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Ginger, Nausea, and Chemotherapy

April 23rd, 2010

Ginger, Zingiber officinale, is one of the most widely consumed aromatic spices in the world, used in cooking and as a main ingredient in many traditional medicines. Known for its warming, anti-spasmodic, and carminative qualities on the digestive system, it has traditionally been used for nausea, vomiting, diarrhea, dyspepsia and colic. Earlier studies found ginger to be effective in reducing nausea related to seasickness 1, motion sickness 2, and morning sickness associated with pregnancy 3.*

Current data suggests that about 70% of cancer patients undergoing chemotherapy experience postchemotherapy nausea and vomiting. 4 Delayed postchemotherapy nausea, nausea occurring 24 hours or later after administration of chemotherapy, as well as anticipatory nausea, are poorly controlled by standard antiemetic medications. Many of these antiemetic medications have significant adverse effects, including sedation, hypotension, headaches, and bowel changes. In an ongoing study using ginger with standard medications for reducing acute and delayed postchemotherapy nausea and anticipatory nausea, ginger appears effective in significantly lowering side effects.*

The National Cancer Institute has funded a phase II/III double-blind study at the University of Rochester Medical Center. It is the largest randomized study to date that shows the effectiveness of ginger and the first to focus on taking the supplement prophylacticlaly. Six hundred forty-four cancer patients were scheduled to have at least 3 chemotherapy treatments, with the first chemotherapy session used as a baseline to establish degree of nausea and vomiting with a standard antiemetic medication regimen.*

The patients were randomly divided into one of 4 groups: group 1 took placebo, group 2 took 0.5 grams of ginger; group 3 took 1 gram of ginger, and the fourth group took 1.5 grams of ginger. All groups also took the standard antiemetic medication regimen. The ginger was given in 250 mg capsule form every 12 hours for 6 days, starting 3 days prior to chemotherapy. Patients reported their levels of nausea on a 7-point scale, 1 being no nausea and 7 being the worst possible nausea. Symptoms were recorded the day of chemotherapy and 4 times a day for the first 4 days after the chemotherapy. By the end of the first day, the patients on the lower 2 doses of ginger scored their nausea level at 1 or 2, whereas the patients on placebo scored at 4 or 5. Researchers reported a 40% reduction in nausea at the 2 lowest ginger doses on the first day and were maintained on the following days. The higher dose ginger group did not show results as good as those of the lower dose group. 4 Given the initial results, the study demonstrates that ginger, with standard antiemetic medications, reduces acute and delayed postchemotherapy nausea and anticipatory nausea. In addition, ginger did not appear to be associated with significant adverse effects.4 This study also suggests that administering ginger prior to chemotherapy can be an effective preventive treatment, as has been found for motion sickness.2,4 *

A recent study confirmed the effectiveness of ginger in decreasing nausea during pregnancy. Sixty-seven pregnant women in Iran who were experiencing nausea and vomiting were given 250 mg of ginger 4 times a day, while the control group was given placebo. The women taking the gingerroot demonstrated 85% improvement, while the placebo group reported a 56% improvement. A significant decrease in the frequency of vomiting occurred among the ginger group: 50% versus 9% for the placebo group. The clinicians concluded that ginger is an effective tool for decreasing nausea and vomiting during pregnancy. 3 *

Clinical study data supports the use of gingerroot as an antiemetic and antinausea agent for chemotherapy, motion sickness, seasickness, and pregnancy. Therapeutic dosing for ginger as an antinausea and antiemetic agent has been established as 0.5 to 1.0 grams, with higher doses proving less effective.*

REFERENCES
1 Schid R., et al. 1994. Comparison of seven commonly used agents for prophylaxis of seasickness. J Travel Med 14, 203-6.
2 Mowery D., D. Clayton. 1982. Motion sickness, ginger, and psychophysics. Lancet, 319, 8273; 655-7.
3 Ozgoli G., M. Goli, M. Simbar. 2009. Effects of ginger capsules on pregnancy, nausea, and vomiting. J Altern Complement Med, March 15(3): 243-6.
4 Hickok J., J. Roscoe, R. Morrow, J.A. Ryan. 2007. A Phase II/III Randomized, Placebo-Controlled Double Blind Clinical Trial of Ginger (Zingiber officinale) for Nausea Caused by Chemotherapy for Cancer: A Currently Occuring URCC CCOP Cancer Control Study. Supportive Cancer Therapy, Vol. 4, 4 Sept. 247-250.