Breast feeding is a wonderful natural way to nourish your baby. We support breast-feeding, however.. if you choose not to, we support you as well. Come and speak with our Drs about your choices!

Come Along Check Your Blood Sugar- It is free!!
If you would like to book an appointment with the general practitioners at the Pakenham Medical Clinic, use the button "BOOK NOW!"

Ginkgo biloba is extracted from the leaves of the maidenhair tree, which is native to China. The nuts from the tree are considered a delicacy in some countries but are known to be toxic when consumed in large quantities.1,2 The leaf extract has featured prominently in traditional Chinese medicine for thousands of years and has been thought to relieve a wide array of symptoms including memory loss, anxiety, asthma, schizophrenia, diabetes and erectile dysfunction.3 Ginkgo biloba has recently attracted attention for its possible effects on Alzheimer’s disease and dementia; however, research findings have been inconsistent and no firm conclusions can be drawn.4 Despite the lack of clear evidence for its benefits, it is widely used both in the East and the West.

Who asks about ginkgo biloba?

To identify the most commonly asked questions, we analysed 125,919 calls from the NPS MedicineWise (NPS) Medicines Line (1 September 2002–30 June 2010) for consumers and 57,840 calls from the Therapeutic Advice and Information Service (TAIS; 1 Jan 2000–30 June 2010) for community healthcare providers.5 The medicine call centres received queries from 353 consumers (3.5% of all complementary medicines questions) and 169 healthcare professionals (3.1%) concerning gingko biloba.5

The average age of consumers calling about ginkgo biloba was 58 years; 77% were women and most questions focused on interactions (58%), efficacy (17%) and adverse drug reactions (ADRs, 10.6%). Similarly, health professionals were predominantly concerned about interactions (69%) and ADRs (28%), whereas efficacy only featured in 3.6% of their calls.

Common consumer questions

Is ginkgo biloba effective for treating tinnitus?

No, ginkgo biloba is probably not effective for treating tinnitus. Ginkgo biloba has been widely used to manage tinnitus. The proposed mechanism of action is via effects on vasoregulation and neuronal metabolism. Several studies have suggested an effect on tinnitus caused by cerebrovascular insufficiency for up to 3 months.6 However, positive improvement was not shown in two large, high-quality studies where tinnitus was the primary complaint.7 The discrepancies in the literature may be related to the different causes of tinnitus.7

Is it safe to combine ginkgo biloba with antidepressants?

The limited information published suggests it is not considered safe to combine ginkgo biloba with antidepressants, including prescription medications such as selective serotonin re-uptake inhibitors, or St John’s wort.8–10 This topic has been poorly researched. However, studies in animals have suggested that taking ginkgo biloba and antidepressants together may increase the risk of serotonin toxicity.8 Symptoms of serotonin toxicity include confusion, sweating, shaking, muscle contraction and diarrhoea.11 However, studies in humans are lacking. There have also been reports of ginkgo biloba possibly causing seizures by reducing the levels of antiepileptic medication.9,10 Given that some antidepressants also increase the risk of seizures, the benefit of using a combination of ginkgo biloba and an antidepressant should be weighed against the potentially high risk of seizure.

Common health professional questions

Is it safe to combine blood pressure medication with ginkgo biloba?

It is considered safe to combine blood pressure medication with ginkgo biloba. However, blood pressure monitoring is recommended when a patient commences taking the herb.12–15 Ginkgo biloba has been shown to reduce blood pressure in some trials,16 although most studies did not report a change in blood pressure.12–15

Does ginkgo biloba interact with aspirin?

No, it is safe to combine ginkgo biloba with aspirin. Case reports have suggested that ginkgo biloba may increase the risk of bleeding17–19 but several randomised controlled trials have found that ginkgo biloba does not increase the risk of bleeding when added to aspirin at a dose of up to 500 mg/day.20–23

Resources

www.webmd.com/vitamins-supp…/ingredientmono-333-ginkgo.aspx…

www.nlm.nih.gov/medlineplus/druginfo/natural/333.html

by ABC Health & Wellbeing

Not sweating? You’re wasting your time. Feeling pain? Just push through it! Not everything you hear about exercise is correct or helpful. We separate the fact from the fiction.

When it comes to exercise, there are plenty of instant experts only too happy to share with you their emphatic advice on everything from the time of day that’s best for getting moving, to dire warnings about how eating before you go swimming might make you drown. Unfortunately their advice is not always accurate.

We’ve spoken to experts with years of study on exercise science behind them. Here they give their verdicts on eight common beliefs that might be stopping you getting the most out of your activity. So why not inform yourself and use it as motivation to get moving?

1. Belief: Exercise in the morning is best for your body

Expert verdict: Not necessarily. The time of day is less important than exercising regularly.

Exercise first thing may help you burn more fat, but studies have shown people often find exercise easier at the end of the day, allowing them to go harder and so burn more fuel anyway. And while getting moving can elevate your metabolism, the benefit from that is no greater in the morning than in the night. It’s true we seem to perform better at different types of exercise at different times of the day. But research suggests you can train your body to get used to exercise at a certain time of day. So if your early morning alarm leaves you more likely to slap the snooze button than slip on some sneakers, don’t worry that you’re missing out on the best time of day to get active. Finding a time you’ll stick at is what matters most.

More info: Is exercise in the morning best for your body?

2. Belief: Exercise wears out your joints

Expert verdict: Usually not. In most cases, exercise will benefit rather than harm joints

Exercise can certainly aggravate pain in damaged joints but that doesn’t necessarily mean it’s wearing away the cartilage. Cartilage is the living tissue that covers the ends of bones in a joint and helps them move against each other easily. When it’s damaged, it can cause pain. But there’s nothing to support the idea that joints are like car tyres or light bulbs with a limited number of “uses” before their lifetime expires. While there are circumstances where exercise might feasibly help wear cartilage in joints away, these tend to occur in only a minority of people. If joints like your ankles or knees hurt from exercise, you might need to try something with lower impact like swimming or bike riding. But stopping exercise altogether is not recommended as it’s one of the best ways we know to keep joints healthy.

More info: Can doing a lot of exercise wear out your joints?

3. Belief: You need to do vigorous exercise if you want to get any benefit

Expert verdict: No, you don’t. But vigorous exercise can have some important extra benefits for some people.

Despite what hard-core exercise fanatics will tell you – you don’t have to push yourself really hard when you exercise to get health benefits. If you’ve been inactive, and you start doing around 30 minutes a day of moderate exercise – where you’re breathing a bit harder than normal but you can still talk – you can cut your risk of heart disease by up to half (and reduce your risk of lots of other nasties too). With vigorous exercise, you’re pushing yourself further, so it’s hard to say more than a few words at a time. This does bring extra benefits over exercising moderately, but these are proportionally smaller, so there’s less “bang for buck” if you like. Still vigorous exercise can save you time; you can get the same health benefits as you would from a session of moderate exercise in roughly half the time. It can also add variety and it’s the best way to maximise fitness. That’s great for competitive sport, and the fitter you are, the less likely it is you’ll die of any health condition you can name. And some people just find it more enjoyable. If that’s not you, that’s fine. Just don’t let it be a reason to avoid exercise altogether.

More info: Do you need to do vigorous exercise?

4. Belief: You should never exercise with a cold

Expert verdict: It depends on your symptoms. Exercise with a light cold may be fine or even helpful.

Colds and flu-like bugs can throw a spanner in the works when you’re on a roll with an exercise regime. In general, exercise is good for immunity. But pushing yourself too hard can have the opposite effect, albeit only temporarily. Nonetheless that’s not helpful if you’re fighting a cold. So should you stop exercise with a cold or push on? A good way to tell is the “neck check”. If your symptoms are from the neck up and not too severe, moderate exercise is unlikely to hurt and might be helpful. But if you feel unwell and your symptoms are more troublesome, and particularly below the neck, it’s best to take a break. Exercise with chest congestion, pain in muscles and joints, or especially, with a fever can prolong your illness and be dangerous (it can make you faint and in rare cases cause heart damage). When your symptoms have passed, you can get back into things but be sure to do that gradually.

More info: Should you avoid exercise when you’ve got a cold?

5. Belief: Exercise means pushing through pain

Expert verdict: A certain level of discomfort is expected but pain is often a sign you need to stop

Some discomfort often goes hand in hand with the exertion of exercise. While this is simply a sign your body is making an effort, it’s important to differentiate that from actual pain, says Carly Ryan, exercise physiologist at Exercise and Sports Science Australia. While it’s hard to generalise, anything that feels stabbing or sharp tends not to be a good sign, she says. And if you’re feeling pain in muscles, joints or anything associated with chest pain, stop exercise immediately. But if it’s just a burning sensation in your muscles and it goes away when you stop, it’s probably fine to start moving once more. But if stopping and restarting sees continuation of say a sharp pain in your knees or a painful twinge in your hamstring, then it’s most likely pain because you’ve overdone it and you need to stop. Ultimately, if what you’re doing feels too much for your body, you may well be best to ease off.

More info: Should you ‘push through pain’ when you exercise?

6. Belief: Swimming after eating is dangerous

Expert verdict: There’s no evidence it’s dangerous but it may be uncomfortable

Plenty of us have had it drilled into us that “you can’t swim after you eat”. Why? Because it will give you muscle cramps and you’ll be unable to stop yourself from drowning. It’s true that after a meal, your gut draws blood from around the body, including from muscles, to help with digestion. This results in less oxygen and nutrients being delivered to muscles. And while this might increase the chances of the muscles not functioning as efficiently as usual, there’s no research suggesting it causes cramps that can make you drown. But doing strenuous exercise with a full stomach can be uncomfortable and has been known to make people vomit. So while a relaxed dip in the pool or surf after a meal is unlikely to kill you, it’s probably best to let your food sit a while before taking the plunge.

More info: Is it dangerous to swim after eating?

7. Belief: If you don’t sweat while exercising, you’re not working hard enough

Expert verdict: Not true. How much you sweat is not a good way to tell how hard you’re exercising.

Sweating is one of the methods your body uses to maintain a stable temperature. When you get too hot, sweat is released from glands onto the surface of your skin, where it evaporates and helps cool you down. While exercise can make us sweat, how much we sweat and how long we remain sweaty depends on a number of factors, such as the external temperature and humidity. Your fitness level can also affect how much you sweat too. So how do you tell if you’re working “hard enough” when you exercise? Any level of exercise has health benefits but guidelines suggest we aim for at least moderate intensity (where your breathing rate is increased but you can still talk), although going harder brings further benefits still.

More info: Is sweating a good indicator of a healthy workout?

8. Belief: Running means kissing healthy knees and ankles goodbye

Expert verdict: Running can cause injuries but there are simple measures that reduce the risk.

Would-be runners are often discouraged when they hear tales of the aches and pains that come with the territory of being a regular pavement pounder. The most common injuries include shin splints, jogger’s heel, Achilles tendinopathy and knee (or iliotibial band – ITB) strain. Not only are these painful, but they can cost a small fortune in physiotheraphy bills and sideline you for weeks. But experts say running itself doesn’t cause injuries; it’s that many casual runners don’t wear appropriate shoes or don’t do resistance training to keep their leg muscles strong. While there’s debate over whether forefoot or rearfoot striking (that is which part of your foot lands first) is better for speed and injury prevention, amateur runners are better to stick with what feels natural, says Sebastian Buccheri, exercise physiologist and board director of Exercise and Sports Science Australia. Most people wear the wrong shoes because they don’t know what their natural foot alignment is. He strongly recommends having a podiatrist assess your feet and stride, so you can be fitted with appropriate running shoes. It also helps to ease yourself into your running, include warm ups and cool downs before and after, do regular strength training exercises, and schedule days for rest and recovery.

More info: Do runners risk injuring their knees and ankles?