Ginger
What is it? Overview Usage Side Effects and Warnings
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Ginger Overview

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Native to southern Asia, ginger is a 2- to 4-foot-long perennial that produces grass-like leaves up to a foot long and almost an inch wide. Although it’s called ginger root in the grocery store, the part of the herb used is actually the rhizome, the underground stem of the plant, with its bark-like outer covering scraped off.

Ginger has been used as food and medicine for millennia. Arabian traders carried ginger root from China and India to be used as a food spice in ancient Greece and Rome, and tax records from the second century AD show that ginger was a delightful source of revenue to the Roman treasury.

Chinese medical texts from the fourth century BC suggest that ginger is effective in treating nausea, diarrhea, stomachaches, cholera, toothaches, bleeding, and rheumatism. Ginger was later used by Chinese herbalists to treat a variety of respiratory conditions, including coughs and the early stages of colds.

Ginger's modern use dates back to the early 1980s, when a scientist named D. Mowrey noticed that ginger-filled capsules reduced his nausea during an episode of flu. Inspired by this, he performed the first double-blind study of ginger. Germany's Commission E subsequently approved ginger as a treatment for indigestion and motion sickness.

One of the most prevalent ingredients in fresh ginger is the pungent substance gingerol. However, when ginger is dried and stored, its gingerol rapidly converts to the substances shogaol and zingerone. If any of these substances has medicinal effects remains unknown.

What Is the Scientific Evidence for Ginger?

Nausea

The evidence for ginger's effectiveness in various forms of nausea remains mixed. It has been suggested that, in some negative studies, poor-quality ginger powder might have been used. 1 In general, while most antinausea drugs influence the brain and the inner ear, ginger appears to act directly on the stomach. 2

Motion Sickness

Ginger has shown inconsistent promise for treatment of motion sickness. A double-blind, placebo-controlled study of 79 Swedish naval cadets at sea found that 1 g of ginger could decrease vomiting and cold sweating, but without significantly decreasing nausea and vertigo. 3 Benefits were also seen in a double-blind study of 36 individuals given ginger, dimenhydrinate, or placebo. 4 However, a 1984 study funded by NASA using intentionally stimulated motion sickness found that ginger was not any more effective than placebo. 5 Two other small studies have also failed to find any benefit. 6 The reason for the discrepancy may lie in the type of ginger used, or the severity of the stimulant used to bring on motion sickness.

Nausea and Vomiting of Pregnancy

Four double-blind, placebo-controlled studies enrolling at total of 246 women found ginger more effective than placebo for treatment of morning sickness 7 For example, a double-blind, placebo-controlled trial of 70 pregnant women evaluated the effectiveness of ginger for morning sickness. 8 Participants received either placebo or 250 mg of powdered ginger three times daily for a period of four days. The results showed that ginger significantly reduced nausea and vomiting. No significant side effects occurred.

At least 3 studies have compared ginger to vitamin B 6 , a commonly recommended treatment for morning sickness. Two studies found them to be equally beneficial, 9 while the third found ginger to be somewhat better. 10 But, since the effectiveness of vitamin B 6 for morning sickness is not solidly established—the evidence rests largely on one fairly old study 11 — these findings are of questionable value.

Note:Despite its use in these studies, ginger has not been proven safe for pregnant women.

Postsurgical Nausea

Although there have been some positive studies, on balance, the evidence regarding ginger for reducing nausea and vomiting following surgery is discouraging. 12 A double-blind British study compared the effects of ginger, placebo, and metoclopramide (Reglan) in the treatment of nausea following gynecological surgery . 13 The results in 60 women indicated that both treatments produced similar benefits as compared to placebo.

A similar British study followed 120 women receiving elective laparoscopic gynecological surgery. 14 Whereas nausea and vomiting developed in 41% of the participants given placebo, in the groups treated with ginger or metoclopramide these symptoms developed in only 21% and 27%, respectively. Benefits were also seen in a double-blind study of 80 people. 15 A study of 60 people found marginally positive results. 16 However, a double-blind study of 108 people undergoing similar surgery found no benefit with ginger as compared to placebo. 17 Negative results were also seen in another recent study of 120 women, 18 and another of 180 women. 19 The bottom line: If ginger is effective for post-surgical nausea at all, the effect must be very slight. 20

Other Forms of Nausea

One study failed to find ginger helpful for reducing nausea caused by the cancer chemotherapy drug cisplatin . 21 In a second study, ginger did not add to the effectiveness of standard medications to treat chemotherapy-induced nausea and vomiting. 22

Osteoarthritis

A large double-blind study (more than 250 participants) found that a combination of ginger and another Asian spice called galanga (Alpinia galanga) can significantly improve arthritis symptoms. 23 This study was widely publicized as proving that ginger is effective for osteoarthritis. However, the study design makes it impossible to draw any conclusions on the effectiveness of the ginger component of the mixture. Ginger alone has only been tested in two very small double-blind studies, and they had contradictory results. 24

Dosage

For most purposes, the standard dosage of powdered ginger is 1 to 4 g daily, divided into 2 to 4 doses per day.

To prevent motion sickness, it may be best to begin treatment 1 or 2 days before the trip and continue it throughout the period of travel.

References

  1. Tyler VE. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York, NY: Pharmaceutical Products Press; 1994:42.
  2. Holtmann S, Clarke AH, Scherer H, Höhn M. The anti-motion sickness mechanism of ginger. A comparative study with placebo and dimenhydrinate. Acta Otolaryngol. 108(3-4):168-74.
  3. Grøntved A, Brask T, Kambskard J, Hentzer E. Ginger root against seasickness. A controlled trial on the open sea. Acta Otolaryngol. 105(1-2):45-9.
  4. Mowrey DB, Clayson DE. Motion sickness, ginger, and psychophysics. Lancet. 1(8273):655-7.
  5. Stott JRR, Hubble MP, Spencer MB. A double blind comparative trial of powdered ginger root, hyosine hydrobromide, and cinnarizine in the prophylaxis of motion sickness induced by cross coupled stimulation. Advisory Group for Aerospace Research and Development, Conference Proceedings. 1985;372:1-6.
  6. Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology. 42(2):111-20.
  7. Jiang X, Williams KM, Liauw WS, Ammit AJ, Roufogalis BD, Duke CC, Day RO, McLachlan AJ. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol. 59(4):425-32.
  8. Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol. 97(4):577-82.
  9. Sripramote M, Lekhyananda N. A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. J Med Assoc Thai. 86(9):846-53.
  10. Ensiyeh J, Sakineh MA. Comparing ginger and vitamin B6 for the treatment of nausea and vomiting in pregnancy: a randomised controlled trial. Midwifery. 25(6):649-53.
  11. Vutyavanich T, Wongtra-ngan S, Ruangsri R. Pyridoxine for nausea and vomiting of pregnancy: a randomized, double-blind, placebo-controlled trial. Am J Obstet Gynecol. 173(3 Pt 1):881-4.
  12. Morin AM, Betz O, Kranke P, Geldner G, Wulf H, Eberhart LH. [Is ginger a relevant antiemetic for postoperative nausea and vomiting?] Anasthesiol Intensivmed Notfallmed Schmerzther. 39(5):281-5.
  13. Bone ME, Wilkinson DJ, Young JR, McNeil J, Charlton S. Ginger root--a new antiemetic. The effect of ginger root on postoperative nausea and vomiting after major gynaecological surgery. Anaesthesia. 45(8):669-71.
  14. Phillips S, Hutchinson S, Ruggier R. Zingiber officinale (ginger)—An antiemetic for day case surgery. Anaesthesia. 1993;48:715-717.
  15. Pongrojpaw D, Chiamchanya C. The efficacy of ginger in prevention of post-operative nausea and vomiting after outpatient gynecological laparoscopy. J Med Assoc Thai. 86(3):244-50.
  16. Apariman S, Ratchanon S, Wiriyasirivej B. Effectiveness of ginger for prevention of nausea and vomiting after gynecological laparoscopy. J Med Assoc Thai. 89(12):2003-9.
  17. Arfeen Z, Owen H, Plummer JL, Ilsley AH, Sorby-Adams RA, Doecke CJ. A double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting. Anaesth Intensive Care. 23(4):449-52.
  18. Visalyaputra S, Petchpaisit N, Somcharoen K, Choavaratana R. The efficacy of ginger root in the prevention of postoperative nausea and vomiting after outpatient gynaecological laparoscopy. Anaesthesia. 53(5):506-10.
  19. Eberhart LH, Mayer R, Betz O, et al. Ginger does not prevent postoperative nausea and vomiting after laparoscopic surgery. Anesth Analg. 2003; 96: 995-998
  20. Morin AM, Betz O, Kranke P, Geldner G, Wulf H, Eberhart LH. [Is ginger a relevant antiemetic for postoperative nausea and vomiting?] Anasthesiol Intensivmed Notfallmed Schmerzther. 39(5):281-5.
  21. Borrelli F, Capasso R, Aviello G, Pittler MH, Izzo AA. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol. 105(4):849-56.
  22. Zick SM, Ruffin MT, Lee J, Normolle DP, Siden R, Alrawi S, Brenner DE. Phase II trial of encapsulated ginger as a treatment for chemotherapy-induced nausea and vomiting. Support Care Cancer. 17(5):563-72.
  23. Altman RD, Marcussen KC. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum. 44(11):2531-8.
  24. Bliddal H, Rosetzsky A, Schlichting P, Weidner MS, Andersen LA, Ibfelt HH, Christensen K, Jensen ON, Barslev J. A randomized, placebo-controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritis. Osteoarthritis Cartilage. 8(1):9-12.
 
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