Research - Ginger
Ginger Rhizome Reduces Pain in Women with Moderate to Severe Dysmenorrhea
Shirvani MA, Motahari-Tabari N, Alipour A. The effect of mefenamic acid and ginger on pain relief in primary dysmenorrhea: a randomized clinical trial. Arch Gynecol Obstet. November 16, 2014; [epub ahead of print]. doi: 10.1007/s00404-014-3548-2.
Dysmenorrhea is the most common adverse symptom of menstruation and is the result of uterine contraction associated with an excess of prostaglandins within the uterus. Primary dysmenorrhea occurs in the absence of uterine pathology and is often treated with non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are effective in approximately 70% of women with primary dysmenorrhea. The remaining 30% of women find these drugs either ineffective or accompanied by undesirable gastrointestinal side effects. The rhizome of ginger (Zingiber officinale, Zingiberaceae) has been found to be an anti-inflammatant, and previous studies suggest that ginger consumption reduces the severity of primary dysmenorrhea. In this randomized study, the effect of ginger rhizome was compared to mefenamic acid in women with primary dysmenorrhea.
Women ≥ 18 years old with moderate to severe dysmenorrhea were recruited from the dormitories at Mazandaran University in Babolsar, Iran. Women were excluded if they had an irregular menstrual cycle, exercised regularly, had secondary dysmenorrhea, had an intrauterine device, or were taking contraceptive medication. Patients were randomly assigned to either a ginger treatment group or a mefenamic acid treatment group. The ginger group took one 250 mg capsule of dried ginger rhizome (Zintoma; Goldaru Pharmaceutical Laboratory; Isfahan, Iran) every 6 hours during menstruation until pain relief occurred. The mefenamic acid group took one 250 mg capsule of mefenamic acid every 8 hours during menstruation until pain relief occurred. Patients recorded the most intense pain felt over the course of menstruation with a 100 mm visual analog scale (VAS). Date of each cycle, length of menstruation, and amount of bleeding were also recorded. Patients were allowed to use additional analgesics, if necessary, and were asked to record usage. Data were recorded for 2 menstrual cycles and analyzed with t-tests, chi-squared tests, and Fisher exact tests.
Each treatment group contained 61 patients. Pain associated with dysmenorrhea decreased significantly in both treatment groups over the study period (P < 0.05 for both). In the ginger treatment group, the level of pain went from 58.01 ± 14.52 to 38.19 ± 20.47, while the level of pain in the mefenamic acid group went from 55.03 ± 14.95 to 33.75 ± 17.71. There was no difference in pain reduction between the treatments. The number of days of menstruation was significantly greater in the ginger treatment group (6.67 ± 1.24) than in the mefenamic acid treatment group (6.21 ± 1.19) at the end of the study (P = 0.03). The patients in the ginger treatment group used more supplemental analgesics than the patients in the mefenamic acid treatment group, but this difference was not significant (P = 0.07). By the end of the study, approximately half of the patients in each group had moved from a classification of moderate/severe dysmenorrhea to a classification of mild dysmenorrhea. Fewer patients had severe dysmenorrhea in the mefenamic acid treatment group (n = 2) than in the ginger treatment group (n = 7) at the end of the study. Side effects of the treatments were not noted.
Both ginger rhizome and mefenamic acid reduced the pain associated with menstruation to a similar extent in women with moderate to severe dysmenorrhea. The greater use of supplemental analgesics, increased time of menstruation, and higher incidence of severe dysmenorrhea in the ginger treatment group suggests that mefenamic acid may be more effective for treating dysmenorrhea. Previous studies have found the effect of ginger supplementation on dysmenorrhea to be similar to NSAIDs, and that the effect is more pronounced if supplementation begins before menstruation. The ginger dosage used in previous studies was between 1000 and 2000 mg per day. This is similar to the maximum dosage (1000 mg/day) used in this study. Some studies have found that dosages higher than 2000 mg/day can lead to adverse effects. Ginger contains the compounds gingerol and gingerdione. These compounds are thought to lead to a decrease in inflammation and a concomitant decrease in prostaglandins. Ginger also contains salicylate which would serve directly as an analgesic. Further studies that begin ginger treatment before menstruation may show an even greater effect of ginger on dysmenorrhea.
–Cheryl McCutchan, PhD
Source : American Botanical Council - HerbClip
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Ginger compress therapy for adults with osteoarthritis
Tessa Therkleson PhD RN
Director of Nursing RATO Health, Lower Hutt, New Zealand.
This paper is a report of a study to explicate the phenomenon of ginger compresses for people with osteoarthritis.BackgroundOsteoarthritis is claimed to be the leading cause of musculoskeletal pain and disability in Western society. Management ideally combines non-pharmacological strategies, including complementary therapies and pain-relieving medication. Ginger has been applied externally for over a thousand years in China to manage arthritis symptoms.
Husserlian phenomenological methodology was used and the data were collected in 2007. Ten purposively selected adults who had suffered osteoarthritis for at least a year kept daily diaries and made drawings, and follow-up interviews and telephone conversations were conducted.
Seven themes were identified in the data: (1) Meditative-like stillness and relaxation of thoughts; (2) Constant penetrating warmth throughout the body; (3) Positive change in outlook; (4) Increased energy and interest in the world; (5) Deeply relaxed state that progressed to a gradual shift in pain and increased interest in others; (6) Increased suppleness within the body and (7) More comfortable, flexible joint mobility. The essential experience of ginger compresses exposed the unique qualities of heat, stimulation, anti-inflammation and analgesia.
Nurses could consider this therapy as part of a holistic treatment for people with osteoarthritis symptoms. Controlled research is needed with larger numbers of older people to explore further the effects of the ginger compress therapy.
Source : J Adv Nurs. 2010 October; 66(10): 2225–2233
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Whole Ginger Extract Has Promising Anti-Prostate Cancer Potential
In a first of its kind study, assessing anti-cancer properties of ginger as a whole instead of the plant's individual components, scientists at Georgia State University have discovered, that whole ginger extract has promising cancer-preventing activity in prostate cancer.
According to an online article in FirstView published in the British Journal of Nutrition, Associate professor of Biology, Ritu Aneja discovered in her lab, that ginger extract had significant effects in stopping the growth of cancer cells, as well as in inducing cell death in a spectrum of prostate cancer cells.
In addition, animal studies revealed that the extract did not show significant toxicity to normal tissues, such as bone marrow. Research revealed very good tumor regression by up to 60 percent, and no toxicity whatsoever.
Despite much research having been performed on anti-cancer properties in ginger, Aneja's lab prefers to take a more holistic approach to investigate the types of molecules involved. She does not believe individual compounds are solely responsible for the extract's anti-cancer properties and considers it to be a synergistic interplay of components, enabling scientists to use much smaller amounts of extract to benefit from its properties instead of using a single chemical.
Data evaluation shows that humans would have to consume only about 3½ ounces of whole ginger extract in their daily diet to achieve the beneficial effects.
Aneja's lab prefers to seek natural, non-toxic ways to combat cancer, using kinder, gentler drugs and plant compounds because current approaches cause major and debilitating side effects.
To detect beneficial properties in plant extracts is a high lywork-intensive process in order to establish what exact chemical compounds in the extract provide the preventative effect, or kill cancer cells.
"Although it might seem easy to work with plant extracts, it is not so, because there are zillions of compounds and other complex derivatives in there, and we don't know which ones are the good ones. Moreover, the compounds we are seeking to identify may be low in abundance, but they may be very important and cannot be disregarded."
The work was started by dedicated and persistent undergrad, Vibhuti "Simran" Sharma, now an environmental chemist for the Southern Company; one of Aneja's numerous undergraduate research students she mentored.
"I did a lot of background research, and found several published papers on ginger, but discovered that there was nothing much done on the whole extract, especially in prostate cancer - a slow growing, long-latency cancer amenable to chemopreventive strategies. Most of the literature focused on only one compound found in ginger."
To enable undergraduate students to study independently in a stimulating and motivational environment, Aneja combines guidance with independent exploration. Sharma continued to educate herself about techniques and protocols and took it upon herself to convert three pounds of ginger into the extract for the study.
Getting the extract to freeze dry was a three-week process of trial and error for Sharma as it turned from ice into a solid but reverted into a liquid, initially.
After experimenting with prostate, breast and cervical cancer cells, she discovered that most cells responded positive to the extract. Aneja's lab took the research further in prostate cancer and Sharma, a graduate herself now, continues to assist in Aneja's lab with the production of more whole ginger extract for further fractionation and ongoing efficacy studies.
"I never knew it could get so big. It's unbelievable. It's great being able to say that I was just an undergrad when I started this research, and now it's being published just a year after I graduated. I take a lot of pride in it, but it would not be possible without the help from everyone in the lab."
Written by Petra Rattue
Source : Medical News Today
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Studies Assess Ginger for Treatment of Nausea During Pregnancy and Menstrual Pain
Reviewed: Ozgoli G, Goli M, Moattar F. Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. J Altern Complement Med. 2009;15(2):129-132. Reviewed: Ozgoli G, Goli M, Simbar M. Effects of ginger capsules on pregnancy, nausea, and vomiting. J Altern Complement Med. 2009:15(3):243-246.
Researchers from Iran recently conducted 2 trials to evaluate the safety and effectiveness of ginger (Zingiber officinale, Zingiberaceae) for treating female reproductive complaints. The first study compared ginger preparations to non-steroidal anti-inflammatory drugs (NSAIDs) for relieving dysmenorrhea (painful or difficult menstruation). The second study evaluated ginger as a treatment for nausea and vomiting during pregnancy.
Dysmenorrhea is experienced by more than half of menstruating women. NSAIDs can be effective in relieving dysmenorrhea, but NSAIDs and other pain relievers commonly cause adverse side effects and are contraindicated in some people. Ancient medical texts refer to the use of ginger for relief of dysmenorrhea, but there are no published clinical trials to support its effectiveness. The researchers therefore conducted a study to compare the effects of ginger, mefenamic acid (a mild analgesic and fever-reducing NSAID used in some types of arthritis and for the relief of moderate short-term menstrual pain), and the NSAID ibuprofen on dysmenorrhea.
For the non-randomized, double-blind trial, the researchers recruited 150 female college students who were 18 years or older and had primary dysmenorrhea. The women completed a questionnaire that assessed menstrual characteristics and severity of pain. Those with moderate to severe dysmenorrhea were enrolled in the study and alternately allocated to 1 of 3 groups: the ginger group, the mefenamic acid group, or the ibuprofen group. Depending on their assigned group, the women were instructed to take either four 250-mg capsules of ginger rhizome powder (Zintoma; Goldaroo Company; Tehran, Iran), four 250-mg capsules of mefenamic acid (Ponstan; Razak Co.; Iran), or four 400-mg capsules of ibuprofen (Brufen; Roozdaru Co.; Iran) each day, beginning on the first day of their menstrual period and continuing for 3 days. After the 3 days, the women rated the severity of their dysmenorrhea, the degree of pain relief, and their satisfaction with the treatment. Only one menstrual cycle was studied.
All 150 women completed the study. There were no significant differences in baseline characteristics among the 3 groups. Dysmenorrhea severity decreased in all 3 groups (P values not reported) after 3 days. Severity of symptoms, improvement in pain relief, satisfaction with the treatment, and compliance with the capsules were not significantly different among the groups. None of the women reported any serious adverse side effects during the study.
The authors conclude that ginger is as effective as mefenamic acid and ibuprofen in decreasing menstrual pain. They also point out certain limitations of this study. The study subjects were alternately assigned to an experimental group rather than randomly assigned; however, baseline characteristics were similar among subjects in all 3 groups, and there is no indication of bias in group assignments. The study did not compare the effect of ginger on other menstrual symptoms, such as nausea, headaches, and fatigue. The scale used to rate dysmenorrhea severity was a verbal, 4-point scale, and the authors suggest that use of a 10-point visual analog scale or other standardized scale may detect more subtle differences in response among the experimental groups.
One issue the authors do not address is the dosage of comparator drugs used in this study. It is not clear if the doses selected for this study (1,600 mg ibuprofen and 1,000 mg mefenamic acid) are typical doses used for treatment of primary dysmenorrhea in the local population. In the United States, daily doses of 2,400-3,200 mg ibuprofen are commonly recommended for treatment of moderate or severe dysmenorrhea and may be more effective than the 1,600 mg dose of ibuprofen used in this study. The recommended dose for mefenamic acid is 1,500 mg per day. It is therefore unclear as to how much of a placebo-effect occurred in this study. It would have been better if a placebo group had been included for comparison. Another limitation is that the study was very brief; typically, dysmenorrhea studies are conducted over a 3 month period. In addition to correcting the limitations discussed by the authors, future trials should assess the safety and efficacy of ginger during several menstrual cycles, investigate a range of ginger doses, and include populations of women other than young college students.
The second study assessed the effects of 1,000 mg of ginger administered in capsule form on the severity of nausea and vomiting in pregnant women. Up to 90% of women experience nausea and vomiting during pregnancy. Little is known about the safety of antinausea drugs during pregnancy, so some pregnant women turn to herbs or other complementary therapies for relief. Ginger has long been used to relieve stomach upset in the traditional medicines of many cultures.
This single-blind, randomized, placebo-controlled trial was conducted at prenatal clinics and Isfahan Shahid Beheshti Hospital in Isfahan, Iran. Seventy healthy, pregnant women who were less than 20 weeks gestational age and who reported mild to moderate nausea with or without vomiting were enrolled in the trial. The women were randomly allocated to an experimental group or a matched control group. Women in the experimental group took four 250-mg capsules containing ginger root powder (Zintoma; Goldaroo Company; Tehran, Iran) daily for 4 days. Women in the control group took 4 placebo capsules containing lactose daily for 4 days. The women were instructed to take a capsule in the morning, at noon, in the afternoon, and at night.
Before starting the study, women rated the severity of their nausea and vomiting using a 10-point visual analog scale (VAS). The women were instructed to avoid fatty foods and to eat smaller, more frequent meals during the study. The women completed a questionnaire each day and recorded the severity of their nausea on the VAS twice a day (at noon and at bedtime). On the fifth day, the women were interviewed by a researcher to assess compliance with the dietary instructions and capsule use.
Of the 70 women who started the study, 67 completed the study (32 in the ginger group and 35 in the placebo group). There were no significant differences in nausea intensity between the 2 groups at baseline. Women in the ginger group reported significantly greater improvement in nausea than women in the placebo group (P < 0.05) during the 4-day trial. Nausea intensity declined in 84% of women in the ginger group and 56% of women in the placebo group (P < 0.05). The incidence of vomiting did not decrease significantly in the placebo group but decreased a significant 50% in the ginger group after 4 days (P < 0.05). None of the women reported any adverse side effects from the capsules. While compliance with the capsules was excellent in both groups, only about half of the women in each group reported complying with the dietary advice.
The authors conclude that daily treatment with 1,000 mg of ginger is a safe and effective way to decrease the intensity of nausea as well as the incidence of vomiting during pregnancy. However, the authors’ conclusions that 1,000 mg is the appropriate dose cannot be asserted given that this study was not a dose-ranging study. Also, the authors’ conclusion that this dose is safe cannot be asserted since there has been no long-term, follow-up studies of the infants, and, given the small sample size, only very large changes in pregnancy outcomes would have been seen.
The results of this study are consistent with 9 published randomized controlled trials, which have also evaluated the effectiveness of ginger for nausea and vomiting during pregnancy. In these trials, daily doses ranged from 1,000 mg to 1,500 mg and the ginger products included capsules containing ginger powder or ginger syrup, which is mixed with a beverage.
The authors point out that the short duration of this trial is a limitation. Another limitation that the authors did not discuss is whether the study was adequately blinded. Ginger capsules have a distinctive odor and flavor and it is possible that the people taking the placebo were aware that they had the placebo treatment. This could have contributed to the study outcome. Future trials should assess the safety and effectiveness of ginger over a longer period of time, should improve study blinding, and enroll pregnant women with severe nausea and vomiting to expand the understanding of this herb’s effectiveness during pregnancy.
—Heather S. Oliff, PhD
Source : American Botanical Council
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Effect of Ginger on patients with functional dyspepsia.
Hu ML, Wu KL, Chuah SK et al.
Nine patients with functional dyspepsia were studied on separate two days in a randomised, double-blind design.
Following a fast of 8 hours the patients took capsules containing a total of 1.2 g of ginger (Zingiber officinale) root powder or placebo. One hour later they consumed 500 mL of low-nutrient soup. Antral area (bottom of stomach, nearthe duodenum), fundus area (top, near the oesophagus) and diameter, and the frequency of antral contractions were then measured using ultrasound at intervals over 90 minutes. The gastric half-emptying time was calculated from the change in antral area. Serum peptides (glucagon-like peptide-1, motilin, ghrelin) were also measured.
The following results were found:
• Gastric half-emptying time was significantly less after ginger than placebo (11.9 minutes vs 21.1 minutes), and the frequency of antral contractions was significantly greater. Antral area decreased more rapidly.
• There was no difference in fundus dimensions, serum peptides or gastrointestinal symptoms.
Ginger accelerated gastric emptying and stimulated antral contractions in patients with functional dyspepsia in a preliminary investigation.
Source : J Gastroenterol Hepatol 2009; 24(Suppl 1): A31
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Effects of Ginger on the Improvement of Asthma [The Evaluation of Its' Treatmental Effects]
Rouhi H, Ganji F, Nasri H. Pakistan J Nutr 2006; 5(4): 373-376
A randomised, placebo-controlled clinical trial conducted in Iran investigated the use of ginger for the treatment ofasthma. Patients were recruited and spirometry readings were taken. After one month, 92 patients received either ginger (tincture, containing 150 mg of rhizome, every 8 hours) or placebo. After two months they were evaluated again. The results indicated that ginger was effective in reducing asthmatic symptoms but had no effect on the severityof the disease, as assessed by spirometry. Those receiving ginger had fewer nocturnal coughing attacks, fewer dyspnoeic attacks and reduced usage of spray medication. The reduction was significantly different from that experienced in the placebo group (p<0.05 for each parameter). The authors noted that the prescribed dosage (about 0.5 g/day) was below the standard therapeutic dose of 1–4 g/day.
Treatment with ginger reduced symptoms of asthma
Source Parkistan J Nutr 2006
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Ginger and cancer
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