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Many successful herbal treatments start like this: some doctor learns that some plant has been used in some ancient medical tradition—like ginger for headaches—and figures, hey, they have patients with headaches, and since it’s just some safe common spice, advises one of their migraine patients to give it a try. At the first sign of a migraine coming on, the patient mixes a quarter teaspoon of powdered ginger in some water, drinks it down, and poof, within a half hour, the migraine goes away. And, it works every time, no side effects.

This is what’s called a case report, which is really just a glorified anecdote. But, case reports have played an important role in the history of medicine. AIDS was first discovered as a series of case reports. Some young guy walks into a clinic in Los Angeles with a bad case of thrush, and the rest is history. Or, reports of an unusual side effect of a failed chest-pain drug leading to the billion dollar blockbuster, Viagra. Case reports may be the “lowest” or “weakest” form of evidence, but they are often the “first line of evidence.” That’s where everything begins. So, a report like this isn’t helpful in and of itself, but it can inspire researchers to put it to the test. The problem is, who’s going to fund it? The market for migraine drugs is worth billions of dollars. A quarter teaspoon of powdered ginger costs about a penny. So, who’d fund a study pitting ginger versus the leading migraine drug? No one, until now.

A double-blinded randomized controlled clinical trial comparing the efficacy of ginger to sumatriptan, also known as Imitrex–one of the top-selling billion-dollar drugs in the world in the treatment of migraine headaches. They tried using just one eighth of a teaspoon of powdered ginger, versus a good dose of the drug. And, they both worked just as well, just as fast. Most started out in moderate or severe pain before. But, after the drug or ginger, ended up in mild pain or pain-free. The same proportion of migraine sufferers reported satisfaction with the results either way. And, so as far as I’m concerned, ginger won—not only because it’s a few billion dollars cheaper, but because there were significantly fewer side effects in the ginger group. On the drug, people reported dizziness, a sedative effect, vertigo, and heartburn. The only thing reported for ginger was an upset tummy, in about one out of 25 people—though taking a whole tablespoon of ginger powder at one time on an empty stomach could irritate anyone’s tummy (just as a note of caution).

Sticking to an eighth of a teaspoon is not only up to 3,000 times cheaper than the drug, but you’re probably less likely to end up as a case report yourself—of people who have had a heart attack, or died, after taking the drug.

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