An over-the-counter ginger supplement could help reduce nausea associated with the use of GLP-1 agonists, new research suggests.

The findings come from a placebo-controlled, double-blind randomized pilot trial of people with obesity and/or type 2 diabetes who were either newly-prescribed a GLP-1 or had a history of nausea even at low doses. The primary outcome, overall nausea severity, was numerically lower with the supplement but not significantly, but the supplement was associated with significantly lower occurrence of any nausea and of mild-to-moderate nausea.

The 14-day study was sponsored by Prestige Consumer Healthcare, the maker of Dramamine. However, the product studied, Advanced Herbals, is a nonpharmaceutical pure ginger chewable in a standardized formulation, sold over the counter for motion sickness. This is the first investigation of the effectiveness of a commercially available dietary supplement for treating nausea associated with GLP-1s, lead investigator David H. Balaban, MD, told Medscape Medical News.

“The important message from the study is that there is an over-the-counter, commercially available supplement with a clinically tested dose of ginger that can be used in association with GLP-1 therapy,” said Balaban, a practicing gastroenterologist at Gastro Health, Charlottesville, Virginia.

The modified intent-to-treat study population included 78 participants randomized to ginger or placebo chewables. They took two per dose as needed for nausea up to four chews (two doses) per day. The GLP-1 drugs were taken weekly, twice during the study.

Participants recorded nausea symptom severity before and after taking the chewable. Nausea was recorded as 0 (none), 1-3 (mild), 4-6 (moderate), 7-9 (severe), or 10 (vomiting). Changes in nausea severity were calculated per dose, per participant, and per nausea event.

At baseline, nausea occurrence and severity were not correlated with GLP-1 dose, type, or duration of use.

At 1 hour post-dose, nausea severity dropped 3.7 points on the 10-point Likert scale in the ginger group compared with 3.0 points in the placebo group, a numeric but not statistically significant difference (P = .286).

However, two other endpoints were statistically significant. The proportion of participants reporting any reduction in nausea with the chewable was 96.2% with ginger vs 87.9% (P < .01) and there was a mild-to-moderate reduction in nausea (a decrease of 1-6 points on the 10-point scale) in 92.3% with ginger versus 81.6% with placebo (P<0.001).

No drug-related adverse events occurred in either group.

Balaban said that the high placebo effect is not surprising. “There’s going to be a waning of nausea over time. A placebo effect was certainly expected, but the downward trajectory of nausea was greater in the ginger group than the placebo group numerically, although we did not have the power to detect a statistically significant reduction.”

However, he added that the other two endpoints had a higher power to detect a difference “because we’re measuring each episode of nausea rather than just calculating per participant…By categorizing the reduction and analyzing each episode, we’re able to generate more power with a still a relatively small pilot study.”

Asked to comment, Michael A. Weintraub, MD, clinical assistant professor of endocrinology at NYU Langone, New York City, told Medscape Medical News he typically aims to minimize GLP-1-related nausea by conservative dosing and slow titration. He also advises patients to eat smaller portions, eat slowly, and limit high fat and spicy foods.

Weintraub noted, “I try not to treat the side effects of one medication with yet another medication,” but he does sometimes recommend that patients try ginger or peppermint tea because patients have anecdotally reported that it helps nausea symptoms. “If it was between an antinausea medication which has the potential for side effects, and something more benign like a ginger chew, if the ginger chew showed some effectiveness, I certainly would recommend it,” he said.

However, he said that the lack of significance of the primary endpoint leaves some doubt about its effectiveness, noting that the approximate 0.7 percentage point difference in nausea severity “does not seem clinically significant, regardless if it was actually statistically significant, which it also was not.”

As for the other two endpoints, Weintraub said that despite the statistical significance, the improvement in symptoms “seems modest.” Nonetheless, he said, “I applaud this company for doing a randomized placebo-controlled trial.”

Balaban noted that ginger is among the nausea remedies mentioned in guidelines published in 2023 for managing GLP-1-related nausea but that was based on clinician opinion, not data. “I don’t want to overstate the magnitude of this pilot protocol, but for patients taking GLP-1 drugs who experience nausea and are looking for an over-the-counter remedy, here are some data.”

Balaban is a consultant to Prestige and Prestige subsidiary Fleet. Weintraub reported having no disclosures.

Miriam E. Tucker is a freelance journalist based in the Washington, DC, area. She is a regular contributor to Medscape, with other work appearing in the Washington Post, NPR’s Shots blog, and Diatribe. She is on X @MiriamETucker and BlueSky @miriametucker.bsky.social.