Ginger

• Overview
• Uses
• Side Effects
• Interactions
• Dosing

Ginger is a plant with leafy stems and yellowish green flowers. The ginger spice comes from the roots of the plant. Ginger is native to warmer parts of Asia, such as China, Japan, and India, but now is grown in parts of South American and Africa. It is also now grown in the Middle East to use as medicine and with food.

Ginger is commonly used to treat various types of "stomach problems," including motion sickness, morning sickness, colic, upset stomach, gas, diarrhea, irritable bowel syndrome (IBS), nausea, nausea caused by cancer treatment, nausea caused by HIV/AIDS treatment, nausea and vomiting after surgery, as well as loss of appetite.

Other uses include pain relief from rheumatoid arthritis (RA), osteoarthritis, menstrual pain, upper respiratory tract infections, cough, respiratory problems, migraine headache, bronchitis, and diabetes. Ginger is also sometimes used for chest pain, low back pain, and stomach pain, discontinuing use of drugs called selective serotonin reuptake inhibitors (SSRIs), anorexia, to stimulate breast milk, as a diuretic, and to increase sweating. It is also used to treat cholera, bleeding, bacterial bloody diarrhea, baldness, malaria, inflamed testicles, poisonous snake bites, and toothaches.

Some people pour the fresh juice on their skin to treat burns. The oil made from ginger is sometimes applied to the skin to relieve pain. Ginger extract is also applied to the skin to prevent insect bites.

In foods and beverages, ginger is used as a flavoring agent.

In manufacturing, ginger is used as for fragrance in soaps and cosmetics.

One of the chemicals in ginger is also used as an ingredient in laxative, anti-gas, and antacid medications.

How does it work?

Ginger contains chemicals that may reduce nausea and inflammation. Researchers believe the chemicals work primarily in the stomach and intestines, but they may also work in the brain and nervous system to control nausea.

Possibly Effective for...

• Nausea and vomiting caused by HIV/AIDS treatment. Research suggests that taking ginger daily, 30 minutes before each dose of antiretroviral treatment for 14 days, reduces the risk of nausea and vomiting in patients receiving HIV treatment.
• Painful menstrual periods. Research shows that taking ginger powder 500-2000 mg during the first 3-4 days of a menstrual cycle modestly decreases pain in women with painful menstrual periods. Some specific doses that have been used include 500 mg of ginger three times daily and a specific ginger extract (Zintoma, Goldaru) 250 mg four times daily. Doses were given for 3 days starting at the beginning of the menstrual period. The specific ginger extract (Zintoma) seems to work about as well as the medications ibuprofen or mefenamic acid.
• Morning sickness. Taking ginger by mouth seems to reduce nausea and vomiting in some pregnant women. But it might work slower or not as well as some drugs used for nausea. Also, taking any herb or medication during pregnancy is a big decision. Before taking ginger, be sure to discuss the possible risks with your healthcare provider.
• Osteoarthritis. Some research shows that taking ginger can modestly reduce pain in some people with a form of arthritis called "osteoarthritis." One study shows that taking 250 mg of a specific ginger extract (Zintona EC) four times daily reduces arthritis pain in the knee after 3 months of treatment. Another study shows that using a different ginger extract (Eurovita Extract 77; EV ext-77), which combines a ginger with alpinia, also reduces pain upon standing, pain after walking, and stiffness. Some research has compared ginger to medications such as ibuprofen. In one study, a specific ginger extract (Eurovita Extract 33; EV ext-33) did not reduce arthritis pain as well as taking 400 mg of ibuprofen three times daily. But in another study, taking 500 mg of ginger extract twice daily worked about as well as 400 mg of ibuprofen three times daily for hip and knee pain related to arthritis. In another study, a specific ginger extract combined with glucosamine (Zinaxin glucosamine, EV ext-35) worked as well as the anti-inflammatory medication diclofenac slow release (100 mg daily) plus glucosamine sulfate (1 gram daily). Research also suggests that massage therapy using an oil containing ginger and orange seems to reduce short-term stiffness and pain in people with knee pain.
• Nausea and vomiting following surgery. Most clinical research shows that taking 1 to 1.5 gram of ginger one hour before surgery seems to reduce nausea and vomiting during the first 24 hours after surgery. One study found ginger reduced nausea and vomiting by 38%. Also, applying 5% ginger oil to patients' wrists before surgery seems to prevent nausea in about 80% of patients. However, taking ginger by mouth might not reduce nausea and vomiting in the period 3-6 hours after surgery. Also, ginger might not have additive effects when used with medications for nausea and vomiting. In addition, ginger might not lower the risk of nausea and vomiting after surgery in people who have a low risk for this event.
• Dizziness (vertigo). Taking ginger seems to reduce the symptoms of dizziness, including nausea .

Possibly Ineffective for...

• Preventing motion sickness and seasickness. Most research suggests that taking ginger up to 4 hours before travel does not prevent motion sickness. Some people report feeling better, but actual measurements taken during studies suggest otherwise. But in one study, ginger appears to be more effective than the drug dimenhydrinate at reducing stomach upset associated with motion sickness.

Insufficient Evidence to Rate Effectiveness for...

• Sudden respiratory system failure (Acute respiratory distress syndrome). Research suggests that administering 120 mg of ginger extract daily for up to 21 days increases the number of days without ventilator support, the amount of nutrients consumed, and reduces the time spent in intensive care units in people with sudden respiratory system a failure. However, ginger extract does not seem to affect death rates in people with this condition.
• Nausea and vomiting due to chemotherapy. There is contradictory evidence about the effectiveness of ginger for nausea and vomiting caused by chemotherapy for cancer. Some evidence suggests that taking ginger by mouth might help reduce nausea caused by chemotherapy. However, other evidence suggests that adding ginger is no more effective than standard anti-nausea treatments alone. Reasons for the conflicting results may be the type and dose of ginger used, as well as the time at which ginger treatment was started.
• Chronic obstructive pulmonary disease (COPD). Research shows that taking two capsules of a specific combination product (AKL1, AKL International Ltd) containing ginger twice daily for 8 weeks does not improve respiratory symptoms in people with COPD.
• Diabetes. There is inconsistent evidence about the effects of ginger on blood sugar control in people with diabetes. Some research suggests that taking ginger daily in two divided doses for 8 weeks reduces insulin levels, but not blood sugar. Another study shows that ginger affects blood sugar, but not insulin levels. Although it's not clear, the conflicting results may be due to the dose of ginger used or the length of time the patients had been diagnosed with diabetes.
• Upset stomach (dyspepsia). Research suggests that taking a single dose of 1.2 grams of ginger root powder one hour before eating speeds up how quickly food empties out of the some in people with dyspepsia.
• Alcohol hangover. Early research suggests that taking a combination of ginger, pith of Citrus tangerine, and brown sugar before drinking decreases symptoms of alcohol hangovers, including nausea, vomiting, and diarrhea.
• High cholesterol. Research suggests that taking 1 gram of ginger three times daily for 45 days lowers triglyceride and cholesterol levels in people with high cholesterol.
• Insect bites. Early research suggest that applying Trikatu to the skin, which contains ginger, long pepper, and black pepper extracts, does not reduce mosquito bite size.
• Irritable bowel syndrome (IBS). There is inconsistent evidence about the effects of ginger on IBS symptoms. Some research suggests that taking ginger daily for 28 days does not improve symptoms. However, other research suggests that using an herbal mixture containing English horsemint, purple nut sedge tuber, and ginger tuber three times daily for 8 weeks is as effective as the drug mebeverine at reducing IBS symptoms. But it's not clear if ginger or the other ingredients promote symptom relief.
• Joint pain. Research shows that taking capsules of a specific combination product (Instaflex Joint Support, Direct Digital, Charlotte, NC) containing ginger for 8 weeks reduces joint pain by 37%. But this product does not seem to reduce joint stiffness or improve joint function.
• Speeding up labor. Early evidence suggests that bathing in water containing ginger oil does not shorten the length of labor.
• Migraine headache. Some reports suggest that taking a combination of ginger and feverfew might reduce the length and intensity of migraine pain. However, it is not clear if the effects are from ginger, feverfew or the combination.
• Muscle pain after exercise. There is contradictory evidence about whether ginger helps for muscle pain caused by exercise. Some research shows benefits, while other research does not.
• Recovery after surgery. Evidence suggests that inhaling and applying a combination of lavender and ginger oils to the skin before surgery does not reduce distress in children after surgery.
• Rheumatoid arthritis (RA). There is some early evidence that ginger might be helpful for decreasing joint pain in people with RA.
• Trouble swallowing. Evidence suggests that spraying a product containing ginger and clematix root (Tongyan) to the back of the throat improves severe problems swallowing in stroke victims. However, it is not beneficial in people with less severe problems swallowing.
• Weight loss. Research suggests that taking a supplement containing ginger, rhubarb, astragalus, red sage, turmeric, and gallic acid (Number Ten) daily for 8 weeks does not increase weight loss or reduce body weight in people who are overweight. But other research suggests that taking a combination supplement (Prograde Metabolism) containing ginger and other ingredients twice daily for 8 weeks reduce body weight, fat mass, waist circumference and hip circumference, when used along with dieting. But it's not clear if ginger is the cause for the weight loss.
• Anorexia.
• Bacterial infection of the intestine (Cholera).
• Baldness.
• Bleeding.
• Colds.
• Discontinuing use of drugs called selective serotonin reuptake inhibitors (SSRIs).
• Flu.
• Loss of appetite.
• Toothaches.
• Other conditions.

More evidence is needed to rate ginger for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Ginger is LIKELY SAFE when taken by mouth appropriately. Some people can have mild side effects including heartburn, diarrhea, and general stomach discomfort. Some women have reported extra menstrual bleeding while taking ginger.

Ginger is POSSIBLY SAFE when it is applied to the skin appropriately, short-term. It might cause irritation on the skin for some people.

Special Precautions & Warnings:

Pregnancy: Ginger is POSSIBLY SAFE when taken by mouth for medicinal uses during pregnancy. But using ginger during pregnancy is controversial. There is some concern that ginger might affect fetal sex hormones. There is also a report of miscarriage during week 12 of pregnancy in a woman who used ginger for morning sickness. However, studies in pregnant women suggest that ginger can be used safely for morning sickness without harm to the baby. The risk for major malformations in infants of women taking ginger does not appear to be higher than the usual rate of 1% to 3%. Also there doesn't appear to be an increased risk of early labor or low birth weight. There is some concern that ginger might increase the risk of bleeding, so some experts advise against using it close to your delivery date. As with any medication given during pregnancy, it's important to weigh the benefit against the risk. Before using ginger during pregnancy, talk it over with your healthcare provider.

Breast-feeding: There is not enough reliable information about the safety of taking ginger if you are breast feeding. Stay on the safe side and avoid use.

Bleeding disorders: Taking ginger might increase your risk of bleeding.

Diabetes: Ginger might increase your insulin levels and/or lower your blood sugar. As a result, your diabetes medications might need to be adjusted by your healthcare provider.

Heart conditions: High doses of ginger might worsen some heart conditions.

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NifedipineInteraction Rating: Major Do not take this combination.

Taking ginger along with nifedipine might slow blood clotting and increase the chances of bruising and bleeding.

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Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Ginger might slow blood clotting. Taking ginger along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

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PhenprocoumonInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Phenprocoumon is used in Europe to slow blood clotting. Ginger can also slow blood clotting. Taking ginger along with phenprocoumon might increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your phenprocoumon might need to be changed.

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Warfarin (Coumadin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Warfarin (Coumadin) is used to slow blood clotting. Ginger can also slow blood clotting. Taking ginger along with warfarin (Coumadin) might increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

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Cyclosporine (Neoral, Sandimmune)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Taking ginger two hours before taking cyclosporine (Neoral, Sandimmune) might increase how much cyclosporine (Neoral, Sandimmune) the body absorbs. This might increase the side effects of cyclosporine (Neoral, Sandimmune). However, ginger does not seem to affect how much cyclosporine (Neoral, Sandimmune) the body absorbs when taken at the same time.

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Medications for diabetes (Antidiabetes drugs)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Ginger might increase your insulin levels and/or decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking ginger along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), and others.

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Medications for high blood pressure (Calcium channel blockers)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Ginger might reduce blood pressure in a way that is similar to some medications for blood pressure and heart disease. Taking ginger along with these medications might cause your blood pressure to drop too low or cause an irregular heartbeat.

Some medications for high blood pressure and heart disease include nifedipine (Adalat, Procardia), verapamil (Calan, Isoptin, Verelan), diltiazem (Cardizem), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and others.

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Metronidazole (Flagyl)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Ginger can increase how much metronidazole (Flagyl) the body absorbs. Taking ginger along with metronidazole (Flagyl) might increase the side effects of metronidazole.

The following doses have been studied in scientific research:

BY MOUTH:

• For nausea and vomiting caused by HIV/AIDS treatment: 1 gram of ginger daily in two divided doses 30 minutes before each antiretroviral treatment for 14 days has been used.
• For painful menstrual periods: 250 mg of a specific ginger extract (Zintoma, Goldaru) four times daily for 3 days from the start of the menstrual period has been used. Also, 1500 mg of ginger powder daily in up to three divided doses, starting up to two days before menstruation and continuing for the first 3 days of the menstruation cycle, has been used.
• For morning sickness: 500 to 2500 mg of ginger daily in two to four divided doses for 3 days to 3 weeks has been used.
• For osteoarthritis: Many different ginger extract products have been used in studies. The dosing used differs depending on the product taken. One ginger extract (Eurovita Extract 33; EV ext-33) 170 mg three times daily has been used. Another extract (Eurovita Extract 77; EV ext-77), which combines a ginger with an alpinia, 255 mg twice daily has also been used. Another ginger extract (Zintona EC) 250 mg four times daily has also been used. Also, a ginger extract (Eurovita Extract 35; EV ext-35) 340 mg daily in combination with 1000 mg of glucosamine daily for 4 weeks has been used.
• For nausea and vomiting after surgery: 1-2 grams of powdered ginger root 30-60 minutes before induction of anesthesia has been used. Sometimes 1 gram of ginger is also given two hours after surgery.
• For dizziness (vertigo): 1 gram of ginger powder as a single dose one hour before causing dizziness has been used.

APPLIED TO THE SKIN:

• For osteoarthritis: A specific gel containing ginger and plai (Plygersic gel, Thailand Institute of Scientific and Technological Research) 4 grams daily in four divided doses for 6 weeks has been used.

INHALED AS AROMATHERAPY:

• For nausea and vomiting after surgery: A solution of ginger essential oil has been used. Aromatherapy with ginger alone, or in combination with spearmint, peppermint, and cardamom, has been inhaled through the nose and exhaled through the mouth three times after surgery.