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Ginkgo and Milk Thistle News

February 8, 2011 Written by JP       [Font too small?]

Being an informed consumer almost always results in greater satisfaction. This applies when you’re shopping for a car, electronics, a new home and, without a doubt, medical care. In the realm of modern health care if you simply accept all of the information presented by so-called experts, you’ll often miss out on opportunities that you won’t even know exist. Two herbs that are frequently criticized in the popular press are Ginkgo biloba and Silybum marianum or milk thistle. On many occasions they’re described as ineffective and/or unproven at best and potentially dangerous at worst. However, what’s often left out of the picture is the actual data that supports their use and offers clues about their relative safety.

Germany is a world leader in incorporating herbal extracts into their contemporary medical system. A recent systematic review by the Institute for Quality and Efficiency in Health Care based in Cologne, Germany summarized the current state of knowledge about the use of Ginkgo biloba in Alzheimer’s disease (AD). What was unique about this particular collection of information is that it was based on unpublished data resulting from randomized controlled trials. A total of 6 studies were deemed eligible in that they compared Ginkgo to a “placebo or a different treatment option”, employed a rigorous scientific design and provided a minimum of 16 weeks of follow up observation. The findings of the review concluded the following:

  • The studies that used high-dose Ginkgo (240 mg/day) all favored treatment vs. placebo.
  • Benefits in “activities of daily living”, “cognition and accompanying psychological symptoms” were noted.
  • Significant side effects were not reported, but further evidence is called for to address effect size in various subgroups of AD patients. (1)

A new study published in the December 2010 issue of the International Journal of Geriatric Psychiatry wasn’t included in the previous review. German researchers administered a patented Ginkgo extract (EGb 761) or placebo to 410 outpatients with mild to moderate dementia. The 24 week trial used a once-daily dosage of 240 mg of Ginkgo as a treatment. Patients receiving the Ginkgo preparation demonstrated improvements in cognitive functioning and neuropsychiatric symptoms. While the Ginkgo therapy was found “significantly superior” to placebo, the side effect profiles “were similar for both treatment groups”. (2)

What’s also of interest to me is the behind-the-scenes experiments being conducted on Ginkgo that explore how exactly it protects the brain and supports cognitive functioning. Current publications appearing in various medical journals report that Ginkgo biloba extracts probably exert therapeutic activity by increasing cerebral blood flow in vital centers of the brain such as the parietal-occipital region. In addition, antioxidants present in Ginkgo have actually been found to reach target areas of the brains of test animals after single or repeated doses of Ginkgo. This raises the possibility that this herbal extract reduces oxidative damage to portions of the brain (cerebellum, frontal cortex, hippocampus and striatum) that are associated with age-related cognitive decline. (3,4,5)

Milk thistle is thought of as a supplement that primarily supports liver health. But thinking about it only as a hepatoprotective agent is a lot like referring to Frank Sinatra as just a guy with blue eyes. Simply put, there’s a lot more to this herbal extract. In fact, there’s an intriguing connection between Ginkgo and milk thistle. Researchers from Canada and Japan have recently discovered that select phytochemicals in milk thistle, such as silibinin and silymarin, may discourage the formation of Alzheimer’s disease by preventing oxidative damage and plaque formation in the brain. What’s even more encouraging is that these noted effects seem to result in symptomatic improvements in animal models of AD and dementia. (6,7,8)

Milk Thistle Extract (Silibinin) May Prevent Memory Impairment

Source: Br J Pharmacol. 2009 Aug;157(7):1270-7. (link)

Another little known fact about milk thistle is that it’s increasingly being studied as an anti-cancer therapy. Prostate cancer (PCa) is one malignancy which is believed to be particularly responsive to components of this herb. Several in-vitro and human intervention trials from 2010 have specifically investigated the promise of milk thistle extracts alone and in combination with nutrients such as selenium in relation to prostate cancer. The most recent study determined that the pairing of 570 mg/day of silymarin, “a milk thistle flavonolignan mixture”, and 240 mcg/day of selenium, a trace mineral, improved the quality of life in men after radical prostatectomy. The study volunteers also demonstrated a decline in LDL (“bad”) and total cholesterol which are “two markers of lipid metabolism known to be associated with PCa progression”. Other preliminary research offers hope in the form of a test tube experiment which determined that a purified milk thistle extract has the potential to reduce the invasiveness of prostate cancer cells and may, thereby, discourage the spread of cancer or metastasis. However, there’s much that needs to be clarified in this fledgling field of research. One area that will most likely receive a lot of attention in the coming years is how to increase the bioavailability of milk thistle so that it can reach target organs, including the prostate. (9,10,11)

It’s quite possible that some of the research I’ve touched upon today is news to you. If that’s true, I’m gratified to know it. But please keep in mind that this is but the tip of the iceberg. If space and time permitted, I could have very easily gone on to describe how milk thistle may one day be used to manage excessive iron stores in the body by dramatically reducing iron absorption. With respect to Ginkgo, there are newly published studies that reveal that it’s potent antioxidant activity may protect against certain medication induced side effects such as tardive dyskinesia and even diet related liver damage. This is precisely the sort of news that you’re unlikely to hear about from the talking heads that frequently appear on cable and network news programs. But that’s my “bread and butter”. I hope it’s also one of the reasons why you keep visiting my site. Until next time … (12,13,14)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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6 Comments & Updates to “Ginkgo and Milk Thistle News”

  1. Davide Says:

    Nice article. I always enjoy reading your blog. I routinely take milk thistle periodically throughout the year to aid in liver detoxification. I also like it because it increases glutathione and SOD production in the liver. From my understanding, these powerful enzymes are much more effective means of attaining a higher antioxidant status in the body than simply taking dietary antioxidants from food.

    I’ve never taken Gingko, but I think I’m going to try it.

  2. JP Says:

    Thank you, Davide!

    Be well!


  3. JP Says:

    Update: Milk thistle lowers inflammation, oxidative stress in diabetics …


    Effects of Silybum marianum (L.) Gaertn. (silymarin) extract supplementation on antioxidant status and hs-CRP in patients with type 2 diabetes mellitus: A randomized, triple-blind, placebo-controlled clinical trial

    Aim: Diabetes is a serious metabolic disorder and oxidative stress and inflammation contribute to its pathogenesis and complications. Since Silybum marianum (L.) Gaertn. (silymarin) extract is an antioxidant with anti-inflammatory properties, this randomized clinical trial was conducted to evaluate the effects of silymarin supplementation on oxidative stress indices and hs-CRP in type 2 diabetes mellitus patients.

    Methods: For the present paralleled, randomized, triple-blinded, placebo-controlled clinical trial, 40 type 2 diabetes patients aged 25–50 yr old and on stable medication were recruited from the Iranian Diabetes Society and endocrinology clinics in East Azarbayjan (Tabriz, Iran) and randomly assigned into two groups. Patients in the silymarin treatment group received 140 mg, thrice daily of dried extracts of Silybum marianum (n = 20) and those in the placebo group (n = 20) received identical placebos for 45 days. Data pertaining to height, weight, waist circumference and BMI, as well as food consumption, were collected at base line and at the conclusion of the study. Fasting blood samples were obtained and antioxidant indices and hs-CRP were assessed at baseline, as well as at the end of the trial.

    Results: All 40 patients completed the study and did not report any adverse effects or symptoms with the silymarin supplementation. Silymarin supplementation significantly increased superoxide dismutase (SOD), glutathione peroxidase (GPX) activity and total antioxidant capacity (TAC) compared to patients taking the placebo, by 12.85%, 30.32% and 8.43%, respectively (p < 0.05). There was a significant reduction in hs-CRP levels by 26.83% (p < 0.05) in the silymarin group compared to the placebo group. Malondialdehyde (MDA) concentration significantly decreased by 12.01% (p < 0.05) in the silymarin group compared to the baseline.

    Conclusions: Silymarin supplementation improves some antioxidant indices (SOD, GPX and TAC) and decrease hs-CRP levels in T2DM patients.

    Be well!


  4. JP Says:

    Update 05/03/15:


    Complementary Therapies in Clinical Practice – Published Online: April 18, 2015

    Ginkgo biloba in the treatment of attention-deficit/hyperactivity disorder in children and adolescents. A randomized, placebo-controlled, trial

    Objective: To evaluate the efficacy of Ginkgo biloba as a complementary therapy for attention-deficit/hyperactivity disorder (ADHD).

    Methods: Children and adolescents with ADHD received methylphenidate (20–30 mg/day) plus either G. biloba (80–120 mg/day) or placebo for 6 weeks. Parent and teacher forms of the ADHD Rating Scale-IV (ADHD-RS-IV) were completed at baseline, week 2, and week 6. Treatment response was defined as 27% improvement from baseline in the ADHD-RS-IV.

    Results: Compared with placebo, more reduction was observed with G. biloba regarding ADHD-RS-IV parent rating inattention score (−7.74 ± 1.94 vs. −5.34 ± 1.85, P < 0.001) and total score (−13.1 ± 3.36 vs. −10.2 ± 3.01, P = 0.001) as well as teacher rating inattention score (−7.29 ± 1.90 vs. −5.96 ± 1.52, P = 0.004). Response rate was higher with G. biloba compared with placebo based on parent rating (93.5% vs. 58.6%, P = 0.002).

    Conclusions: The G. biloba is an effective complementary treatment for ADHD. Further studies with longer treatment duration are warranted in this regard.

    Be well!


  5. JP Says:

    Update 06/24/15:


    Minerva Med. 2014 Dec;105(6 Suppl 2):1-8.

    Effect of Liverubin™ on hepatic biochemical profile in patients of alcoholic liver disease: a retrospective study.

    Liverubin™ is an available drug in the Indian market that contains silymarin, the major active complex extracted from the medicinal plant milk thistle (Silybum marianum L.). The study retrospectively tracked and analyzed the data of 602 patients, out of which 230 were alcohol induced; 131 with alcohol-induced liver damage (ALD), 13 with liver cirrhosis, and 86 with fatty liver; to assess the effects of water soluble Silymarin (Liverubin™) on important hepatic biochemical parameters. The data was collected from 32 major cities treated by 72 physicians across India who were observed for the specified treatment duration of 11 months. Data was analyzed by using descriptive statistics. At the end of the treatment the hepatic biochemical profile was appreciably improved: the mean % of change in the levels of important hepatic biochemical parameters was observed as follows: total bilirubin 63.48% (direct bilirubin: 64.96%; indirect bilirubin: 61.63%). The serum SGOT and SGPT changed at a mean % of 65.43 and 69.31 respectively while serum alkaline phosphatase was changed at a mean % rate of 39.81. Liverubin™ proved to be safe & well-tolerated among the studied population and no significant treatment related adverse events were reported during the study. Liverubin™ treatment is found to bring about effective lowering of abnormally elevated hepatic biochemical parameters. Liverubin™, water soluble active Silymarin, in the popularly prescribed doses of 140-mg tid is observed to be a promising safe and effective drug in cases of alcoholic liver disease.

    Be well!


  6. JP Says:

    Update 07/14/15:


    MMW Fortschr Med. 2014 Dec 15;156 Suppl 4:120-6.

    [Effect of silymarin on liver health and quality of life. Results of a non-interventional study].

    BACKGROUND: Many drugs are known to have hepatotoxic side effects. The effect of silymarin on liver function and liver-injury-impaired quality of life under daily practice conditions in patients with elevated values of liver enzymes was evaluated in the present non-interventional study.

    METHOD: Patients with drug-induced elevated aminotransferase levels and indication for silymarin (Legalon forte) treatment for 2 to 3 months were documented prospectively over 4 months. At baseline, after 2 and 4 months, respectively, the following parameters were documented: alanine transaminase (ALT), aspartate transaminase (AST), γ-glutamyltransferase (GGT), alkaline phosphatase, total bilirubin, presence of liver-related skin symptoms and discoloured urine, severity of liver-related symptoms and quality of life.

    RESULTS: In total, 190 patients (53.2% male, median age 60.0 years [range 19-81]) from 48 centres participated in the non-interventional study. Among potentially hepatotoxic drugs, analgesics/anti-inflammatory drugs were used most frequently (45.8%). These drugs have been administered for a median period of 2.8 years (range 0.0-26.1). At baseline, all patients had elevated levels of ALT, AST or GGT. Fatigue, flatulence, upper abdominal discomfort, lethargy, and joint complaints were the most severe liver-related symptoms and prevalent in over 62% of patients. Quality of life was affected in 88.7% of patients. Significant reductions were achieved in all documented laboratory parameters (p < 0.001), leading to marked improvement in liver-related symptoms and increased quality of life already after 2 months. The percentage of patients with liver enzymes in the normal range increased considerably within 4 months. No adverse drug reactions were observed.

    CONCLUSIONS: Silymarin is a safe and efficacious treatment option for patients with elevated liver enzymes. A benefit in terms of liver-related symptoms as well as quality of life and performance was demonstrated already after 2 months of treatment.

    Be well!


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