Ginger - Medicinal Uses, Interactions, Side Effects, Dosage

Ginger - Uses and Benefits, Preparations and Dosage

<p><strong>Ginger </strong></p> <p>Ginger is noted for its aroma and pungent <em>flavor. </em>The fresh or (hied rhizome (usually referred to as the root) is a valuable spice dnd condiment, as well as a traditional herbal medicine. </p> <p><strong>Uses and Benefits:</strong></p> <p> Ginger root is widely used as a digestive aid for mild dyspepsia, and is commonly promoted to help treat or prevent nausea or motion sickness. Known since ancient times (especially in Asian, Indian, and Arabic herbal traditions), ginger has also been used for arthritis, colic, diarrhea, heart disease, and as it general "warming" herb.</p> <p><strong>Pharmacology:</strong></p> <p>Important chemical constituents are thought to be the phenolic compounds (e.g, gingerols, shogaols) and es­sential oils (primarily the sesquiterpenes such as zingiberene, zingiberol, and curcumene). Ginger and isolated constituents, pri­marily gingerols, <em>have </em>been studied in many animal and <em>in vitro </em>experiments; the details of these studies <em>have </em>been extensively <em>reviewed.</em>In summary, ginger was found to enhance gastroin­testinal motility in some (but not all) animal studies, and to de­crease chemotherapy-induced vomiting. It reduces experimentally induced gastric lesions, and enhances bile excretion. <em>In vitro, </em>ginger is an antioxidant; inhibits formation of inflammatory prosta­glandins and leukotrienes and inhibits platelet aggregation. </p> <p><strong>Clinical Trials:</strong></p> <p>Ginger root, primarily in doses of 0.5-1 g, has been well-studied for motion sickness and as an antiemetic; results of controlled trials are generally positive, but are not all consistent. Ginger was more effective than placebo and dimenhydrinate (Dramamine) in an initial single-blind experiment for motion sick­ness, measuring the tolerance of students in a rotating chair. Although one small, placebo-controlled study also reported an antivertigo effect to caloric stimulation of the vestibular apparatus, three subsequent controlled studies of experimental motion sickness (using a rotating chair or turntable) found ginger to be no more effective than placebo.</p> <p>Better results were found in "real-life" clinical studies of motion sickness. Ginger was reported to help prevent or reduce sea-sick­ness on ocean vessels in three double-blind, randomized con­trolled trials (RCTs). In naval cadets, a single dose of ginger reduced vomiting and cold sweats more effectively than placebo. 17 In 60 cruise passengers, ginger had equivalent effects to standard doses of antiemetic antihistamines when given every 4 hours, and in 1741 tourists on whale safaris when given in two doses shortly before and after departure. In a separate RCT of 28 children (ages 4-8) prone to travel sickness, 0.25 g every 4 hours reduced symptoms of travel sickness more effectively, and with less side effects, than dimenhydrinate.</p> <p>Mixed results were found for postsurgical nausea following laparoscopic gynecologic procedures in four large double-blind RCTs; results were positive in two studies and negative in the other two. In the positive studies, 1 g of a ginger root product before surgery reduced the incidence of nausea as effectively as a standard dose of metoclopramide, and decreased the need for postoperative medications. In the other two studies, there</p> <p><strong>Adverse Effects:</strong></p> <p>Ginger has no known clinical adverse effects other then rare heartburn.</p> <p><strong>Side Effects and Interactions:</strong> </p> <p>Drug interactions have not been studied or reported in humans. In a rat model, ginger did not interact with warfarin's activity on blood coagulation. </p> <p><strong>Cautions: </strong></p> <p>Although ginger has antiprostaglandin and antiplatelet effects <em>in vitro, </em>increased risk of bleeding has not been demonstrated with oral doses up to 4 g daily, and there have been case reports of bleeding. Because doses greater than 4 g/day may affect platelet function, it would be prudent to recommend lower doses for patients who are taking anticoagulant drugs or are otherwise at high bleeding risk. </p> <p>Despite its widespread use in foods, ingestion of ginger during pregnancy is controversial. Ginger extract and isolated ginger constituents have mutagenic and antimutagenic properties, depending on the <em>in vitro </em>experimental test. Embryotoxic effects have been described in pregnant rats. In the two controlled clinical trials of pregnant women (totaling 59 women who received ginger), there were no significant adverse effects detected on pregnancy outcome. Based on the experience of its wide-spread use in foods, it is unlikely that ginger has detrimental effects during pregnancy; nevertheless, it would be prudent to be cautious and to avoid higher doses (> 2 g daily).</p> <p><strong>Preparations </strong><strong>& </strong><strong>Doses:</strong></p> <p>Common preparations include powdered ginger capsules, liquid extracts, tinctures, and candies. The doses examined in various clinical trials range from 0.2 to 1 g of dried ginger root, usually administered in capsules, as a single dose or repeated <em>every </em>4 hours or q.i.d. depending on the study, Doses recommended by herbal authorities are similar, usually 0.5-1 g two to four times a day, up to 4 g daily.Larger daily doses of up to 9 g of fresh or dried ginger are often used in traditional Chinese medicine. Substantial ginger content is found in highly spiced meals or strong ginger ales and teas. </p> <p><strong>Summary Evaluation </strong></p> <p>Although the results of controlled trials are not consistently positive, the <em>evidence </em>demonstrates that ginger root has some clinical benefits for the prevention or treatment of nausea and motion sickness, and may <em>have </em>effects similar to standard antiemetic an­tihistamine-type drugs. Unlike most antiemetic agents, <em>however, </em>ginger is nonsedating and has no other significant <em>adverse </em>effects. It is not unreasonable for patients to try ginger as a mild herbal antiemetic or for motion sickness. Anti-inflammatory and other purported clinical claims are not well substantiated.</p>

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