{"entity":{"id":"ginkgo","kind":"technology","name":"Ginkgo biloba","aka":["Ginkgo","Maidenhair tree"],"tldr":"Ginkgo is sold to support memory, and some people take it hoping to prevent the thinking and memory problems that can follow chemotherapy. A trial in women with breast cancer found it did not prevent them, a large trial found no reduction in cancer risk, and it increases the risk of bleeding.","summary":"Ginkgo leaf extract is one of the most studied herbal products. Memorial Sloan Kettering's About Herbs summary reports that the large Ginkgo Evaluation of Memory study and later trials found no improvement in cognition and no prevention of dementia, that secondary outcomes of that study did not support its use to reduce cancer risk, and that ginkgo was ineffective in preventing chemotherapy-associated cognitive dysfunction in women with breast cancer. The safety concern is bleeding: MSK lists spontaneous bleeding including brain haemorrhage, prolonged bleeding time, and additive effects with anticoagulants, antiplatelet drugs and anti-inflammatory painkillers, which matters for anyone with low platelets from chemotherapy or facing surgery. It can also lower the seizure threshold, interacts with several drug-handling enzymes and transporters (CYP450, P-glycoprotein, UGT) with uncertain clinical relevance, and inhibited tacrolimus metabolism in a preclinical study. High doses were hepatocarcinogenic in animals, of unknown significance in people. OnCo's record on cognitive problems after cancer treatment covers the approaches that have been tested for that problem.","status":"negative","asOf":"2026-11-04","links":[{"label":"MSK About Herbs: Ginkgo (page last updated 9 August 2023)","url":"https://www.mskcc.org/cancer-care/integrative-medicine/herbs/ginkgo"}],"tags":["complementary","supportive-care","evidence:no-benefit"],"related":["echinacea","garlic-supplements"],"cancers":["breast-hr-positive"],"sections":["supportive-care","chemotherapy"],"technologies":["integrative-oncology","cognitive-impairment-after-cancer-treatment","dietary-supplements-treatment-interactions"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Flavonoids and terpene lactones (ginkgolides) affect blood flow and platelet-activating factor; the antiplatelet action is what causes the bleeding risk.","strengths":["Studied in large trials, so the answer is clear"],"limitations":["No benefit for chemotherapy-related cognitive problems or cancer prevention","Bleeding risk, including with low platelets","Seizure-threshold and enzyme interactions"]},"route":"/technologies/ginkgo/","neighbours":{"technology":[{"id":"dietary-supplements-treatment-interactions","kind":"technology","name":"Dietary supplements during cancer treatment: interactions and harms","route":"/technologies/dietary-supplements-treatment-interactions/"},{"id":"echinacea","kind":"technology","name":"Echinacea","route":"/technologies/echinacea/"},{"id":"integrative-oncology","kind":"technology","name":"Evidence-based integrative oncology","route":"/technologies/integrative-oncology/"},{"id":"garlic-supplements","kind":"technology","name":"Garlic supplements","route":"/technologies/garlic-supplements/"},{"id":"cognitive-impairment-after-cancer-treatment","kind":"technology","name":"Thinking and memory after cancer treatment: what is measurable, and what helps","route":"/technologies/cognitive-impairment-after-cancer-treatment/"}],"cancer":[{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"bottleneck":[{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}]}}