofen
highIbuprofen reduces platelet aggregation through COX-1 inhibition, and Ginkgo biloba has antiplatelet activity through ginkgolide B's antagonism of platelet-activating factor. Used together they can compound the effect on platelets and raise bleeding risk; a fatal intracerebral hemorrhage has been reported in a long-term ginkgo user who started regular ibuprofen.
+ aspirin
moderateGinkgo biloba can inhibit platelet-activating factor (PAF) and platelet aggregation, which may add to aspirin's irreversible inhibition of cyclooxygenase-1 and thromboxane A2. Observational data suggest a modest increase in minor bleeding events when the two are combined, and there are case reports of more serious bleeds in vulnerable patients, though a controlled trial found no measurable added effect on platelet function.
+ warfarin
moderateWarfarin and ginkgo act on clotting through different pathways, raising a plausible but not firmly proven bleeding concern.
Choosing a product
What to look for on the label — and what to be skeptical of.
Look for…
Be skeptical of…
Frequently asked questions
Will ginkgo improve my memory?⌄
In healthy adults with normal cognition, controlled trials generally find no significant memory improvement. In adults with mild cognitive impairment or early dementia, smaller trials have shown modest benefits, but the largest long-term trial (GEM) found no effect on dementia incidence.
Is ginkgo safe to take with aspirin or fish oil?⌄
Caution is warranted. Both ginkgo and aspirin have antiplatelet effects, and case reports describe intracranial bleeding with the combination. Fish oil at high doses adds further antiplatelet effect. If you are on any anticoagulant or antiplatelet regimen, discuss with your prescriber.
How long until ginkgo works?⌄
Effects build over 4 to 6 weeks of consistent daily use. Don't expect acute effects from a single dose. If you don't see meaningful improvement after 12 weeks at 240 mg/day, it likely isn't going to.
Can I eat ginkgo nuts?⌄
Cooked ginkgo seeds are eaten in some Asian cuisines but should be limited to small amounts (a few seeds per day) because they contain 4-O-methylpyridoxine, which can cause seizures at higher amounts. Raw seeds are more dangerous. Ginkgo supplements use leaf extract, not seed.
Does ginkgo really help with tinnitus?⌄
Trial results are mixed. Some show modest improvement, others show no effect. If you try it, give it 12 weeks at 120 to 240 mg/day before judging. Many users find it doesn't help dramatically, but it has a clean safety profile if you have no bleeding concerns.
References by claim
dementia and mild cognitive impairment
cognitive function in healthy adults
intermittent claudication
vertigo and dizziness
Safety
Memorial Sloan Kettering — Ginkgo — MSKCC About Herbs link
Track Ginkgo with Pilora
Set up dose reminders, check interactions, and join the community in the Pilora iPhone app.
Coming to App StoreDisclaimer: These statements have not been evaluated by the FDA. This page is educational, not a substitute for personalized medical advice. Evidence grades are AI-assisted assessments — talk to your doctor before starting any new supplement, especially if you’re pregnant, breastfeeding, on medications, or managing a chronic condition.