Administration Guide and Suggestions of Ginger.
- Basic Botanical Information of Ginger.
- Botanical Description of Zingiber officinale and Phytochemical Constituents of Ginger.
- Origin and Narrative History of of Ginger,Traditional and Current Uses.
- Medicinal Action and Uses Brief Introduction of Ginger.
- Functions and Applications of Ginger.
- Historical View,Classical Reference Notes,Pharmacology and Medical Benefits of Ginger.
- Additional Research of Ginger.
- Administration Guide and Suggestions of Ginger.
- Culture and Practice of Ginger Tea.
- The Essence of Ginger.
- Research Update:Ginger and Its Constituents.
Administration Guide and Suggestions of Ginger.
Indications and Dosage Suggestions from CP:The CP(Chinese-Pharmacopia 2010) noted the herb Ginger taste hot spicy,nature light warm.Enter into lung,spleen,stomach meridians.Functions resolve the exterior and dissipate cold,warming middle energizer to arrest vomiting,preventing phlegm from forming and stopping coughing,resolves the toxin of fish and crabs.Indicated for anemofrigid cold(wind-cold type of common cold),gastrofrigid vomiting(stomach cold vomiting),cold phlegm cough,poisoning from fish and crabs.Suggested dosage 3~10grams,store in a cool and moist place,or bury in wet sands,freeze-proofing.
Indications Suggestions from PDR:The PDR 4th edition suggested the herb Ginger indicated for approved purpose "Loss of appetite,Travel sickness,Dyspeptic complaints",and unproven use "in folk medicine,Ginger is used as a carminative,expectorant,and astringent.Chinese Medicine:In China,Ginger is used to treat colds,nausea,vomiting,and shortness of breath.Indian Medicine:Indian medicine uses include anorexia,dyspeptic symptoms,and pharyngitis."3
Indications Suggestions from APA Guide:The APA Guide Book suggested:"What it is used for:Ginger is a powerhouse of Far Eastern traditional medicine,in which it has been used for millennia as a digestive aid and to remedy stomach upset,gassy indigestion,bloating,and cramping.It has also been used to relieve headaches(including migraine),calm inflammation and rheumatic pains,treat kidney ailments,soothe sore throats,and ease other cold symptoms such as cough,among many other things.Ginger tea or tincture taken hot is said to cleanse the system through perspiration and to suppress menstruation.Comtemporary herbalists recommend ginger for many of these traditional purpose,especially for cold and flu symptoms and digestive and menstrual irregularities.A number also consider it potentially valuable for preventing liver damage and treating peptic ulcers,impotence,rheumatic disorders,and depression.Of particular interest lately has been ginger's purported power to prevent nausea due to seasickness,motion sickness,morning sickness,and gynecologic surgery.Chinese sailors were known to chew on ginger root to keep seasickness at bay.External formulations of ginger juice have traditionally been placed on minor burns and skin inflammations to soothe and heal them.Some sources claim that ginger is useful in combination with olive oil to treat dandruff and that a few drops of the warmed oil will help soothe an earache."2
Dosage Suggestions from PDR:The PDR 4th edition suggested some varied dosages for different conditions:"Mode of Administration:comminuted rhizome and dry extracts for teas and other galenic preparations for internal use.the powdered drug is used in some stomach preparations.Preparation:to prepare an infusion,pour boiling water over 0.5 to 1 g drug and strain after 5 minutes(1 teaspoonful-3 g drug).Daily Dosage:Antiemesis:capsules/powder-0.5 to 2 g.Chemotherapy-induced nausea and vomiting:all dosage forms-1.5g.Dysepsia:capsule/powder-2 to 4 g/day.Motion sickness:capsules/powder-1 g to be taken 30 minutes before travel;for continuing symptoms,0.5 to 1 g every 4 hours.Rheumatoid Arthritis and Osteoarthritis:Powder-1 to 2 g/day.Storage:Powdered Ginger root should be stored in a cool,dry place protected from light.Powdered Ginger should not be stored in plastic containers."3
Dosage Suggestions from APA Guide:The APA Guide Book give some commonly reported dosage:"Dosage Commonly Reported:3 to 10 grams of fresh ginger,or 2 to 4 grams of dried ginger,are taken daily;a nubbin of ginger may range from 5 to 10 grams.A one-inch-square piece of ginger candy is equivalent to about 500 milligrams ginger.To prevent motion sickness,1,000 milligrams in capsule form is taken thirty minutes before travel;one to two more 500-milligram capsules are then taken as needed.As a digestive aid,a decoction is made using 2 teaspoons powdered or grated root per cup of water,or three 533-milligram root capsules are taken three times a day."2
OverDosage:The PDR 4th edition suggested and warned:"According to research,the LD50 of 6-Gingerol and 6-shagaol is set between 250 and 680 mg/kg.(Fulder and Tenne,1991;Suekawa et al,1984.)Toxicity tests in mice using a Ginger extract via lavage resulted in no mortality or adverse effects in doses up to 2.5 g/kg over a 7 day period.When the dose was increased to between 3 and 3.5 g/kg,a 10% to 30% mortality rate was reported(Macola,1989.)Overdosage may cause cardiac arrhythmia and CNS depression."3
Pediatric:Ginger should not be used by children under 2 years of age.
Ginger may be used by children over 2 years of age to treat nausea, digestive cramping, and headaches. Adjust the recommended adult dose to account for the child's weight. Most herbal dosages for adults are calculated on the basis of a 150 lb (70 kg) adult. Therefore, if the child weighs 50 lb (20 to 25 kg), the appropriate dose of ginger for this child would be 1/3 of the adult dosage.
Most people take 2 - 4 grams of the dried rhizome powder two to three times per day or a tincture of 1.5 - 3 ml three times daily. For treatment of nausea, people try single doses of approximately 250 mg every two to three hours, for a total of 1 gram per day. For prevention of motion sickness, many people start taking ginger tablets, capsules, or liquid herbal extract two days before the planned trip.
To lessen the possibility of side effects, no more than 4000 mg (4 grams) of powdered ginger or 10,000 mg (10 grams) of fresh ginger should be taken orally per day.
Ginger for medical use is available in a wide variety of dosage forms that include fresh ginger, dried powder (usually in capsules containing 500 mg or 1000 mg), and liquids such as extracts, tinctures, and syrups. Extracts are concentrated liquid preparations usually made by soaking chopped or mashed plant parts in a liquid such as alcohol, and then straining out the solid parts. Tinctures are less concentrated than extracts, but they are prepared in similar ways. Due to its sharp, tangy taste, ginger may be sweetened with sugar to make a syrup that may be more acceptable to children.
Ginger tea is made by simmering approximately 500 mg of fresh, grated ginger or approximately1000 mg of dried ginger in about 5 ounces of boiling water for about 10 minutes. The solid particles are then removed from the tea before drinking it. Ginger tea is often sweetened or flavored with other sweet spices such as cinnamon.
Decoction -For chills and phlegmy colds, use 1 - 2 slices to a cup of water and simmer for 10 minutes. A pinch of cinnamon can be added.
Tincture -Use 2 -10 drops per dose as a warming circulatory stimulant; also for flatulence, indigestion, and nausea.
Capsules -Take 1 - 2 x 200 mg capsules before a journey for travel sickness. Use up to 1 g doses for morning sickness in pregnancy.
Decoction -The Chinese use dried ginger in combination with other herbs as a restorative for yang or spleen energies, for abdominal fullness, nausea, and excess phlegm.
Massage Oil-Add 5-10 drops ginger oil to 25 ml almond oil for rheumatism or lumbago. Combines well with juniper or eucalyptus oil.
Oil-use 1-2 drops on a sugar lump or in half a teaspoon of honey for flatulence, menstrual cramps, nausea, or stomach upsets.
Although dosing varies, some common recommendations for powdered ginger are: Motion sickness 1000 mg (one gram) up to 4 hours before travel
For nausea, gas, or indigestion: 2 to 4 grams of fresh root daily (0.25 to 1.0 g of powdered root) or 1.5 to 3.0 mL (30 to 90 drops) tincture daily. To prevent vomiting, take 1 gram of powdered ginger (1/2 tsp) or its equivalent every four hours as needed, or 2 ginger capsules (1 gram) three times daily. You may also chew a ? oz piece of fresh ginger.
To relieve arthritis pain: Take fresh ginger juice, extract, or tea, 2 to 4 grams daily; rub ginger oil into painful joint; or place fresh root in a warm poultice or compress and apply to painful areas.
For cold and flu symptoms, sore throat, headache and menstrual cramps: Steep 2 tbsp of freshly shredded ginger in boiled water, two to three times daily, or place a drop of ginger oil or a few slices of fresh rhizome in steaming water and inhale.
Nausea after surgery:1000 mg one gram)one hour before surgery
Nausea from chemotherapy:2000 mg to 4000 mg ( 2grams to 4 grams)per day
Nausea of pregnancy:500 mg to 1500 mg (0.5 gram to 1.5 grams) up to four times a day
Indigestion: 2 to 4 grams a day
Motion sickness: 1 gram 30 minutes before travel; for continuing symptoms, 0.5 to 1 gram every 4 hours.
To prevent vomiting: 0.5 to 2 grams daily
Arthritis: 1 to 2 grams daily
Pregnancy: For nausea associated with pregnancy, women can take up to 1 gram daily, but should not use ginger for extended period of time.
Indicated for: Arthritis, fevers, headaches, and toothaches, lowers blood cholesterol and blood-pressure and aids in preventing internal blood clots. Coughs or bronchitis, osteoarthritis and rheumatoid arthritis, improves the complexion, eases tendonitis. There is some evidence to suggest that it helps to combat skin, ovarian, colon and breast cancer.
When should I be careful taking it?
Individuals with diabetes should avoid using large amounts of ginger because it may lower blood sugar levels, potentially resulting in hypoglycemia (blood sugar that is too low). Signs that blood sugar may be too low include shakiness, sweating, confusion, distorted speech, and loss of muscle control. If not corrected, low blood sugar can lead to seizures, unconsciousness, and even death.
Ginger is also thought to promote the flow of bile, which can worsen gallstones, so individuals who have gallstones should not use it.
Because of its cholagogic effects,the herb ginger could not be taken in the presence of gallstone conditions except after consultation with a physician.Ginger may inhibit thromboxane synthesis and should not be used by patients who are at risk for hemorrhage.
Although ginger is generally considered to be safe during pregnancy, one case of a miscarriage has been reported in a woman who was using ginger to relieve nausea. Whether the miscarriage was related to the use of ginger is unknown. In laboratory studies, one component of ginger has appeared to cause birth defects in babies born to animals given very large doses of ginger during pregnancy. No similar results have been reported in humans, and equivalent amounts of ginger for humans would be nearly impossible to ingest. To avoid any possible problems, ginger should only be used with the supervision of a health professional for pregnancy-induced nausea.
Because very little is known about the possible effects of large amounts of ginger for infants and very young children, women who are breast-feeding and children less than 2 years of age should avoid taking it as a supplement. The amounts of ginger ordinarily used to flavor foods are thought to be within acceptable limits for all age groups, however.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.
The American Herbal Products Association (AHPA) gives fresh ginger root a class 1 safety rating, indicating that it is a safe herb with a wide dosage range. Side effects associated with ginger are rare, but if taken in excessive doses the herb may cause mild heartburn. The AHPA gives dried ginger root a class 2b rating, indicating that it should not be used during pregnancy.
People with gallstones should consult a physician before taking ginger.
Avoid taking in acute inflammatory conditions. Although there is some evidence that ginger may actually be helpful in gastritis and peptic ulcertation, care is needed in these conditions as any spice may excaccerbate the problem. Avoid when pregnant or trying to get pregnant (large doses may have abortifacient effects). Avoid therapeutic doses if taking anti-coagulant therapy such as warfarin and seek advice if taking medication for heart problems. High blood pressure should always be monitored by a healthcare professional. Do not use if suffering from Gall stones.
The PDR herbalists reported:"Precautions and Adverse Reactions:No health hazards or side effects are known in conjunction with the proper administration of designated therapeutic dosages.Adverse reactions include minor gastrointestinal complaints such as gas,bloating,and heartburn.
It has been reported that administration of 6 grams of dried powdered ginger has been shown to increase the exfoliation of gastric surface epithelial cells in human subjects.It is postulated that this action may possibly lead to ulcer formation.Therefore,it is recommended that dosages on an empty stomach be limited to 6 grams. There have been reports that Ginger can cause hypersensitivity reactions resulting in dermatitis.Large overdose can cause central nervous system depression and cardiac arrhythmias.
Pregnancy:some experts suggest that Ginger should not be used in pregnancy or lactation.The Commmission E lists morning sickness associated with pregnancy as a contraindication,and the American Herbal Products Association lists pregnancy as a contraindication;however,no clinical evidence has been found to substantiate any harmful effects to mother or fetus.Most research provides evidence that Ginger can be used and is effective in the treatment of morning sickness.Ginger tea administered to pregnant Sprague-Dawley rats resulted in double the number of fetal losses compared to the control group(p less than 0.05).There were no gross morphologie malformations observed in the fetuses in the treatment group but fetuses in the treatment group were significantly heavier than control fetuses."3
Possible side effects:
Ingesting ginger occasionally in the amounts used to flavor foods has not been associated with side effects. Taking amounts over about 2000 mg (2 grams) of fresh ginger or about 3000 mg (3 grams) of powdered ginger per day on a continual basis may result in side effects more often than lower or less frequent doses. Side effects may be more common with uncooked, fresh ginger than with other forms of ginger.
Major Side Effects:Very large overdoses of ginger in laboratory animals have been associated with changes in heart rhythm and central nervous system symptoms such as dizziness and weakness. No reports of similar side effects in humans have been published.
Less Severe Side Effects:Side effects most often reported by individuals taking supplemental ginger include: Burning or tingling in the mouth;Diarrhea;Heartburn,etc.
Using ginger occasionally in foods has not been associated with interactions. However, when taken continually, supplemental amounts exceeding 2000 mg (2 grams) of fresh ginger or 3000 mg (3 grams) of powdered ginger per day may have a small risk of interactions.
The PDR herbalists suggested the Ginger root has moderate risk drug interactions with Anticoagulants,minor risk drug interactions with Antiplatelet agents,low molecular weight heparins,thrombolytic agents.3
Interactions with Prescription Drugs:
In studies of laboratory animals, extremely high doses of ginger have been associated with a small increase in the time blood needs to clot. At least one case of an increased international normalized ratio (INR) and nosebleed has been reported in a human taking both an anticoagulant and an unknown amount of supplemental ginger. Therefore, the possibility exists that high continual doses of ginger taken with an antiplatelet or anticoagulant drug, could increase the effect of the drug and that uncontrolled bleeding could occur.
Antiplatelet drugs include Plavix and Ticlid. Anticoagulants include heparin and warfarin.
Because ginger may have a lowering effect on blood sugar, taking large amounts of ginger for extended periods of time may increase the effectiveness of medications used for the treatment of diabetes. If you are using insulin or taking medications for diabetes, talk to your doctor or pharmacist before taking supplemental ginger.
Due to an unpredictable effect on blood pressure, prolonged daily use of powdered ginger over about 4000 mg (4 grams) or fresh ginger over about 10,000 mg (10 grams) may interfere with the effects of drugs that lower blood pressure. Some blood pressure-lowering drugs are:
ACE inhibitors such as captopril, enalapril, lisinopril, and Monopril
Beta blockers such as atenolol, metoprolol, and propranolol
Calcium channel blockers such as nifedipine, Norvasc, and verapamil
Diuretics such as Dyazide, furosemide, and hydrochlorothiazide
The effectiveness of drugs used to treat heart conditions may also be altered by large amounts of ginger taken for extended periods of time. Talk to your doctor or pharmacist before taking ginger if you take drugs for any heart condition.
Ginger is believed to affect the production of acid in the stomach. Therefore, it may interfere with the effectiveness of sucralfate (Carafate), Histamine-2 (H-2) receptor blockers and proton pump inhibitors.
H-2 receptor blockers include: cimetidine (Tagamet);famotidine (Pepcid);nizatidine (Axid);ranitidine (Zantac)
Proton pump inhibitors include: esomeprazole (Nexium);lansoprazole (Prevacid);omeprazole (Prilosec);pantoprazole (Protonix)
Although ginger may interfere with blood clotting, there have been no scientific or case reports of interactions between ginger and blood-thinning medications. However, people taking these medications with ginger should be monitored closely by a healthcare practitioner for risk of bleeding.
Ginger may reduce the toxic side effects of cyclophosphamide (a medication used to treat a variety of cancers). More research is needed in this area.
Interactions with Non-prescription Drugs:
In theory, ginger can slow down the ability of blood to clot. Aspirin can also delay clotting, so high doses of ginger should not be taken at the same time as aspirin.
The possibility that ginger can affect the production of stomach acid could interfere with the effectiveness of antacids and over-the-counter medications such as Pepcid AC, Prilosec OTC, and Zantac AR.
Interactions with Herbal Products:
Theoretically, if large doses of ginger are used with other herbs that affect blood clotting, bleeding may occur. The most common herbal products that might inhibit blood clotting are:
Danshen;Devil's Claw,Garlic,Ginkgo,Ginseng;Horse Chestnut;Papain;Red Clover;Saw Palmetto,etc.Some interactions between herbal products and medications can be more severe than others.
Toxicity and Safety of Ginger:
Acute Toxicity of Ginger Oil:LD50.Lethal dose,50 percent death.Mice.Abdominal injection.1.23 ml/kg.LD50.Lethal dose,50 percent death.Mice.Gastric Perfusion. 3.45ml/kg.
Reference:Zhang Zhu Xin, et al. Journal of Chinese Materia Medica. 1988;19(9):407-409.
Acute Toxicity of Shogaol:LD50.Lethal dose,50 percent death.Mice.IV injection.50.9mg/kg;LD50.Lethal dose,50 percent death.Mice.Abdominal Injection.109mg/kg;LD50.Lethal dose,50 percent death.Mice.Gastric Perfusion.687mg/kg.
Acute Toxicity of Gingerol:LD50.Lethal dose,50 percent death.Mice.IV injection.25.5mg/kg;LD50.Lethal dose,50 percent death.Mice.Abdominal Injection.581mg/kg;LD50.Lethal dose,50 percent death.Mice.Gastric Perfusion.250mg/kg.
Reference:Chi Tian Zheng Shu, et al. Foreign Medicine, vol. of TCM. 1981;(2):53.
Crude drug toxicity:LD50 (mice/water extract of dried ginger): 33500 mg/kg.Shoyakugaku Zasshi, 37 (1), 37-83 (1983)
Safety in General:The FDA includes ginger on its list of foods that are Generally Recognized As Safe(GRAS).The APA guide herbalists suggested "The recent medical literature contains no reports of notable adverse reactions to medicinal amounts of ginger,and the spice has certainly been used worldwide for centuries to no apparent ill effect.The FDA includes ginger on its list of foods that are Generally Recognized As Safe(GRAS).Laboratory studies,however,indicate that consuming very large quantities could depress the central nervous system and cause abnormal heart rhythms.
The safety of using ginger to prevent nausea is somewhat unclear;while recommended amounts to prevent motion sickness appear to be harmless,some sources express concern that ginger could cause adverse reactions when used for postoperative nausea or for nausea and vomiting associated with pregnancy.Ginger appears to hinder platelet aggregation--a function crucial to blood clotting--by inhibiting thromboxane synthetase and its action as a prostacylcin agonist.This was observed in a study of seven women who took 5 grams of raw ginger by mouth and then had their blood tested.While this blood alteration is probably dose-related,it has generated considerable concern.Some reassurance can be derived from a randomized,double-blind study of eight healthy male volunteers in which no significant differences in various measures of platelet function were seen when the subjects took 2 grams of dried ginger as compared with a placebo.This does not rule out a hazardous effect with large doses,however. Other researchers worry that because ginger is a powerful thromboxane synthetase inhibitor,it may affect testosterone receptor binding in the fetus,possibly influencing sex steroid differentiation of the fetal brain.For these reasons,several sources advise pregnant women to avoid taking ginger in medicinal doses until more research can be done to confirm that this is safe.German health authorities,for example,warn that medicinal amounts of ginger should not be taken for morning sickness.No studies in humans or the laboratory suggest that pregnant women who use small amounts of ginger as a spice could harm their unborn child,however.
According to the test-tube and small-animal studies,ginger has properties that may interfere with diabetic,blood-thinning,or heart medicine,so talk to your doctor before starting to take medicinal amounts of ginger.Also,do not use ginger to treat gallstone pain,German health authorities advise,before checking with your doctor.There is confusion over the apparent mutation-promoting and mutation-inhibiting properties of ginger,as seen in some laboratory studies;this requires further exploration."2
1: Ginger,a traditional herb with hot nature for lung governs,its botanical introduction,uses and applications from ancient epoch till today,and stories.
2: see The American Pharmaceutical Association Practical Guide to Natural Medicines,1st Ed,p288 to 291.
3: see PDR for Herbal Medicines 4th Ed.,under title "Ginger",p365 to 369;
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