Ginkgos

Coenzyme Q10 (also known as ubiquinone or ubidecarenone), while not a herb, is a provitamin found in the mitochondria of plant and animal cells. It is involved in electron transport and may act as a free-radical scavenger, an antioxidant, or a membrane stabilizer. Coenzyme Q10 supplementation is primarily promoted as treating a variety of cardiovascular disorders, including the following  

Many patients with these conditions may also be prescribed warfarin. Coenzyme Q10 is structurally related to menaquinone (vitamin K) and may have procoagulant effects. 

Although not commonly used in the U.S., danshen (the root of Salvia miltiorrhiza), also known as tan seng, is a very popular herb recommended in Chinese medicine for various cardiovascular diseases. The pharmacological effects of danshen have been described primarily in vitro and also in animals and include the following  

The available evidence contraindicates concurrent use of danshen and warfarin. 

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Fats and fatty oils). For the most part, oil is contained in the kernel or embryo of the seed, though it can also occur in the flesh of the ginkgo fmit and in the endosperm of coconut, palm, and pine nuts. Relative amounts of some fatty acids present in a few types of nuts are given in Table 5. Considerable variations in the percentages of fatty acids have also been reported in both pecan and peanut oils from a variety of sources. (Table 6). (For main physical characteristics and the composition of nut oils, see Fats and fatty oils. 

Many carboxylic acids were first isolated from natural sources and were given names based on their origin. Fonnic acid (Latin formica, meaning ant ) was obtained by distilling ants. Since ancient times acetic acid (Latin acetum, for vinegar ) has been known to be present in wine that has turned sour. Butyric acid (Latin butyrum, meaning butter ) contributes to the odor of both rancid butter and ginkgo benies, and lactic acid (Latin lac, for milk ) has been isolated from sour milk. 

For centuries, the beneficial effects of crude extracts from the ginkgo tree were well known in China and India. In traditional Chinese medicine, a boiled-down extract of ginkgo leaves is inhaled to alleviate asthmatic symptoms, and, in India, ginkgo extracts constitute a key ingredient of Soma, a mystical liquid that is thought to increase life span.5 The Japanese know it as the Itcho tree and they frequently use its edible fruit, the ginkgo nut, in cooking. 

The isolation of four terpenes from the bitter principles of Ginkgo by Furukawa in 19326 marked an important advance in the quest for the identification of the active constituents of Ginkgo extracts. A second major milestone was reached in 1967 when Nakanishi and his group reported their extensive and brilliant studies which permitted the structures of these compounds to be fully defined.4 On the basis of spectroscopic data and chemical reactivity... 

Gnkgo (maiden hair tree, kew tree) Ginkgo biloba Raynauds disease, cerebral insufficiency anxiety, stress, tinnitus, dementias, circulatory problems, asthma Rare if used as directed possible effects include headache, dizziness, heart palpitations, Gl effects, rash, allergic dermatitis Do not take with antidepressant drugs, such as the MAOIs, or the antiplatelet drugs such as coumarin, unless advised to do so by the primary care provider. 

Herbals Hypericum perforatum, L-carnitine/coenzyme QIO, Ginkgo biloba Study findings have been negative. 

Fruits (except citrus and melons) Peach, loquat, kiwi, apple, pear, persimmon, nectarine, apricot, cherry, UME, strawberry, grape, ginkgo nut, chestnut, walnuts... 

Dong quai Fenugreek Feverfew Garlic Ginger Ginkgo Horse chestnut ... 

Intravenous preparations of herbs are available in other countries. An intravenous preparation of ginkgo is manufactured in Europe but is not available in the United States. 

Some herbs are standardized for several active constituents, while others are standardized to a single active ingredient. St. John s wort is standardized to contain 0.3% hypericin, whereas ginkgo is standardized to contain 24% flavone glycosides and 6% ter-pene lactones. However, standardizing an herb product to one or more plant component(s) that are identifiable by assay may be incorrect. Many herbalists believe that the whole plant contributes to the efficacy and that there are many unknown active compounds in each plant [6]. 

ConsumerLab.com is an independent testing company that evaluates whether certain dietary supplements have met their standardization claims. Dietary supplements that have been tested include herbs (ginkgo, saw palmetto, ginseng), vitamins (vitamin C), and others (glucosamine, chondroitin, SAMe). Products that meet the German testing standards are published at the ConsumerLab.com website [33]. 

A third case describes a 72-year-old woman who developed a left frontal subdural hematoma after taking ginkgo 50 mg three times daily for 6-7 months... 

It remains unknown whether these cases are coincidence or causality. The most commonly reported side effects with ginkgo include gastric disturbances,... 

Many dietary supplements have antiplatelet activity, which may increase the risk of bleeding when used concurrently with anticoagulants. Feverfew inhibits cyclooxygenase and phospholipase A2 and may interact with anticoagulants and potentiate the antiplatelet effect of aspirin. Other supplements that possess antiplatelet activity include but are not limited to garlic, ginkgo, vitamin E, vitamin A, and selenium. 

Blumenthal M. ConsumerLab.com tests ginkgo and saw palmetto products. HerbalGram 48 66, 2000. 

Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of ginkgo biloba extract. N Engl J Med 336 1108, 1997. 

Rowin J, Lewis S. Spontaneous bilateral subdural hematomas associated with chronic ginkgo biloba ingestion. Neurology 46 1775-1776, 1996. 

Dean K. Multi-component supplement with ginkgo. HerbalGram 48 27, 2000. 

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