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Ginkgo biloba, a supplement derived from the leaves of the ginkgo tree, is widely used for various health purposes. While it is generally considered safe for most adults when taken in moderate amounts, certain risks and precautions should be noted.

Bleeding Risk: Ginkgo may increase the risk of bleeding. Individuals with bleeding disorders or those scheduled for surgery should avoid ginkgo, as it might cause excessive bleeding during and after surgical procedures. It is advisable to discontinue ginkgo at least two weeks before any planned surgery.

Seizure Risk: Ginkgo contains a compound called ginkgotoxin, predominantly found in its seeds but also present in smaller amounts in the leaves. This substance can lower the seizure threshold, potentially leading to seizures, especially in individuals with epilepsy or those prone to seizures. Therefore, such individuals should avoid ginkgo.

Pregnancy and Breastfeeding: The safety of ginkgo during pregnancy and breastfeeding is not well established. There is concern that ginkgo might cause early labor or excessive bleeding during delivery if used near that time. Due to the lack of sufficient information, it is recommended that pregnant and breastfeeding women avoid using ginkgo.

Allergic Reactions: Some individuals may experience allergic reactions to ginkgo, particularly those who are allergic to plants like poison ivy, poison oak, poison sumac, mango rind, or cashew shell oil. Handling ginkgo seeds can cause severe allergic skin reactions and irritation of mucous membranes.

Consumption of Ginkgo Seeds: Eating raw or roasted ginkgo seeds is unsafe. Consuming more than ten roasted seeds per day can lead to serious health issues, including difficulty breathing, weak pulse, seizures, loss of consciousness, and shock. Fresh ginkgo seeds are even more dangerous and can be fatal.

Potential Carcinogenicity: Some studies have raised concerns about ginkgo's potential to increase the risk of liver and thyroid cancers. However, these findings are based on animal studies with high doses of ginkgo, and it is unclear if they apply to humans.

Given these risks, it is essential to consult with a healthcare provider before starting ginkgo, especially for individuals with existing health conditions, those taking medications, or those who are pregnant or breastfeeding.

Common side effects:

• Stomach upset
• Nausea
• Diarrhea
• Dizziness
• Headache

Less common but important to monitor:

• Easy bleeding or bruising
• Fainting
• Irregular heartbeat
• Paralysis
• Muscle weakness
• Restlessness
• Seizures
• Difficulty speaking
• Severe headache
• Weakness on one side of the body
• Vision problems

Serious side effects:

• Rash
• Itching
• Swelling of the face, tongue, or throat
• Severe dizziness
• Difficulty breathing

Ginkgo Biloba, a popular herbal supplement, can interact with various medications, potentially leading to adverse effects. It's important to be aware of these interactions to ensure safe use.

Blood Thinners and Antiplatelet Agents: Ginkgo may increase the risk of bleeding when taken with anticoagulants like Warfarin, heparin, or antiplatelet drugs such as Aspirin and Clopidogrel. Combining ginkgo with these medications can enhance their blood-thinning effects, raising the likelihood of bleeding complications.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Using ginkgo alongside NSAIDs, including Ibuprofen and Naproxen, may further elevate the risk of bleeding due to their combined effects on blood clotting.

Antidepressants: Ginkgo might interfere with certain antidepressants, such as fluoxetine (Prozac) and imipramine (Tofranil), potentially reducing their effectiveness.

Anticonvulsants and Seizure Medications: Ginkgo can decrease the efficacy of anticonvulsant drugs like carbamazepine (Tegretol) and valproic acid (Depakote), possibly increasing the risk of seizures.

Diabetes Medications: Ginkgo may affect blood sugar levels, necessitating careful monitoring when used with diabetes medications to avoid unexpected changes in blood glucose.

Statins: Ginkgo might alter the effectiveness of statins such as simvastatin (Zocor) and atorvastatin (Lipitor), potentially reducing their cholesterol-lowering benefits.

Alprazolam (Xanax): Taking ginkgo with alprazolam may diminish the drug's effectiveness in managing anxiety symptoms.

Nifedipine (Procardia): Ginkgo can interact with nifedipine, a medication used for high blood pressure and heart conditions, possibly leading to increased side effects like headaches and dizziness.

Efavirenz (Sustiva): Ginkgo may reduce the effectiveness of efavirenz, a drug used to treat HIV infection.

Surgery Considerations: Due to its potential to increase bleeding risk, it's advisable to stop taking ginkgo at least two weeks before any scheduled surgery.

Given these potential interactions, it's crucial to consult with a healthcare provider before starting ginkgo biloba, especially if you're taking any of the medications mentioned above.