Ginkgo biloba
EMA Well-Established Use extract (EGb 761) for age-related cognitive complaints; Cochrane evidence is mixed but the regulatory tier is high.
Why
Ginkgo biloba leaf extract (EGb 761) holds an EMA Well-Established Use monograph for symptomatic treatment of mild dementia, and a Traditional Use registration for age-related cognitive complaints. The Cochrane review of ginkgo for cognitive impairment and dementia found inconsistent results across older trials but a positive signal at 240 mg/day in larger, more recent RCTs. A separate Cochrane review supports symptomatic benefit in intermittent claudication.
How it works
Flavonoid glycosides (ginkgolides A, B, C) inhibit platelet-activating factor and improve microvascular perfusion. Terpenoid lactones scavenge reactive oxygen species and protect neuronal mitochondria.
Expected onset · Cognitive endpoints typically assessed over 12–24 weeks; claudication walking-distance effects emerge by 8–12 weeks
How to take
Dosage
EGb 761 standardised extract 120–240 mg/day, in one or two divided doses.
Timing
Morning, or split morning + evening
On the label
Look for 'EGb 761' or extracts standardised to 24% flavone glycosides and 6% terpene lactones. Unstandardised leaf preparations are poorly characterised.
Ideal for
Older adults with subjective memory complaints or early-stage cognitive symptoms; adults with mild intermittent claudication.
Safety
Evidence
EMA HMPC classifies dry quantified leaf extract as Well-Established Use for symptomatic treatment of mild dementia: the highest regulatory tier for a botanical. Cochrane 2009 SR found inconsistent results overall, with the stronger signal in larger trials at 240 mg/day of EGb 761. Cochrane 2013 SR on claudication found a small but statistically significant improvement in pain-free walking distance vs placebo.
Where to get it
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