What supplements help with nausea?

Supplements for Nausea Management

Ginger (0.5-1.0g daily) is the most evidence-supported supplement for reducing nausea, particularly for acute nausea during chemotherapy and pregnancy. While evidence is mixed for some applications, it has shown the most consistent benefit among available supplements for nausea management 1.

Evidence-Based Supplement Options

Ginger (Zingiber officinale)

• Dosage: 0.5-1.0g daily (divided doses)

• Evidence strength: Moderate

• Applications:

  • Chemotherapy-induced nausea: Significantly reduces acute nausea severity compared to placebo when used alongside standard antiemetics 1, 2
  • Pregnancy-related nausea: Effective for mild to moderate nausea and vomiting in early pregnancy 3, 4
  • Postoperative nausea: Promising as add-on therapy 5

• Administration: Can be taken as capsules, powder, or syrup mixed with water

• Key finding: Lower doses (0.5-1.0g) appear more effective than higher doses (1.5g) for chemotherapy-induced nausea 1, 2

• Caution: May interact with anticoagulants by slowing blood clotting 1, 6

Cannabinoids (FDA-approved forms only)

• Options: Dronabinol and nabilone
• Evidence strength: Moderate (for refractory cases)
• Application: May be useful for treating refractory chemotherapy-induced nausea and vomiting 1
• Recommendation: Only recommended when standard antiemetics fail 1

Acupuncture/Acupressure

• Evidence strength: Limited to moderate
• Applications:
  • Mixed results for chemotherapy-induced nausea 1
  • May be considered as complementary approach 1
• Note: One study showed acupuncture produced higher complete response rates (53% vs 36%) compared to ondansetron in the delayed phase (24-120 hours) of chemotherapy-induced nausea 1

Ineffective or Insufficient Evidence Supplements

• Gabapentin: Does not appear to offer antiemetic benefit over standard regimens 1
• Medical marijuana: Insufficient evidence for recommendation over FDA-approved cannabinoids 1
• Megestrol acetate: Questionable value and potential side effects 1

Clinical Algorithm for Supplement Selection

1. First-line (mild to moderate nausea):

   • Ginger 0.5-1.0g daily in divided doses
   • Start 1-3 days before anticipated nausea (e.g., chemotherapy) when possible

2. For refractory nausea (when standard medications fail):

   • Consider FDA-approved cannabinoids (dronabinol or nabilone)
   • Consult with healthcare provider for appropriate dosing

3. Complementary approaches:

   • Acupuncture/acupressure may be added to standard treatments

Important Considerations and Pitfalls

• Do not substitute supplements for proven antiemetics: Supplements should generally be used as complementary approaches alongside standard medical treatments for severe nausea 1

• Drug interactions: Monitor for potential interactions, particularly with:

  • Anticoagulants/antiplatelet medications when using ginger 1, 6
  • Medications metabolized by CYP enzymes 6

• Quality and standardization: Commercial ginger supplements vary in active compound content; pharmaceutical-grade products may provide more consistent results

• Timing matters: For chemotherapy-induced nausea, starting ginger 1-3 days before treatment appears most effective 1, 2