Ginkgo Biloba - Beneficial or Not

Ginkgo biloba is from an ornamental tree originating in China thousands of years ago. The ginkgo is the world's oldest living tree species. Ginkgo is available as ginkgo leaf, ginkgo leaf extract, and ginkgo seed. Ginkgo leaf extract is the most commonly used form.

Uses

There has been a large amount of research on the use and benefits of ginkgo. Most of the studies have been poorly designed, yielding questionable results. More well designed studies are needed in order to make valid recommendations regarding use and benefits.
Ginkgo extract is reported to aid in mental functioning and relieve muscle pain. It may have blood pressure lowering ability, inhibit blood clotting, and have anti-aging properties.
There is some amount of evidence that ginkgo may be helpful with the following conditions:

• Intermittent claudicaton
• Alzheimer's/multi-infarct dementia
• Cerebral insufficiency ( characterized by impaired concentration, confusion, decreased physical performance, fatigue, headache, dizziness, depression and anxiety)

There is indefinite but early evidence indicating gingko is beneficial for the following conditions:

• Memory enhancement in healthy people
• Altitude (mountain) sickness
• Symptoms of premenstrual syndrome (PMS)
• Reduction of chemotherapy induced end-organ vascular damage.
• Tinnitus (ringing in the ears) - use is controversial and a recent large trial showed evidence that it is not helpful

Precautions

Ginkgo is usually well tolerated but may increase bleeding and should be used cautiously by persons with known blood clotting problems or receiving blood thinners.
Ginkgo seeds are toxic and can cause seizures and loss of consciousness. They should not be consumed.
Insulin and blood sugar levels can theoretically be affected by ginkgo. Diabetics should be closedly monitored if taking ginkgo.
Consumption of ginkgo is not recommended in pregnancy or during breast feeding.

Side Effects

The use of ginkgo has produced rare side effects including:

• Headache
• Dizziness
• Stomach upset
• Nausea
• Diarrhea
• Vomiting
• Muscle weakness
• Loss of muscle tone
• Restlessness
• Heart racing
• Rash
• Irritation around mouth

Dosing

Adult dose is generally 80 to 240 mg of a 50:1 standardized leaf extract taken daily by mouth in two to three divided doses. Ginkgo is not recommended for children. This herb has been taken safely by adults at recommended doses for up to six months.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no assurance that the product you purchase is pure and of a specific concentration. There may also be contaminants present that could have harmful effects. These substances can interact with your current medications and with other supplements you may already be taking. Before taking any herb or supplement, you should tell your health care provider to receive appropriate advice.

Resources

National Center for Complementary and Alternative Medicine

Tick Bites and Lyme Disease

Tick bites are more common in the late spring and summer months.  Lyme disease is a tick-transmitted disease caused by a bacterium, Borrelia burgdorferi.  This organism is carried by the deer tick and the white-footed mouse is the primary animal reservoir for Borrelia burgdorferi and the preferred host for nymphal and larval forms of the deer tick.  Deer are hosts for adult ticks but do not carry Borrelia.

Lyme disease has been reported in 49 states, but most cases occur from Massachusetts to Maryland, in Wisconsin and Minnesota, and in California and Oregon.

Deer tick nymphs attack humans and are very small and hard to see.  Infection does not usually occur until the tick has been in place for more than 36 hours.  Looking for and removing ticks quickly can prevent development of Lyme disease. 

The proper technique for tick removal includes the following:

• Use tweezers to grasp the tick as close to the skin surface as possible.
• Pull backwards gently but firmly without jerking or twisting.
• Do not squeeze, crush, or puncture the body of the tick.
• After removing the tick, wash the skin and hands thoroughly with soap and water.
• If any mouth parts of the tick remain in the skin, these should be left alone; they will be expelled on their own. 

Ticks that transmit Lyme disease are usually brown and about the size of a poppy seed (nymphs).  Larger ticks that are brown with a white collar are usually dog ticks and do not transmit the disease.

Even a deer tick must first take a blood meal which takes 36 to 48 hours and transmit the organism that causes Lyme disease.  That is why early removal of the tick before it is engorged with blood will help prevent the disease.

Lyme disease usually manifests on the skin with a red area at the bite site.  The area expands, often with central clearing.  If untreated, other smaller areas develop on the skin over time.  Flu-like symptoms then develop with malaise, fatigue, chills, fever, headache, muscle aches and joint pain.  These and other symptoms may continue for weeks.  Neurologic symptoms may develop in some patients including numbness and sensory changes.  A small number of patients will develop cardiac symptoms such as heart block, decreased cardiac output and inflamed heart muscle with chest pain.

Untreated Lyme disease will develop late stage symptoms months or years after the initial infection.  This can include arthritis with joint pain and swelling.  Mood changes, sleep disturbance and memory problems are also late stage manifestations.

Lyme disease is treated with antibiotics.  Patients that have been bitten by a suspect tick but with no clinical manifestations are often treated with a single dose of doxycycline.  Patients with symptoms of disease are treated with doxycycline for 14 to 21 days.  Other antibiotics are also used depending on the situation.

There is currently no vaccine available to prevent this disease, so careful monitoring for tick bites is the best prevention.

Cold Cereal For Breakfast May Not Be Bad

A recent study comparing children who skipped breakfast with those who eat cold cereal and those who eat "other breakfasts" indicates that the cereal eaters have healthier diets.

It was found that breakfast skippers tended to eat more snack foods during the day with higher calorie content. They ended up with larger waists and higher BMIs (body mass index) than their cereal eating counterparts. Twenty-two percent of breakfast skippers were overweight compared to just under 20% of the "other breakfast" eaters and 15% of the cereal eaters.

Kids who ate ready-to-eat cereals had more favorable nutrient intake profiles and healthier weights that either the breakfast skippers or kids who ate "other breakfasts."

Researchers found that 20% of children between the ages of 9 and 13 and nearly a third of kids from 14 to 18 were skipping breakfast.

So the bottom line appears to be, don't worry about your children eating cold cereal for breakfast. Eating cereal appears to be healthier than not eating breakfast or eating other types of breakfast food.

Topical Anti-Inflammatory Medications May Be Safe

A recent report indicates that topical non-steroidal anti-inflammatory drugs (NSAISs) may be safe and effective for acute musculoskeletal conditions in adults.

The use of topical NSAIDs is attractive because there is found to be no GI side effects from using these medications compared to taking the same medications by mouth.

The goal of the study was to evaluate the evidence from randomized double blind, controlled trials of the efficacy and safety of topically applied NSAIDs for relief of acute pain. There were very few systemic adverse events or adverse events causing study withdrawals, and local skin reactions were usually mild, self-limited, and not different from those seen with placebo.

It has been concluded that topical NSAIDs can provide good levels of pain relief without the systemic adverse events associated with oral NSAIDs when used to treat acute musculoskeletal conditions.

Topical NSAIDs can provide good levels of pain relief in acute conditions such as sprains, strains and overuse injuries, probably similar to that provided by oral NSAIDs. Topical NSAIDs are not associated with an increased incidence of local skin reactions compared with placebo, and do not cause systemic(gastrointestinal problems) problems seen with oral NSAIDs. This makes them particularly useful for individuals unable to tolerate taking these medications by mouth.

Stress Relief

Stress is defined as a state of mental or emotional strain. Everyone experiences stress to some degree and depends on individual perception.

Stress has been termed the "fight or flight" response to perceived danger. This occurs when you must defend yourself from real danger by either standing your ground and fighting or running away to a safer place. The body's physical response includes releasing a surge of hormones such as adrenaline and cortisol that cause increased glucose to the blood, elevated heart rate and blood pressure and heightened alertness by increasing the brain's use of glucose.

When sources of stress become constant and more difficult to deal with, the "fight or flight" response continues on with no let up. The constant heightened level of bodily response then begins to show negative symptoms that indicate harm to overall health and emotional well being.

Stress can occur due to physical trauma such as an accident or surgery, but also due to psychological factors such as relationship problems, pressure of school, job, or social situations like speaking before a group or meeting new people.

Harmful effects of stress can include increased blood pressure, headaches, stomach ache, muscle aches, sleep problems, diarrhea, constipation, fatigue, appetite problems, weight problems, sexual problems, increased susceptibility to infections, and others.

Emotional effects can include depression, anxiety, irritability, panic attacks, feelings of helplessness, confusion, forgetfulness, guilt, mood swings and insecurity.

Social effects of stress can include job dissatisfaction, decreased productivity, marital problems, social isolation, resentment of others, angry outbursts, loss of friends.

Managing stress includes many aspects. Learning what is stressful to you and talking control is important. Developing a realistic work schedule, managing time more effectively, taking time out to relax, saying "no" when necessary, prioritizing time, delegating tasks and standing up for your rights will lessen stress.

Learning how to relax by using relaxation training techniques and meditation can be very helpful. A regular schedule of exercise like walking, swimming, or biking is often recommended along with a balanced diet.

Connecting with friends and family, talking with a counselor or therapist is often recommended. Medications are available that can reduce symptoms of stress, so discussing problems with your primary care doctor can be helpful.

Community mental health centers, the YMCA and other community organizations offer stress management programs.