Ginger

Related Terms

• African ginger, Amomum zingiber L., black ginger, bordia, chayenne ginger, cochin ginger, curcumin gan jiang, gegibre, gingembre, gingerall, ginger BP, ginger oil, ginger power BP, ginger root, ginger trips, ingwer, Jamaica ginger, kankyo, oleoresins, race ginger, rhizoma zingeberis, sheng jiang, vanillyl ketones, verma, zerzero, Zingiber capitatum, Zingiber officinale Roscoe, Zingiber zerumbet Smith, Zingiber blancoi Massk, Zingiber majus Rumph, zingerone, zingibain, Zingiberis rhizoma, Zinopin® (Pycnogenol® and standardized ginger root extract), Zintona EC.

Background

• The rhizomes and stems of ginger have assumed significant roles in Chinese, Japanese, and Indian medicine since the 1500s. The oleoresin of ginger is often contained in digestive, antitussive, antiflatulent, laxative, and antacid compounds.
• There is supportive evidence from one randomized controlled trial and an open-label study that ginger reduces the severity and duration of chemotherapy-induced nausea/emesis. Effects appear to be additive to prochlorperazine (Compazine®). The optimal dose remains unclear. Ginger's effects on other types of nausea/emesis, such as postoperative nausea or motion sickness, remain indeterminate.
• Ginger is used orally, topically, and intramuscularly for a wide array of other conditions, without scientific evidence of benefit.
• Ginger may inhibit platelet aggregation/decrease platelet thromboxane production, thus theoretically increasing bleeding risk.

Evidence

*Key to grades:

A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

For full grading rationale, click here.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare professional before starting a new therapy. Consult a healthcare professional immediately if you experience side effects.

Allergies

• Ginger supplements should be avoided by individuals with a known allergy to ginger, its components, or other members of the Zingiberaceae family, including Alpinia formosana, Alpinia purpurata (red ginger), Alpinia zerumbet (shell ginger), Costus barbatus, Costus malortieanus, Costus pictus, Costus productus, Dimerocostus strobilaceus, or Elettaria cardamomum (green cardamom). Allergic contact rashes have been reported, and these rashes may be more likely in people who work with ginger, who apply ginger to the skin, or who have a positive allergy test for Balsam of Peru. An allergic eye reaction has also been reported.

Side Effects and Warnings

• Few side effects have been associated with ginger at low doses. There is a lack of available studies that confirm the long-term, safe use of ginger supplements. The most commonly reported side effects of ginger involve the stomach and intestines. Irritation or bad taste in the mouth, heartburn, belching, bloating, gas, and nausea have been reported, especially with powdered forms of ginger. There are several reports that fresh ginger that is swallowed without enough chewing can result in blockage of the intestines. Individuals who have had ulcers, inflammatory bowel disease, or blocked intestines should use ginger supplements cautiously and should avoid large amounts of freshly cut ginger. People with gallstones should use ginger with caution.
• In theory, ginger can cause abnormal heart rhythms, although reports in humans are lacking. Some publications suggest that ginger may raise or lower blood pressure, although limited scientific information is available.
• In addition, ginger may theoretically prevent blood clotting by preventing the clumping of platelets. In one study, gingerol compounds and their derivatives were shown to be more potent anti-platelet agents than aspirin. This raises a concern that individuals who are treated with medications that slow blood clotting or who undergo surgery may have a high risk of excessive bleeding if they take ginger supplements. Ginger is traditionally said to reduce blood sugar levels at high doses, but there is a lack of scientific evidence available. In one study, two of eight participants reported an intense urge to urinate 30 minutes after ingesting ginger. Ginger has also been associated with pinkeye (conjunctivitis), but this was considered a rare occurrence.

Pregnancy and Breastfeeding

• Some authors suggest that pregnant women should not take ginger in amounts greater than found in food (or more than 1 gram dry weight per day). There are reports that ginger can increase discharge from the uterus in menstruating women, and possibly lead to abortion, mutations of the fetus, or increased risk of bleeding. However, other reports state that there is a lack of scientific evidence that ginger endangers pregnancy. Little scientific study is available in this area to support either perspective, although ginger has been studied in a small number of pregnant women (to assess effects on nausea), without reports of adverse pregnancy outcomes. There is controversy in this area. The use of ginger in pregnancy is cautioned against in traditional Chinese medicine (TCM). However, higher doses of ginger are generally used in Chinese medicine.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare professional before starting a new therapy.

Interactions with Drugs

• There is evidence that ginger may increase stomach acid production. As a result, it theoretically may work against the effects of antacids, sucralfate (Carafate®), or anti-reflux medications such as H-2 blockers like ranitidine (Zantac®) or proton pump inhibitors like lansoprazole (Prevacid®). In contrast, other laboratory and animal studies report that ginger may act to protect the stomach.
• In theory, ginger may increase the risk of bleeding when taken with blood-thinners (although clear human evidence is lacking). Some examples include aspirin, anticoagulants such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
• In theory, large doses of ginger may increase the effects of medications that slow thinking or cause drowsiness.
• Ginger may also interfere with medications that change the contraction of the heart, including beta-blockers, digoxin, and other heart medications.
• Because ginger can theoretically lower blood sugar levels, it may interfere with the effects of insulin or diabetes medications that are taken by mouth.
• Ginger may interact with drugs broken down by the liver or with xanthine oxidase drugs.
• Ginger may also interact with drugs taken for nausea/vomiting, arthritis, blood disorders, high cholesterol, high/low blood pressure, allergies (antihistamines), cancer, inflammation, vasodilators, or weight loss. Caution is advised when taking ginger with drugs that weaken the immune system, due to a possible interaction.

Interactions with Herbs and Dietary Supplements

• Ginger may increase stomach acid production. As a result, it theoretically may work against the effects of antacids.
• In theory, ginger may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding (although clear human evidence is lacking). Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
• In theory, ginger with large amounts of calcium may increase the risk of abnormal heart rhythms. Study results suggest that dietary phytochemicals, such as capsaicin, curcumin, and resveratrol, have inhibitory effects on P-glycoprotein and potencies to cause drug-food interactions.
• Ginger may also theoretically lower blood sugar levels. Caution is advised when using herbs or supplements that may also affect blood sugar.
• Ginger may interact with herbs broken down by the liver or with xanthine oxidase herbs.
• Ginger may also interact with herbs or supplements taken for nausea/vomiting, pain, arthritis, blood disorders, high cholesterol, high/low blood pressure, allergies (antihistamines), cancer, inflammation, vasodilators, or weight loss. Caution is advised when taking ginger with herbs or supplements that affect the immune system, due to possible interactions. Ginger may have antioxidant properties and use with other antioxidants may result in additive effects.

Authors

• This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Selected References

Natural Standard developed the above evidence-based information based on a systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Altman RD, Marcussen KC. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum 2001;44(11):2531-2538.
2. Bean P. The use of alternative medicine in the treatment of hepatitis C. Am Clin Lab 2002;21(4):19-21.
3. Bliddal H, Rosetzsky A, Schlichting P, et al. A randomized, placebo-controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritis. Osteoarthritis Cartilage 2000;8(1):9-12.
4. Borrelli F, Capasso R, Aviello G, et al. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol 2005 Apr;105(4):849-56.
5. Bryer E. A literature review of the effectiveness of ginger in alleviating mild-to-moderate nausea and vomiting of pregnancy. J Midwifery Womens Health 2005;50(1):e1-e3.
6. Chaiyakunapruk N, Kitikannakorn N, Nathisuwan S, et al. The efficacy of ginger for the prevention of postoperative nausea and vomiting: a meta-analysis. Am J Obstet Gynecol 2006 Jan;194(1):95-9.
7. Chittumma P, Kaewkiattikun K, Wiriyasiriwach B. Comparison of the effectiveness of ginger and vitamin B6 for treatment of nausea and vomiting in early pregnancy: a randomized double-blind controlled trial. J Med Assoc Thai 2007 Jan;90(1):15-20.
8. Dupuis LL, Nathan PC. Options for the prevention and management of acute chemotherapy-induced nausea and vomiting in children. Paediatr Drugs 2003;5(9):597-613.
9. Eberhart LH, Mayer R, Betz O, et al. Ginger does not prevent postoperative nausea and vomiting after laparoscopic surgery. Anesth Analg 2003;96(4):995-8, table.
10. Jewell D, Young G. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev 2002;(1):CD000145.
11. Mahesh R, Perumal RV, Pandi PV. Cancer chemotherapy-induced nausea and vomiting: role of mediators, development of drugs and treatment methods. Pharmazie 2005;60(2):83-96.
12. Roberts AT, Martin CK, Liu Z, et al. The safety and efficacy of a dietary herbal supplement and gallic acid for weight loss. J Med Food 2007 Mar;10(1):184-8.
13. Visalyaputra S, Petchpaisit N, Somcharoen K, et al. The efficacy of ginger root in the prevention of postoperative nausea and vomiting after outpatient gynaecological laparoscopy. Anaesthesia 1998;53(5):506-510.
14. Vutyavanich T, Kraisarin T, Ruangsri R. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet.Gynecol 2001;97(4):577-582.
15. Wigler I, Grotto I, Caspi D, et al. The effects of Zintona EC (a ginger extract) on symptomatic gonarthritis. Osteoarthritis Cartilage 2003;11(11):783-789.

Folate

Ginkgo Biloba