Ginger

Plant Part Used

Root/Rhizome

Active Constituents

Gingerols, shogaols, paradols. zingerone; volatile oils: zingiberene, bisabolene, camphene, geraniol, linalool, borneol.(1),(53)

[span class=alert]This section is a list of chemical entities identified in this dietary supplement to possess pharmacological activity. This list does not imply that other, yet unidentified, constituents do not influence the pharmacological activity of this dietary supplement nor does it imply that any one constituent possesses greater influence on the overall pharmacological effect of this dietary supplement.[/span]

Introduction

Ginger has been used throughout history as both a culinary herb and a medicinal agent. Ginger has gained attention in the United States because of its effect on motion sickness,(2) nausea, as an aid in digestion, and its anti-rheumatic and anti-inflammatory effects.(3),(4),(5),(54)

Interactions and Depletions

Interactions

Dosage Info

Dosage Range

75-2000mg in divided doses of a standardized extract. with food

1-4gm of the fresh root daily in divided doses.

CHILDREN (ages 6-12) – use 1/3 of adult dosage.

Most Common Dosage

250mg of a standardized extract. 2-3 times daily with food

2gm of the fresh root, 2-3 times daily

CHILDREN (ages 6-12) – use 1/3 of adult dosage.

Standardization

[span class=doc]Standardization represents the complete body of information and controls that serve to enhance the batch to batch consistency of a botanical product, including but not limited to the presence of a marker compound at a defined level or within a defined range.[/span]

The most current available medical and scientific literature indicates that this dietary supplement should be standardized to 4% volatile oils or 5% total pungent compounds including 6-gingerol and/or 6-shogaol.

Uses

Frequently Reported Uses

  • Morning Sickness
  • Motion Sickness
  • Adjunctive Support In Chemotherapy And Radiation
  • Nausea
  • Anti-Inflammatory.
  • Antioxidant

Other Reported Uses

  • Appetite Stimulant
  • Analgesic
  • Anticoagulant
  • Antispasmodic
  • Colds, Flu (Diaphoretic)
  • Decreases Platelet Aggregation, Improves Blood Flow
  • Flatulence
  • Indigestion
  • Dyspepsia
  • Cholagogue, Increases Bile Flow
  • Migraine Headache Prevention
  • Anticancer
  • Antibacterial

Toxicities & Precautions

General

No known toxicity in recommended dosages.(6),(56)

Health Conditions

Based on pharmacology, use with caution in individuals with bleeding disorders.(7)

Ginger was reported to cause severe hyperkalemia in a patient with cirrhosis. Use ginger with caution in those with liver disorders or pre-disposed to liver diseases.(57)

Side Effects

There is little risk of toxicity in normal doses, but some individuals may experience GI upset.(8) Ginger may cause contact dermatitis in sensitive individuals.(58)

Pregnancy/ Breast Feeding

If pregnant or nursing, consult a physician before use. A laboratory animal study reported that when a proprietary extract of ginger was administered to pregnant rats during the period of organogenesis, with neither maternal nor developmental toxicity at daily doses of up to 1000 mg/kg body weight seen.(9)

Age Limitations

Do not use in children under 2 years of age unless recommended by a physician.

Pharmacology

Antiemetic Effects

Several clinical studies have been published which support ginger’s antiemetic activity compared to drug or placebo therapy.(10),(11),(12),(13),(59) Ginger may also be of value in the treatment of hyperemesis gravidarum, a condition in morning sickness where severe dehydration and electrolyte disturbances may occur through excessive vomiting.(14) In addition, two double-blind, controlled clinical studies reported that the use of ginger for treatment of nausea in pregnancy was found to decrease the number of events as well as lessening the severity of nausea.(15),(16) A randomized, controlled equivalence trial found that women using ginger in early pregnancy will reduce their symptoms.(17) The effectiveness of ginger root pre-surgically as an antiemetic agent was comparable with metoclopramide in a double-blind, placebo controlled study.(18) A double blind randomized controlled trial of 170 pregnant women also found that  ginger was as effective as the over-the-counter  (OTC) drug dimenhydrinate  (Dramamine) in the treatment of nausea and vomiting during pregnancy with fewer side effects including drowsiness.(60)

Ginger root preparations may be useful in controlling nausea and vomiting after surgery with general anesthesia and in outpatient surgery.(19),(20),(61) However, there has been a report of dried ginger root having no value in decreasing postoperative nausea, but product quality and lack of standardization may have contributed to this negative finding.(21) Shogaol is thought to give ginger its antiemetic effect, and some authors report that this effect may be due to in part to ginger’s increase in gastric emptying and its thromboxane synthetase activity.(22),(23),(24)

An analysis of clinical studies in 2000 on ginger’s effectiveness in decreasing nausea reported that the studies collectively favored ginger over placebo.(25) Ginger has also been reported to decrease the nausea associated with certain chemotherapy and radiation treatments.(26) A laboratory animal study reported that ginger administration decreased the cisplatin-induced emesis in dogs.(27) The ginger juice preparation significantly reversed cisplatin-induced delays in gastric emptying, and actually was more effective than the antiemetic drug ondansetron in reversing these gastrointestinal side effects. Ginger administration prior to chemotherapy is also reported to decrease nausea associated with 8-MOP therapy.(28) A small clinical study found that a high protein meal given with ginger may reduce the delayed nausea of chemotherapy and reduced use of antiemetic medications.(62)

A Phase II clinical trial reported in 2009 found the ginger was not effective in reducing the prevalence or severity of acute or delayed chemotherapy-induced nausea and vomiting, although dried, encapsulated ginger was used in the study and not standardized.(63)

Gingerol is reported to stimulate gastric secretions and enhance gastric motility.(29),(30),(64) Whether or not ginger works on the CNS or locally in the gut is debated, but research has reported both central and peripheral involvement.(31) A small human study did report however that a ginger root powder preparation had no effect on gastric emptying.(32) Ginger’s structural phenols are similar to aspirin and may have an effect on prostaglandins, PGE2 and PGF2, as well as thromboxane, leading to its use as a platelet aggregation inhibitor.(33),(34) One randomized double blind study of 8 healthy volunteers concluded that the effect of ginger on thromboxane synthetase activity is dose dependent and only occurs with fresh ginger. The authors concluded that up to 2 g of dried ginger is unlikely to cause platelet dysfunction when used therapeutically. However, the use of a standardized dried ginger preparation may not produce similar results as fresh ginger on platelet aggregation.

Anti-inflammatory

Ginger has reported anti-inflammatory properties and has been used in some inflammatory conditions such as arthritis.(44),(45) Ginger was reported to be effective against pain and swelling in more than three-quarters of the 56 patients studied (28 with rheumatoid arthritis, 18 with osteoarthritis and 10 with muscular discomfort).(46) None of the patients reported adverse effects during the period of ginger consumption which ranged from 3 months to 2.5 years. It has been suggested that at least one of the mechanisms by which ginger has anti-inflammatory effects is the inhibition of prostaglandin and leukotriene biosynthesis.(5)  More recent studies suggest ginger may inhibit lipopolysaccharide (LPS) induced COX-2 expression and PGE(2) production.(65) An in vitro study reported that an isolated constituent of ginger, (6)-shogaol, may share the sites of action with capsaicin on the terminals of substance P-containing neurons, inhibiting the release of substance P and producing an analgesic effect such as capsaicin.(47) Two-hundred and forty seven patients completed a randomized, double-blind, placebo-controlled, multicenter, parallel-group study lasting 6-weeks evaluating the safety and efficacy of 2 ginger species (Zingiber officinale and Alpinia galanga) in osteoarthritis (OA) of the knee. The ginger extract group had greater response in the primary endpoint of reduced knee pain upon standing as well as all the secondary endpoints evaluated. Less rescue medication (acetaminophen) was used by the ginger group. More gastrointestinal adverse effects, most of them mild were experienced by the ginger group. It is important to note that the change in the quality of life was equal between the ginger and placebo group.(48) Another study found no significant advantage of using ginger root over conventional anti-inflammatory agents such as ibuprofen.(49) However, the potential for side-effects of NSAID medications should be taken into consideration, as ginger usage has reported fewer side-effects.

Ginger’s anti-inflammatory effects have also been reported in laboratory studies to provide protection against UVB-induced reactive oxygen species (ROS) production.(66)

Other Uses

The volatile oils in ginger are thought to act as peripheral vasodilators or circulatory stimulants.(35) A study has described ginger’s use in prevention and treatment of migraine headaches.(36) A laboratory study reported that constituents in ginger induced perfused laboratory animal muscle to consume oxygen in association with increases in perfusion pressure and lactate production, leading to a thermogenic state.(37)

Ginger use has also been reported in animal studies to have a hypocholesterolemic effect similar to the drug gemfibrozil when administered orally.(38) An animal study reported that the use of ginger extract as a dietary supplement significantly decreased the development of atherosclerotic lesions, and also was associated with a significant reduction in plasma and LDL cholesterol levels and a significant reduction in the LDL basal oxidative state, as well as their susceptibility to oxidation and aggregation.(39) A double blind controlled clinical study found a significant reduce in triglyceride, cholesterol, low density lipoprotein (LDL), very low density lipoprotein (VLDL) after treatment with encapsulated ginger.(67)

Ginger has reported antioxidant value in laboratory studies.(40),(41),(42) A recent study in laboratory animals administered ginger root reported a significant decrease in lipid peroxidation by supporting the activities of antioxidant enzymes such as superoxide dismutase, catalase, and glutathione peroxidase.(43) The blood glutathione content was significantly increased in ginger fed rats, with similar effects also observed after ascorbic acid therapy (100mg/kg), with the conclusion that ginger root may be comparatively as effective as ascorbic acid as an antioxidant. Laboratory studies also suggest ginger may improve insulin sensitivity in diabetic rats, with the mechanism including aldose-reductase activity.(68)

Ginger has been reported to have anticancer activity to various human cancer cell lines (including colon, breast, pancreatic and ovarian) in laboratory studies, inhibiting G1 phase cell cycle growth and inhibiting cell adhesion, invasion, motility and activities of MMP-2 and MMP-9 in human breast cancer cell lines.(69),(70),(71)

Ginger also has antibacterial properties and has been used for this purpose in traditional therapies.(50),(51) Of interest is a report that a dried preparation of ginger had anti-rhinoviral activity in vitro.(52)

Read More

  1) Cultivation

  2) Essential Oil

  3) South Africa Herbs

  4) Ayuverda

References

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  52. View Abstract: Denyer CV, Jackson P, Loakes DM, et al. Isolation of Antirhinoviral Sesquiterpenes from Ginger (Zingiber officinale). J Nat Prod. May1994;57(5):658-62.
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  57. Rivero Fernández M, Moreira Vicente V, Rodríguez AL, Ruiz del Arbol Olmos L. [Severe hyperkalaemia caused by ginger in cirrhotic patient] Med Clin (Barc). 22Sep2007;129(10):398-399. Spanish. No abstract available.
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