Ginger

Ginger

By JP Saleeby, MD

The rhizome Ginger (Zingiber officinale) has been used in Asia for centuries as a culinary spice and as a medicinal for the treatment of various ailments. The milder young ginger root as well as the more pungent mature root is used in Chinese and Japanese cuisine to flavor dishes. In the Qing Dynasty it was even used to make a ginger-flavored liqueur called Canton. In Great Britain ginger is used in the production of a spirited beverage called Crabbie's Green Ginger Wine. Both the Orientals and Arabs use ginger infusions to flavor their coffee and tea, while in the West the traditional use is to flavor cookies and candies, and in the beverage ginger ale.

A most unusual use of ginger was amongst pre-WWI British mounted regiments when during public ceremonies a peeled ginger root suppository was placed in the horse’s rectum. The practice known as figging (or feauging), resulted in a burning sensation, while leaving no permanent damage; it made the horses hold their heads and tails high. As you can well imagine this practice in humans is observed within the S&M community.

In medicine, Ginger root (a misnomer as it is not a root but rather a horizontal subterranean stem) is use by TCM doctors for gastrointestinal illness, nausea, vomiting, diarrhea and arthritic disease. In the United States it has been used to treat gastrointestinal upset, nausea, motion sickness, pregnancy-induced nausea and arthritis mostly in folk medicine and alternative medicine. It may be gradually gaining acceptance in traditional western medicine in this country with recent scientific studies reporting positive outcomes.

The flavor and characteristic sent of ginger root is due to a mixture of zingerone, shoagoles and gingerols which are the volatile oils making up about 3% of the dry weight of fresh ginger. Gingerols are the medicinal components having analgesic, sedative, antipyretic, antiemetic and antibacterial properties in addition to reducing gastrointestinal motility. Gingerol ( [6]-gingerol ) is a relative of capsaicin, the compound that gives peppers their hot spicy taste. When gingerol is exposed to heat (such as in cooking) it is transformed into zingerone with its more palatable less pungent and spicy-sweet aroma.

The mechanism of action of ginger is poorly understood, however the antiemetic properties may be due to inhibition of serotonin receptors which exert affect directly on the gastrointestinal and central nervous system. The use of ginger in the treatment of arthritic disease such as osteoarthritis and rheumatism may be due to the fact that ginger inhibits the activation of tumor necrosis factor-alfa (TNF-a) and cyclooxygenase-2 (COX-2) expression, thus acting as an anti-inflammatory agent.

Ginger has been used for years as an over-the-counter preparation for treating motion sickness without the drowsiness of medications such as dimenhydrinate (Dramamine). It apparently works pretty well, according to some scientific studies conducted on seagoing naval cadets. While a rather entertaining “scientific” study on Discovery TV’s hit show the MythBusters explored [in “Episode 43: Seasickness – Kill or Cure” (premiered: Nov. 16, 2005 )] several non-pharmaceutical remedies along with placebo to tackle Adam’s very sensitive motion sickness. Ginger happened to be one of the more successful “home remedies” to combat this illness on the show. Now back to double-blinded peer reviewed published studies. In pregnancy-induced nausea several trials show comparable effectiveness with vitamin B6 and superiority over placebo of ginger to control morning sickness. The Cochrane review showed ginger as a safe (for baby and mommy) and effective antiemetic in pregnancy.

There are also studies to substantiate the use of ginger in post-operative nausea (post anesthesia). Ginger did not fare as well in controlling chemotherapy-induced nausea and vomiting however.

How does ginger stack up when treating arthritic pain? Where several studies showed mixed results when ginger was used to treat osteoarthritis and rheumatoid arthritis, a couple of trials did show statistically significant pain relief and reduction in swelling with the use of ginger. Ginger has also been studied in in vitro models and animals for conditions ranging from the treatment of bacterial and fungal infections, cancers and as antihypertensive agents. However, not many have been successfully studied in humans.

There does not appear to be any significant toxicity with Ginger. Although the FDA considers Ginger rather safe, there is a theoretical risk when used with the blood thinner warfarin (Coumadin). At high doses Ginger may cause elevation in protimes (PT) of those who take this medication. The only other caution to be observed is the use of this herb in people with gallbladder disease; those suffering gallstones may have an exacerbation in their condition as ginger releases bile from the gallbladder.

Clinical trials typically use 250 mg to 1000 mg of standardized powdered ginger root in capsular form. This dose is taken anywhere from once to four times a day. For pregnancy-induced nausea studies a successful regiment is 250 mg four times daily has been used.

In my neck of the woods a common beverage consumed by folks today started out as a local medicinal. The “world famous” Blenheim Ginger Ale is bottled less than 15 miles from my home in Bennettsville, SC. Blenheim Ginger Ale is named after the natural mineral spring in Blenheim, SC. Dr. C. R. May in the late 1800’s advised patients to drink this mineral water to sooth their upset stomachs. When it was reported that the remedy worked, but that many of the patients disliked the strong mineral taste of the water he added Jamacian Ginger to the water, thus spawning the now famous ginger ale. Jamacian Ginger has historically been used as a medicinal. It is classified as a stimulant and carminative for treatment of dyspepsia and colic and the tea brewed from the root was a folk remedy for colds. In 1903 Dr. May teamed up with a partner to bottle the product under the Blenheim Bottling Company. To this day it is considered the oldest and smallest bottling company in America. Some folks today use the “HOT” red-topped Blenheim Ginger Ale more as a medicinal than a soft drink for the treatment of sore throats, colds, the flu, and to settle their stomachaches. Renown journalist Charles Kuralt in his famous “On the Road” TV series featured the ginger ale on one of his episodes, and Penn Jillette (of the comic-magic duo Penn & Teller) is reportedly a big fan of the beverage. Penn was pictured on the cover of a September 1994 Wired magazine issue wearing a Blenheim T-Shirt, bottle in hand. Cheers!

----

JP Saleeby, MD is medical director of the emergency department at Marlboro Park Hospital in Bennettsville, SC. He authored a book on Adaptogen Herbs in 2006. For more information visit www.saleeby.net

Reference:

White, B, “Ginger: An Overview”, AmFmPractice, June, 2007, Vol. 75, Num. 11, http://www.aafp.org/afp/20070601/1689.html

Grontved A, Brask T, Kambskard J, Hentzer E. Ginger root against seasickness. A controlled trial on the open sea. Acta Otolaryngol 1988;105:45-9.

Stewart JJ, Wood MJ, Wood CD, Mims ME. Effects of ginger on motion sickness susceptibility and gastric function. Pharmacology 1991;42:111-20.

Borrelli F, Capasso R, Aviello G, Pittler MH, Izzo AA. Effectiveness and safety of ginger in the treatment of pregnancy-induced nausea and vomiting. Obstet Gynecol 2005;105:849-56.

Ernst E, Pittler MH. Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. Br J Anaesth 2000;84:367-71.

Altman RD, Marcussen KC. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum 2001;44:2531-8.

Jiang X, Williams KM, Liauw WS, Ammit AJ, Roufogalis BD, Duke CC, et al. Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2005;59:425-32.

The Blenheim Shrine, http://www.blenheimshrine.com

Aliverti, Brent, Blenheim Ginger Ale, http://theacf.com/blenheim

Wikipedia, http://en.wikipedia.org/wiki/Ginger

Susan Jakes, "Beverage of Champions. Part One: Hot Coke with Ginger, A Possibly Magical Elixir", http://en.wikipedia.org/wiki/Ginger

MythBusters Episode 43: Seasickness — Kill or Cure, http://dsc.discovery.com/fansites/mythbusters/episode/00to49/episode_02.html

All web sites accessed 7/1/2007

© 2007