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	<title>Comments on: Ginkgo biloba …what is it good for?</title>
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	<link>http://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/</link>
	<description>Scotty, The Naked Time, stardate 1704.3, Episode 7</description>
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		<title>By: milk thistle</title>
		<link>http://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/#comment-660</link>
		<dc:creator>milk thistle</dc:creator>
		<pubDate>Sun, 23 Nov 2008 12:38:54 +0000</pubDate>
		<guid isPermaLink="false">http://apgaylard.wordpress.com/?p=377#comment-660</guid>
		<description>[...] or as part of a multibotanical regimen, shows little potential as an important therapy for reliefhttp://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/Milk Thistle -- Summary ReportMilk thistle actions, indications, and uses with clinical studies and [...]</description>
		<content:encoded><![CDATA[<p>[...] or as part of a multibotanical regimen, shows little potential as an important therapy for reliefhttp://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/Milk Thistle &#8212; Summary ReportMilk thistle actions, indications, and uses with clinical studies and [...]</p>
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		<title>By: apgaylard</title>
		<link>http://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/#comment-655</link>
		<dc:creator>apgaylard</dc:creator>
		<pubDate>Wed, 19 Nov 2008 19:34:04 +0000</pubDate>
		<guid isPermaLink="false">http://apgaylard.wordpress.com/?p=377#comment-655</guid>
		<description>dvnutrix: Thanks for the reference and the astute comment.  It looks like a pretty sound study.  As you say, it&#039;d be great if things were different!</description>
		<content:encoded><![CDATA[<p>dvnutrix: Thanks for the reference and the astute comment.  It looks like a pretty sound study.  As you say, it&#8217;d be great if things were different!</p>
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		<title>By: dvnutrix</title>
		<link>http://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/#comment-653</link>
		<dc:creator>dvnutrix</dc:creator>
		<pubDate>Wed, 19 Nov 2008 17:41:39 +0000</pubDate>
		<guid isPermaLink="false">http://apgaylard.wordpress.com/?p=377#comment-653</guid>
		<description>Sadly, another RCT with Gingko has been reported, and it doesn&#039;t prevent the onset of Alzheimer&#039;s Disease: &lt;a href=&quot;http://jama.ama-assn.org/cgi/content/full/300/19/2253&quot; rel=&quot;nofollow&quot;&gt;Ginkgo biloba for Prevention of Dementia&lt;/a&gt;.
&lt;blockquote&gt;In this study, G biloba at 120 mg twice a day was not effective in reducing either the overall incidence rate of dementia or AD incidence in elderly individuals with normal cognition or those with MCI. 
&lt;/blockquote&gt;
It would be fabulous if there were a simple intervention that would block the onset of such a cruel disease, but it looks as if Gingko isn&#039;t that intervenion (not that anything else is as yet).</description>
		<content:encoded><![CDATA[<p>Sadly, another RCT with Gingko has been reported, and it doesn&#8217;t prevent the onset of Alzheimer&#8217;s Disease: <a href="http://jama.ama-assn.org/cgi/content/full/300/19/2253" rel="nofollow">Ginkgo biloba for Prevention of Dementia</a>.</p>
<blockquote><p>In this study, G biloba at 120 mg twice a day was not effective in reducing either the overall incidence rate of dementia or AD incidence in elderly individuals with normal cognition or those with MCI.
</p></blockquote>
<p>It would be fabulous if there were a simple intervention that would block the onset of such a cruel disease, but it looks as if Gingko isn&#8217;t that intervenion (not that anything else is as yet).</p>
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		<title>By: apgaylard</title>
		<link>http://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/#comment-638</link>
		<dc:creator>apgaylard</dc:creator>
		<pubDate>Sun, 16 Nov 2008 21:26:41 +0000</pubDate>
		<guid isPermaLink="false">http://apgaylard.wordpress.com/?p=377#comment-638</guid>
		<description>dvnutrix: That&#039;s an interesting point.  It looks like the Cochrane review has been re-issued with a less positive assessment than it had originally.

In &lt;a href=&quot;http://www.ncbi.nlm.nih.gov/pubmed/12519586&quot; rel=&quot;nofollow&quot;&gt;2002&lt;/a&gt; it was, &quot;Overall there is promising evidence of improvement in cognition and function associated with Ginkgo.&quot;

Then the 2007 revision, &quot;There is no convincing evidence that Ginkgo biloba is efficacious for dementia and cognitive impairment&quot; (as cited).

So I think I have some sympathy, as it seems to have been a bit of a moving target.  Still the 2002 version did carry caveats:
&lt;blockquote&gt;&quot;However, the three more modern trials show inconsistent results. Our view is that there is need for a large trial using modern methodology and permitting an intention-to-treat analysis to provide robust estimates of the size and mechanism of any treatment effects.&quot;&lt;/blockquote&gt;

I wonder if it shows the dangers of accepting too low a standard of evidence to support the recommendadtion of a product to the general public.  From what I&#039;ve read I don&#039;t see even the positive trials being large enough and of sufficient quality for that.  Perhaps part of the classic double standard in the burden of proof required for alternative and conventional therapies?

Anyway, I&#039;ll see what they have to say and perhaps suggest that they review their position.</description>
		<content:encoded><![CDATA[<p>dvnutrix: That&#8217;s an interesting point.  It looks like the Cochrane review has been re-issued with a less positive assessment than it had originally.</p>
<p>In <a href="http://www.ncbi.nlm.nih.gov/pubmed/12519586" rel="nofollow">2002</a> it was, &#8220;Overall there is promising evidence of improvement in cognition and function associated with Ginkgo.&#8221;</p>
<p>Then the 2007 revision, &#8220;There is no convincing evidence that Ginkgo biloba is efficacious for dementia and cognitive impairment&#8221; (as cited).</p>
<p>So I think I have some sympathy, as it seems to have been a bit of a moving target.  Still the 2002 version did carry caveats:</p>
<blockquote><p>&#8220;However, the three more modern trials show inconsistent results. Our view is that there is need for a large trial using modern methodology and permitting an intention-to-treat analysis to provide robust estimates of the size and mechanism of any treatment effects.&#8221;</p></blockquote>
<p>I wonder if it shows the dangers of accepting too low a standard of evidence to support the recommendadtion of a product to the general public.  From what I&#8217;ve read I don&#8217;t see even the positive trials being large enough and of sufficient quality for that.  Perhaps part of the classic double standard in the burden of proof required for alternative and conventional therapies?</p>
<p>Anyway, I&#8217;ll see what they have to say and perhaps suggest that they review their position.</p>
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		<title>By: dvnutrix</title>
		<link>http://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/#comment-637</link>
		<dc:creator>dvnutrix</dc:creator>
		<pubDate>Sun, 16 Nov 2008 20:01:12 +0000</pubDate>
		<guid isPermaLink="false">http://apgaylard.wordpress.com/?p=377#comment-637</guid>
		<description>It is an interesting dilemma for the ASA. They may carry out a review of the literature one year and judge that a product is making reasonable claims. However, some time later, with more evidence (direct or indirect), it seems that the evidence really isn&#039;t that strong - do they have any obligation to review the situation on a regular basis or just to respond to requests that they should?</description>
		<content:encoded><![CDATA[<p>It is an interesting dilemma for the ASA. They may carry out a review of the literature one year and judge that a product is making reasonable claims. However, some time later, with more evidence (direct or indirect), it seems that the evidence really isn&#8217;t that strong &#8211; do they have any obligation to review the situation on a regular basis or just to respond to requests that they should?</p>
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		<title>By: g2-4d8879ecffa3d97be7c27b518f4dc430</title>
		<link>http://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/#comment-636</link>
		<dc:creator>g2-4d8879ecffa3d97be7c27b518f4dc430</dc:creator>
		<pubDate>Sun, 16 Nov 2008 16:40:36 +0000</pubDate>
		<guid isPermaLink="false">http://apgaylard.wordpress.com/?p=377#comment-636</guid>
		<description>I find that remembering how the hell you&#039;re meant to spell this herb does aid my memory.</description>
		<content:encoded><![CDATA[<p>I find that remembering how the hell you&#8217;re meant to spell this herb does aid my memory.</p>
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		<title>By: draust</title>
		<link>http://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/#comment-635</link>
		<dc:creator>draust</dc:creator>
		<pubDate>Sun, 16 Nov 2008 15:31:10 +0000</pubDate>
		<guid isPermaLink="false">http://apgaylard.wordpress.com/?p=377#comment-635</guid>
		<description>Yes, I  figured. I try for understatement on occasion, but polemic usually gets the better of me. Oh well...</description>
		<content:encoded><![CDATA[<p>Yes, I  figured. I try for understatement on occasion, but polemic usually gets the better of me. Oh well&#8230;</p>
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		<title>By: apgaylard</title>
		<link>http://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/#comment-634</link>
		<dc:creator>apgaylard</dc:creator>
		<pubDate>Sun, 16 Nov 2008 15:21:17 +0000</pubDate>
		<guid isPermaLink="false">http://apgaylard.wordpress.com/?p=377#comment-634</guid>
		<description>draust: Thought you might like the allusion; I decided to err on the side of understatement.</description>
		<content:encoded><![CDATA[<p>draust: Thought you might like the allusion; I decided to err on the side of understatement.</p>
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		<title>By: draust</title>
		<link>http://apgaylard.wordpress.com/2008/11/16/ginkgo-biloba-%e2%80%a6what-is-it-good-for/#comment-633</link>
		<dc:creator>draust</dc:creator>
		<pubDate>Sun, 16 Nov 2008 13:41:35 +0000</pubDate>
		<guid isPermaLink="false">http://apgaylard.wordpress.com/?p=377#comment-633</guid>
		<description>I&#039;m surprised at your restraint in not completing the famous &lt;a href=&quot;http://uk.youtube.com/watch?v=_d8C4AIFgUg&amp;feature=related&quot; rel=&quot;nofollow&quot;&gt;song lyric&lt;/a&gt; alluded to in your title, AP.

&lt;blockquote&gt;&quot;Gingko...*huh*
What it is good for?
Absolutely nothing!
Say it again...!&quot;&lt;/blockquote&gt;

While it might not be strictly 100% accurate for Gingko, it seems to be getting prophetically close. And a lot closer than Mr Holland and Mr Barrett.</description>
		<content:encoded><![CDATA[<p>I&#8217;m surprised at your restraint in not completing the famous <a href="http://uk.youtube.com/watch?v=_d8C4AIFgUg&amp;feature=related" rel="nofollow">song lyric</a> alluded to in your title, AP.</p>
<blockquote><p>&#8220;Gingko&#8230;*huh*<br />
What it is good for?<br />
Absolutely nothing!<br />
Say it again&#8230;!&#8221;</p></blockquote>
<p>While it might not be strictly 100% accurate for Gingko, it seems to be getting prophetically close. And a lot closer than Mr Holland and Mr Barrett.</p>
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