Garlic Supplement

Updated | 2021-12-02

Written and reviewed by the NatureClaim Team


See what others say about Garlic:



Garlic


Overview of Garlic

Scientific Name: Allium sativum


Order: Asparagales


Family: Amaryllidaceae


Numerous papers have been published describing the health potential of aged garlic. Do not confuse garlic with the highly toxic plant, autumn crocus (Colchicum autumnale). We also provide information on the nutritional value of garlic.



Evidence

Strong:

insufficient information

Good:

  • Atherosclerosis (ASVD) or “hardening of the arteries”, some evidence indicates that a garlic / Monascus purpureus blend is more effective [1-10]
  • Heart Disease, may reduce blood pressure [11-27]
  • Immune Health, a nasal spray containing garlic may also improve immune health [28-34]

Promising:

  • Dental Health, may reduce the number of germs [35-37]
  • Sickle Cell Anemia (Antioxidant Activity) [38-40]
  • Type 2 Diabetes [41-44]

Conflicting (Unclear):

  • Helicobactor pylori Infection, garlic oil may be more promising [45-51]

Limited Evidence:

  • Antioxidant for Atherosclerotic Patients [52-53]
  • Colon Cancer [54-55]
  • Ear Inflammation in Children, a blend containing garlic / mullein / calendula / Saint John’s wort in olive oil [56-57]
  • Gallstones [58]
  • Hair Loss, a cream containing garlic [59]
  • Hepatopulmonary Syndrome [60]
  • Lead Poisoning [61]
  • Lung Cancer [62]
  • Prostate Cancer, garlic in combination with tomatoes may be more effective [63-64]
  • Venous Ulcers, an ointment containing garlic / Saint John’s wort / calendula [65]
  • Vaginal Yeast Infection, oral ingestion of a tablet containing garlic [66-67]

No Evidence:

  • Lowers Cholesterol [70-97]
    • Numerous papers have studied the cholesterol lowering ability of garlic; however, garlic in combination with fish oil / Monascus purpureus / ginkgo or time-release garlic tablets may be more effective

No Clinical Research:

All other conditions.


Side Effects
Side effects may include:
  • Allergic Reactions
  • Bad Breath
  • Bloating
  • Body Odor
  • Constipation
  • Difficulty Breathing
  • Dizziness
  • Fatigue
  • Gastrointestinal Upset
  • Headache
  • Irritation of Mouth and Throat
  • Muscle Pain
  • Nausea
  • Rashes
  • Sweating
  • Vomiting
Precautions and Adverse Events:
  • Avoid or contact a licensed healthcare practitioner, if you have digestive tract problems, pemphigus, allergies to plants in the order Asparagales (asparagus, onions, etc.), been taking anti-coagulation and anti-platelet drugs as garlic may increase the risk of bleeding and bruising.
  • Ingestion of garlic may increase nosebleeds, cause anti-coagulation, increase the risk of bleeding after shock wave lithotripsy (SWL), cause hypothyroidism (underactive thyroid).
  • There has been a case of garlic causing obstruction of the small intestines, gastrointestinal pain, hematemesis, and hematochezia.
  • Applying garlic onto the skin can cause burns, contact dermatitis, and may cause a photo contact allergic reaction.
  • Excessive garlic use may decrease red blood cell hemoglobin production.
  • Avoid garlic use at least 2 weeks before surgery.
  • Garlic can cause burns if applied within the mouth.
  • Inhalation of garlic powder may cause asthma.
  • Some people are allergic to garlic.
[98-122]


Pregnant or Nursing

Garlic appears to be safe for consumption in food amounts during pregnancy and breast-feeding. There is not enough research on the use of supplements containing garlic during pregnancy and breast-feeding, so consult a licensed healthcare practitioner before use or avoid use. [98-122]



Interactions

Major:

  • Protease Inhibitors including HIV/AIDS Drugs
  • Ritonavir
  • Saquinavir
[123-136]

Moderate:

  • Herbal Medicines Containing Forskoline (Plectranthus barbatus/Coleus forskolii)
  • Drugs changed by Cytochrome P450s (CYPs) in the liver
  • Warfarin
  • Anti-Coagulants
  • Anti-Platelet Drugs
  • Aspirin
  • Chlorpropamide
  • Docetaxel
  • Fluindione
  • Forskolin
  • Indomethacin
  • Low Molecular Weight Heparins
  • Paracetamol
  • Thrombolytic Agents
[123-136]

Potential:

  • Chlorzoxazone
  • Garlic may NOT interact with Alprazolam, Dextromethorphan, Midazolam
[123-136]


Dosage

Garlic is not a "drug", so the best doses have not been thoroughly established. Make sure to follow the specific product instructions and take as directed on the label, or consult a licensed healthcare practitioner before use.





References

1. Ahmadi N, Tsimikas S, Hajsadeghi F, Saeed A, Nabavi V, Bevinal MA, Kadakia J, Flores F, Ebrahimi R, Budoff MJ. Relation of oxidative biomarkers, vascular dysfunction, and progression of coronary artery calcium. Am J Cardiol. 2010 Feb 15;105(4):459-66. 2. Budoff MJ, Ahmadi N, Gul KM, Liu ST, Flores FR, Tiano J, Takasu J, Miller E, Tsimikas S. Aged garlic extract supplemented with B vitamins, folic acid and L-arginine retards the progression of subclinical atherosclerosis: a randomized clinical trial. Prev Med. 2009 Aug-Sep;49(2-3):101-7. 3. Kiesewetter H, Jung F, Jung EM, Blume J, Mrowietz C, Birk A, Koscielny J, Wenzel E. Effects of garlic coated tablets in peripheral arterial occlusive disease. Clin Investig. 1993 May;71(5):383-6. 4. Koscielny J, Klüssendorf D, Latza R, Schmitt R, Radtke H, Siegel G, Kiesewetter H. The antiatherosclerotic effect of Allium sativum. Atherosclerosis. 1999 May;144(1):237-49. 5. Larijani VN, Ahmadi N, Zeb I, Khan F, Flores F, Budoff M. Beneficial effects of aged garlic extract and coenzyme Q10 on vascular elasticity and endothelial function: the FAITH randomized clinical trial. Nutrition. 2013 Jan;29(1):71-5. 6. Sobenin IA, Pryanishnikov VV, Kunnova LM, Rabinovich YA, Martirosyan DM, Orekhov AN. The effects of time-released garlic powder tablets on multifunctional cardiovascular risk in patients with coronary artery disease. Lipids Health Dis. 2010 Oct 19;9:119. 7. Sumioka I, Hayama M, Shimokawa Y, Shiraishi S, Tokunaga A. Lipid-lowering effect of monascus garlic fermented extract (MGFE) in hyperlipidemic subjects. Hiroshima J Med Sci. 2006 Jun;55(2):59-64. 8. Verma SK, Rajeevan V, Jain P, Bordia A. Effect of garlic (Allium sativum) oil on exercise tolerance in patients with coronary artery disease. Indian J Physiol Pharmacol. 2005 Jan;49(1):115-8. 9. Williams MJ, Sutherland WH, McCormick MP, Yeoman DJ, de Jong SA. Aged garlic extract improves endothelial function in men with coronary artery disease. Phytother Res. 2005 Apr;19(4):314-9. 10. Zhang XH, Lowe D, Giles P, Fell S, Board AR, Baughan JA, Connock MJ, Maslin DJ. A randomized trial of the effects of garlic oil upon coronary heart disease risk factors in trained male runners. Blood Coagul Fibrinolysis. 2001 Jan;12(1):67-74. 11. Ashraf R, Khan RA, Ashraf I, Qureshi AA. Effects of Allium sativum (garlic) on systolic and diastolic blood pressure in patients with essential hypertension. Pak J Pharm Sci. 2013 Sep;26(5):859-63. 12. Auer W, Eiber A, Hertkorn E, Hoehfeld E, Koehrle U, Lorenz A, Mader F, Merx W, Otto G, Schmid-Otto B, et al. Hypertension and hyperlipidaemia: garlic helps in mild cases. Br J Clin Pract Suppl. 1990 Aug;69:3-6. 13. Dhawan V, Jain S. Effect of garlic supplementation on oxidized low density lipoproteins and lipid peroxidation in patients of essential hypertension. Mol Cell Biochem. 2004 Nov;266(1-2):109-15. 14. Dhawan V, Jain S. Garlic supplementation prevents oxidative DNA damage in essential hypertension. Mol Cell Biochem. 2005 Jul;275(1-2):85-94. 15. Gómez-Arbeláez D, Lahera V, Oubiña P, Valero-Muñoz M, de Las Heras N, Rodríguez Y, García RG, Camacho PA, López-Jaramillo P. Aged garlic extract improves adiponectin levels in subjects with metabolic syndrome: a double-blind, placebo-controlled, randomized, crossover study. Mediators Inflamm. 2013;2013:285795. 16. McMahon FG, Vargas R. Can garlic lower blood pressure? A pilot study. Pharmacotherapy. 1993 Jul-Aug;13(4):406-7. 17. Orekhov AN, Sobenin IA, Korneev NV, Kirichenko TV, Myasoedova VA, Melnichenko AA, Balcells M, Edelman ER, Bobryshev YV. Anti-atherosclerotic therapy based on botanicals. Recent Pat Cardiovasc Drug Discov. 2013 Apr;8(1):56-66. 18. Qidwai W, Qureshi R, Hasan SN, Azam SI. Effect of dietary garlic (Allium Sativum) on the blood pressure in humans--a pilot study. J Pak Med Assoc. 2000 Jun;50(6):204-7. 19. Ried K, Frank OR, Stocks NP. Aged garlic extract lowers blood pressure in patients with treated but uncontrolled hypertension: a randomised controlled trial. Maturitas. 2010 Oct;67(2):144-50. 20. Ried K, Frank OR, Stocks NP. Aged garlic extract reduces blood pressure in hypertensives: a dose-response trial. Eur J Clin Nutr. 2013 Jan;67(1):64-70. 21. Sobenin IA, Andrianova IV, Demidova ON, Gorchakova T, Orekhov AN. Lipid-lowering effects of time-released garlic powder tablets in double-blinded placebo-controlled randomized study. J Atheroscler Thromb. 2008 Dec;15(6):334-8. 22. Sobenin IA, Andrianova IV, Fomchenkov IV, Gorchakova TV, Orekhov AN. Time-released garlic powder tablets lower systolic and diastolic blood pressure in men with mild and moderate arterial hypertension. Hypertens Res. 2009 Jun;32(6):433-7. 23. Steiner M, Khan AH, Holbert D, Lin RI. A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids. Am J Clin Nutr. 1996 Dec;64(6):866-70. 24. Steiner M, Lin RS. Changes in platelet function and susceptibility of lipoproteins to oxidation associated with administration of aged garlic extract. J Cardiovasc Pharmacol. 1998 Jun;31(6):904-8. 25. Turner B, Mølgaard C, Marckmann P. Effect of garlic (Allium sativum) powder tablets on serum lipids, blood pressure and arterial stiffness in normo-lipidaemic volunteers: a randomised, double-blind, placebo-controlled trial. Br J Nutr. 2004 Oct;92(4):701-6. 26. van Doorn MB, Espirito Santo SM, Meijer P, Kamerling IM, Schoemaker RC, Dirsch V, Vollmar A, Haffner T, Gebhardt R, Cohen AF, Princen HM, Burggraaf J. Effect of garlic powder on C-reactive protein and plasma lipids in overweight and smoking subjects. Am J Clin Nutr. 2006 Dec;84(6):1324-9. 27. Vorberg G, Schneider B. Therapy with garlic: results of a placebo-controlled, double-blind study. Br J Clin Pract Suppl. 1990 Aug;69:7-11. 28. Bhattacharyya M, Girish GV, Karmohapatra SK, Samad SA, Sinha AK. Systemic production of IFN-alpha by garlic (Allium sativum) in humans. J Interferon Cytokine Res. 2007 May;27(5):377-82. 29. Dunstan JA, Breckler L, Hale J, Lehmann H, Franklin P, Lyons G, Ching SY, Mori TA, Barden A, Prescott SL. Supplementation with vitamins C, E, beta-carotene and selenium has no effect on anti-oxidant status and immune responses in allergic adults: a randomized controlled trial. Clin Exp Allergy. 2007 Feb;37(2):180-7. 30. Hiltunen R, Josling PD, James MH. Preventing airborne infection with an intranasal cellulose powder formulation (Nasaleze travel). Adv Ther. 2007 Sep-Oct;24(5):1146-53. 31. Ishikawa H, Saeki T, Otani T, Suzuki T, Shimozuma K, Nishino H, Fukuda S, Morimoto K. Aged garlic extract prevents a decline of NK cell number and activity in patients with advanced cancer. J Nutr. 2006 Mar;136(3 Suppl):816S-820S. 32. Josling P. Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey. Adv Ther. 2001 Jul-Aug;18(4):189-93. 33. Mozaffari-Khosravi H, Hesabgar HA, Owlia MB, Hadinedoushan H, Barzegar K, Fllahzadeh MH. The effect of garlic tablet on pro-inflammatory cytokines in postmenopausal osteoporotic women: a randomized controlled clinical trial. J Diet Suppl. 2012 Dec;9(4):262-71. 34. Nantz MP, Rowe CA, Muller CE, Creasy RA, Stanilka JM, Percival SS. Supplementation with aged garlic extract improves both NK and γδ-T cell function and reduces the severity of cold and flu symptoms: a randomized, double-blind, placebo-controlled nutrition intervention. Clin Nutr. 2012 Jun;31(3):337-44. 35. Bakhshi M, Taheri JB, Shabestari SB, Tanik A, Pahlevan R. Comparison of therapeutic effect of aqueous extract of garlic and nystatin mouthwash in denture stomatitis. Gerodontology. 2012 Jun;29(2):e680-4. 36. Chavan SD, Shetty NL, Kanuri M. Comparative evaluation of garlic extract mouthwash and chlorhexidine mouthwash on salivary Streptococcus mutans count - an in vitro study. Oral Health Prev Dent. 2010;8(4):369-74. 37. Groppo FC, Ramacciato JC, Simões RP, Flório FM, Sartoratto A. Antimicrobial activity of garlic, tea tree oil, and chlorhexidine against oral microorganisms. Int Dent J. 2002 Dec;52(6):433-7. 38. Ohnishi ST, Ohnishi T, Ogunmola GB. Sickle cell anemia: a potential nutritional approach for a molecular disease. Nutrition. 2000 May;16(5):330-8. 39. Takasu J, Uykimpang R, Sunga MA, Amagase H, Niihara Y. Aged garlic extract therapy for sickle cell anemia patients. BMC Blood Disord. 2002 Jun 19;2(1):3. 40. Takasu J, Uykimpang R, Sunga MA, Amagase H, Niihara Y. Aged garlic extract is a potential therapy for sickle-cell anemia. J Nutr. 2006 Mar;136(3 Suppl):803S-805S. 41. Ashraf R, Aamir K, Shaikh AR, Ahmed T. Effects of garlic on dyslipidemia in patients with type 2 diabetes mellitus. J Ayub Med Coll Abbottabad. 2005 Jul-Sep;17(3):60-4. 42. Ashraf R, Khan RA, Ashraf I. Garlic (Allium sativum) supplementation with standard antidiabetic agent provides better diabetic control in type 2 diabetes patients. Pak J Pharm Sci. 2011 Oct;24(4):565-70. 43. Sobenin IA, Nedosugova LV, Filatova LV, Balabolkin MI, Gorchakova TV, Orekhov AN. Metabolic effects of time-released garlic powder tablets in type 2 diabetes mellitus: the results of double-blinded placebo-controlled study. Acta Diabetol. 2008 Mar;45(1):1-6. 44. Vorberg G, Schneider B. Therapy with garlic: results of a placebo-controlled, double-blind study. Br J Clin Pract Suppl. 1990 Aug;69:7-11. 45. Graham DY, Anderson SY, Lang T. Garlic or jalapeño peppers for treatment of Helicobacter pylori infection. Am J Gastroenterol. 1999 May;94(5):1200-2. 46. McNulty CA, Wilson MP, Havinga W, Johnston B, O'Gara EA, Maslin DJ. A pilot study to determine the effectiveness of garlic oil capsules in the treatment of dyspeptic patients with Helicobacter pylori. Helicobacter. 2001 Sep;6(3):249-53. 47. O'Gara EA, Maslin DJ, Nevill AM, Hill DJ. The effect of simulated gastric environments on the anti-Helicobacter activity of garlic oil. J Appl Microbiol. 2008 May;104(5):1324-31. 48. Salih BA, Abasiyanik FM. Does regular garlic intake affect the prevalence of Helicobacter pylori in asymptomatic subjects? Saudi Med J. 2003 Aug;24(8):842-5. Erratum in: Saudi Med J. 2003 Oct;24(10):1152. 49. Wang Y, Zhang L, Moslehi R, Ma J, Pan K, Zhou T, Liu W, Brown LM, Hu Y, Pee D, Gail MH, You W. Long-term garlic or micronutrient supplementation, but not anti-Helicobacter pylori therapy, increases serum folate or glutathione without affecting serum vitamin B-12 or homocysteine in a rural Chinese population. J Nutr. 2009 Jan;139(1):106-12. 50. You WC, Brown LM, Zhang L, Li JY, Jin ML, Chang YS, Ma JL, Pan KF, Liu WD, Hu Y, Crystal-Mansour S, Pee D, Blot WJ, Fraumeni JF Jr, Xu GW, Gail MH. Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst. 2006 Jul 19;98(14):974-83. 51. You WC, Zhang L, Gail MH, Ma JL, Chang YS, Blot WJ, Li JY, Zhao CL, Liu WD, Li HQ, Hu YR, Bravo JC, Correa P, Xu GW, Fraumeni JF Jr. Helicobacter pylori infection, garlic intake and precancerous lesions in a Chinese population at low risk of gastric cancer. Int J Epidemiol. 1998 Dec;27(6):941-4. 52. Avci A, Atli T, Ergüder IB, Varli M, Devrim E, Aras S, Durak I. Effects of garlic consumption on plasma and erythrocyte antioxidant parameters in elderly subjects. Gerontology. 2008;54(3):173-6. 53. Durak I, Aytaç B, Atmaca Y, Devrim E, Avci A, Erol C, Oral D. Effects of garlic extract consumption on plasma and erythrocyte antioxidant parameters in atherosclerotic patients. Life Sci. 2004 Sep 3;75(16):1959-66. 54. Tanaka S, Haruma K, Kunihiro M, Nagata S, Kitadai Y, Manabe N, Sumii M, Yoshihara M, Kajiyama G, Chayama K. Effects of aged garlic extract (AGE) on colorectal adenomas: a double-blinded study. Hiroshima J Med Sci. 2004 Dec;53(3-4):39-45. 55. Tanaka S, Haruma K, Yoshihara M, Kajiyama G, Kira K, Amagase H, Chayama K. Aged garlic extract has potential suppressive effect on colorectal adenomas in humans. J Nutr. 2006 Mar;136(3 Suppl):821S-826S. 56. Sarrell EM, Cohen HA, Kahan E. Naturopathic treatment for ear pain in children. Pediatrics. 2003 May;111(5 Pt 1):e574-9. 57. Sarrell EM, Mandelberg A, Cohen HA. Efficacy of naturopathic extracts in the management of ear pain associated with acute otitis media. Arch Pediatr Adolesc Med. 2001 Jul;155(7):796-9. 58. Nijhawan S, Agarwal V, Sharma D, Rai RR. Evaluation of garlic oil as a contact dissolution agent for gallstones: comparison with monooctanoin. Trop Gastroenterol. 2000 Oct-Dec;21(4):177-9. 59. Hajheydari Z, Jamshidi M, Akbari J, Mohammadpour R. Combination of topical garlic gel and betamethasone valerate cream in the treatment of localized alopecia areata: a double-blind randomized controlled study. Indian J Dermatol Venereol Leprol. 2007 Jan-Feb;73(1):29-32. 60. De BK, Dutta D, Pal SK, Gangopadhyay S, Das Baksi S, Pani A. The role of garlic in hepatopulmonary syndrome: a randomized controlled trial. Can J Gastroenterol. 2010 Mar;24(3):183-8. 61. Kianoush S, Balali-Mood M, Mousavi SR, Moradi V, Sadeghi M, Dadpour B, Rajabi O, Shakeri MT. Comparison of therapeutic effects of garlic and d-Penicillamine in patients with chronic occupational lead poisoning. Basic Clin Pharmacol Toxicol. 2012 May;110(5):476-81. 62. Jin ZY, Wu M, Han RQ, Zhang XF, Wang XS, Liu AM, Zhou JY, Lu QY, Zhang ZF, Zhao JK. Raw garlic consumption as a protective factor for lung cancer, a population-based case-control study in a Chinese population. Cancer Prev Res (Phila). 2013 Jul;6(7):711-8. 63. Galeone C, Pelucchi C, Talamini R, Negri E, Dal Maso L, Montella M, Ramazzotti V, Franceschi S, La Vecchia C. Onion and garlic intake and the odds of benign prostatic hyperplasia. Urology. 2007 Oct;70(4):672-6. 64. Salem S, Salahi M, Mohseni M, Ahmadi H, Mehrsai A, Jahani Y, Pourmand G. Major dietary factors and prostate cancer risk: a prospective multicenter case-control study. Nutr Cancer. 2011;63(1):21-7. 65. Kundaković T, Milenković M, Zlatković S, Nikolić V, Nikolić G, Binić I. Treatment of venous ulcers with the herbal-based ointment Herbadermal®: a prospective non-randomized pilot study. Forsch Komplementmed. 2012;19(1):26-30. 66. Lemar KM, Turner MP, Lloyd D. Garlic (Allium sativum) as an anti-Candida agent: a comparison of the efficacy of fresh garlic and freeze-dried extracts. J Appl Microbiol. 2002;93(3):398-405. 67. Watson CJ, Fairley CK, Grando D, Garland SM, Myers SP, Pirotta M. Associations with asymptomatic colonization with Candida in women reporting past vaginal candidiasis: an observational study. Eur J Obstet Gynecol Reprod Biol. 2013 Jul;169(2):376-9. 68. Ma JL, Zhang L, Brown LM, Li JY, Shen L, Pan KF, Liu WD, Hu Y, Han ZX, Crystal-Mansour S, Pee D, Blot WJ, Fraumeni JF Jr, You WC, Gail MH. Fifteen-year effects of Helicobacter pylori, garlic, and vitamin treatments on gastric cancer incidence and mortality. J Natl Cancer Inst. 2012 Mar 21;104(6):488-92. 69. You WC, Brown LM, Zhang L, Li JY, Jin ML, Chang YS, Ma JL, Pan KF, Liu WD, Hu Y, Crystal-Mansour S, Pee D, Blot WJ, Fraumeni JF Jr, Xu GW, Gail MH. Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. J Natl Cancer Inst. 2006 Jul 19;98(14):974-83. 70. Adler AJ, Holub BJ. Effect of garlic and fish-oil supplementation on serum lipid and lipoprotein concentrations in hypercholesterolemic men. Am J Clin Nutr. 1997 Feb;65(2):445-50. 71. Arora RC, Arora S. Comparative effect of clofibrate, garlic and onion on alimentary hyperlipemia. Atherosclerosis. 1981 Jul;39(4):447-52. 72. Arora RC, Arora S, Gupta RK. The long-term use of garlic in ischemic heart disease--an appraisal. Atherosclerosis. 1981 Oct;40(2):175-9. 73. Auer W, Eiber A, Hertkorn E, Hoehfeld E, Koehrle U, Lorenz A, Mader F, Merx W, Otto G, Schmid-Otto B, et al. Hypertension and hyperlipidaemia: garlic helps in mild cases. Br J Clin Pract Suppl. 1990 Aug;69:3-6. 74. Berthold HK, Sudhop T, von Bergmann K. Effect of a garlic oil preparation on serum lipoproteins and cholesterol metabolism: a randomized controlled trial. JAMA. 1998 Jun 17;279(23):1900-2. 75. Bordia A. Effect of garlic on blood lipids in patients with coronary heart disease. Am J Clin Nutr. 1981 Oct;34(10):2100-3. 76. Byrne DJ, Neil HA, Vallance DT, Winder AF. A pilot study of garlic consumption shows no significant effect on markers of oxidation or sub-fraction composition of low-density lipoprotein including lipoprotein(a) after allowance for non-compliance and the placebo effect. Clin Chim Acta. 1999 Jul;285(1-2):21-33. 77. Gardner CD, Chatterjee LM, Carlson JJ. The effect of a garlic preparation on plasma lipid levels in moderately hypercholesterolemic adults. Atherosclerosis. 2001 Jan;154(1):213-20. 78. Gardner CD, Lawson LD, Block E, Chatterjee LM, Kiazand A, Balise RR, Kraemer HC. Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Arch Intern Med. 2007 Feb 26;167(4):346-53. 79. Higashikawa F, Noda M, Awaya T, Ushijima M, Sugiyama M. Reduction of serum lipids by the intake of the extract of garlic fermented with Monascus pilosus: a randomized, double-blind, placebo-controlled clinical trial. Clin Nutr. 2012 Apr;31(2):261-6. 80. Jain AK, Vargas R, Gotzkowsky S, McMahon FG. Can garlic reduce levels of serum lipids? A controlled clinical study. Am J Med. 1993 Jun;94(6):632-5. 81. Jeyaraj S, Shivaji G, Jeyaraj SD, Vengatesan A. Effect of combined supplementation of fish oil with garlic pearls on the serum lipid profile in hypercholesterolemic subjects. Indian Heart J. 2005 Jul-Aug;57(4):327-31. 82. Kannar D, Wattanapenpaiboon N, Savige GS, Wahlqvist ML. Hypocholesterolemic effect of an enteric-coated garlic supplement. J Am Coll Nutr. 2001 Jun;20(3):225-31. 83. Kenzelmann R, Kade F. Limitation of the deterioration of lipid parameters by a standardized garlic-ginkgo combination product. A multicenter placebo-controlled double-blind study. Arzneimittelforschung. 1993 Sep;43(9):978-81. 84. Kojuri J, Vosoughi AR, Akrami M. Effects of anethum graveolens and garlic on lipid profile in hyperlipidemic patients. Lipids Health Dis. 2007 Mar 1;6:5. 85. Mader FH. Treatment of hyperlipidaemia with garlic-powder tablets. Evidence from the German Association of General Practitioners' multicentric placebo-controlled double-blind study. Arzneimittelforschung. 1990 Oct;40(10):1111-6. 86. McCrindle BW, Helden E, Conner WT. Garlic extract therapy in children with hypercholesterolemia. Arch Pediatr Adolesc Med. 1998 Nov;152(11):1089-94. 87. Morcos NC. Modulation of lipid profile by fish oil and garlic combination. J Natl Med Assoc. 1997 Oct;89(10):673-8. 88. Peleg A, Hershcovici T, Lipa R, Anbar R, Redler M, Beigel Y. Effect of garlic on lipid profile and psychopathologic parameters in people with mild to moderate hypercholesterolemia. Isr Med Assoc J. 2003 Sep;5(9):637-40. 89. Satitvipawee P, Rawdaree P, Indrabhakti S, Ratanasuwan T, Getn-gern P, Viwatwongkasem C. No effect of garlic extract supplement on serum lipid levels in hypercholesterolemic subjects. J Med Assoc Thai. 2003 Aug;86(8):750-7. 90. Sobenin IA, Andrianova IV, Demidova ON, Gorchakova T, Orekhov AN. Lipid-lowering effects of time-released garlic powder tablets in double-blinded placebo-controlled randomized study. J Atheroscler Thromb. 2008 Dec;15(6):334-8. 91. Steiner M, Khan AH, Holbert D, Lin RI. A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids. Am J Clin Nutr. 1996 Dec;64(6):866-70. 92. Superko HR, Krauss RM. Garlic powder, effect on plasma lipids, postprandial lipemia, low-density lipoprotein particle size, high-density lipoprotein subclass distribution and lipoprotein(a). J Am Coll Cardiol. 2000 Feb;35(2):321-6. 93. Turner B, Mølgaard C, Marckmann P. Effect of garlic (Allium sativum) powder tablets on serum lipids, blood pressure and arterial stiffness in normo-lipidaemic volunteers: a randomised, double-blind, placebo-controlled trial. Br J Nutr. 2004 Oct;92(4):701-6. 94. van Doorn MB, Espirito Santo SM, Meijer P, Kamerling IM, Schoemaker RC, Dirsch V, Vollmar A, Haffner T, Gebhardt R, Cohen AF, Princen HM, Burggraaf J. Effect of garlic powder on C-reactive protein and plasma lipids in overweight and smoking subjects. Am J Clin Nutr. 2006 Dec;84(6):1324-9. 95. Vorberg G, Schneider B. Therapy with garlic: results of a placebo-controlled, double-blind study. Br J Clin Pract Suppl. 1990 Aug;69:7-11. 96. Zhang L, Gail MH, Wang YQ, Brown LM, Pan KF, Ma JL, Amagase H, You WC, Moslehi R. A randomized factorial study of the effects of long-term garlic and micronutrient supplementation and of 2-wk antibiotic treatment for Helicobacter pylori infection on serum cholesterol and lipoproteins. Am J Clin Nutr. 2006 Oct;84(4):912-9. 97. Zhang XH, Lowe D, Giles P, Fell S, Connock MJ, Maslin DJ. Gender may affect the action of garlic oil on plasma cholesterol and glucose levels of normal subjects. J Nutr. 2001 May;131(5):1471-8. 98. Alvarez MS, Jacobs S, Jiang SB, Brancaccio RR, Soter NA, Cohen DE. Photocontact allergy to diallyl disulfide. Am J Contact Dermat. 2003 Sep;14(3):161-5. 99. Bagga S, Thomas BS, Bhat M. Garlic burn as self-inflicted mucosal injury--a case report and review of the literature. Quintessence Int. 2008 Jun;39(6):491-4. 100. Baruchin AM, Sagi A, Yoffe B, Ronen M. Garlic burns. Burns. 2001 Nov;27(7):781-2. 101. Carden SM, Good WV, Carden PA, Good RM. Garlic and the strabismus surgeon. Clin Experiment Ophthalmol. 2002 Aug;30(4):303-4. 102. Delaney TA, Donnelly AM. Garlic dermatitis. Australas J Dermatol. 1996 May;37(2):109-10. 103. DerMarderosian A, Beutler JA. The review of natural products: the most complete source of natural product information. 7th ed. St. Louis, MO, USA: Wolters Kluwer Health; 2012. 104. Falleroni AE, Zeiss CR, Levitz D. Occupational asthma secondary to inhalation of garlic dust. J Allergy Clin Immunol. 1981 Aug;68(2):156-60. 105. Fetrow CW, Avila JR. The complete guide to herbal medicines. Spring House, PA, USA: Springhouse Corporation; 2000. 106. Friedman T, Shalom A, Westreich M. Self-inflicted garlic burns: our experience and literature review. Int J Dermatol. 2006 Oct;45(10):1161-3. 107. Gravas S, Tzortzis V, Rountas C, Melekos MD. Extracorporeal shock-wave lithotripsy and garlic consumption: a lesson to learn. Urol Res. 2010 Feb;38(1):61-3. 108. Gruenwald J, Brendler T, Jaenicke C, editors. PDR for herbal medicines. 4th ed. Montvale, NJ, USA: Thomson Healthcare; 2007. 109. Jappe U, Bonnekoh B, Hausen BM, Gollnick H. Garlic-related dermatoses: case report and review of the literature. Am J Contact Dermat. 1999 Mar;10(1):37-9. 110. Lachter J, Babich JP, Brookman JC, Factor AY. Garlic: a way out of work. Mil Med. 2003 Jun;168(6):499-500. 111. Lemière C, Cartier A, Lehrer SB, Malo JL. Occupational asthma caused by aromatic herbs. Allergy. 1996 Sep;51(9):647-9. 112. Lybarger JA, Gallagher JS, Pulver DW, Litwin A, Brooks S, Bernstein IL. Occupational asthma induced by inhalation and ingestion of garlic. J Allergy Clin Immunol. 1982 May;69(5):448-54. 113. Moneret-Vautrin DA, Morisset M, Lemerdy P, Croizier A, Kanny G. Food allergy and IgE sensitization caused by spices: CICBAA data (based on 589 cases of food allergy). Allerg Immunol (Paris). 2002 Apr;34(4):135-40. 114. Moyle M, Frowen K, Nixon R. Use of gloves in protection from diallyl disulphide allergy. Australas J Dermatol. 2004 Nov;45(4):223-5. 115. Parish RA, McIntire S, Heimbach DM. Garlic burns: a naturopathic remedy gone awry. Pediatr Emerg Care. 1987 Dec;3(4):258-60. 116. Pérez-Pimiento AJ, Moneo I, Santaolalla M, de Paz S, Fernández-Parra B, Domínguez-Lázaro AR. Anaphylactic reaction to young garlic. Allergy. 1999 Jun;54(6):626-9. 117. Polat M, Oztas P, Yalcin B, Tamer E, Gur G, Alli N. Contact dermatitis due to Allivum sativum and Ranunculus illyricus: two cases. Contact Dermatitis. 2007 Oct;57(4):279-80. 118. Rafaat M, Leung AK. Garlic burns. Pediatr Dermatol. 2000 Nov-Dec;17(6):475-6. 119. Ruocco V, Brenner S, Lombardi ML. A case of diet-related pemphigus. Dermatology. 1996;192(4):373-4. 120. Shakeel M, Trinidade A, McCluney N, Clive B. Complementary and alternative medicine in epistaxis: a point worth considering during the patient's history. Eur J Emerg Med. 2010 Feb;17(1):17-9. 121. Silva BM, Hosman AE, Devlin HL, Shovlin CL. Lifestyle and dietary influences on nosebleed severity in hereditary hemorrhagic telangiectasia. Laryngoscope. 2013 May;123(5):1092-9. 122. van der Walt A, Lopata AL, Nieuwenhuizen NE, Jeebhay MF. Work-related allergy and asthma in spice mill workers - The impact of processing dried spices on IgE reactivity patterns. Int Arch Allergy Immunol. 2010;152(3):271-8. 123. Ang-Lee MK, Moss J, Yuan CS. Herbal medicines and perioperative care. JAMA. 2001 Jul 11;286(2):208-16. 124. DerMarderosian A, Beutler JA. The review of natural products: the most complete source of natural product information. 7th ed. St. Louis, MO, USA: Wolters Kluwer Health; 2012. 125. Delgoda R, Westlake AC. Herbal interactions involving cytochrome p450 enzymes: a mini review. Toxicol Rev. 2004;23(4):239-49. 126. Evans V. Herbs and the brain: friend or foe? The effects of ginkgo and garlic on warfarin use. J Neurosci Nurs. 2000 Aug;32(4):229-32. 127. Fetrow CW, Avila JR. The complete guide to herbal medicines. Spring House, PA, USA: Springhouse Corporation; 2000. 128. Gruenwald J, Brendler T, Jaenicke C, editors. PDR for herbal medicines. 4th ed. Montvale, NJ, USA: Thomson Healthcare; 2007. 129. Hermann R, von Richter O. Clinical evidence of herbal drugs as perpetrators of pharmacokinetic drug interactions. Planta Med. 2012 Sep;78(13):1458-77. 130. Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs. 2001;61(15):2163-75. 131. Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs. 2009;69(13):1777-98. 132. Mills E, Montori V, Perri D, Phillips E, Koren G. Natural health product-HIV drug interactions: a systematic review. Int J STD AIDS. 2005 Mar;16(3):181-6. 133. Tattelman E. Health effects of garlic. Am Fam Physician. 2005 Jul 1;72(1):103-6. 134. Tsai HH, Lin HW, Simon Pickard A, Tsai HY, Mahady GB. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Pract. 2012 Nov;66(11):1056-78. 135. Ulbricht C, Chao W, Costa D, Rusie-Seamon E, Weissner W, Woods J. Clinical evidence of herb-drug interactions: a systematic review by the natural standard research collaboration. Curr Drug Metab. 2008 Dec;9(10):1063-120. 136. Vaes LP, Chyka PA. Interactions of warfarin with garlic, ginger, ginkgo, or ginseng: nature of the evidence. Ann Pharmacother. 2000 Dec;34(12):1478-82. 137. Afendi FM, Okada T, Yamazaki M, Hirai-Morita A, Nakamura Y, Nakamura K, Ikeda S, Takahashi H, Altaf-Ul-Amin M, Darusman LK, Saito K, Kanaya S. KNApSAcK family databases: integrated metabolite-plant species databases for multifaceted plant research. Plant Cell Physiol. 2012 Feb;53(2):e1.