Ginger is an herb that has been used for thousands of years in China as a medicinal practice to reduce nausea. Ginger was used by the ancient Greeks to prevent nausea after feasting. Recent studies suggest that it may help people with chemotherapy-induced nausea as well.
How is Ginger Used?
Ginger (Zingiber officinale) is derived from the root of the ginger plant. It can be taken as a supplement, or used as a food, a drink or as a spice added to your favorite foods. As a food, ginger may be used fresh, dried or crystallized.
Studies looking at the use of ginger for chemotherapy-associated nausea usually involve the use of ginger over a period of several days, beginning a few days prior to the infusion of chemotherapy. Doses of supplements used in these studies have ranged from 0.5 grams up to 1.5 grams daily. According to the American Cancer Society, the maximum daily dose of ginger is 5 grams or less.
In studies to date, the most effective dose of ginger appeared to be a 250 milligram supplement given 2 to 4 times a day. This is equivalent to roughly ¼ tsp of dried ginger or ½ tsp of fresh ginger daily. Crystallized ginger contains around 500 mg of ginger per square inch. Ginger tea made with ¼ tsp of ginger contains approximately 250 mg. Homemade ginger ale has roughly 1 gram of ginger per 8 ounce glass. It’s important to note that “real” ginger is needed to get the anti-nausea effects of ginger. Ginger ale purchased from a store may contain “ginger flavoring” rather than real ginger.
It’s also imperative to talk with your oncologist before using ginger during cancer treatment. As noted below, ginger has properties that could be harmful for some people.
What is Chemotherapy-Induced Nausea?Nausea refers to the stomach upset that may or may not precede vomiting. It is a very common side effect of chemotherapy medications. Some medications are more likely to cause nausea than others, and everyone is different when it comes to the amount of nausea they will experience. While the treatment of chemotherapy-induced nausea has come far in the last decades, it’s estimated that at least 70% of people still experience some degree of nausea during and after chemotherapy.
Why Might Ginger Work to Reduce Nausea?It’s not known exactly how ginger works in the body to reduce nausea. Ginger contains oleoresins, substances that have an effect on the muscles of the digestive system. Ginger also has anti-inflammatory effects in the body.
What Does the Research Say?A 2009 study of over 600 cancer patients found that a supplement of ginger reduced chemotherapy-induced nausea by 40%. A 2012 study to evaluate the best dose of ginger also found a significant reduction in nausea among people who used ginger. In this study, patients were given a placebo or 0.5 grams, 1 gram, or 1.5 grams of ginger divided twice a day for 6 days, and beginning 3 days prior to the chemotherapy infusion. The most effective dose in this study was 0.5 to 1.0 grams.
Chemotherapy can cause nausea immediately, or over several hours and days following infusion. A 2012 study done with breast cancer patients found that ginger was most effective in alleviating nausea that occurred between 6 and 24 hours following chemotherapy. Another study performed on child and young adult cancer patients found that ginger helped with both acute (within 24 hours) and delayed (after 24 hours) nausea associated with chemotherapy.
Cautions in Using GingerIt's important to discuss any supplements you consider using with your oncologist, including ginger, since these could be harmful for some people. It’s also important to emphasize that using ginger is not a substitute for the anti-nausea medications given to alleviate nausea and vomiting during and after chemotherapy. In the studies reviewed, ginger was used in addition to preventative anti-nausea drugs.
Ginger can act like a blood thinner, so it’s important to avoid using ginger along with medications (or other supplements) that thin the blood, such as Coumadin (warfarin), Heparin and Ticlid (ticlodipine). Ginger should not be used near the time of surgery for cancer for this reason. A low platelet count (thrombocytopenia) due to chemotherapy may also increase the risk of bleeding, and your oncologist will want to evaluate your blood counts before recommending whether ginger should be used to help alleviate nausea.
Ginger shouldn’t be used by people with gallstones, and may result in decreased blood sugar in people with diabetes.
Dietary and supplemental ginger is usually well-tolerated, although some people may experience heartburn, diarrhea, bruising, flushing or a rash.
Further Reading About Ginger:
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American Cancer Society. Ginger. Updated 05/13/10. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/ginger
Haniadka, R. et al. Zingiber officinale (Ginger) as an Anti-Emetic in Cancer Chemotherapy: A Review. Journal of Complementary and Alternative Medicine. 2012. 18(5):440-4.
Panahi, Y. et al. Effect of Ginger on Acute and Delayed Chemotherapy-Induced Nausea and Vomiting: A Pilot, Randomized, Open-Label Clinical Trials. Integrative Cancer Therapies. 2012 Feb 7. (Epub ahead of print).
Pillai, A. et al. Anti-emetic effect of ginger powder versus placebo as an add-on therapy in children and young adults receiving high emetogenic chemotherapy. Pediatric Blood and Cancer. 2011. 56(2):234-8.
Ryan, J. et al. Ginger (Zingiber officinale) reduces acute chemotherapy-induced nausea: a URCC CCOP study of 576 patients. Supportive Care in Cancer. 2012. 20(7):1479-1489.
University of Rochester Medical Center. Research. Ginger Quells Cancer Patients’ Nausea From Chemotherapy. 05/15/09. http://www.urmc.rochester.edu/pr/news/story.cfm?id=2491