Any supplement that helps with severe nausea caused by pregnancy or cancer chemotherapy will usually work for nausea from other reasons, such as motion sickness and medication, too.
Most medical experts and clinical treatment guidelines are beginning to recommend at least one supplement for nausea, but unfortunately this is another area of the dietary supplement world that does not receive enough credit. There needs to be more education for both health care professionals and patients.
What is Nausea?
Nausea is the feeling of being sick to your stomach, as if you’re going to vomit. It can be a subtle, low-grade feeling or a strong, almost overpowering sensation.
There’s a specific area of the brain called the vomiting center that controls emesis (a fancy word for throwing up). When it receives a signal—often through the neurotransmitter serotonin— from other areas of the brain, the gastrointestinal tract, or even the inner ear, the vomiting center triggers your stomach to send everything back up. Many antinausea medications (also known as antiemetics) work by blocking receptors for serotonin so the message doesn’t get through.
Here’s another example where “everything in moderation” applies. While serotonin does many good things in the body (it’s the “happy” neurotransmitter), a large increase can cause nausea, vomiting, and other GI issues, such as diarrhea.
Home Remedies For Nausea and Vomiting
1. (tie) Ginger (Zingiber officinale) 500 to 1,500 milligrams a day in divided doses
This common supplement may block serotonin receptors in both the central nervous system and the gastrointestinal tract, and it might also have a calming and antispasmodic impact on the GI tract.
In one National Cancer Institute study (the University of Rochester Cancer Center and the National Cancer Institute’s Community Clinical Oncology Program, which is just known as URCC CCOP), conducted with 576 cancer patients (primarily breast cancer) at 23 medical sites around the United States, subjects took 500, 1,000, or 1,500 milligrams a day of ginger supplements along with conventional prescription medicines for nausea and vomiting or a placebo (along with conventional meds).
The 500- and 1,000- milligram ginger groups experienced a 40 percent reduction in nausea. This was a large trial, so it should be standard practice now to recommend 500 to 1,000 milligrams of ginger (equivalent to 1⁄4 to 1⁄2 teaspoon of ground ginger) daily for several days before and after chemotherapy.
Higher doses (1,500 milligrams per day) did not work better in this study, but they have in other studies, especially in some individuals with higher weights. Chemotherapy-induced nausea and vomiting is very difficult to alleviate, so if ginger works in this situation, then it should work in other cases of nausea and vomiting.
Ginger supplements are also effective for nausea during pregnancy. (Talk to your OB-GYN, though. Although most doctors agree it works, some feel it has not had enough safety testing.)
About 75 to 80 percent of women experience nausea early in their pregnancy (about 50 percent have vomiting and nausea). In a small percentage of women, it can be so severe that it causes significant weight loss, electrolyte imbalances, and dehydration. The nausea and vomiting in pregnancy is associated with levels of the hormone hCG (human chorionic gonadotropin), which stimulates estrogen production in the ovaries; estrogen increases the risk of nausea and vomiting.
Ginger supplements at these dosages: 350 to 500 milligrams three times a day, 125 to 250 milligrams four times a day, and 500 to 1,000 milligrams total per day for 4 days to 3 weeks have all noticeably reduced nausea and vomiting in patients in the first trimester of pregnancy. Higher dosages are not better, and you run the risk of causing side effects, including uterine contractions and heartburn.
Most important, past clinical trials of ginger in pregnancy showed no greater rate of birth defects, miscarriages, or deformities compared to pregnant women who didn’t take the supplement.
I recommend using real ginger root–based dietary supplements, not flavored products, like ginger ale or ginger tea, which are not as concentrated. If you have trouble taking pills, you can find purified ginger candies, gum, and other options at most health food stores.
The active ingredients in ginger are probably gingerols, zingerone, and shogaols, and I think they’ll soon be standardized in many dietary supplements so you can look at the label and know exactly what you’re getting.
In the best clinical trial ever conducted for ginger (the cancer study mentioned on this page), the capsules contained a purified liquid extract of ginger root (250 milligrams in each capsule) with 8.5 milligrams of concentrated gingerols, zingerone, and shogaol. So when buying a ginger supplement, first make sure it’s from ginger root and then see if it’s standardized to any amount of gingerols, zingerone, and shogaol. I would never buy a ginger supplement with more than 5 percent gingerols because this increases the risk of gastrointestinal side effects, such as acid reflux and stomachache.
Note: There is a moderate risk of increased self-reported bleeding events, especially when combining ginger with other blood thinners, such as aspirin or warfarin. This is why people on prescription blood thinners or with a low platelet count were usually not candidates for ginger supplements in clinical trials.
1. (tie) Vitamin B6 (pyridoxine) 10 to 25 milligrams every 8 hours or 25 to 50 milligrams once a day
It’s well known that a low level of vitamin B6 is associated with a higher risk of severe nausea in pregnancy, and it may contribute to other types of nausea as well. Clinical studies with B6 for severe nausea in pregnancy have been almost as impressive as those with ginger. (The American College of Obstetricians and Gynecologists recommends B6 as “first-line pharmaco-therapy” for nausea in pregnancy.) There are many theories about how it works to reduce nausea.
One is that it functions as a coenzyme to help reduce the ability of hormones (like estrogen) to cause nausea. It also may play a role in the production and balance of important neurotransmitters— such as serotonin, dopamine, norepinephrine, and GABA (gamma-aminobutyric acid)—preventing excesses or deficiencies of these compounds from causing nausea.
Ginger and vitamin B6 are really almost standard medicine to relieve nausea and vomiting during pregnancy, so if one doesn’t work, try the other. (Some pharmaceutical companies offer higher doses of B6 in prescription or medical food form.) Vitamin B6 hasn’t been well tested for nausea outside of pregnancy, but I believe it should be helpful.
The most commonly recommended dosage (in the form of pyridoxine hydrochloride) is 10 to 25 milligrams every 8 hours (for a total of 30 to 75 milligrams per day), but some effective studies also used as little as 25 to 50 milligrams total per day. You can take it with or without food for several days.
2. Whey protein powder isolate 25 to 50 grams a day
A combination of whey protein powder and ginger is showing an even greater benefit for nausea than either one alone in some recent studies. In one trial, 32 grams of whey protein powder and four 250-milligram doses of ginger supplements daily for several days after chemo-therapy led to a large reduction in nausea.
This is not a surprise (to me, at least) because concentrated protein has been shown to reduce nausea better than carbohydrates and fats. This was first tested in pregnancy, and now it seems to be holding true for other causes of nausea, too, such as motion sickness and chemotherapy-related nausea.
How does it do this? The GI tract can have what are known as dysrhythmias, which essentially means the normal flow or movement is altered by some kind of internal (drug or hormone) or external (high waves on the ocean) stimulus. Protein reestablishes that normal rhythm. (Ginger can do this as well, but it works differently.) Concentrated protein sources, such as powders, also slow the rate of gastric emptying, which reduces nausea as well. There are so many concentrated protein sources out there—including whey, casein, egg white, soy, rice, hemp, pea, chia, and flax—but it’s the “isolate” derivatives, or pure protein products without much fat, carbohydrates, or lactose, that appear to be the most helpful. Even though these preliminary nausea studies looked at whey protein, I think any protein isolate is worth a try. (See the Weight Loss section for more information.)
Now for the catch! High-protein diets that include too few carbohydrates can also increase the risk of constipation and, yes, nausea. That’s not to say you shouldn’t increase your protein intake; you just need to find a nutrient balance that works well for your body.
What Supplements Are Useless For Treating Nausea and Vomiting?
Antidepressant dietary supplements
Products like 5-HTP or other supplements that increase brain levels of serotonin can cause nausea much like prescription anti-depressants do. Participants in clinical trials who took increasing doses (the dose was gradually upped) as well as high doses of 5-HTP (up to 900 milligrams per day) had a greater risk of nausea. St. John’s wort has also caused nausea in clinical trials, although the number has been small.
The following have caused gastrointestinal side effects or nausea in clinical trials.
- Black cohosh
- Glucosamine and chondroitin
- Omega-3 or fish oil supplements (usually 3,000 milligrams or more triggers nausea, but it can occur at lower doses, too)
- Selenium in high doses (more than 200 micrograms a day)
- Vitamin C in high doses (1,000 milligrams or more)
What Supplements Are Suitable For Kids To Treat Nausea and Vomiting?
Ginger is being tested for children with chemotherapy-related nausea, and it’s demonstrating benefits preliminarily, so talk to your child’s doctor. It should not be surprising that what works for nausea and vomiting in adults can also work in kids, but at lower dosages.
What Lifestyle Changes Can Help With Nausea and Vomiting?
Over-the-counter wristbands place light pressure around the lower forearm in a spot that helps prevent and reduce nausea and vomiting (called P6 or Pericardium 6). The bands have a stud in the middle that pushes down slightly on a point between the two tendons on your inner forearm. For maximum benefit, wear the wristbands on both arms. There are many similar devices, so look for them in any drugstore.
In addition to acupres-sure, there’s very good evidence that acupuncture can help reduce nausea and vomiting from chemotherapy. Practitioners use the same forearm point mentioned above, among other points.
Make nice with your stomach
When you are feeling nauseated, drink beverages and eat foods that are gentle on your stomach (like what your mother used to give you when you had the flu: ginger ale, drinks that have lost their fizz or gone flat, bland foods, sour candy, and dry crackers).
Cold drinks and foods should be easier to tolerate than warm foods. Also, eat five or six small meals daily versus two or three large ones when nausea strikes (it’s easier for your stomach to digest smaller meals). It should be obvious, but I’ll say it anyway: Avoid spicy, fatty, fried, or very sweet foods. I tell patients to eat as if they were a baby when they’re nauseated. Cut food into tiny pieces or mash it so it’s easier to swallow and easier for your digestive tract to process.
If you have chronic nausea or vomiting due to pregnancy or chemotherapy, make sure you’re getting enough nutrients. Try nutritional shakes or drinks, which may be easier to keep down than a solid meal.
Protect your teeth
Did you know that the watery-mouth feeling you get before throwing up is your body’s way of protecting your tooth enamel? If you’re vomiting frequently, brush your teeth at least twice a day to remove acid and food residue and gargle with mouthwash; even slightly abnormal mouth odors can increase nausea.