2025.09.20 – Routine with Ginkgo Biloba, Fluoxetine, Losartan, Atorvastatin, Coenzyme Q10, Methylphenidate, Vitamin D3, Hibiscus Tea, Coffee, Nuts, Magnesium Bisglycinate, and Curcumin – My Diary

Exhaustive Narrative of Facts

The documented morning intake included:

Hibiscus tea.
Coffee.
Coenzyme Q10 at 100 mg.
Methylphenidate at 36 mg.
Atorvastatin at 10 mg.
Vitamin D3 at 1000 IU.
Losartan at 50 mg.
Five nuts, taken for the last time on the specified day.
Magnesium bisglycinate at 375 mg, also taken for the last time on the specified day.
Curcumin, which had run out the previous day.
Ginkgo biloba extract, initially considered at 120 mg starting the following day.
Fluoxetine at 20 mg.

Nuts were discontinued after the last specified intake.
Magnesium bisglycinate at 375 mg was discontinued after the last specified intake.
Curcumin supplementation ended once it ran out.
Ginkgo biloba extract was first considered at 120 mg but ultimately the decision was made to remain at 60 mg/day.

Clinical studies often use 120–240 mg/day for memory and circulatory purposes.
A lower dose of 60 mg/day was chosen instead, prioritizing safety over potency.
The suggestion of starting with 60 mg/day for one week and then increasing to 120 mg/day if tolerated was noted, but the final decision was to remain at 60 mg/day without escalation.
At 60 mg/day, the risk of interactions and adverse effects is reduced, though efficacy may be weaker compared to higher studied doses.
Ginkgo biloba is best taken in the morning with food to avoid stomach irritation and insomnia.
If divided into two doses of 60 mg, the second is preferable at midday and not at night.

Some individuals report immediate subjective effects such as improved mental clarity, energy, or concentration, potentially due to acute vasodilation and increased cerebral blood flow.
Documented clinical benefits for cognition and vascular health generally require at least 4–6 weeks of continuous intake.
There is a distinction between immediate subjective effects and long-term outcomes observed in studies.

Combination with fluoxetine may increase bleeding risk, with the interaction classified as moderate, and may potentially reduce antidepressant efficacy.
Combination with losartan does not show strong documented clinical interaction, but experimental studies in rats suggest ginkgo biloba alters losartan metabolism, increasing losartan levels while decreasing its active metabolite EXP3174.
Ginkgo biloba may slightly lower blood pressure through vasodilation, potentially enhancing the effect of antihypertensives like losartan.
A large human trial (Ginkgo Evaluation of Memory, 3,069 participants, 240 mg/day) showed no significant change in blood pressure or hypertension risk compared with placebo.
Smaller trials reported modest reductions in blood pressure, such as approximately 6% systolic and 21% diastolic after three months in prehypertensive participants, though these findings were not consistently replicated.
Reviews conclude that there is no convincing evidence to support ginkgo biloba as an antihypertensive.
Recommendations exist to discontinue ginkgo biloba one to two weeks before surgery to reduce bleeding risk.
Reports also describe cases of convulsions associated with some ginkgo preparations, making it unsuitable for individuals with a seizure history.

Magnesium participates in the relaxation of vascular smooth muscle, promoting vasodilation and lowering blood pressure.
Losartan is an angiotensin II receptor antagonist that lowers blood pressure by preventing vasoconstriction and sodium retention.
Taken together, magnesium and losartan may both reduce blood pressure through different mechanisms, which can in some cases potentiate hypotension with symptoms such as dizziness, blurred vision, weakness, or fainting.
Magnesium bisglycinate at 375 mg was taken in the routine but discontinued after the last specified day, so this combined effect with losartan is no longer relevant going forward.

Atorvastatin is often recommended at night due to cholesterol synthesis patterns, though at low doses and with modern formulations the timing may be less critical.
Methylphenidate and fluoxetine can interact, potentially causing nervousness or insomnia.
Coffee combined with methylphenidate may increase stimulation.