Ginger is a hot, fragrant spice that has been used for recipes and medicinal purposes for centuries, treating ailments such as motion or sea sickness and other gastrointestinal discomforts. The scientific name for ginger is Zingiber officinale. Ginger is known for its immune boosting and cancer fighting action, as well as its anti-inflammatory properties. For more than 2,500 years, ginger has been used as an anti-inflammatory agent for many diseases in both Ayurvedic and Chinese medicine.
Despite its lengthy use as a natural remedy, science is only just starting to show evidence of how ginger can be used to help treat many of the modern world’s diseases, ranging from arthritis to cancer.
The active ingredients in ginger are very potent anti-oxidant and anti-inflammatory compounds called gingerols and shogaols. In those that consume ginger regularly, gingerols are known to inhibit the formation of inflammatory cytokines and reduce the symptoms and pain associated with diseases such as osteoarthritis (OA) and rheumatoid arthritis (RA).
In a study published in 2003, 29 patients, including both men and women, who ranged in age from 42 to 85 years and who had painful knee arthritis, participated in a placebo-controlled, double-blind, crossover study for twelve months. By the end of the first six month period, those patients given ginger extract were experiencing significantly less pain on movement than those given the placebo.
In the second phase of the study, patients who had been taking the placebo in the first 6 months were switched to the ginger extract. They too noted a significant reduction in pain on movement. Those patients that had been taking ginger extract in the first half of the study were switched to the placebo for the second half of the study and reported an increase in pain on movement. In the same study, all patients noted a reduction of swelling in the knees after taking the ginger extract. In fact, the average knee circumference dropped by approximately 3.9 cm over the 12 week period. This is strong evidence that ginger and its magic ingredients, the gingerols and shogaols, are powerful anti-inflammatories and pain relievers.(1)
Another study published in 2005 shows ginger’s effectiveness as an anti-inflammatory comes from its ability to suppress the pro-inflammatory chemokines known as MCP-1 and IP-10.(2) These chemokines induce the migration of leukocytes and monocytes from the blood into the inflamed area and, consequently, the activation of these cells that fuels the inflammatory fire. These chemokines have also been shown to be involved in the development of RA and OA. When joints become inflamed as a result of damaged cartilage and synovial tissue, there is an influx of inflammatory cytokines. These cytokines can induce more MCP-1, which then attracts more leukocytes and monocytes into the area. This can end up being a vicious circle, setting the stage for chronic inflammation.
So we can see from this research that ginger’s ability to inhibit MCP-1 and IP-10 in the joints and synovial tissue could play an important role in managing the effects of arthritis. Indeed, the evidence supporting ginger’s anti-inflammatory properties is very compelling, so it makes a lot of sense to include this in your diet, particularly if you have arthritis. How much ginger should you eat to gain the benefits? Typically, for arthritis, as little as a one quarter inch of ginger root, cooked in food, can provide relief.
One study, published in 2003, suggests that the reason for ginger’s beneficial effects is the free radical protection provided by one of its active phenolic compounds called 6-gingerol. This compound has been shown to inhibit the production of nitric oxide that forms a very damaging free radical called peroxynitrate.(3)
Research shows that ginger may also have beneficial effects on diabetes. Chronic hyperglycaemia increases circulating levels of inflammatory biomarkers such as IL-6, TNF-α and C-Reactive Protein. (TNF-α and IL-6 are cytokines that initiate inflammatory responses and cause the production of CRP).
The research shows that low-grade inflammation, a common feature in type 2 diabetes, plays a major role in the pathogenesis of the secondary complications of diabetes. Increased CRP, IL-6 and TNF-α are associated with nephropathy, retinopathy and cardiovascular disease in both types of diabetes.(4)
In a randomised, double-blind, placebo-controlled trial, patients with type 2 diabetes were randomly assigned to two groups. One group received a ginger supplement twice a day, immediately after lunch and dinner, for eight weeks. The second group received a placebo. The ginger supplement was made from fresh rhizomes of Zingiber officinale, which were ground into a fine powder after drying and sent to the lab to prepare tablets. Each tablet contained one gram of ginger. The results showed that ginger supplementation decreased inflammation through a reduction of the TNF-α and CRP levels in blood samples of the patients. The researchers concluded that ginger may be a good remedy to diminish the risk of some of the secondary chronic complications that result from diabetes.(5)
A study published in 2013 study, showed that hepatic inflammation (liver inflammation) underlies the pathogenesis of many chronic diseases, such as insulin resistance, type 2 diabetes, atherosclerosis, and non-alcoholic fatty liver disease.(6) Liver inflammation leads to the secretion of pro-inflammatory cytokines and chemokines that, in turn, contribute to the amplification of the inflammatory signal and the subsequent progression of these chronic diseases.
NF-κB is the master regulator of the hepatic inflammatory response. This study shows that gingerol achieves its potent anti-inflammatory effects by inhibiting NF-κB. This study also showed that COX-2 has an important role in the inflammatory process. COX-2 is a potent pro-inflammatory mediator that promotes the production of inflammatory cytokines, including IL-6 and IL-1β. Your typical NSAID treatments are COX-2 inhibitors that block the secretion of these inflammatory cytokines; however, as shown in this study and others, gingerols also inhibit COX-2, so they can reduce pain naturally.
Potent anti-inflammatory foods and supplements can reduce the elevated expression or over-production of NF-kB and TNF-a. We also know that the activation of NF-kB is linked to a variety of inflammatory diseases including cancer, atherosclerosis, diabetes, asthma, arthritis, Crohn’s disease, osteoporosis and so on. Given gingerol’s ability to inhibit NF-kB and inflammatory cytokines, it makes sense to include this supplement into our dietary routine not only to alleviate symptoms if they are present, but to prevent chronic inflammation in the first place.
Tips on buying and storing
As mentioned above, whenever possible choose fresh ginger over dried since it is superior in flavour and contains higher levels of gingerol. Fresh ginger can be purchased in most supermarkets. The root should be fresh-looking, firm, smooth and free of mould, with no signs of decay or wrinkled skin.
Mature ginger has a tough skin that requires peeling. It can be stored in the fridge for up to three weeks if it is left unpeeled. If choosing dry ginger, keep it in a tightly sealed container in a cool, dark and dry place for no more than six months. However, if you don’t like ginger, you can also take the supplement form, which is much more concentrated. Indeed, it worth bearing in mind that in the studies we’ve discussed above, all of these used ginger extract rather than fresh ginger. In supplement form, you may see extracts of ginger said to be equivalent to a certain amount of fresh ginger root or it may be stated as ‘standardised extract’. A high potency supplement will have between 100 and 120 mg of extract. Also look for the gingerols content because this is the active ingredient – ideally, we are looking for over 20 mg of active gingerols.
There are very few side effects to taking ginger supplements when used in the dosages recommended. Side effects most often reported are gas, bloating, heartburn and nausea, but these are most often associated with powdered ginger. Always tell your doctor if you are taking ginger or other supplements because they may interact with prescription medications. Due to the anticoagulant effect of ginger, it should not be paired with pharmaceutical (prescription) drugs with the same effect, such as warfarin and possibly NSAIDs like aspirin. This is even more important if used during pregnancy.
1. The effects of Zintona EC (a ginger extract) on symptomatic gonarthritis. Osteoarthr Cartil. 2003;11(11):783-789. doi:10.1016/S1063-4584(03)00169-9.
2. Ginger Extract Components Suppress Induction of Chemokine Expression in Human Synoviocytes. J Altern Complement Med. 2005;11(1):149-154. doi:10.1089/acm.2005.11.149.
3. -Gingerol inhibits nitric oxide synthesis in activated J774.1 mouse macrophages and prevents peroxynitrite-induced oxidation and nitration reactions. Life Sci. 2003;73(26):3427-3437. doi:10.1016/j.lfs.2003.06.022.
4. Goldberg RB. Cytokine and Cytokine-Like Inflammation Markers, Endothelial Dysfunction, and Imbalanced Coagulation in Development of Diabetes and Its Complications. J Clin Endocrinol Metab. 2009;94(9):3171-3182. doi:10.1210/jc.2008-2534.
5. Anti-inflammatory effects of zingiber officinale in type 2 diabetic patients. Adv Pharm Bull. 2013;3(2):273-276. doi:10.5681/apb.2013.044.
6. Attenuation of Proinflammatory Responses by S--Gingerol via Inhibition of ROS/NF-Kappa B/COX2 Activation in HuH7 Cells. Evidence-Based Complement Altern Med. 2013;8. doi:10.1155/2013/146142.
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