GINGER
Drugs in Pregnancy and Lactation.
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Name: GINGER
Class: Herb
Risk Factor:C
Fetal Risk Summary
The rhizome of the perennial plant, ginger (Zingiber officinale) is used as a dried powdered spice in foods and as a natural medicine for its alleged carminative, cardiotonic, antithrombotic, antibacterial, antioxidant, antitussive, antiemetic, stimulant, antihepatotoxic, antiinflammatory, antimutagenic, diaphoretic, diuretic, spasmolytic, immunostimulant, and cholagogue actions (1). The active ingredients in ginger are thought to be primarily a class of structurally cardiotonic compounds called gingerols. Other pharmacologically active compounds that have been identified in ginger include shogaol, dehydrogingerdiones, gingerdiones, and zingerone. Some of these ingredients inhibit prostaglandin synthetase (cyclooxygenase) but, in some cases, this activity may be confined only to fresh ginger (1).
In a reproduction study in rats, ginger tea (20 g/L or 50 g/L) was given to rats during organogenesis (days 6 through 15) via their drinking water (2). The lower concentration (20 g/L) was equivalent to the ginger tea consumed by humans (2). No maternal toxicity or teratogenicity were seen, but early embryonic loss was double that of the controls (p<0.05) at both doses. In addition, surviving fetuses, especially females, were significantly heavier than controls and had more advanced skeletal growth (2). Another rat study used a patented standardized ethanol extract of Zingiber officinale (EV.EXT 33) to administer doses up to 1000 mg/kg/day during organogenesis (3). Compared to a control group, no embryo toxicity, teratogenicity, or treatment-related adverse effects were observed in the pregnant rats or their offspring.
Several authors have commented on or reported, with mixed results, studies examining the antiemetic properties of ginger in nonpregnant patients (4,5,6,7,8,9 and 10), and a review of this topic was published in 2000 (11). The oral dosage in the studies varied from 1 to 2 g/day of the powdered root or rhizome. Although the exact mechanism of action is unknown, it appears to be a local effect in the gastrointestinal tract rather than a central action (7,10). The effect may be mediated by antagonism of gastrointestinal 5-hydroxytryptamine (serotonin) to prevent stimulation of the vagus nerve and, thus, the vomiting center (8,10). One author commented that ginger has been long used in Chinese herbal or folk medicine for the treatment of pregnancy-induced nausea and vomiting (5).
The efficacy of ginger as an antiemetic in pregnancy was studied in a double-blind, randomized, cross-over trial involving women with hyperemesis gravidarum (12). All the subjects had been admitted to a hospital with hyperemesis and if their symptoms persisted for more than 2 days, they were enrolled in the study after giving informed consent. A total of 27 women at a mean gestational age of about 11 weeks completed the study. The women were administered either powdered root of ginger (1 g/day) or placebo for 4 days, then nothing for 2 days, then given the alternate agent for 4 days. More patients stated a pReference for (p=0.003), and had greater relief from their symptoms (p=0.035), with ginger than with placebo. No maternal adverse effects were observed. The pregnancy outcomes were one spontaneous abortion in the 12th week of gestation, one elective abortion for reasons other than nausea and vomiting, and 25 normal living infants. The mean gestational age at delivery was 39.9 weeks (range 3641 weeks) with a mean birth weight of 3585 g (range 24505150 g). All had Apgar scores of 910 at 5 minutes, and none had a congenital abnormality (12).
In a comment relating to the above study, one author urged caution in the use of ginger during pregnancy, citing ginger's action as a thromboxane synthetase inhibitor which, theoretically, could affect testosterone receptor binding and result in adverse sex steroid differentiation of the fetal brain (13). Although the author's research failed to find evidence of toxicity due to ginger, he recommended that it not be used in pregnancy until this effect was studied. No published reports to refute or support this alleged effect, however, have been located.
A 2001 randomized, double-masked study also evaluated the effect on ginger on nausea and vomiting of pregnancy (14). Ginger 1 g/day was compared to placebo for 4 days starting at a mean gestational age of about 10 weeks. Ginger resulted in a significant decrease in the severity of nausea and vomiting. No adverse effects on pregnancy outcome were detected (14).
Breast Feeding Summary
No studies describing the use of ginger during lactation have been located. It is unlikely, however, that small doses of ginger, such as those used as a spice, would affect a nursing infant. The effects, if any, of the higher doses used as an antiemetic are also unknown, but probably of little consequence to the infant. The oral bioavailability of ginger and its active ingredients, however, has not been studied in animals or humans.
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References
- Ginger. The Review of Natural Products. St Louis, MO:Facts and Comparisons, May 2000.
- Wilkinson JM. Effect of ginger tea on the fetal development of Sprague-Dawley rats. Reprod Toxicol 2000;14:50712.
- Weidner MS, Sigwart K. Investigation of the teratogenic potential of a Zingiber officinale extract in the rat. Reprod Toxicol 2001;15:7580.
- Mowrey DB, Clayson DE. Motion sickness, ginger, and psychophysics. Lancet 1982;1:6557.
- Liu WHD. Ginger root, a new antiemetic. Anaesthesia 1990;45:1085.
- Bone ME, Wilkinson DJ, Young JR, McNeil J, Charlton S. Ginger roota new antiemetic. The effect of ginger root on postoperative nausea and vomiting after major gynaecological surgery. Anaesthesia 1990;45:66971.
- Phillips S, Ruggier R, Hutchinson SE. Zingiber officinale (Ginger)an antiemetic for day case surgery. Anaesthesia 1993;48:7157.
- Lumb AB. Mechanism of antiemetic effect of ginger. Anaesthesia 1993;48:1118.
- Arfeen Z, Owen H, Plummer JL, Ilsley AH, Sorby-Adams RAC, Doecke CJ. A double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting. Anaesth Intens Care 1995;23:44952.
- Visalyaputra S, Petchpaisit N, Somcharoen K, Choavaratana R. The efficacy of ginger root in the prevention of postoperative nausea and vomiting after outpatient gynaecological laparoscopy. Anaesthesia 1998;53:486510.
- Ernst E, Pittler MH. Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. Br J Anaesth 2000;84:36771.
- Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Rep Bio 1990;38:1924.
- Backon J. Ginger in preventing nausea and vomiting of pregnancy: a caveat due to its thromboxane synthetase activity and effect on testosterone binding. Eur J Obstet Gynecol Rep Bio 1991;42:163.
- Vutyavanich T, Kraisarin T, Ruangsri RA. Ginger for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol 2001;97:57782.
Q&A about Ginger
I have a recipe that calls for 1/2 teaspoon of minced ginger. Can i use ground ginger instead beacuse i dont want to have to buy ginger im only going to use one time. How much ground ginger would i need?
I have some Thai ginger in my garden and I am looking at putting some other plants around it. I was thinking of regular ginger and maybe turmeric. Does anyone have any suggestions on other plants that would compliment (ie. look good next to) the Thai ginger?
I bought some non-alcoholic ginger beer from World Market and it tastes like it's fermented or something. It's by the company The Ginger People and has real pieces of ginger in it. So, if a bottle of ginger beer with real ginger in it is old enough, can it start fermenting or going bad?
I just had a cookie that was clearly made with ginger, but I also tasted black pepper and it was more than just a hint. Is this normal with ginger?
I liked the cookie and it made me wonder about making cookies with a black pepper. hmmm any ideas?
Here are a couple you can try.
GRAMA LOLLIS' CHRISTMAS BLACK PEPPER COOKIES
Ingredients :
1 c. butter (soft)
1 1/2 c. sugar
2 tsp. baking soda
2 c. flour
1 egg (beaten)
2 tbsp. light corn syrup
1 tsp. each cloves, ginger, cinnamon
Black pepper
Preparation :
Cream butter, sugar with eggs and corn syrup. Sift flour with spices and soda. Combine. Chill. Roll on floured surface. Cut with fancy cutters. Bake until golden, 350 degrees, 5-10 minutes. Ice if desired.
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Pepper Spice Cookies
Adapted from Better Homes and Gardens
Makes about 50 cookies
½ cup butter, softened
1 cup sugar
1 ½ teaspoon baking powder
½ teaspoon finely ground black pepper
½ teaspoon ground ginger
½ teaspoon ground cloves
½ teaspoon ground cinnamon
½ teaspoon cayenne pepper
1 egg
1 tablespoon milk
2 cups all-purpose flour
medium grind black pepper
10 ounces bittersweet chocolate, coarsely chopped
1 tablespoon shortening
* Mix sugar, baking powder, black pepper, ginger, cloves, cinnamon, and cayenne in a bowl.
* Cream butter into sugar and spice mixture.
* Beat egg and milk. Add to creamed butter and sugar mixture.
* Beat in as much flour as you can, then add the remaining flour. Knead dough if necessary.
* Shape dough into a ball. Divide in half. Roll each half into a 6 ½ in roll. Wrap with plastic wrap, and chill 4-24 hours.
* Slice rolls into ¼ inch rounds. Place on an ungreased baking sheet, and sprinkle tops of cookies with medium grind pepper.
* Bake for 8 minutes at 375°, or until done.
* Melt chocolate in a double boiler. Incorporate shortening.
* Dip cooled cookies in melted chocolate. Place on waxed paper.
* Transfer to the refrigerator until chocolate has hardened.
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Black Pepper Butter Cookies
2 1/4 cups all-purpose flour
1 cup granulated sugar
1 cup sweet unsalted butter, softened
1 large egg
1 teaspoon baking soda
1 teaspoon pure vanilla extract
1 1/2 teaspoons black pepper
extra sugar, for dipping glass
1. Mix all ingredients (except for the extra sugar for dipping the glass) together well using a heavy duty mixer.
2. Roll into 1/2 inch size balls-you will need three large ungreased cookie sheets, 16 balls per sheet.
3. Use the flat base of a drinking glass that has been dipped into sugar to flatten each dough ball on the cookie sheets.
4. Bake in a preheated 350 F (or 180 C) oven for 8-11 minutes or until lighly browned on the edges- do not overbake.
5. Remove to wire racks to cool.
Note from someone who had tried this recipe.
I thought it was too intriguing and had to try it. A few modifications that I made to the recipe:
* It was too crumbly and wasn’t mixing together very well so I added an egg white.
* Use parchment paper or non-stick cookie mats — they do stick a little.
* I baked them for 15 minutes (and warning — they do spread!).
* Don’t smoosh them down if you want a softer cookie.
I have a ginger root I have bought and I want to get it to become a ginger plant. What steps should I take to do this. I had a previous failed attempt to leave the ginger root in water (suspended as I have seen potatoes done before) and it rotted. Any ideas? Anyone done this?
All you have to do is cut the root into quarters, making sure each has an eye bud. Plant it about an inch deep in ordinary garden soil where it gets plenty of sun, water it and watch it grow. The blossoms are heaven-scented.
I slowly boiled 2lb peeled diced ginger in water 3x, drained, and then again very very slowly in a heavy syrup. The ginger is still tough. The syrup is candying on top, and the ginger is very sharp. I have kept it in a large jar out of the light for 3 months. Please help.
I remember hearing somewhere that one should never dye strawberry blonde hair strawberry blonde, as it will turn pink.
Will ginger also turn pink? Is that just a myth anyway? My hair is a light ginger color, and I want to add strawberry blonde highlights. Will it work? Or will I mess up my hair?
I am making some asian salmon and I need to know what GINGER SPEARS from a GINGER KNOT is. I know what a ginger knot is and I already have it. How do I spear it or whatever?
I know the ginger is cut into quarter sized "coins" then simmered in sugar and water. At some point, gelatin is added then the ginger is removed, drained and rolled in sugar. When do I add the gelatin and how much is added?
Ingredients:
Fresh ginger root (larger pieces are easier to peel)
Granulated Sugar
Water
7-Up (or similar citrus soda)
Equipment needed:
Steamer (can be any kind: stainless steel, Oriental-style bamboo, a colander, couscousier, or any other steaming contraption of your preference)
Crockpot (or a non-reactive cooking pot – enamel, glass or stainless steel)
Two wire racks – for draining and drying the sliced ginger pieces
Method:
In a mixing bowl large enough to hold the desired amount of ginger, mix a solution of 1/2 water and 1/2 7-Up (or other citrus soda). You will need enough liquid to immerse the ginger completely.
Break off any small buds from ginger root and reserve them for another use. Peel the large pieces of ginger with a vegetable peeler or paring knife, and drop the peeled pieces into the liquid solution.
Slice the peeled ginger pieces into 1/8-inch slices (or as close to that thickness as you can come) slicing the ginger crosswise or on a diagonal – in the direction that will obtain the largest slices possible. Return the slices as you cut them to the liquid solution.
Drain the sliced ginger and arrange the slices in stacks. Lay several stacks on their sides in the bottom of the steamer basket (or whatever you’re using) until the entire bottom of the basket is covered with stacks resting on their edges. Repeat with a second layer, and a third, if desired. If there are a few unstacked slices left over, those may be laid flat over the top.
Place the steamer basket over simmering water, cover, and allow to steam for 30-40 minutes or until the ginger is quite tender. If older, larger or more fibrous ginger is used, ginger may require an additional 10-15 minutes of steaming time.
In the Crockpot (or other cooking pot, as described) make a light simple syrup: for each cup of sliced ginger, you will need 1 cup of water, and 1 ½ cups of granulated sugar. Bring this mixture to a boil to dissolve the sugar, then add the sliced ginger. When the mixture again comes to a boil, reduce the heat to as low as possible, cover the pot, and allow to simmer gently for 6-8 hours, stirring occasionally. (NOTE: If the syrup evaporates to the point w2here it no longer completely covers the ginger slices, simply dissolve more sugar in water, in a small saucepan, to make another batch of simple syrup as described above, and pour over as needed to keep the ginger covered.)
Andie Says: If you are cooking this on top of the stove, and must leave during the process, simply turn off the heat, leave the pot, covered, at room temperature until you return, then bring mixture back to the boil, reduce heat, and continue simmering gently. The total cooking time will be what counts.
After 6 hours of cooking time, remove a couple of slices of ginger, allow them to drain and cool, then taste them. They should be very tender. If they are not, simply continue simmering and tasting – process may require as much as 2 additional hours – even longer if slices are thicker.
When ginger is tender, remove the pot from heat (or turn off the Crockpot) and allow to cool for 30-40 minutes. Slices should still be warm, but not hot enough to burn. Using a skimmer or tongs, remover the slices from the syrup and place them, without overlapping, on a wire rack (over a sheet pan or parchment or wax paper to catch drips). Allow the slices to dry until just “tacky”–they should be slightly tacky, but should not stick to a finger pressed onto a slice then lifted.
(Strain the syrup into a jar and save for use in cooking, drinks, fruit salads, etc.)
Place 1/2 cup, granulated sugar in a shallow, 1-quart container – (such as a plastic Tupperware or Rubbermaid) with a fitted lid. Drop several slices of ginger into the container, cover and shake until the slices are very well coated with sugar. Then place the slices on a clean drying rack, and repeat with more slices, until all have been sugared – adding more sugar to the container as needed.
Leave the sugared slices on the rack overnight, or as needed depending on humidity (if desired, or if weather is especially humid, a fan will speed up drying time). Test for doneness by squeezing 2 slices together; if they do not stick together, they are finished. Store preserved ginger in airtight containers with screw or snap tops, plastic or glass – but do not use recloseable plastic bags. Ginger prepared and stored in this manner will deep indefinitely at room temperature.
If, for any reason, the ginger dries out over time, do not discard it: simply chop it finely and use in cooking or baking. You may even dry it further in a very low oven, and grind it to a powder in a coffee mill or spice grinder.
I'm serving a pumpkin cake and want to pour a warm, white dessert sauce over it, with ginger flavor. Can I? How?
