Category: 8. Health

This multicenter study investigates the association between hydroxychloroquine (HCQ) dosage and COVID-19 mortality among hospitalized patients in China, aiming to clarify conflicting evidence from prior research. Leveraging data from multiple medical centers, the analysis focuses on determining whether low-dose HCQ confers mortality benefits with acceptable safety, contrasting with potential risks of higher doses. By systematically evaluating clinical outcomes across different HCQ dosage groups, the research seeks to provide evidence-informed guidance for antiviral therapy in COVID-19 management, particularly in resource-constrained settings.

The retrospective cohort includes 2,387 COVID-19 patients admitted to 12 hospitals in Hubei Province between January and June 2020. Patients are categorized into three groups: non-HCQ use (n=1,124), low-dose HCQ (≤600 mg/day, n=893), and high-dose HCQ (>600 mg/day, n=370). Baseline characteristics are compared across groups, with adjustments for age, sex, comorbidities (hypertension, diabetes, cardiovascular disease), disease severity (mild, severe, critical), and concurrent medications (antibiotics, glucocorticoids). The primary endpoint is all-cause mortality, while secondary endpoints include treatment-related adverse events (AEs), such as QT interval prolongation and ventricular arrhythmias.

Descriptive statistics show that high-dose HCQ users are more likely to be male, older, and have preexisting conditions, reflecting clinical decisions to escalate therapy in severe cases. Univariate analysis reveals significantly lower mortality in the low-dose HCQ group (15.2%) compared to non-HCQ (22.8%) and high-dose HCQ (28.9%) groups (p<0.001 for both comparisons). After propensity score matching (1:1:1 matching), the low-dose group maintains a survival advantage (adjusted HR=0.68, 95% CI: 0.51-0.90, p=0.008), while the high-dose group exhibits higher mortality (HR=1.32, 95% CI: 1.05-1.67, p=0.018). Subgroup analyses by disease severity show consistent benefits of low-dose HCQ in severe (HR=0.72, p=0.023) and critical (HR=0.65, p=0.011) patients, but no significant effect in mild cases.

Safety data indicate a dose-dependent increase in AEs: low-dose HCQ has an AE rate of 12.7%, comparable to non-HCQ (10.9%, p=0.21), while high-dose HCQ shows a significantly higher rate (22.4%, p<0.001). The most common AEs are gastrointestinal symptoms (nausea, diarrhea) and electrolyte imbalances, with rare but serious ventricular arrhythmias (2.1% in high-dose vs. 0.8% in low-dose, p=0.03). Multivariate Cox regression identifies high-dose HCQ (HR=1.45, 95% CI: 1.12-1.87, p=0.005) and older age (HR=1.08 per year, p<0.001) as independent risk factors for mortality, while low-dose HCQ (HR=0.79, 95% CI: 0.63-0.99, p=0.04) and early treatment initiation (within 5 days of symptom onset, HR=0.64, p=0.002) are protective.

The findings align with prior studies suggesting HCQ’s immunomodulatory effects at low doses may reduce cytokine storm and viral replication, whereas high doses increase toxicity without additional benefit. Mechanistically, HCQ’s inhibition of Toll-like receptor signaling and enhancement of autophagic antiviral responses are hypothesized to be dose-dependent, with therapeutic windows narrow enough to distinguish protective vs. toxic effects. The study’s real-world data contrast with the negative results of the RECOVERY trial, potentially due to RECOVERY’s inclusion of higher-dose and later-treatment patients, highlighting the importance of dosing strategy and timing in HCQ therapy.

Limitations include the retrospective design’s susceptibility to residual confounding, lack of randomization, and reliance on administrative data for dosing accuracy. Additionally, the study’s focus on hospitalized patients limits generalizability to outpatient settings or other populations. However, the large sample size, multi-center design, and rigorous statistical adjustments strengthen the validity of dose-response conclusions.

Clinically, the results support cautious use of low-dose HCQ (≤600 mg/day) in severe COVID-19 cases, particularly when initiated early, while advising against high-dose regimens due to increased toxicity. This aligns with emerging guidelines emphasizing personalized dosing based on patient characteristics and close monitoring of cardiac biomarkers. Future randomized controlled trials are needed to confirm these findings and explore HCQ’s role in combination with other antiviral agents, such as remdesivir or nirmatrelvir.

In summary, this study provides observational evidence that low-dose hydroxychloroquine is associated with reduced COVID-19 mortality in hospitalized patients, particularly those with severe illness, when administered within the first week of symptoms. The findings highlight the critical role of dosing precision in antiviral therapy, balancing therapeutic benefits with safety profiles. As COVID-19 continues to evolve, such real-world data contribute to the dynamic optimization of treatment protocols, especially in regions where access to novel antivirals is limited.

In the last years of her life, my mother began to have nightmares. One recurred from time to time and became a metaphor for the dementia that, in the end, took her life. In it, she was trapped on a ship and could not get off.

Once, while staying with my sister, mum began to crash around her room in the night. When my sister went to investigate, she found our mother trying to get off her ship. On another occasion, while with me, she clambered on top of the toilet, again to get off the ship. She fell backwards, cracking her head on the floor, and required stitches.

My mother’s nightmares could have been linked to Alzheimer’s disease, according to a 2024 study by a team at Boston University in the US state of Massachusetts. It found that cognitive impairment had a correlation with higher nightmare frequency and distress in the elderly.

However, Dr Abidemi Otaiku, a neuroscientist at Imperial College London, says that nightmares can be a marker of earlier dementia – and even a driver of it.

His findings have shown that frequent or persistent nightmares may be an easily identifiable marker of dementia risk, one that can be detected even in the first decade of life. Other risk factors for dementia, such as diabetes and hypertension, typically only surface from middle age, he says.

In the last years of her life, my mother began to have nightmares. One recurred from time to time and became a metaphor for the dementia that, in the end, took her life. In it, she was trapped on a ship and could not get off.

Once, while staying with my sister, mum began to crash around her room in the night. When my sister went to investigate, she found our mother trying to get off her ship. On another occasion, while with me, she clambered on top of the toilet, again to get off the ship. She fell backwards, cracking her head on the floor, and required stitches.

My mother’s nightmares could have been linked to Alzheimer’s disease, according to a 2024 study by a team at Boston University in the US state of Massachusetts. It found that cognitive impairment had a correlation with higher nightmare frequency and distress in the elderly.

However, Dr Abidemi Otaiku, a neuroscientist at Imperial College London, says that nightmares can be a marker of earlier dementia – and even a driver of it.

His findings have shown that frequent or persistent nightmares may be an easily identifiable marker of dementia risk, one that can be detected even in the first decade of life. Other risk factors for dementia, such as diabetes and hypertension, typically only surface from middle age, he says.

Scientists reveal that children exposed to certain plastic-derived chemicals before age five face higher risks of asthma and wheeze, underscoring growing concerns over everyday environmental exposures.

Study: Phthalates and bisphenols early-life exposure, and childhood allergic conditions: a pooled analysis of cohort studies. Image Credit: antoniodiaz / Shutterstock

In a recent study published in the Journal of Exposure Science & Environmental Epidemiology, researchers utilized an extensive (n = 5,306) pooled Australian, United States (US), and Canadian cohort to investigate the clinical outcomes of childhood and early life (before the age of 5) exposure to harmful plastic-derived chemicals.

Their findings reveal that increased prenatal and early-life exposure to phthalates and bisphenols, chemicals found in many everyday products such as shampoos and food packaging, was associated with a modestly increased risk of developing asthma and other allergic conditions by preschool age. The findings contribute to a growing body of evidence on how we address invisible pollutants that surround us and our children from birth.

Background

Phthalates and bisphenols, ubiquitous chemicals found in plastics, packaging, toys, grooming, and personal-care products, are increasingly scrutinized for their potentially harmful effects on child health. A growing body of evidence suggests that these persistent environmental contaminants act as endocrine-disrupting chemicals (EDCs), altering metabolic and neurodevelopmental pathways and having potentially lifelong consequences.

The impacts of phthalates and bisphenols on respiratory outcomes and allergies remain less understood. While a limited number of epidemiological investigations have linked these EDCs with an increased risk of adverse childhood respiratory outcomes (wheezing, eczema, asthma, and rhinitis), recent systematic reviews and meta-analyses have flagged these findings as inconsistent and often confounding, potentially due to a glaring lack of methodological standardization between studies.

Furthermore, even in this understudied field, investigations on the impacts of EDCs on children under the age of five, a period of rapid development and exacerbated chemical sensitivity, are underrepresented. Consequently, clinicians and policymakers have little to no scientific evidence upon which to base their public health and environmental recommendations.

About the study

The present study aims to address this knowledge gap and inform future environmental and public health policy. By pooling major birth cohorts across three countries, it evaluates how urinary levels of phthalates and bisphenols (measured during pregnancy and early childhood) correlate with diagnosed allergic outcomes by age five. The study further aims to elucidate if any identified EDC-allergy risk associations are influenced by exposure timing, dose, or sex.

Study data were obtained and pooled from four established longitudinal cohorts: 1. Australia’s Barwon Infant Study (BIS), 2. Canada’s Canadian Healthy Infant Longitudinal Development Study (CHILD) study, and the United States’ (US’s) 3. Health Outcomes and Measures of the Environment (HOME) Study and 4. Environmental Influences on Child Health Outcomes (ECHO).

Individuals with preserved urinary samples or urinary phthalates and bisphenols data from their first five years of life (postnatal subcohort) or pregnancy time (prenatal), alongside at least one allergy test from the same period, were included as current study participants. EDCs were characterized and quantified using standardized high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS).

Study outcomes (wheezing, asthma, rhinitis, and eczema) were assessed using several cohort-specific questionnaires (e.g., the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire). Where possible, caregiver-reported questionnaires were supplemented with clinical allergy evaluations. Sex-stratified generalized estimating equations (for chemical analysis) and quantile G-computation (to evaluate the cumulative effects of several co-occurring EDCs) were leveraged, accounting for potential sociodemographic confounders.

Study findings

The present study validates a link between plastic-derived EDCs and adverse childhood respiratory outcomes. It leverages a final sample cohort of 5,306 children. It reveals that prenatal exposure to dibutyl phthalates (DBP) and butyl benzyl phthalate (BBzP) is associated with a higher risk of asthma in children under five. A two-fold increase in exposure to these phthalates corresponded to a 6-8% increase in asthma risk (RR = 1.08 for DBP and 1.06 for BBzP).

Multivariate dose‒response relationship between the overall chemical mixture and childhood allergic conditions stratified by sex. Red circles: Females. Blue triangles: Male. Models obtained with quantile G-computation. Prenatal analysis models adjusted for cohort membership, maternal age, ethnicity, parental education, marital status, family history of asthma, prenatal tobacco smoke exposure, and season of birth. Postnatal analysis models were further adjusted for breastfeeding duration, age at outcome assessment, postnatal smoke exposure and gestational age.

Mono-(3-carboxypropyl) phthalate (MCPP), one of the most common phthalate metabolites, was similarly associated with a 5% increased risk of rhinitis (relative risk, RR = 1.05). Postnatal phthalate exposure showed similar trends, with BBzP, DEHP, and MCPP levels all associated with an increased risk of childhood wheezing (5-9%).

Additionally, combined exposure to a mixture of phthalates was associated with a higher risk of wheezing, with mixture models revealing that a one-quartile increase in overall postnatal chemical exposure increased the risk of childhood wheeze by 14%.

The study also investigated other factors, finding only limited evidence that the effects of these chemicals differed between boys and girls. However, the analysis did suggest that the timing of exposure during pregnancy could be important, with stronger associations observed for exposure during the first and second trimesters for certain outcomes. The study also noted that some associations were non-linear, following U-shaped or inverted U-shaped patterns, meaning that risk did not always increase steadily with higher exposure.

While the study found no statistically significant associations for bisphenols like BPA, the authors note that low detection rates for these chemicals may have limited the statistical power to identify minor effects. Curiously, high-molecular-weight phthalates were associated with a lower risk of eczema. The study’s authors suggest that this surprising finding requires further investigation, noting that it could be influenced by factors such as reverse causation, where children with eczema may use more personal care products.

Conclusions

With over 5,000 children from across continents contributing to its dataset, this large-scale, multinational study adds to the growing body of evidence that early-life exposure to phthalates may subtly increase the risk of childhood asthma, wheeze, and rhinitis. Although associations between bisphenols and respiratory conditions could not be observed, these findings suggest a need for reduced exposure to plastic-derived chemicals during pregnancy and early childhood. The authors themselves caution that the observed effects are modest on an individual level and highlight study limitations, such as differences in data collection between cohorts and the potential for unmeasured confounding factors, underscoring the need for further research.

Men who swapped cigarettes for vaping during IVF saw better sperm motility and fewer miscarriages, but experts warn that vaping isn’t risk-free for hopeful parents.

Study: Impact of conventional cigarette and electronic cigarette use on sperm quality and IVF/ICSI outcomes. Image Credit: New Africa / Shutterstock

In a recent study published in the journal Scientific Reports, researchers evaluated whether exclusive Electronic cigarette (e-cigarette) use alters semen quality and live-birth outcomes compared with traditional cigarette smoking in couples undergoing in vitro fertilization (IVF).

The study did not include a non-smoking control group, so results specifically compare E-cigarette users to conventional cigarette smokers, not to non-smokers.

Background

Despite decades of anti-smoking campaigns, about one-third of men of reproductive age still smoke conventional cigarettes. Meanwhile, sleek E-cigarettes that heat flavored nicotine liquids have surged in popularity and are marketed as safer. Traditional smoking is firmly linked to lower sperm count, reduced motility, and higher miscarriage rates, but the reproductive impact of electronic aerosols that are rich in metals and aldehydes remains poorly defined.

Couples investing in costly IVF worry whether switching from smoke to vapor truly protects fertility or merely changes the risk profile. Comparative evidence, particularly within assisted reproductive technology, is limited, and further research is needed to clarify these uncertainties.

About the study

Medical records from one infertility clinic were reviewed for 296 couples who underwent IVF or intracytoplasmic sperm injection between May 2022 and January 2024. Male partners had exclusively smoked either conventional cigarettes or E-cigarettes for at least six months and provided semen after two to seven days of abstinence.

The study enrolled couples in which the woman’s infertility was attributed to tubal disease, polycystic ovary syndrome, thyroid dysfunction, hyperprolactinemia, or a prior failed intrauterine insemination. Every female participant was a confirmed nonsmoker.

Researchers excluded participants with advanced maternal age, endometriosis, adenomyosis, poor ovarian response, recurrent pregnancy loss, congenital genitourinary anomalies, severe male-factor infertility, or any history of switching between cigarette types. Only the first or second embryo transfer cycles were included to avoid confounding from recurrent implantation failure.

They then performed standard semen analysis, calculated body mass index, assayed serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin, anti-Müllerian hormone (AMH), and sex hormone-binding globulin (SHBG), and proceeded with controlled ovarian stimulation under a gonadotropin-releasing hormone (GnRH) antagonist protocol, retrieving oocytes 36 hours after a recombinant human chorionic gonadotropin (rhCG) trigger.

All embryos were cryopreserved as blastocysts and transferred in frozen-thawed cycles. Outcomes included categories of pregnancy, miscarriage, and live birth, plus semen parameters. Chi-square and independent t-tests were used to compare groups, and logistic regression identified live-birth predictors at a p-value of ≤ 0.05.

Study results

Male partners in the conventional-cigarette (n = 151) and E-cigarette (n = 145) cohorts shared comparable body metrics and most hormonal parameters, but three laboratory values diverged. Traditional smokers exhibited higher serum prolactin (13.84 ± 5.97 ng/mL vs 13.02 ± 4.80 ng/mL; p = 0.029) and greater sperm concentration (81.55 ± 57.19 × 10⁶/mL vs 71.78 ± 44.40 × 10⁶/mL; p = 0.007), whereas progressive motility was higher among vapers (48.91 ± 11.75 % vs 48.15 ± 13.29 %; p = 0.014); semen volume, leukocyte count, and strict morphology did not differ (p > 0.10).

Female partners in both cohorts were similar in age and ovarian-reserve indices. Their body mass index, however, was modestly higher when the male partner smoked conventional cigarettes (23.38 ± 4.29 kg/m²) compared to vaping (22.16 ± 3.47 kg/m²; p = 0.017). Controlled ovarian stimulation proceeded uniformly: stimulation lasted 9.6 ± 1.5 days with a total gonadotropin dose of 2,385.68 ± 1,047.71 IU in smokers and 2,338.45 ± 898.18 IU in vapers, producing comparable oocytes retrieved (19.19 ± 10.29 vs 19.76 ± 10.67) and two-pronuclear embryos (11.23 ± 7.00 vs 11.28 ± 6.75; all p > 0.38).

Pregnancy endpoints diverged only after ultrasound confirmation. Biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and biochemical miscarriage rates were statistically indistinguishable (p ≥ 0.16). Male partners who vaped rather than smoked were associated with a drop in ultrasound-confirmed miscarriages from 36.3% to 12%, a roughly two-thirds relative reduction (p < 0.001). Concurrently, live-birth rates increased from 41.1% to 55.9%, representing a 15-percentage-point absolute rise (p = 0.011).

Multivariable logistic regression for all 296 couples revealed two independent live-birth predictors: every 1 mIU/mL increase in male serum FSH raised the odds by 19% (adjusted odds ratio 1.19, 95% confidence interval 1.06-1.34; p = 0.004), whereas each additional two-pronuclear embryo reduced the odds (adjusted odds ratio 0.19, 95% confidence interval 0.05-0.71; p = 0.013). However, this latter result is biologically counterintuitive and contradicts the direction seen in univariate analysis; it likely reflects either a statistical artifact or residual confounding and should be interpreted with caution.

Smoking modality, sperm motility, and paternal or maternal body mass index did not retain independent significance once these laboratory factors were taken into account.

The authors note that, although differences in semen parameters and live birth outcomes were observed between cigarette types, key predictors of live birth (such as FSH and 2PN embryo count) did not differ significantly between groups.

Conclusions

To summarize, E-cigarette use by male partners undergoing IVF appears less detrimental to reproductive success than continued conventional smoking. Although semen concentration was marginally lower, progressive motility was higher and prolactin lower among vapers, translating into fewer clinical miscarriages and a fifteen-point gain in live-birth rate.

Importantly, cigarette type did not override established predictors such as FSH level or embryo count, underscoring that vaping is no guarantee of success.

Crucially, the authors emphasize that these findings should not be interpreted as an endorsement of E-cigarette use, since E-cigarettes still pose potential health risks and their long-term impact on reproductive health is not fully understood.

The retrospective design, reliance on self-reported data, lack of information on dietary factors, unmeasured heavy metal exposure, and unaccounted variability in E-cigarette devices all limit causal conclusions and generalizability. Further research, including direct comparisons with non-smokers and more detailed toxicological assessment, is needed to clarify the reproductive risks of E-cigarettes and guide fertility counseling.

These findings highlight how lifestyle choices can still influence assisted reproduction outcomes and support counseling men to abandon combustible tobacco while pursuing parenthood more safely.

Photo Credit: iStock.com/insta_photos

Understanding the link between job strain, stress, and smoking to severe climacteric symptoms, urging better workplace and healthcare support for midlife women. 

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Researchers conducted a retrospective study published in the July 2025 issue of European Journal of Obstetrics and Gynecology and Reproductive Biology to explore how work- and health-related factors were associated with climacteric symptoms among middle-aged full-time working women prior to receiving any treatment.  

They assessed 313 Finnish women aged 52–56 years who were employed full-time and had never used any treatment for climacteric symptoms (n = 313). Symptom experience was measured based on the presence and severity of menopause-related symptoms negatively affecting general or work-related well-being. These symptoms included hot flushes, sweat, sleeping problems, vaginal dryness and tenderness, loss of sexual desire, and depressive symptoms. The analyzed work- and health-related factors included psychosocial work environment, health behaviors such as body size, physical activity, smoking, perceived stress, and social support.  

The results showed that a high-strain job, active smoking status, elevated stress levels, and limited social support were linked to both higher frequency and greater severity of climacteric symptoms. Women presenting these characteristics experienced menopause-related symptoms more often and with an increased intensity compared to those without these traits.  

Investigators concluded that multiple factors impacted how full-time working women experienced climacteric symptoms before treatment, underscoring the need for collaborative efforts between healthcare professionals and employers to support women’s health and well-being. 

Source: ejog.org/article/S0301-2115(25)00307-0/fulltext 

Varicose veins bulge and twist across the calves of up to 30 percent of adults, a reminder that blood sometimes pools instead of flowing home to the heart. When sluggish blood flow lingers, clots can form and, in rare cases, travel to the lungs or brain.

Centuries ago physicians in China brewed teas from Ginkgo biloba leaves to sharpen memory. Today researchers wonder whether the same ginkgo leaves might support weary leg veins and cut the risk of small, yet dangerous, blood clots.

Why circulation can falter

Blood rising from the feet must fight gravity, and faulty valves can leave veins stretched and valves leaky. The lingering pressure distends vein walls, encourages inflammation, and slows platelet aggregation, the first step toward clotting.

Slow venous return creates the setting for deep‑vein thrombosis as well as the aching, throbbing symptoms many patients feel after a day of standing.

That overlap has pushed vascular specialists toward plant‑based compounds that might tone the vein wall and limit sticky platelets.

After logging stroke cases at Xuanwu Hospital in Beijing, neurologist Xiangqian Huang of Capital Medical University began probing ginkgo’s effects on clot behavior in the brain, work that now informs leg‑vein research.

Ginkgo leaves and blood flow

Ginkgo extract made blood platelets less sticky when triggered by one type of chemical but didn’t have much effect when triggered by another.

Dr. Xiangqian Huang and the team also noticed that blood took slightly longer to clot after treatment with the extract.

The leaf contains natural compounds that seem to interact with enzymes responsible for forming clots.

In a 2025 animal study, researchers found that ginkgo reduced damage inside blood vessels in rats with clotting problems and slightly increased the time it took for their blood to clot. 

Insights from a Beijing stroke ward

Huang’s real‑world study followed 99 patients for five days. Among stroke survivors who received ginkgo plus baby aspirin, arachidonic‑acid platelet aggregation fell more than in peers on aspirin alone, while major bleeding did not rise.

Minor nose or gum bleeds surfaced in four of thirty‑three combination patients, a signal that enhanced anticoagulation deserves monitoring. No severe hemorrhages occurred, suggesting short‑term safety when doses stay low.

The design also enrolled participants with internal jugular venous stenosis, a group whose clots mirror those in leg veins.

In that arm ginkgo alone curbed blood platelet stickiness within 24 hours, and the effect held steady through day five.

Aspirin, ginkgo, and blood clots

A team of scientists led by Christopher Gardner from Stanford Department of Medicine examined the potential adverse effects of concomitant aspirin and Ginkgo biloba on blood platelet function after giving the duo to older adults for four weeks. The worry was that the herbs might blunt or boost common drugs. 

Gardner and colleagues detected no dangerous bleeding, yet laboratory tests showed additive platelet inhibition, suggesting that low‑dose pairings could protect high‑risk patients who cannot tolerate stronger pharmaceuticals.

Doctors, however, should adjust regimens around surgeries or when other blood thinners enter the mix.

Because the leaf targets arachidonic‑acid pathways that aspirin already touches, the partnership makes pharmacologic sense.

Still, anyone taking nonsteroidal anti‑inflammatory drugs should discuss timing and dosage to avoid stacking identical mechanisms.

Helping legs feel lighter

Deep veins are not the only place where endothelial cells detach under strain.

In a classic double‑blind trial, scientists found that a capsule combining ginkgo, troxerutin, and heptaminol cut circulating endothelial cell counts by 14.5 percent in patients with chronic varicose veins, placebo achieved only 8.4 percent.

Endothelial cells are early barometers of vein injury, so their decline hints at real structural healing.

Participants also reported reduced ankle swelling and night cramps, benefits echoed by later Russian and Italian studies that tracked leg circumference.

Modern phlebology still relies on compression stockings and laser ablation, yet many sufferers ask for gentler first steps.

A standardized ginkgo formula, already licensed for vascular disorders in parts of Europe, may slot neatly between lifestyle changes and invasive procedures.

Blood clot prevention with ginkgo

Yang’s rat data showed lighter clots, higher nitric‑oxide levels, and longer clotting times after gavage with 60 milligrams per kilogram of extract.

Nitric oxide relaxes vessel walls and counters platelet stickiness, aligning with human data from stroke and vein clinics.

Network‑pharmacology maps place AKT1, ALB, and TNF at the center of ginkgo’s target web. Those same genes regulate inflammation, suggesting that the tree’s reach extends beyond platelets to the very lining of our veins.

Because oxidative stress weakens venous valves, the antioxidant side of the extract warrants equal attention.

Flavonols scavenge free radicals, potentially slowing the progressive dilation that makes early spider veins blossom into rope‑like cords.

Talking with your doctor

Ginkgo supplements crowd store shelves, yet extracts used in clinical trials are highly standardized. Look for EGb 761 or products specifying at least 24 percent flavonol glycosides and 6 percent terpene lactones.

Patients on warfarin, direct oral anticoagulants, or upcoming dental work should alert their clinicians before starting any form of ginkgo.

Health professionals may stagger doses, check clotting labs, or advise pausing the herb to keep bleeding risk low.

For those with aching calves and a family history of clots, discussing ginkgo as an adjunct to compression or low‑intensity exercise could make sense.

Evidence remains preliminary, yet the plant’s dual action on platelets and vein walls is steadily moving from bench to bedside.

Future multicenter trials ought to track long‑term safety and measure quality‑of‑life changes such as heaviness, itch, and nightly restlessness. If findings stay positive, an ancient tree might soon earn a modern role in vascular medicine.

The study is published in Thrombosis Journal.

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