- Ginger root
- shen jiang
For Patients & Caregivers
Ginger has been shown to help relieve nausea and vomiting.
Ginger root contains compounds that may help relieve or prevent nausea and vomiting. These substances can increase the flow of saliva and digestive juices and may also help calm the stomach and intestine. Scientists are still unsure exactly how ginger exerts these effects. In humans, studies have shown that eating fresh ginger (but not dried ginger) in high doses can “thin” the blood by preventing the platelets from sticking together. In addition, laboratory studies suggest that ginger can protect brain cells from the plaques that cause Alzheimer’s disease, but this effect has not been studied in humans.
- To stimulate appetite
Ginger is known to stimulate the flow of saliva and digestive secretions, but clinical trials have not been performed.
- To relieve indigestion
Compounds found in ginger are known to stimulate the flow of saliva and digestive juices, reduce gas, and calm the stomach and intestine, but human data are lacking.
- To treat diarrhea
Compounds found in ginger are known to calm the stomach and intestine, but scientific evidence is lacking.
- To treat nausea and vomiting
Several clinical trials support use of ginger for short-term treatment of nausea and vomiting associated with chemotherapy and motion sickness. However, because of blood-thinning effects, ginger supplements should not be used around the time of surgery. It is also not suggested for use during pregnancy because of possible unknown risks to the developing embryo.
- To treat rheumatoid arthritis and osteoarthritis
A few studies have been conducted with positive results but more research is needed.
- To treat respiratory ailments
Certain compounds in ginger may improve inflammation and protect against certain viruses, but no human studies have been conducted to confirm this.
- To treat drug withdrawal symptoms
A small animal study suggests that ginger may help ease withdrawal symptoms from drugs like morphine. However, no other studies have been published and human studies would be needed to see if this was true.
- Due to its blood-thinning effects, ginger supplements should be stopped 2 weeks before undergoing surgery, and should not be used immediately after surgery to control nausea or vomiting. Other types of medications given by your healthcare provider can be used to control these symptoms.
- Ginger supplements should be avoided in patients with bleeding disorders.
- Ginger supplements should be avoided during pregnancy or lactation.
- Ginger supplements should be avoided by individuals with gallstones.
- You are taking warfarin or other blood thinners (Ginger supplements may increase the risk of bleeding).
- You are taking NSAIDs, nonsteroidal anti-inflammatory drugs (Ginger supplements may increase bleeding tendency when used with these drugs).
- You are taking insulin or medication to lower blood glucose (Ginger supplements may cause larger reductions in glucose levels).
- You are taking tacrolimus (Ginger supplements increase the blood levels of this drug and may increase side effects).
- You have a bleeding disorder (Ginger supplements may increase bleeding time).
- You have gallstones (Ginger supplements may increase the flow of bile).
- You are having surgery (Ginger supplements may increase bleeding risk).
- You are pregnant or lactating (The effect of ginger supplements on the human gestational development are unknown).
- Skin irritation, swelling, and redness
- Case Report: A 76-year-old woman on long-term blood-thinning therapy who took ginger products developed a nosebleed, and it was found that her blood was clotting too slowly following use of ginger products. Clotting returned to normal after discontinuing ginger and with the administration of vitamin K.
For Healthcare Professionals
Derived from the rhizome of the plant, ginger is native to Asia and is used both as food and as medicine. In traditional Chinese medicine, ginger is used to expel “cold”, “wind” and “dampness”, and is believed to stop the reverse flow of Qi (energy) (1). Western use has been primarily for gastrointestinal symptoms and respiratory ailments. In vitro and animal studies suggest that ginger has antiemetic (2), anticancer (3) (4) (5) (6), anti-inflammatory (6) (7) (8), anti-drug-dependence (9), and hypoglycemic effects (7). It may also protect against Alzheimer’s disease (10) (11) (12). Ginger influences gastric emptying in healthy individuals (13) and may promote feelings of satiety (14). Systematic reviews of ginger suggest effectiveness of ginger for treating primary dysmenorrhea (55) and moderate efficacy against osteoarthritic and chronic low back pain (15) (16).
Although clinical trials indicate that ginger can effectively reduce nausea and vomiting, (17) (18) (19) (20) it should be avoided perioperatively due to its anticoagulant/antiplatelet effects (21) (22) (23) (24) (25) (26), and during pregnancy since animal studies highlight concerns regarding embryo development (26) (27). Dietary ginger seems to be without these effects (28) (29) (30), although some studies suggest that high concentrations of fresh ginger have both antiplatelet (31) and antiviral (32) potential.
The evidence for ginger in prevention of chemotherapy-induced nausea and vomiting (CINV) is generally positive (33) (34) (35) (36), although a systemic review of randomized controlled (RCTs) or crossover trials was unable to draw any conclusions (37); aromatherapy using ginger was found ineffective in relieving CINV, but improvements were seen in quality of life (56). Another pilot study suggests that ginger supplementation may have chemopreventive effects for those at increased risk for colon cancer with normal-appearing colonic mucosa (38). More and larger studies are needed to confirm any true benefit with ginger supplementation for symptom control or chemoprevention.
The antiemetic action of ginger is attributed to the rhizome constituents shogaol and gingerol, which stimulate the flow of saliva, bile, and gastric secretions, and galanolactone, which can act as a competitive antagonist at serotonin 5-HT3 receptors (2) (22). Additional activities include the stimulation of antral contractions, reduction of postprandial antral area, and acceleration of gastric emptying (13). Ginger inhibits thromboxane formation and platelet aggregation (43). However, these effects appear to be dose- and formulation-dependent (e.g., dried, fresh, or extract) (31). In vitro studies suggest that fresh ginger stimulates mucosal cells to secrete IFN-β to combat viral infection (32), while certain ginger preparations have been shown to reduce lipopolysaccharide-induced secretion of IL-8 in human bronchial epithelial cells (8) and inhibit human telomerase reverse transcriptase (hTERT) and c-Myc expression in human lung cancer cells (44).
Gingerol induces apoptosis of gastric cancer cells through TRAIL-dependent caspase 3/7 activation (3) and inhibits cell-cycle progression by reducing cyclin D1 expression (4). It also inhibits secretion of angiogenic cytokines such as VEGF and IL-8 in ovarian cancer cells (5). In animal models, shogaol reduces in vivo tumor growth by damaging microtubules and inducing mitotic arrest (3). Increased levels of circulating antioxidant and phase II enzymes, and reduced lipid peroxidation levels are also mechanisms by which ginger protects against DMH-induced colon cancers (45).
- Ginger supplements should not be used in the perioperative setting due to the potential risk for increased bleeding (21) (24). This is in line with a general caution to avoid such herbs that have antiplatelet and anticoagulation properties due to concerns for perioperative bleeding. But according to a systematic review, the evidence is inconclusive. Further study is warranted (57).
- Likewise, ginger supplements should be avoided in patients with bleeding disorders (46).
- Ginger supplements should be avoided during pregnancy or lactation due to lack of data on human fetal outcomes and concerns regarding embryo development in animal studies (27) (47). The German Commission E also contraindicates ginger for morning sickness during pregnancy (48).
- Individuals with gallstones should avoid ginger supplements due to potential cholagogic effects (49).
Common: Heartburn and dermatitis (36) .
Overanticoagulation: A 76-year-old woman on long-term phenprocoumon therapy developed an elevated international normalized ratio (INR) and epistaxis following use of ginger products. INR returned to normal range after discontinuing ginger along with administration of vitamin K (50).
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Ginger may increase bleeding tendency with concomitant use of drugs such as diclofenac or ibuprofen (26).
- Anticoagulants / Antiplatelets: Because ginger can inhibit thromboxane formation and platelet aggregation, concomitant use with anticoagulants may increase the risk of bleeding (51). But according to a systematic review, current evidence is inconclusive. Further study is warranted (57).
- Hypoglycemics / Insulin: Ginger may cause additive reductions in blood glucose (7).
- Tacrolimus: Pretreatment with ginger increases the plasma levels of tacrolimus (52).
- Cyclosporine: Concomitant use with ginger resulted in decreased blood concentration of cyclosporine, in vivo (54).