Garlic

Clinical evidence suggests that garlic supplementation may reduce the risk factors associated with atherosclerosis and cardiovascular disease by inhibiting platelet aggregation, increasing fibrinolysis, reducing blood pressure and reducing serum lipid levels. The overall results from clinical trials, and meta-analyses of these trials, indicate that garlic may reduce total cholesterol levels by 6–10%, after 3–6 months of supplementation. Recent clinical trials have shown that the concomitant use of garlic supplements with a low cholesterol diet will not further reduce cholesterol lev- els. The prevention and treatment of mild hypertension or ischemic diseases with gar- lic supplements requires further clinical evaluation. Two cases of increased international normalized ratio results, attributed to the ingestion of garlic products, were reported in patients previously stabilized on warfarin. Adverse reactions asso- ciated with garlic consumption are mainly limited to contact dermatitis, gastroin- testinal complaints and garlic odor. However, one case of spontaneous spinal epidural hematoma, secondary to a qualitative platelet disorder due to excessive garlic inges- tion, has been reported. A few cases of post-operative bleeding after chronic inges- tion of garlic have also been noted. Garlic products should be used with caution in patients receiving anticoagulant or antiplatelet therapy, or having bleeding disorders. Patients should avoid garlic supplementation for 10–14 days prior to any surgical procedure. The recommended daily dosage is 900 mg/day of garlic powder, 2–5 mg/day of garlic oil, aged garlic extract (7.2 g/day) or 2 to 4 g of fresh garlic.