Tinnitus is the perception of sound when no corresponding external sound is present. While often described as a ringing, it may also sound like a clicking, buzzing, hiss, or roaring.  The sound may be soft or loud, low or high pitched, and often appears to be coming from one or both ears. In some people, the sound may interfere with concentration and in some cases it is associated with anxiety and depression. Tinnitus is usually associated with some degree of hearing loss and with decreased understanding ...

tinnitus

General-information-about-Ginkgo-Biloba

General information about Ginkgo Biloba 

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Ginkgo, one of the oldest living tree species in the world (some trees in China are over 2,500 years old), has a long history in traditional Chinese medicine. Members of the royal court received ginkgo nuts for senility. Other historically documented uses of ginkgo are for asthma, bronchitis, and kidney and bladder diseases. 1

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Today, ginkgo leaf extract is promoted as a dietary supplement for many conditions, including anxiety, allergies, dementia, eye problems, peripheral artery disease (when plaque buildup narrows the blood vessels that carry blood to the head, organs, and limbs), tinnitus, and other health problems.

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Active ingredients in Ginkgo Biloba 

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Ginkgo biloba has two main active ingredients in different concentrations: terpene lactones (which mostly include ginkgolides and diterpenes) and ginkgo flavone glycosides (which mostly contain ginkethin, bilobethin and sciadopizisin). Most of the studies that investigated the effect of ginkgo biloba used the standardized ginkgo biloba extract (EGb761), which was developed by a German pharmaceutical company in 1964. Flavonoids include quercetin, rutin, kaempferol and isoramnetin. Lactones include ginkgolide A, ginkgolide B, ginkgolide C, bilobalide, and ginggotoxin, lactone, which is structurally related to pyridoxine.&nbsp;

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Numerous pharmacological studies have suggested that it is the terpene trilactones and flavonoids in ginkgo that are responsible for the main pharmacological effects of the extract.&nbsp;

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Benefits of ginkgo biloba for health 

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Ginkgo biloba can provide a number of health benefits, including improving cognitive function, supporting blood circulation, relieving leg and joint pain, and more. Traditional uses are wide-ranging, but not all have been confirmed by research, so we will take a detailed look at those for which scientific data are available.

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Most of the positive effects of ginkgo are due to high levels of flavonoids and terpenoids, compounds known for their strong antioxidant effects. Antioxidants fight or neutralize the harmful effects of free radicals. Many of the purported benefits of taking ginkgo have been linked to these antioxidant effects.

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Improving memory in dementia and Alzheimer's 

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There is some evidence to suggest that ginkgo may help people with dementia, although more research is needed. Benefits may include:

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<ul><li style="font-weight: 400;" aria-level="1">Improved thinking and memory</li><li style="font-weight: 400;" aria-level="1">Better social behavior</li><li style="font-weight: 400;" aria-level="1">Better ability to perform daily tasks</li></ul>One study found that ginkgo biloba extract, known as EGb 761, was clinically effective in the treatment of Alzheimer's dementia. &nbsp;<a href="https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-2007-979544" target="_blank" data-ref="Thieme E-Journals - Pharmacopsychiatry / Abstract" rel="noopener">[ref. 1]</a>&nbsp;

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Another study published in JAMA similarly concluded that EGb 761 is safe to use and effective in stabilizing and possibly improving the cognitive and social functioning of dementia patients over a period of 6 and 12 months. 3

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Another study, published in January 2017 in the Journal of Ethnopharmacology, analyzed 12 systematic reviews and concluded that ginkgo has potentially beneficial effects for people with dementia when taken for at least five months. Another systematic review of nine studies found that ginkgo was associated with a delayed decline in cognition, function, and behavior in people with dementia. 4

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Heart disease and ginkgo 

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In traditional Chinese medicine, ginkgo seeds have been used to open "channels" of energy to various organ systems, including the kidneys, liver, brain, and lungs. Ginkgo's clear ability to increase blood flow to different parts of the body may be the source of its purported benefits for the heart.

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Some research suggests that ginkgo can have a positive impact on the symptoms of cardiovascular disease. A study published in December 2017 in the journal Stroke and Vascular Neurology looked at 348 people in China with onset of acute ischemic stroke. About half of the participants adhered to a treatment plan with daily ginkgo and aspirin, while those in the other group received only aspirin. After six months, the researchers found that the group taking aspirin in combination with ginkgo did better, and had reduced cognitive and neurological impairment without increasing the incidence of vascular events. 5

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Another study found that taking ginkgo was associated with improved blood circulation in people with coronary artery disease. 6

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Ginkgo for depression and anxiety 

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Little research suggests that ginkgo may play a role in the treatment of psychiatric disorders, including depression and anxiety. A study published in September 2018 in the journal Medicine concluded that ginkgo, as an adjunct treatment to a selective serotonin reuptake inhibitor, may help improve depressive symptoms and cognitive function. 7

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Anticancer effects of biflavonoids in Ginkgo Biloba 

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Previous studies have shown that both G. biloba leaf extract and exocarp extract (GBEE) possess inhibitory effects on various cancer cells. Some monomeric compounds have also been reported to have antiproliferative activity on a variety of cancer cells, including ginkkolic acid, ginkgolide B and several bioflavonoids.

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A newly discovered biflavonoid — amentoflavone 7′′-O-β-d-glucopyranoside — and four known biflavonoids were isolated and identified from male ginkgo flowers by a team of scientists in 2019. Bilobethin and isoginketin are the flavonoids that show better antiproliferative activity on different lines of cancer. 8

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In another study, ginkgo biloba extract inhibited metastasis and ERK/nuclear factor kappa B (NF-κB) signaling pathway in gastric cancer. 9

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Other potential benefits of ginkgo with less evidence 

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<ul><li style="font-weight: 400;" aria-level="1">May support vision and eye health Very few studies have examined how ginkgo is related to vision and eye health. However, the early results are promising. There have been studies in people with glaucoma and age-related macular degeneration, in which after taking ginkgo there is an improvement in vision. More human studies are needed.</li><li style="font-weight: 400;" aria-level="1">Can relieve headaches and migraines - In traditional Chinese medicine, ginkgo is a very popular remedy for headaches and migraines. There is very little research on ginkgo's ability to treat headaches. However, depending on the underlying cause of the headache, ginkgo can help.</li><li style="font-weight: 400;" aria-level="1">May improve symptoms of asthma and COPD Some research suggests that ginkgo can improve symptoms of asthma and other inflammatory respiratory diseases such as COPD. This is due to the anti-inflammatory compounds in ginkgo, which can allow a decrease in airway inflammation and an increase in lung capacity.</li></ul>

Are-there-any-contraindications-to-the-use-of-ginkgo?

Are there any contraindications to the use of ginkgo? 

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Ginkgo biloba supplements are generally considered safe when taken in moderation. Side effects of ginkgo can include headache, upset stomach, dizziness, allergic skin reactions. Ginkgo seeds should not be consumed as they can be poisonous.&nbsp;

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Ginkgo biloba is not recommended for children, pregnant or breastfeeding women, people at increased risk of bleeding, people with diabetes, and people prone to seizures.

Ginkgo biloba contains high levels of flavonoids and terpenoids, compounds known for their strong antioxidant effects. Some research suggests that ginkgo supplements may help with dementia and cognitive impairment, heart disease, depression, anxiety, and sexual dysfunction, although more research is needed.&nbsp;

Ginkgo Biloba - Benefits, Intake and Possible Side Effects

Бетина Цветкова

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Author: Rositsa Tashkova, Master of Molecular Biology and Microbiology

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With the development of medicine, our life expectancy has increased considerably within only a few decades. This allows us to spend much more time with our relatives and loved ones, but it is also a prerequisite for age-related diseases.&nbsp; Perhaps one of the most insidious of these is senile dementia, as it alters our personality, mental abilities, and memory.

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The most common form of dementia is Alzheimer's disease. It is a neurodegenerative disease, in which plaque builds up in the brain over time, killing certain types of neurons, and causing changes in the transmission of nerve impulses in various important areas of the brain.

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Currently available methods of treating Alzheimer's are not effective enough and have undesirable side effects. Therefore, in this article we will consider the treatment of the disease from the point of view of Traditional Chinese medicine (TCM) - with the help of herbs and medicinal plants, which have the potential to slow down the development of the disease and are actively studied:

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<ul>
<li>Sage (Salvia officinalis)</li>
<li>Ginkgo biloba</li>
<li>Toothed clubmoss or firmoss (Huperzia serrata)</li>
<li>Plants of the Amaryllidaceae family</li>
<li>Uncaria rhynchophylla - a type of cat's claw (diào gōu téng or fish hook vine)</li>
<li>Yuan zhi (Polygala tenuifolia)</li>
</ul>

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The information was takenf rom the articles "Traditional Chinese medicines and Alzheimer's disease" [<a href="https://www.bioseek.eu/en/eng/research/pubmed/Traditional_Chinese_medicines_and_Alzheimer_s_disease_21791295" target="_blank" rel="noopener">ref.1</a>] and "Herbaltherapy: a new pathway for the treatment of Alzheimer's disease" [<a href="https://www.bioseek.eu/en/eng/research/pubmed/Herbal_therapy_a_new_pathway_for_the_treatment_of_Alzheimer_s_disease_21067555" target="_blank" rel="noopener">ref.2</a>].

Sage-(Salvia-officinalis)-and-ursolic-acid

Sage (Salvia officinalis) and ursolic acid

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One of the promising medicinal plants in the fight against Alzheimer's is sage or also known as garden sage, common sage, or culinary sage. The main active substance in the herb leaves is ursolic acid. It is a pentacyclic triterpenoid found also in the wax layer of apples, in the fruit crusts, as well as in rosemary and thyme.

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According to one clinical trial, sage extract significantly improved the cognitive abilities of patients with mild to moderate&nbsp;Alzheimer's disease between the ages of 65 and 80 years. No adverse side effects were observed.&nbsp;[<a href="https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2710.2003.00463.x" target="_blank" rel="noopener">ref.3</a>]

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Another active substance in sage, which has the potential to improve the condition of patients with dementia is rosmarinic acid, since it destabilizes and inhibits the formation of amyloid filaments. [<a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1747-0285.2005.00318.x" target="_blank" rel="noopener">ref.4</a>]

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Ginkgo biloba leaf extract

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Ginkgo biloba leaf extract, named EGb761, has the potential to have a beneficial effect on patients with various neurodegenerative diseases , including Alzheimer's and dementia, thanks to the flavonoids, terpenes and organic acids contained in it.

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The extract lowers oxidative stress, has anti-inflammatory properties, neutralizes free radicals, improves impaired mitochondrial function, reduces platelet aggregation (against blood clotting). [<a href="https://www.bioseek.eu/en/eng/research/pubmed/Traditional_Chinese_medicines_and_Alzheimer_s_disease_21791295" target="_blank" rel="noopener">ref.1</a>] All these properties are important for the treatment of this disease.

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Toothed-clubmoss-or-firmoss-(Huperzia-serrata)

Toothed clubmoss or firmoss (Huperzia serrata)

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The toothed clubmoss is a plant also known as firmoss. It contains the inhibitor of acetylcholinesterase hooperzine A, which is also its active substance.

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According to various studies, hooperzine A has a positive effect in neurodegenerative diseases such as myasthenia gravis, Alzheimer's and Parkinson's disease.

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The substance has the property to improve general cognitive functions, overall clinical status, behavioral disorders in Alzheimer's patients, without side effects. [<a href="https://www.bioseek.eu/en/eng/research/pubmed/Herbal_therapy_a_new_pathway_for_the_treatment_of_Alzheimer_s_disease_21067555" target="_blank" rel="noopener">ref.2</a>]

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Plants-of-theAmaryllidaceae-family

Plants of theAmaryllidaceae family

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Plants of the Amaryllidaceae family are widely used in Traditional Chinese medicine for a variety of conditions - from the bite of a venomous snake, through paralysis to rheumatoid arthritis.

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The active substance is galantamine, which according to some studies can improve memory and protect neurons from oxidative stress.

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One clinical trial confirmed the efficacy and safety of galantamine in the treatment of Alzheimer's disease [<a href="https://www.bioseek.eu/en/eng/research/pubmed/Acetylcholinesterase_inhibitors_and_memantine_for_neuroenhancement_in_healthy_individuals_a_systematic_review_20193764" target="_blank" rel="noopener">ref.5</a>]. The use of galantamine for the treatment of mild to moderate Alzheimer's is approved by the State Food and Drug Administration in China and the US Food and Drug Administration (FDA).

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Uncaria-rhynchophylla---a-type-of-cat's-claw

Uncaria rhynchophylla - a type of cat's claw

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Uncaria rhynchophylla is a variety of the better known cat's claw (Uncaria tomentosa). It is also called diào gōu téng or fish hook vine. The herb is used to relieve headaches, dizziness, tinnitus and contains a number of active substances from the group of alkaloids.

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There is evidence that its extracts have a significant destabilising and inhibiting effect on the formation of amyloid fibers. This effects is even stronger than that of other herbs used in Traditional Chinese medicine. [<a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/jnr.20891" target="_blank" rel="noopener">ref.6</a>]

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Yuan-zhi-(Polygala-tenuifolia)

Yuan zhi (Polygala tenuifolia)

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Polygala tenuifolia is one of the 50 fundamental herbs used in Traditional Chinese medicine and is among the most used to treat memory loss. It has expectorant, antipsychotic, sedative, anti-inflammatory and hypnotic effects.

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In the dried root of the herb there is a substance called tenuifolin, which is evidenced to possess the properties necessary to slow the progression of Alzheimer's disease and to improve poor mental functions. [<a href="https://www.bioseek.eu/en/eng/research/pubmed/Traditional_Chinese_medicines_and_Alzheimer_s_disease_21791295" target="_blank" rel="noopener">ref.1</a>]

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The potential of these medicinal plants and their extracts, the clinical trials [<a href="https://clinicaltrials.gov/ct2/show/NCT04249869" target="_blank" rel="noopener">ref.7</a>], as well as the activity of Chinese scientists in researching the effectiveness of various herbs, give a ray of hope that we will soon find effective and safe treatment and prevention of diseases such as Alzheimer's, Parkinson's and senile dementia.

Q&amp;A

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What types of dementia are there?

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Various diseases and conditions can lead to or be characterized by dementia. These include: Alzheimer's disease, vascular dementia, Lewy body dementia, frontotemporal dementia, alcohol-related dementia, Down syndrome and Alzheimer's disease, HIV-related dementia.

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What is vascular dementia?

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Vascular dementia is a common name for dementia caused by a problem with the blood supply to the brain. There are two main types of vascular dementia: multiinfarct dementia and Binswanger's disease (subcortical vascular dementia). Both types are associated with one or more strokes.

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Multiinfarct dementia is the most common vascular dementia and at the beginning of its development has a more favorable picture than that of Alzheimer's, and the sufferer can keep their personality relatively unchanged for longer. Some of its symptoms are depression, mood swings and epilepsy. Risk factors for the development of vascular dementia are high blood pressure, high cholesterol, smoking.

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How to take care of a dementia sufferer at home?

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Ask a specialist how to talk to the patient, how to make toilet care easier, try to learn how he or she perceives the world. Tips to help the patient have better orientation: keep familiar objects and people around, browse through family photo albums frequently, keep the lights on at night, use reminders, notes, to-do lists or instructions for daily activities while the sufferer is still able to use them, stick to a simple schedule of activities, talk about current events.

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In case of problems with anxiety and sleep, play soothing music, go for short walks regularly, if possible. Learn how to secure your home and think about how to prevent falls, suffocation and injuries. It is necessary to make regular examinations of the patient's vision and hearing.

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If he or she is driving a car, it is important to carefully consider at what stage this will no longer be safe and to approach it carefully when talking about the need to stop.

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Traditional Chinese medicine: 6 herbs for Alzheimer's and dementia