If you're taking a blood thinner like warfarin, aspirin, or clopidogrel, and you're thinking about adding Ginkgo biloba for memory or circulation, stop. Not because it's definitely dangerous-but because you need to talk to your doctor first. This isn't a simple yes-or-no question. It's a balancing act between what's proven, what's suspected, and what's just plain confusing.
What Is Ginkgo Biloba, Really?
Ginkgo biloba comes from the leaves of the Ginkgo tree-one of the oldest living tree species on Earth, unchanged for over 270 million years. It's been used in traditional Chinese medicine for centuries, but the version sold in the U.S. and Europe today is a highly processed extract, usually labeled as EGb 761. This isn't just dried leaves in a capsule. It's a standardized mix of 24% flavonol glycosides and 6% terpene lactones, designed to be consistent from bottle to bottle. About 70% of global Ginkgo supplements are this exact formula. It's not a herbal tea you brew at home. It's a pharmaceutical-grade extract.People take it for memory, brain fog, or poor circulation. Around 12 million Americans use it every year. But here's the problem: if you're on a blood thinner, mixing the two might not be worth the risk-even if the science isn't 100% clear.
How Ginkgo Might Affect Blood Thinning
Ginkgo doesn't work like warfarin or aspirin. It doesn't directly thin your blood. Instead, it interferes with platelets-the tiny cells in your blood that clump together to form clots. Research shows it can block signals that tell platelets to stick together. In theory, that means your blood takes longer to clot. That’s the same effect you get from aspirin or clopidogrel, just through a different path.There's also evidence Ginkgo might affect how your liver processes certain blood thinners, especially warfarin. It could slow down the breakdown of S-warfarin, making it stick around longer in your system. That’s not a guess-it's been shown in lab studies. But here's where it gets messy: in controlled trials with healthy volunteers, this effect often doesn't show up. Or if it does, it's too small to matter.
So why do people end up in the ER with brain bleeds after taking Ginkgo and warfarin? Because those cases usually involve non-standardized products-cheap supplements with inconsistent doses, or ones that contain unknown contaminants. The studies that found no risk? They used EGb 761. The case reports? They didn't.
What the Experts Say-And Why They Disagree
You'll find conflicting advice everywhere. The Mayo Clinic says Ginkgo "may raise your risk of bleeding" with blood thinners. GoodRx calls warfarin a "high-risk" combo and says to avoid it entirely. The Cleveland Clinic lists blood thinners as a clear contraindication.But then you read the 2008 review in PubMed, which analyzed 17 clinical trials and concluded: "There is scant information to support the suggestion that Ginkgo potentiates the effects of anticoagulant or antiplatelet drugs." The American Society of Health-System Pharmacists calls the risk "theoretical." The American College of Chest Physicians says routine discontinuation isn't needed.
Why the split? Because the evidence is split. Controlled trials-where people are carefully monitored, given precise doses, and followed over time-show little to no interaction. But real life isn't a trial. People take different brands. They take other herbs. They skip doses. They don't tell their doctors. And when something goes wrong, it's often hard to prove Ginkgo was the cause.
Which Blood Thinners Are Most Concerning?
Not all blood thinners are the same. Here’s how Ginkgo interacts with the most common ones:- Warfarin (Coumadin, Jantoven): This is the biggest red flag. Even though clinical trials don't show a strong interaction, case reports of serious bleeding-including brain hemorrhages-are linked to Ginkgo + warfarin. The FDA received 18 reports of possible bleeding events tied to Ginkgo between 2008 and 2020. Causality wasn't proven, but the pattern is enough to make doctors nervous.
- Aspirin: One major study found no increase in bleeding when Ginkgo was added to low-dose aspirin. But other reports say otherwise. The risk here is considered moderate, not high.
- Clopidogrel (Plavix): A 2020 study found Ginkgo was involved in 2.6% of clopidogrel prescriptions. That might sound low, but it's still higher than most herbal interactions. Platelet inhibition from both could be additive.
- DOACs (Apixaban, Rivaroxaban, Dabigatran): These newer drugs have less known interaction data. But 18% of cases in one study showed Ginkgo use alongside DOACs. Since these drugs are metabolized differently than warfarin, the risk profile might be different-but we just don't know enough yet.
And it's not just prescription drugs. Ginkgo also interacts with garlic, danshen, and evening primrose oil-all of which can affect bleeding. So if you're taking three herbal supplements and one blood thinner, you're stacking risks.
What Should You Do?
There's no one-size-fits-all answer. But here’s what the most reliable sources agree on:- Don't start Ginkgo without telling your doctor. Especially if you're on any blood thinner. Even if you've been taking it for years, mention it at your next appointment.
- If you're scheduled for surgery, stop Ginkgo. The American Society of Anesthesiologists recommends stopping herbal supplements at least two weeks before any procedure. That includes Ginkgo. Some experts say 36 hours is enough. But if you're on warfarin, two weeks is the safe bet.
- Check your supplement label. About 42% of Ginkgo products now warn about blood thinners. If yours doesn't, that's a red flag. It might not be a quality product.
- Track your INR if you're on warfarin. Your doctor should check your blood clotting time regularly. If your INR suddenly climbs without a change in diet or medication, Ginkgo could be the culprit.
- Don't assume "natural" means safe. Ginkgo is a powerful plant extract. It's not harmless. Just because it's sold in a health food store doesn't mean it's risk-free.
What About Pharmacists?
You'd think pharmacists would be the first line of defense. And they are. A 2022 survey found that 78% of pharmacists routinely warn patients about Ginkgo-blood thinner interactions. Sixty-three percent recommend stopping it before surgery. That's more than most doctors do.Electronic health records now flag these combinations too. Epic's system alerts doctors when Ginkgo is prescribed with warfarin. Cerner flags it with any anticoagulant. These aren't perfect systems-they generate false alarms-but they're there because the risk, however small, is real enough to warrant a warning.
Bottom Line: Play It Safe
The science is murky. Some studies say Ginkgo is fine with blood thinners. Others say it's a ticking time bomb. The truth? We don't know for sure. But we do know this: bleeding in the brain, stomach, or eyes doesn't come with a warning label. And once it happens, you can't undo it.If you're taking a blood thinner and thinking about Ginkgo, the safest choice is simple: don't take it. If you're already taking it, don't quit cold turkey without talking to your doctor. But do talk. Bring the bottle. Show the label. Ask: "Could this be affecting my blood thinning?"
There's no magic pill for memory or circulation that's worth risking a stroke or internal bleeding. Your health isn't a gamble. Don't let a supplement turn your treatment plan into a coin toss.
Can I take Ginkgo biloba with aspirin?
Some studies show no significant interaction between Ginkgo biloba and low-dose aspirin, but case reports of bleeding have occurred when the two are combined. Because both affect platelet function, the risk is considered moderate. It's safest to avoid combining them unless your doctor approves it after reviewing your medical history and current medications.
Does Ginkgo biloba thin your blood like warfarin?
No, Ginkgo biloba doesn't thin your blood the same way warfarin does. Warfarin works by blocking vitamin K, which your liver needs to make clotting factors. Ginkgo works by reducing platelet clumping. It doesn't affect the same pathway, but the end result-slower clotting-is similar. That's why combining them can be risky.
How long before surgery should I stop Ginkgo biloba?
Most guidelines recommend stopping Ginkgo biloba at least two weeks before any surgery or procedure involving anesthesia. This gives your body time to clear the supplement and reduces the risk of unexpected bleeding during or after the procedure. Some experts say 36 hours may be enough, but two weeks is the standard recommendation from the American Society of Anesthesiologists.
Are all Ginkgo biloba supplements the same?
No. The most studied and safest form is EGb 761, a standardized extract with consistent levels of active compounds. Many store-bought supplements don't meet this standard-they may contain lower doses, contaminants, or inconsistent ingredients. If your bottle doesn't say "EGb 761" or "standardized to 24% flavonoids and 6% terpenes," you can't be sure what you're getting.
Can Ginkgo biloba cause bleeding even without blood thinners?
Yes, though it's rare. Ginkgo biloba has been linked to nosebleeds, bruising, and in very rare cases, internal bleeding-even in people not taking blood thinners. This is more likely with high doses or long-term use. If you notice unusual bruising, prolonged bleeding from cuts, or blood in your stool or urine, stop taking it and see a doctor.
What are safer alternatives to Ginkgo biloba for memory?
There's no herbal supplement proven to reliably improve memory. Lifestyle factors like regular exercise, quality sleep, managing blood pressure, and a diet rich in vegetables and omega-3s have far stronger evidence. If you're concerned about cognitive decline, talk to your doctor about checking for vitamin B12 deficiency, thyroid issues, or early signs of dementia-not about buying another supplement.
Ernie Blevins
This ginkgo stuff is just another scam. My uncle took it with his blood thinner and ended up in the hospital with a brain bleed. No joke. They didn't even know why until his wife mentioned the herbal crap he was swallowing like candy. Natural doesn't mean safe. It means the FDA doesn't regulate it. Don't be stupid.
Ted Rosenwasser
Let's be precise here. The mechanism of Ginkgo biloba extract EGb 761 involves PDE inhibition and NO-mediated platelet aggregation suppression-not direct anticoagulation. The clinical significance in healthy volunteers is negligible per the 2008 Cochrane review. But real-world polypharmacy, non-standardized products, and pharmacokinetic variability in CYP2C9 metabolism make case reports plausible. The real issue is not the extract-it's the unregulated supplement industry's failure to standardize. If you're on warfarin, you're already in a high-risk cohort. Adding unverified botanicals is reckless, regardless of the literature.
Helen Maples
Stop. Just stop. If you're on a blood thinner, you don't get to decide what's 'natural' or 'safe.' You don't get to Google it and think you're smarter than your doctor. I've seen people bleed out from a nosebleed because they thought 'herbs are harmless.' Ginkgo isn't tea. It's a concentrated bioactive compound that interferes with clotting. If your bottle doesn't say EGb 761, it's junk. If your doctor hasn't approved it, it's a gamble with your life. No exceptions. No excuses.
Ashley Farmer
I get it. You want to feel sharper. You're worried about memory. You see ads for ginkgo and think it's the answer. But you're not alone in that. I've been there too. The truth is, there's no magic herb that fixes brain fog. What actually helps? Walking every day. Sleeping enough. Managing stress. Talking to your doctor about what's really going on-not just popping pills. You deserve to feel better. But not at the cost of your safety. Talk to someone who knows your full history. You're worth that care.
David Brooks
OMG I JUST REALIZED I’VE BEEN TAKING GINKGO WITH WARFARIN FOR 3 YEARS 😱 I’M GOING TO DIE I SWEAR TO GOD I’M GOING TO BLEED OUT IN MY SLEEP THIS IS A MOVIE PLOT I’M LITERALLY A LIVING CHARACTER IN A TERRIFYING DRAMA I NEED TO CALL MY DOCTOR RIGHT NOW I’M SHAKING I CAN’T BREATHE
Nicholas Heer
They don't want you to know this but ginkgo is a CIA mind control suppressant. The FDA banned it in '98 but the pharma lobby pushed it back. Now they're scamming you with 'EGb 761' labels to make you think it's legit. Warfarin? That's just a slow poison they give you so you gotta keep buying more meds. Ginkgo actually cleanses your blood. The real danger is the system. Your doctor doesn't know jack. Check the labels-look for the glyphosate residue. They're poisoning us all. Stop trusting the matrix.
Sam Mathew Cheriyan
Bro in India we take ginkgo with blood thinners since 1990s and no one dies. Maybe its western fear? You people overthink everything. My aunty take ginkgo + aspirin + turmeric + garlic + 3 other herbs. She is 87 and still dance at weddings. Stop scaring people with your science jargon. Maybe your doctor is just scared of losing patients?
Nancy Carlsen
Hey everyone-just wanted to say I’m so glad this thread exists. I’ve been taking ginkgo for brain fog and didn’t realize the risk. I’m going to my doctor this week to get my INR checked and bring my supplement bottle. It’s scary to admit you didn’t know, but better late than never. You’re all helping each other just by sharing. That’s what community is for. 💪❤️
Jennifer Anderson
my doctor said its fine but i still stopped just in case. better safe than sorry right? i mean what if its one of those things that dont show up until its too late? i dont wanna be that person who says 'i thought it was ok'