Can Ginkgo Biloba Extract Be Safely Combined with Thyroid and Liver Medications?

Is it safe to use ginkgo biloba extract simultaneously with liver medications, thyroid hormones, and ginseng? Thank you!

Hello Dr.
Liao,
My husband underwent treatment for stage III nasopharyngeal carcinoma 10 years ago (radiation and chemotherapy).
In the past couple of years, he has developed symptoms of hypothyroidism and elevated liver enzymes, for which the doctor has prescribed long-term medications including Antaxin and liver support medications.
Additionally, my mother-in-law insists that he drink a daily herbal soup made from [ginseng, astragalus, red dates, and goji berries] (I usually prepare 2000cc for him to drink throughout the day).

This past week, he experienced dizziness (which he has recurrently), and any movement triggers it, making walking and standing difficult.
After consulting a second doctor, he was prescribed ginkgo biloba for three days, and after taking it only twice, his symptoms improved significantly, almost returning to normal.
Therefore, I am considering purchasing Xunli Ning or Jing Ning (ginkgo leaf extract) for long-term maintenance.

I have a couple of questions:
1.
Can Xunli Ning or Jing Ning (ginkgo leaf extract) be taken together with liver medications, thyroid hormones, and herbal medicine?
2.
Currently, due to his health condition and the fact that we are a dual-income household, we often eat out and cannot prepare three meals a day.
He is also taking daily supplements: B vitamins, vitamin E, lutein, glucosamine tablets, and calcium.
Is it appropriate to take these supplements along with his medications, or could this overload his system and be detrimental to his health?
I apologize for being a bit verbose and for any inconvenience caused.
Thank you for your assistance.

ching, 40~49 year old female. Ask Date: 2015/11/02

Dr. Liao Huiling reply Pharmacology

1.
Regarding whether your family member's current condition is suitable for daily consumption of [ginseng + astragalus + red dates + goji berries], it is recommended to consult a traditional Chinese medicine practitioner.
2.
Ginkgo biloba extract does not have serious interactions with liver medications or thyroid hormones.
3.
No vitamin or dietary supplement can replace the nutrients from a regular diet; excessive intake may impose a burden on the liver and kidneys, so please be cautious.

Reply Date: 2015/11/02

More Info

When considering the use of Ginkgo Biloba extract alongside thyroid and liver medications, it is essential to evaluate both the potential benefits and risks associated with such combinations. Ginkgo Biloba, a herbal supplement often used for its purported cognitive benefits and circulation improvement, can interact with various medications, including those for thyroid and liver conditions.

1. Combining Ginkgo Biloba with Thyroid and Liver Medications: Generally, Ginkgo Biloba does not have severe interactions with thyroid medications like levothyroxine. However, it is crucial to monitor thyroid hormone levels regularly, as herbal supplements can sometimes influence metabolic processes. For liver medications, particularly those used to manage liver disease, the situation is more nuanced. Ginkgo Biloba is metabolized in the liver, and while it is not known to cause significant liver toxicity, patients with liver conditions should exercise caution. It is advisable to consult with a healthcare provider before starting Ginkgo Biloba, especially if the patient is on medications for liver health.

2. Use of Traditional Chinese Medicine (TCM) and Other Supplements: The combination of Ginkgo Biloba with traditional Chinese medicine (TCM) formulations, such as the herbal soup your mother-in-law prepares, should also be approached with caution. TCM can have various effects on the body, and the interaction with Ginkgo Biloba is not well-documented. Therefore, it would be prudent to consult a qualified TCM practitioner who can assess the specific herbs being used and their compatibility with Ginkgo Biloba and the medications your husband is taking.

3. Nutritional Supplements: The daily intake of B vitamins, Vitamin E, lutein, glucosamine, and calcium alongside Ginkgo Biloba and other medications is generally considered safe, provided that the dosages are within recommended limits. However, excessive intake of supplements can lead to potential side effects or interactions. For example, high doses of Vitamin E can increase the risk of bleeding, especially if the patient is on anticoagulant therapy. It is essential to ensure that the total intake of vitamins and supplements does not exceed the recommended dietary allowances (RDAs) and to discuss any concerns with a healthcare provider.

4. Monitoring and Adjustments: Given your husband's complex medical history and current health status, regular monitoring of liver function tests, thyroid hormone levels, and overall health is crucial. If he experiences any new symptoms or if there are changes in his condition, it may be necessary to adjust his treatment plan.
In summary, while Ginkgo Biloba can be a beneficial addition to your husband's regimen, it is essential to approach its use with caution, particularly in the context of existing liver and thyroid medications. Consulting with healthcare professionals, including both conventional and alternative medicine practitioners, can help ensure that all aspects of his health are considered and managed appropriately. Regular follow-ups and open communication with his healthcare team will be vital in navigating his treatment effectively.

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