Black ginger known as Thai ginseng has been used as food and folk medicine in Thailand for more than 1000 years

1. FOOD AS MEDICINE:
BLACK GINGER
KAEMPFERIA PARVIFLORA
By
Kevin KF Ng, MD, PhD.
Former Associate Professor of Medicine
Division of Clinical Pharmacology
University of Miami, Miami, FL., USA
Email: kevinng68@gmail.com
A Slide Presentation for HealthCare Providers May 2021

2. Presentation Outline
▪ What is black ginger?
▪ Geographical distribution
▪ Classification
▪ Scientific studies
▪ Bioactive compounds
▪ Animal studies
▪ Clinical studies
▪ Safety issues
▪ Summary

3. What is Black Ginger?
▪ Black ginger is the rhizome of Kaempferia parviflora which has traditionally been
used as food and folk medicine for more than 1000 years in Thailand.
▪ The dried rhizome is generally pulverized and used as tea bags, while the fresh one
is utilized to brew wine.

4. Geographical distribution of black ginger (Kaempferia parviflora)

5. SCIENTIFIC CLASSIFICATION

6. Scientific classification of Black Ginger
Species K. parviflora

7. Other names for Kaempferia parviflora root/rhizome
▪Black ginger
▪Thai ginseng
▪Krachai dum

8. Difference between black ginger and common ginger
©DRKEVINNGKFNG

9. Number of publications “black ginger” on PubMed from
1976 to 2020
https://pubmed.ncbi.nlm.nih.gov/?term=black+ginger

10. BIOACTIVE COMPOUNDS

11. Bioactive constituents of black ginger (Kaempferia parviflora)
▪ Approximately 141 chemical constituents have been isolated and reported from
Kaempferia species
▪ The major phytochemicals of Kaempferia parviflora include:
▪ 5,7-dimethoxyflavone (0.289%)
▪ 5,7,4′-trimethoxyflavone (0.0101%)
▪ With more than 20 chemically identifiable constituents
▪ Most of the studies were done with extracts or methoxyflavones:
▪ 5,7-dimethoxyflavone (DMF)
▪ 5,7,4′-trimethoxyflavone (TMF)
▪ 3, 5, 7, 3’,4’-Pentamethoxyflavone (PMF)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871153/

12. 141 Phytochemicals were isolated in Kaempferia species (2019)
Some major chemical constituents include:
▪ isopimarane
▪ abietane
▪ labdane
▪ clerodane diterpenoids
▪ Flavonoids (methoxyflavones)
▪ phenolic acids
▪ phenyl-heptanoids
▪ curcuminoids
▪ tetrahydropyrano-phenolic
▪ Steroids
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836233/#:~:text=Results%3A%20Approximatel
y%20141%20chemical%20constituents,tetrahydropyrano%2Dphenolic%2C%20and%20steroids.

13. Structures of methoxyflavones (PMF, DMF, TMF)
https://www.researchgate.net/figure/Structures-and-physicochemical-
properties-of-methoxyflavones-PMF-DMF-TMF-modified_fig1_262019251

14. Structure of methoxyflavones isolated from Kaempferia parviflora
https://www.hindawi.com/journals/ecam/2018/4057456/

15. BIOLOGICAL ACTIVITY
PHARMCOKINETICS

16. Recent Advances in Kaempferia Biological Activity:
A Comprehensive Review (2019)
▪ .
▪ Antimicrobial Activity Anticholinesterase Activity
▪ Antioxidant Activity Effect on Cytochromes CYP 450
▪ Anti-Inflammatory Activity Vascular Activity
▪ Anticancer Activity Xanthine Oxidase Inhibitory Activity
▪ Allergenic Activity Nociceptive Activity.
▪ Anti-Obesity Activity Wound-Healing Activity
▪ Adaptogenic Activity
▪ Neurological Activity
▪ Effects on Sexual Performance
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836233/

17. Blood concentration and time profile of PMF and TMF in normal
subjects after receiving 90 and 180 mg/day of KP extract (2019)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566825/
( : PMF concentration in KP extract 90 mg/day group (n = 5)
▲: PMF concentration in KP extract 180 mg/day group (n = 9),
: TMF concentration in KP extract 180 mg/day group (n = 4)

18. Pharmacokinetic parameters OF KAEMPFERIA PARVIFLORA
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566825/

19. ANIMAL STUDIES

20. Studies of black ginger on laboratory animals
▪ Anti-inflammatory activity
▪ Anti-obesity activity
▪ Aphrodisiac activity
▪ Anti-diabetes activity
▪ Physical performance enhancement

21. Kaempferia parviflora extract (KPE) suppresses body weight gain and
intra-abdominal fat in mice (2014)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4256566/
obesity

22. Kaempferia parviflora extract(KPE) increases urinary noradrenaline
secretion in mice following treatment for 2 weeks(2014)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4256566/
obesity

23. Anti-obesity effect of Kaempferia parviflora extract and its major
components polymethoxyflavonoid on TSOD mice,
a spontaneously obese Type II diabetes model (2011)
https://www.sciencedirect.com/science/article/abs/pii/S0367326X11002188
TSOD mice, a spontaneously obese Type II diabetes model

24. Anti-inflammatory effect of Kaempferia parviflora extract on the
nuclear factor-kappa B (NF-κB) signaling pathway in LPS-stimulated
RAW 264.7 cells (2018)
https://www.mdpi.com/1422-0067/19/11/3457/htm
inflammation

25. Anti-inflammatory effect of the Kaempferia parviflora extract on the expression of
(LPS)-induced inflammatory proteins, inducible NO synthase (iNOS),
cyclooxygenase-2 (COX-2) & TNF-α in murine macrophage-like cell line cells (2018)
https://www.mdpi.com/1422-0067/19/11/3457/htm
(A)
inflammation

26. Kaempferia parviflora extract (KPE) enhanced muscular endurance in
the consecutive forced swimming test in mice (2016)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946221/
adaptogen
0 week
2-week
1-week
4-week

27. Kaempferia parviflora extract (KPE) suppressed muscular inflammation
in vivo and in vitro (2016)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946221/
adaptogen

28. Effects of K. parviflora on serum testosterone level in
streptozotocin-induced diabetic male rats (2016)
https://www.researchgate.net/publication/310247011_Effects_of_Black_ginger_Kaempfer
ia_parviflora_on_the_testicular_function_in_streptozotocin-induced_diabetic_male_rats
testosterone

29. Effects of K. parviflora on epididymal sperm parameter in
streptozotocin-induced diabetic male rat (2016)
https://www.researchgate.net/figure/Effects-of-K-parviflora-on-epididymal-
sperm-parameter-Data-are-presented-as-the_fig1_310247011
sperm

30. Enhancement of energy production by black ginger extract containing
polymethoxy flavonoids in myocytes through improving glucose,
lactic acid and lipid metabolism (2016)
▪ Enhancement of muscular energy production is thought to improve locomotive functions and prevent
metabolic syndromes including diabetes and lipidemia. Black ginger (Kaempferia parviflora) has been
cultivated for traditional medicine in Thailand.
▪ Recent studies have shown that black ginger extract (KPE) activated brown adipocytes and lipolysis in
white adipose tissue, which may cure obesity-related dysfunction of lipid metabolism. However, the effect
of KPE on glucose and lipid utilization in muscle cells has not been examined yet. Hence, we evaluated
the effect of KPE and its constituents on energy metabolism in pre-differentiated (p) and differentiated (d)
C2C12 myoblasts.
▪ KPE (0.1-10 μg/ml) was added to pC2C12 cells in the differentiation process for a week or used to treat
dC2C12 cells for 24 h. After culturing, parameters of glucose and lipid metabolism and mitochondrial
biogenesis were assessed.
▪ In terms of the results, KPE enhanced the uptake of 2-deoxyglucose and lactic acid as well as the mRNA
expression of glucose transporter (GLUT) 4 and monocarboxylate transporter (MCT) 1 in both types of
cells. The expression of peroxisome proliferator-activated receptor γ coactivator (PGC)-1α was enhanced
in pC2C12 cells. In addition, KPE enhanced the production of ATP and mitochondrial biogenesis.
▪ Polymethoxy flavonoids in KPE including 5-hydroxy-7-methoxyflavone, 5-hydroxy-3,7,4'-trimethoxyflavone
and 5,7-dimethoxyflavone enhanced the expression of GLUT4 and PGC-1α. Moreover, KPE and 5,7-
dimethoxyflavone enhanced the phosphorylation of 5'AMP-activated protein kinase (AMPK).
▪ In conclusion, KPE and its polymethoxy flavonoids were found to enhance energy metabolism in
myocytes. KPE may improve the dysfunction of muscle metabolism that leads to metabolic syndrome
and locomotive dysfunction.
https://pubmed.ncbi.nlm.nih.gov/26581843/#:~:text=Black%20ginger%20(Kaempfe
ria%20parviflora)%20has,related%20dysfunction%20of%20lipid%20metabolism.
diabetes

31. Kaempferia parviflora Ethanol Extract, a Peroxisome Proliferator-Activated Receptor γ
Ligand-binding Agonist, Improves Glucose Tolerance and Suppresses Fat Accumulation
in Diabetic NSY Mice (2019)
▪ This study assessed the effect of Kaempferia parviflora, also known as black ginger (BG), and its ethanol extract (BGE)
on peroxisome proliferator-activated receptor (PPAR) γ agonistic activity, glucose tolerance, fat accumulation, and
lipids-induced hypertriglyceridemia in mice. PPARγ ligand-binding capacity in vitro and polymethoxy flavone contents
were highly observed in organic solvent extracts.
▪ In an animal experiment A, male diabetic Nagoya-Shibata-Yasuda mice were divided into five dietary groups and fed
each diet for 8 weeks: AIN-93G diet (low-fat [LF] diet), high-fat (HF) diet, HF diet supplemented with 1% BG, HF diet
supplemented with 0.19% BGE, and HF diet supplemented with pioglitazone (PPARγ agonist, 3 mg/kg/day) as a PPARγ
agonistic positive control.
▪ As determined from glucose and insulin tolerance tests, plasma glucose levels were improved in the BG and BGE groups.
The BGE extract suppressed fat accumulation in adipose tissues, liver, and muscles without changing the plasma
adiponectin level.
▪ In an animal experiment B, in order to investigate the effect of BG and BGE on lipid-induced hypertriglyceridemia, male
ddY mice were divided into three test groups: control, BG-administered group (500 mg/kg), and BGE-administered group
(100 mg/kg). The plasma triacylglycerol level was not different among the groups during the lipids administration test
▪ These results conclude that the BGE extract containing several kinds of polymethoxy flavones showed PPARγ ligand-
binding capacity in vitro and prevented obesity and insulin resistance independent of adiponectin secretion in mice.
▪ PRACTICAL APPLICATION: Kaempferia parviflora, also known as black ginger (BG), is often used as a folk medicine and a
functional food material to prevent metabolic syndrome mainly in Asian regions. Here, we have clarified that ethanol
extract from BG (BGE) contains several kinds of polymethoxy flavones to show PPARγ ligand-binding capacity and is an
active extract for the improvement of obesity and insulin resistance. The BGE is expected to be applied for functional
food materials in health food markets. Also, polymethoxy flavones to show PPARγ ligand-binding capacity can be
generally applied as a physiological active compound of functional food supplements.
https://pubmed.ncbi.nlm.nih.gov/30726580/
Diabetes

32. TRADITIONAL MEDICINE
CLINICAL TRIALS

33. Traditional use of black ginger in Thailand
▪ Black ginger, the rhizome of Kaempferia parviflora (Zingiberaceae), has traditionally
been used as food and a folk medicine for more than 1000 years in Thailand.
▪ In Thai traditional medicine, black ginger has been claimed to cure
▪ allergy,
▪ asthma,
▪ impotence,
▪ gout,
▪ diarrhea,
▪ dysentery,
▪ peptic ulcer and
▪ diabetes.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946221/

34. Recent clinical trials on humans
▪ Sexual health
▪ Physical fitness
▪ Type 2 Diabetes
https://www.thailandmedical.news/news/health-benefits-of-thai-herb-kaempferia-parviflora-(thai:-krachai-dam-or-
%E0%B8%81%E0%B8%A3%E0%B8%B0%E0%B8%8A%E0%B8%B2%E0%B8%A2%E0%B8%94%E0%B8%B3)-

35. Kaempferia parviflora ethanol extract improves sexual health in men:
a pilot study (2018)
▪ Design, setting, participants and interventions
▪ We conducted an open-label, one-arm study on 14 generally healthy males aged 50–68 years with self-reported mild
erectile dysfunction, who were not using prescription treatments. Participants took 100 mg KaempMax™ daily for
30 days.
▪ Main outcome measures
▪ Evaluations were conducted at baseline and on the final study assessment. Primary efficacy analyses included the
International Index of Erectile Function (IIEF); secondary efficacy analyses included the Global Assessment Question
about erectile function.
▪ Results
▪ Thirteen participants completed the 30-day study. Supplementation with KaempMax™ resulted in statistically significant
improvements in erectile function, intercourse satisfaction and total scores on the IIEF questionnaire. KaempMax™ was
well tolerated and exhibited an excellent safety profile.
▪ Conclusion
▪ Our results suggest that KaempMax™ may improve erectile function in healthy middle-aged and older men. While the
effects were not as pronounced as what might be seen with prescription medication, most participants found them
satisfactory. Additional, longer and placebo-controlled clinical trials will be needed.
https://www.sciencedirect.com/science/article/abs/pii/S
2095496418300633
phrodisiac

36. Effect of Kaempferia parviflora Extract on Physical Fitness of Soccer Players:
A Randomized Double-Blind Placebo-Controlled Trial (2015)
▪ Results
▪ The study showed that after treatment with Kaempferia parviflora, the right-hand
grip strength was significantly increased at weeks 4, 8, and 12. The left-hand grip
strength was significantly increased at week 8. However, the back-and-leg strength,
the 40-yard technical test, the sit-and-reach test, the 50-metre sprint test, and the
cardiorespiratory fitness test results of the treatment group were not significantly
different from those of the placebo group.
▪ Conclusions
▪ Taking Kaempferia parviflora supplements for 12 weeks may significantly enhance
some physical fitness components in soccer players.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4538785/

37. Effect of Krachaidum (Kaempferia parviflora) on
hand grip strength. (2016)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871153/
physical

38. Effect of Kaempferia parviflora (KP) extract on glucose tolerance in
volunteers at baseline and 28 days of the treatment (2019)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566825/
Diabetes

39. Clinical Effects of Krachaidum (Kaempferia parviflora):
A Systematic Review (2017)
▪ Of 683 records identified, 7 studies met the criteria for analysis::
▪ Effects of Krachaidum on Physical or Exercise Performance (4 studies)
▪ Effects of Krachaidum on Erectile Response (1 study)
▪ Effects of Krachaidum on Pain Indicators (1 study)
▪ Effects of Krachaidum on Energy Expenditure (1 study)
▪ Conclusion
▪ In summary, although various indications of Krachaidum were found with varying qualities of
evidence, the positive benefits of Krachaidum were reported, and adverse events were not found.
▪ As a very small number of studies were included, it would be difficult to make reliable conclusions.
▪ Additional clinical studies with larger sample sizes are needed.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871153/
review

40. DOSAGE
SIDE EFFECTS
COMMERCIAL PRODUCTS

41. Kaempferia parviflora dosage
▪ Recommendation from Thai Traditional Medicine Institute
suggests the daily dose of Kaempferia parviflora is 1.2g.
▪ The powder of Kaempferia parviflora extract has been developed
as a food ingredient on the market, which is standardized for
containing not less than 2.5% of 5,7-dimethoxyflavone and 10%
of total methoxyflavones.
https://healthjade.net/black-ginger/

42. Kaempferia parviflora adverse effects
▪ Administration with 1.35g of Kaempferia parviflora daily does not produce any
adverse effects.
▪ Acute and chronic toxicity study has proved that oral administration of Kaempferia
parviflora does not induce any abnormal changes in body weight and histology in
various visceral organs.
▪ Toxicological study exhibits that the ethanol Kaempferia parviflora extract (at the
doses of 60, 120, and 240 mg/kg for 60 days) does not induce significant changes
in hemoglobin, white blood cells, or differential cell count. No any negative effects
on renal and hepatic functions have been found at the tested doses.
https://healthjade.net/black-ginger/

43. Commercial products of black ginger root (Kaempferia parviflora)
▪ Dried black ginger root
▪ Black ginger root powder
▪ Black ginger root extract
▪ Black ginger extract powder
▪ Black ginger root capsule
▪ Black ginger root liquor

44. Summary
▪ Black ginger is the rhizome of Kaempferia parviflora which has
traditionally been used as food and folk medicine for more than
1000 years in Thailand.
▪ Analysis of the bioactive compounds in black ginger showed that
there are more than 140 ingredients in Kaempferia parviflora .
▪ The major bioactive compounds are methoxyflavones which have
been investigated for their anti-obesity, anti-diabetes, physical
performance and aphrodisiac properties.
▪ However, the clinical studies are limited. More studies need to be
done.