Ginkgo

[Guest guest]

GINKGO

The trials on Ginkgo all use EGb which is a 50:1 extract. The usual dose is

40mg tds ie the equivalent of 2000 mg of Ginkgo daily. This includes the

trial quoted by Charlotte on dementia, the others on " cerebral

insufficiency " , intermittent claudication and venous return.

It is the one herb where all the research is on a standardized extract. I

quote the above findings for information - dosage has always been a matter

for fierce debate!!!.....

My email is still insisting on being called Pre-installed User although I

have fiddled with the settings!

Alison Denham

[Guest guest]

<Going back to Ginkgo, I am very

uncomfortable about using such a manufactured product but am starting to

use higher dosages. What do other people think? <Alison

Denham

I share this concern. Partly it's about humility

- our knowledge is usually very limited, and to use standardized extracts

implies that we now know enough to decide that this is the ideal form in

which to prescribe and to describe a herb. But at a deeper level I think

it's important to identify the plant as the medicine rather than particular

constituents or preparations.

However, I have been using Ginkgo standardized

extract, generally 10-15 mls per week, for a while now (I don't like to

use as high a dosage as most trials because I tend to think that they use

as much as they can without getting side effects to maximise the chances

of results, and that I can afford to be a bit more conservative and increase

the dose if it seems necessary). I'm not convinced that I'm getting better

results than I used to when using the tincture, although I used to use

higher amounts of that (15-25 mls on average).

There is a way for practitioners to do double

blind comparisons of different preparations, though not placebo controlled.

This could be done by having a friend pour different preparations of a

herb (if one is obviously much stronger it could be diluted with an ethanol/water

mix first) into similar bottles, and write on the labels a code that they

will note down, so only they know which preparation is in which bottle.

On each prescription you make up you would note the code. You could then

find out which bottle contained which preparation when you needed to order

more of the herb.

That might seem like a palaver, but I'm going

to give it a try - diluting the Ginkgo standardized extract by 50% ( making

it a 1:1, effectively) and comparing it with an ordinary tincture. I think

most of us have a good idea that some preparations are particularly good

and others particularly poor, but I know that in my case I am never sure

to what extent my preconceptions about different products come into that,

and this would be a fairly sure way of dealing with that. You'd also have

to avoid taste comparison, which I suspect for many of us is a strong indicator

of quality in many herbs, till after looking through your results.

A variant on this that avoids having to keep two

types of preparation is for local groups or pairs of practitioners to do

swaps of different preparations, again with a third party who knows who

has which preparation. For individual practitioners the comparison would

have to be longitudinal, but imporessions of quality could be formed from

the outset, unaffected by knowledge of which preparation is in the bottle.

With the proviso that all involved know the range

of possible preparations they might be using and agree the acceptability

of all of them, are there other ethical considerations to this? I

can't think of any serious ones - I generally tell patients only the name

of the herb rather than the details of the preparation if they want to

know what is in their medicine.

McDermott