Ginger

Ginger is one of the few herbs where the evidence matches what people already use it for. These are the questions our naturopaths ask in store.

A good fit if

• You want something for nausea rather than a general tummy complaint
• You want something that won't make you drowsy the way some travel sickness tablets can
• You're pregnant and have talked it through with your doctor or midwife
• You'd rather start with a dried or powdered form than a concentrated extract

Check with us first if

• You take warfarin or another blood thinner, especially with a concentrated extract.
• You have surgery or a dental procedure booked.
• You're having chemotherapy. Ginger belongs in your conversation with your oncologist.
• You have gallstones, because ginger increases bile flow.
• You already take several herbs that affect your platelets.

• Fresh rhizome. Best known for: Cooking, and the basis of every home remedy. Absorption: The most gingerol of any form. We found no trial measuring its absorption. Typical use: It is a food, so no permitted health claims apply to it.
• Ginger dry / ginger powder (items 2353, 2356). Best known for: The simplest rules of any ginger form. Absorption: Drying turns gingerols into shogaols. Typical use: Allowed in listed medicines with no conditions and no warnings.
• Standardised extract below 25:1. Best known for: Most of the retail capsules on the shelf. Absorption: We found no absorption evidence. Typical use: It does not have to carry a blood-thinner warning.
• Concentrated extract, 25:1 or stronger. Best known for: Higher-strength capsules. Absorption: We found no absorption evidence. Typical use: The only ginger that legally has to carry the bleeding-risk warning.
• Ginger oil (item 2354). Best known for: An essential oil, allowed in listed medicines with no conditions. Absorption: We found no clinical trial of ginger oil taken by mouth. Typical use: There is no evidence base to draw on here.

Reference values. There's no recommended intake for ginger, because it's a herb rather than a nutrient.

Typical supplemental range. Australian labels usually suggest 500 mg to 3 g of dried ginger a day, often split into smaller doses. For nausea in pregnancy, trials used 500 to 1,500 mg a day in divided doses, and one review suggested staying under 1,500 mg. General trials on inflammation and metabolism used 1 to 3 g a day.

Upper level. Australia's permitted ingredients list (Schedule 1) sets no daily maximum for any form of ginger. The only number in the rules is the one that triggers the blood thinner warning: an extract ratio of 25:1 or more, giving 2 g or more equivalent dry weight per dose.

Worth knowing. Extract strength matters more with ginger than with most herbs, so compare the equivalent dry weight rather than the capsule size. What you need depends on your age, diet and health, so talk to one of our naturopaths.

Food first, where the diet allows it.

• Fresh ginger rhizome: the culinary form; gingerol content is highest before drying
• Dried or powdered ginger: drying converts gingerols into shogaols
• Ginger tea: A traditional preparation; strength varies entirely with how it's made

If any of these sound like you, talk to one of our naturopaths or your doctor before you start.

• You take blood thinners (anticoagulants). Concentrated extracts (25:1 or more, giving 2 g or more of dried-ginger equivalent per dosage unit) must carry an Australian warning about this.
• You take warfarin. The evidence conflicts: ginger is named among herbs that raise bleeding risk, but a review of randomised trials only found no significant effect on blood thinning.
• You have a platelet problem. Ginger is listed among herbal medicines found to reduce platelet clumping (aggregation).
• You have surgery or dental work coming up. Stop beforehand and tell your surgeon.
• Pregnancy. Pooled data found no significant rise in miscarriage risk, but the confidence interval is wide, so only use it with medical advice.
• You have gallstones or gallbladder or bile duct disease. Ginger stimulates bile flow.
• Severe nausea and vomiting in pregnancy. Hyperemesis gravidarum needs medical care, not a supplement.
• If you take prescription medicines, check with your doctor, pharmacist or our naturopaths before you start.