Garlic - Drugs & Vitamins - Drug Library

Scientific Name: Garlic
Other Names: Allium, Allium sativum, Rustic Treacle, Stinking Rose

Who is this for?

Uses

Note: Much of garlic's reputation is based on observation and tradition. While numerous animal and human studies have been carried out to test garlic's effectiveness for a wide range of health conditions, many of the studies have been small and short. Not all of the studies used the same or even comparable garlic products or similar dosing schedules. Therefore, comparing the study results is difficult and many of them are unreliable. However, taking garlic appears to have few or no serious side effects and it may be a useful addition to conventional treatments for certain conditions.

In the United States, oral garlic supplements are sold mainly to reduce the risk of heart disease. They have been studied most to treat high cholesterol. Results of numerous animal and human studies show that garlic does seem to be better than placebo (sugar pills with no medical effectiveness) for lowering high blood levels of total cholesterol and triglycerides. Garlic does not lower blood cholesterol as much as dietary changes plus prescription drugs known as HMG-CoA reductase inhibitors (HMGs). Also called statins, HMGs include Crestor, Lescol, Lipitor, lovastatin, pravastatin, and simvastatin. In general, these medications in combination with low-fat diets may produce a 28% to 60% reduction in total cholesterol. Garlic may be responsible for cholesterol reductions in the 6% to 12% range. Additionally, several studies appear to show that garlic's cholesterol-lowering effects may be only short-term. Lower cholesterol--generally seen after one month of treatment with garlic--may return to near pre-treatment levels after 6 months to 12 months of garlic therapy. One study of 30 children with an inherited type of high cholesterol known as familial hypercholesterolemia found no effect from garlic on their cholesterol levels.

While garlic also appears to have a small effect on lowering high blood pressure, overall results from a number of studies were generally not considered to be significant. On average, individuals who participated in several small clinical trials of a powdered garlic product had blood pressure reductions of 5% to 7% more than other participants who took an inactive placebo. It is believed that garlic may affect blood pressure by relaxing blood vessels, causing them to widen and allowing blood to flow more easily.

In addition, the thickness of the blood may be reduced by taking garlic, which may block the body's production of thromboxane, a chemical involved in blood clotting and blood vessel tightening. Garlic has also been proved to reduce the stickiness of platelets. Platelets are blood components that are partly responsible for forming atherosclerotic plaques--the cholesterol-associated deposits that can block arteries. In several studies conducted in laboratory animals, garlic appeared to stop or delay the formation of atherosclerotic plaques. Two separate human studies that each lasted for four years, also showed that existing plaques could be reduced in size by garlic supplementation.

Other protective effects may result from garlic's ability to lower the levels of homocysteine in the blood. Homocysteine is an amino acid (molecules that combine to form proteins) that is produced from the break down of another amino acid in the body. High levels of homocysteine raise the risk of having heart disease and other conditions. Because it irritates the inside of blood vessels, homocysteine causes artery damage, which may lead to blood clots. It may also be a factor in the complications (eye, kidney, and nerve damage) of diabetes. Additionally, high homocysteine levels may contribute to dementia. In general, dementia is an increasing deficiency in thought processes caused by brain damage or illnesses, such as Alzheimer?s disease. In animal studies and a few small studies in humans, supplemental garlic has shown a general reducing effect on homocysteine levels.

Additional animal studies have shown that either oral or injected garlic can lower blood sugar levels in some animals that have diabetes. Although not all types of supplemental garlic showed an effect, raw garlic has also reduced blood sugar levels even in laboratory rats that did not have diabetes. In some of the studies, animals receiving garlic increased the release of insulin and used insulin more efficiently. In one study, garlic supplementation prevented weight gain in laboratory rats with diabetes. However, one study of humans found that garlic was not any better than an inactive placebo for controlling type 2 diabetes. Although garlic has been used in Asia and other parts of the world to treat diabetes, much more research is needed to prove or disprove its effects on blood sugar levels.

Some garlic preparations have also been promoted for boosting immune function. Garlic has been shown in laboratory research to increase blood levels of at least two enzymes that have antioxidant properties. Antioxidants are thought to protect body cells from damage caused by a chemical process called oxidation. In one study, seven people living with AIDS showed improvements in natural immune function after 12 weeks of garlic supplementation. No further human studies have been published to support these results, although some animal research seems to confirm them.

Extensive research, conducted mostly in Asia, has associated high intakes of raw and/or cooked garlic and similar plant foods with a lower incidence of colorectal, esophageal, and stomach cancers. One study showed reductions in both the size and the number of pre-cancerous colon polyps (small growths along the inside of the intestines) among individuals who took aged garlic extract for one year. One five-year observational study that followed more than 40,000 American women between the ages of 55 and 69, also found that the women who used a lot of garlic in food preparation were less likely to have colon cancer than the women who did not cook with garlic. However, a study conducted over a three-year period in the Netherlands, did not show a reduction in breast, colon, lung, or rectal cancers among individuals who consumed garlic as compared with those whose diets did not include garlic. Much more research is needed to determine whether garlic can protect against prostate cancer.

Garlic has long been known to be anti-infective. Laboratory studies show that it kills or damages a wide range of microorganisms such as bacteria, fungi, protozoans, and viruses. The blood levels needed to control or kill most internal infective agents may be too high to achieve by taking garlic orally. It may be effective, though, for controlling infective agents on the skin's surface and in the mouth. Several studies carried out in humans show that a compound extracted from garlic is effective and safe for application on fungal infections such as athlete's foot and ringworm. Both laboratory and human studies have shown that chewing garlic or applying a garlic preparation kills or controls a number of different microorganisms that live in the mouth.

When should I be careful taking it?

Garlic may interfere with blood clotting. Therefore, individuals who have hemophilia or other bleeding disorders should avoid eating or using large amounts of garlic. High doses of supplemental garlic should be stopped about two weeks before scheduled surgery.

Precautions

Because the chemicals in garlic may cause stomach irritation, individuals with stomach ulcers or sensitive stomachs should be careful about eating or swallowing garlic.

Individuals who are allergic to other members of the lily family of plants, which also includes onions and flowers such as crocus, hyacinth, lilies, and tulips; may also be sensitive to garlic. For susceptible individuals, touching garlic plants or taking garlic supplements may result in allergic responses such as skin rash or upset stomach.

Garlic is known to enter both amniotic fluid (the liquid that surrounds a developing developing baby before birth) and breast milk. Although the taste and smell of these liquids may change, no negative effects have been reported for an infant whose mother uses garlic supplements.

What side effects should I watch for?

Some cases of asthma have been reported in people who process garlic. Other case reports attribute allergic symptoms such as irritated eyes, runny nose, and itching skin to working with large amounts of garlic for extended times. In very rare instances, garlic allergy is thought to have caused sudden and serious swelling, shortness of breath, and loss of consciousness.

Fresh garlic applied to the skin could result in blistering, chemical burns, or dermatitis. The chemicals that give garlic its smell may also irritate or burn the skin, especially when fresh garlic is allowed to stay on the skin for prolonged periods or when it is covered with a waterproof barrier such as a plastic bandage. Cases of serious burns have been reported by individuals who have no known sensitivities to garlic.

Other side effects associated with the oral use of garlic include:

Bad breath
Body odor
Diarrhea
Gas
Heartburn
Mouth irritation
Nausea
Stomach upset
Vomiting

What interactions should I watch for?

Prescription Drugs

In studies and case reports, garlic has been shown to increase the time blood needs to clot. When it is taken with "blood thinners"--antiplatelet or anticoagulant drugs, the effect of the drug may be increased, resulting in uncontrolled bleeding.

Antiplatelet drugs include clopidogrel and Ticlid
Anticoagulants include heparin and warfarin

When garlic was given to healthy volunteers who were also taking a type of antiviral drug (a protease inhibitor named Fortovase); blood levels of the drug were reduced by about half, making it less effective for controlling HIV. Although garlic's possible effects on other antiviral drugs are unknown, individuals taking any type of antiviral therapy should avoid taking very large amounts of garlic.

A few small studies seem to show that garlic can reduce blood sugar in laboratory animals. Although additional studies are needed to document these results, individuals taking oral medications or insulin for diabetes should check with their doctors before taking large amounts of garlic.

Because garlic is broken down by certain enzymes in the liver, excessively large amounts of it possibly may interfere with the use of prescription drugs that are processed by the same enzymes. Some of these drugs are:

Allergy drugs such as fexofenadine
Antifungal drugs such as itraconazole and ketoconazole
Cancer drugs such as etoposide, paclitaxel, vinblastine, or vincristine
Drugs for high cholesterol such as lovastatin, pravastatin, and simvastatin
Oral contraceptives

Non-prescription Drugs

Garlic can reduce the ability of blood to clot after an injury. Aspirin can also decrease clotting, so large amounts of garlic should not be taken orally at the same time aspirin is being taken.

Both garlic and acetaminophen are processed by the same set of enzymes in the liver. When they are taken together, large amounts of garlic may interfere with the breakdown of acetaminophen. As a result too much acetaminophen may stay in the blood. In rare cases, very high blood levels of acetaminophen can cause liver damage.

Herbals

Theoretically, if garlic is used with other herbs that affect blood clotting, excessive bleeding is possible. Some of the most common herbal products that might inhibit blood clotting are:

Danshen
Devil's Claw
Eleuthero
Ginger
Gingko
Horse Chestnut
Panax Ginseng
Papain
Red Clover

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals. For specific information on how garlic interacts with drugs, other herbals, and foods and the severity of those interactions, please use our Drug Interactions Checker to check for possible interactions.

Should I take it?

Garlic has been highly prized--both for flavoring and for medicine--since ancient times. Believed to have originated in eastern Asia, it is now grown and used in nearly every country. It belongs to the same family of aromatic plants as chives, leeks, and onions. Flowers such as lilies are also related to garlic. Depending on the species of garlic, plants may be as tall as 3 feet or as small as about half a foot. All garlic plants have long, thin, grass-like leaves that surround a central stem. After white, pink, purple, or reddish flowers bloom during the summer and early fall, a large underground part known as a bulb develops. The bulb, which can be as large as a person's fist for some types of garlic, easily breaks into smaller pieces that are called cloves. Although garlic leaves are used as food in some areas of the world, the cloves are most used for flavoring and medicines. Often, garlic cloves are added to cooking oils to preserve the garlic and flavor the oil. In some areas, garlic oil is applied to the skin as a repellant for biting insects.

Although garlic contains many different chemicals, the sulfur compounds and volatile oils that give garlic its strong smell also account for much of its medical value. Also called essential oils, volatile oils possess the characteristic smell and taste of the plant. Volatile oils usually evaporate quickly at room temperature.

Dosage and Administration

Around the world, supplemental garlic is sold in a number of different forms--including capsules, concentrates, extracts, liquids, powders, raw garlic bulbs, and tablets. Fresh garlic juice and syrups made from fresh garlic are used more for medicine in Europe and Asia than in the United States. Some garlic products are aged to reduce odor or to allow the formation of additional chemical compounds. Some reliable evidence suggests that heat may reduce some or all of garlic's effectiveness, so preparations that are manufactured without being heated may retain more of the chemicals that are thought to be beneficial.

In this country, garlic preparations are most often available as capsules or tablets made from dried garlic powder or as aged garlic extract. Made by crushing garlic and letting it mature in a cool place for up to 20 months, aged garlic extract has fewer irritating, odor-causing chemicals than fresh garlic. Either dried or aged garlic products are marketed in several strengths and in multiple combinations with other herbal ingredients such as echinacea or ginkgo. Garlic preparations should be standardized to contain between 0.5% and 1.3% of alliin, one of the sulfur compounds in it. Standardization by the manufacturer should assure the same amount of active ingredient in every batch of the commercial preparation. Standardization of herbal products is not required by the U.S. Food and Drug Administration (FDA), so not every product sold in this country will contain the same amounts of active ingredients.

The recommended supplemental dose of garlic is 600 mg to 900 mg daily, usually taken in three or four doses during the day. Individuals who choose to take a garlic supplement should follow the directions for the product that is purchased. Virtually no limits are placed on the consumption of dietary garlic, however--with reported continual daily amounts of several ounces being common among Asian cultures whose members regularly consume garlic plants as a vegetable.

Fresh garlic varies in the amounts of active ingredients it contains depending on the location and conditions in which it is grown and the way it was processed and stored. For those who prefer using it, one-half to three cloves of raw garlic can be chewed up to three times a day. Cooking may destroy some of the medicinally effective chemicals in garlic, so garlic used in seasoning foods may not be as beneficial to health as commercial supplements or raw garlic.

Summary

Some limited clinical evidence seems to show that garlic taken orally can help moderately to reduce high cholesterol and high blood pressure. Less evidence supports its effectiveness in preventing heart disease, enhancing immune function, and protecting against some types of cancer.

Risks

Garlic in recommended amounts seems to have few risks. People who have bleeding disorders or who take medications to thin the blood, should be aware that taking large amounts of garlic may further reduce the blood's ability to clot.

Side Effects

In the amounts used in food or recommended medicinal doses, garlic has few side effects. Large amounts, however, have been associated with irritated mouth or stomach. A few people may have asthma or rash from handling the garlic plants for a long time or in large amounts. If it is left in contact with the skin for extended periods of time, garlic may cause irritation or burns.

Interactions

If it is taken at the same time as drugs or other herbs that "thin the blood"' very large amounts of garlic taken by mouth could increase the amount of time that blood needs to clot. Garlic in high amounts may interfere with some antiviral and antidiabetic medications, as well as with other drugs, such as acetaminophen, that are broken down by the same liver enzymes as garlic. It may increase the activity of drugs that lower blood sugar.

Last Revised April 11, 2008

References

Abdullah T, Kirkpatrick DV, Williams L, Carter J. Garlic as an antimicrobial and immune modulator in AIDS. (abstract no. Th.B.P.304) Proceedings of the International Conference on AIDS. 1989;5:466.

Abebe W. Herbal medications: potential for adverse interactions with analgesic drugs. Journal of Clinical Pharmacy and Therapeutics. 2002;27(6):391-401.

Abdullah TH, Kandil O, Elkadi A, Carter J. Garlic revisited: therapeutic for the major diseases of our times? Journal of the National Medical Association. 1988;80(4):439-445.

Ackermann RT, Mulrow CD, Ramirez G, Gardner CD, Morbidoni L, Lawrence VA. Garlic shows promise for improving some cardiovascular risk factors. Archives of Internal Medicine. 2001;161(6):813-824.

Agarwal MK, Iqbal M, Athar M. Garlic oil ameliorates ferric nitrilotriacetate (Fe-NTA)-induced damage and tumor promotion: implications for cancer prevention. Food Chemistry and Toxicology. 2007;45(9):1634-1640.

Aggarwal A, Ades PA. Interactions of herbal remedies with prescription cardiovascular medications. Coronary Artery Diseases. 2001;12(7):581-584.

Ahmad MS, Ahmed N. Antiglycation properties of aged garlic extract: possible role in prevention of diabetic complications. Journal of Nutrition. 2006;136(3 Suppl):796S-799S.

Alder R, Lookinland S, Berry JA, Williams M. A systematic review of the effectiveness of garlic as an anti-hyperlipidemic agent. Journal of the American Academy of Nurse Practitioners. 2003;15(3):120-129.

Ali BH. Agents ameliorating or augmenting experimental gentamicin nephrotoxicity: some recent research. Food Chemistry and Toxicology. 2003;41(11):1447-1452.

Allison GL, Lowe GM, Rahman K. Aged garlic extract and its constituents inhibit platelet aggregation through multiple mechanisms. Journal of Nutrition. 2006;136(3 Suppl):782S-788S.

Al-Qattan KK, Khan I, Alnaqeeb MA, Ali M. Mechanism of garlic (Allium sativum) induced reduction of hypertension in 2K-1C rats: a possible mediation of Na/H exchanger isoform-1. Prostaglandins, Leukotrienes and Essential Fatty Acids. 2003;69(4):217-222.

Alvarez MS, Jacobs S, Jiang SB, Brancaccio RR, Soter NA, Cohen DE. Photocontact allergy to diallyl disulfide. American Journal of Contact Dermatitis. 2003;14(3):161-165.

Al-Waili NS, Saloom KY, Akmal M, et al. Effects of heating, storage, and ultraviolet exposure on antimicrobial activity of garlic juice. Journal of Medicinal Food. 2007;10(1):208-212.

Ameen M, Musthapa MS, Abidi P, Ahmad I, Rahman Q. Garlic attenuates chrysotile-mediated pulmonary toxicity in rats by altering the phase I and phase II drug metabolizing enzyme system. Journal of Biochemistry and Molecular Toxicology. 2003;17(6):366-371.

Anibarro B, Fontela JL, De La Hoz F. Occupational asthma induced by garlic dust. Journal of Allergy and Clinical Immunology. 1997;100(6 Pt 1):734-738.

Anim-Nyame N, Sooranna SR, Johnson MR, Gamble J, Steer PJ. Garlic supplementation increases peripheral blood flow: a role for interleukin-6? Journal of Nutrition and Biochemistry. 2004;15(1):30-36.

Anon. Garlic. In: DerMarderosian A, Beutler JA, eds. Facts and Comparisons: The Review of Natural Products. St. Louis, MO, Facts and Comparisons. October 2001.

Anwar MM, Meki AR. Oxidative stress in streptozotocin-induced diabetic rats: effects of garlic oil and melatonin. Comparative Biochemistry and Physiology. A: Molecular and Integrative Physiology. 2003.135(4):539-547.

Argento A, Tiraferri E, Marzaloni M. Oral anticoagulants and medicinal plants. An emerging interaction. [article in Italian]. Annals of Italian Internal Medicine. 2000;15(2):139-143.

Arora RC, Arora S, Gupta RK. The long-term use of garlic in ischemic heart disease -- an appraisal. Atherosclerosis. 1981;40(2):175-179.

Auer W, Eiber A, Hertkorn E, et al. Hypertension and hyperlipidaemia [sic]: garlic helps in mild cases. British Journal of Clinical Practice. Supplement. 1990;69:3-6.

Bakri IM, Douglas CW. Inhibitory effect of garlic extract on oral bacteria. Archives of Oral Biology. 2005;50(7):645-651.

Balasenthil S, Rao KS, Nagini S. Altered cytokeratin expression during chemoprevention of hamster buccal pouch carcinogenesis by S-allylcysteine. Polish Journal of Pharmacology. 2003;55(5):793-798.

Baluchnejadmojarad T, Roghani M. Endothelium-dependent and -independent effect of aqueous extract of garlic on vascular reactivity on diabetic rats. Fitoterapia. 2003;74(7-8):630-637.

Baluchnejadmojarad T, Roghani M. Garlic extract attenuates time-dependent changes in the reactivity of isolated aorta in streptozotocin-diabetic rats. Life Sciences. 2003;73(18):2281-2289.

Baruchin AM, Sagi A, Yoffe B, Ronen M. Garlic burns. Burns. 2001;27(7):781-782.

Beckert BW, Concannon MJ, Henry SL, Smith DS, Puckett CL. The effect of herbal medicines on platelet function: an in vivo experiment and review of the literature. Plastic and Reconstructive Surgery. 2007;120(7):2044-2050.

Berthold HK, Sudhop T, von Bergmann K. Effect of a garlic oil preparation on serum lipoproteins and cholesterol metabolism: a randomized controlled trial. Journal of the American Medical Association. 1998;279(23):1900-1902.

Bhattacharyya M, Girish GV, Karmohapatra SK, Samad SA, Sinha AK. Systemic production of IFN-alpha by garlic (Allium sativum) in humans. Journal of Interferon and Cytokine Research. 2007;27(5):377-382.

Bordia A, Bansal HC, Arora SK, Singh SV. Effect of the essential oils of garlic and onion on alimentary hyperlipidemia. Atherosclerosis. 1975;21(1):15-19.

Borek C. Antioxidant health effects of aged garlic extract. Journal of Nutrition. 2001;131(Suppl 3):1010S-1015S.

Borek C. Garlic reduces dementia and heart-disease risk. Journal of Nutrition. 2006 Mar;136(3 Suppl):810S-812S.

Borrelli F, Capasso R, Izzo AA. Garlic (Allium sativum L.): adverse effects and drug interactions in humans. Molecular Nutrition and Food Research. 2007;51(11):1386-1397.

Budoff M. Aged garlic extract retards progression of coronary artery calcification. Journal of Nutrition. 2006;136(3 Suppl):741S-744S.

Chan KC, Yin MC, Chao WJ. Effect of diallyl trisulfide-rich garlic oil on blood coagulation and plasma activity of anticoagulation factors in rats. Food Chemistry and Toxicology. 2007;45(3):502-507.

Chang HS, Yamato O, Sakai Y, Yamasaki M, Maede Y. Acceleration of superoxide generation in polymorphonuclear leukocytes and inhibition of platelet aggregation by alk(en)yl thiosulfates derived from onion and garlic in dogs and humans. Prostaglandins, Leukotrienes and Essential Fatty Acids. 2004;70(1):77-83.

Chaudhuri BN, Mukherjee SK, Mongia SS, Chakravarty SK. Hypolipidemic effect of garlic and thyroid function. Biomedica Biochimica Acta. 1984;43(7):1045-1047.

Chauhan NB, Sandoval J. Amelioration of early cognitive deficits by aged garlic extract in Alzheimer's transgenic mice. Phytotherapy Research. 2007;21(7):629-640.

Chetty KN, Calahan L, Harris KC, Dorsey W, Hill D, Chetty S, Jain SK. Garlic attenuates hypercholesterolemic risk factors in olive oil fed rats and high cholesterol fed rats. Pathophysiology. 2003;9(3):127-132.

Chowdhury R, Dutta A, Chaudhuri SR, Sharma N, Giri AK, Chaudhuri K. In vitro and in vivo reduction of sodium arsenite induced toxicity by aqueous garlic extract. Food Chemistry and Toxicology. 2008;46(2):740-751.

Chuah SC, Moore PK, Zhu YZ. S-allylcysteine mediates cardioprotection in an acute myocardial infarction rat model via a hydrogen sulfide-mediated pathway. American Journal of Physiology and Heart Circulatory Physiology. 2007;293(5):H2693-H2701.

Chung JG, Lu HF, Yeh CC, Cheng KC, Lin SS, Lee JH. Inhibition of N-acetyltransferase activity and gene expression in human colon cancer cell lines by diallyl sulfide. Food Chemistry and Toxicology. 2004;42(2):201-208.

Consumer Labs. Product review: Garlic supplements. 2002. Available at: http://www.consumerlab.com/results/garlic.asp. Accessed March 25, 2004.

Cox MC, Low J, Lee J, et al. Influence of garlic (Allium sativum) on the pharmacokinetics of docetaxel. Clinical Cancer Research. 2006;12(15):4636-4640.

Dausch JG, Nixon DW. Garlic: a review of its relationship to malignant disease. Preventive Medicine. 1990;19(3):346-361.

Dhawan V, Jain S. Garlic supplementation prevents oxidative DNA damage in essential hypertension. Molecular and Cellular Biochemistry. 2005;275(1-2):85-94.

Dillon SA, Burmi RS, Lowe GM, Billington D, Rahman K. Antioxidant properties of aged garlic extract: an in vitro study incorporating human low density lipoprotein. Life Sciences. 2003;72(14):1583-1594.

Dorant E, van den Brandt PA, Goldbohm RA. A prospective cohort study on the relationship between onion and leek consumption, garlic supplement use and the risk of colorectal carcinoma in The Netherlands. Carcinogenesis. 1996;17(3):477-484.

Dorant E, van den Brandt PA, Goldbohm RA. A prospective cohort study on Allium vegetable consumption, garlic supplement use, and the risk of lung carcinoma in The Netherlands. Cancer Research. 1994;54(23):6148-6153.

Dorant E, van den Brandt PA, Goldbohm RA. Allium vegetable consumption, garlic supplement intake, and female breast carcinoma incidence. Breast Cancer Research and Treatment. 1995;33(2):163-170.

Durak I, Cetin R, Candir O, Devrim E, Kilicoglu B, Avci A. Black grape and garlic extracts protect against cyclosporine a nephrotoxicity. Immunology Investigations. 2007;36(1):105-114.

Eja ME, Asikong BE, Abriba C, Arikpo GE, Anwan EE, Enyi-Idoh KH. A comparative assessment of the antimicrobial effects of garlic (Allium sativum) and antibiotics on diarrheagenic organisms. Southeast Asian Journal of Tropical Medicine and Public Health. 2007;38(2):343-348.

El-Bayoumy K, Sinha R, Pinto JT, Rivlin RS. Cancer chemoprevention by garlic and garlic-containing sulfur and selenium compounds. Journal of Nutrition. 2006;136(3 Suppl):864S-869S.

Elkayam A, Mirelman D, Peleg E, et al. The effects of allicin on weight in fructose-induced hyperinsulinemic, hyperlipidemic, hypertensive rats. American Journal of Hypertension. 2003;16(12):1053-1056.

El Shenawy NS, Soliman MF, Reyad SI. The effect of antioxidant properties of aqueous garlic extract and Nigella sativa as anti-schistosomiasis agents in mice. Review of the Institute for Tropical Medicine Sao Paulo. 2008;50(1):29-36.

Ernst E. Cardiovascular effects of garlic (Allium sativum): a review. Pharmacotherapeutica. 1987;5(2):83-89.

Fani MM, Kohanteb J, Dayaghi M. Inhibitory activity of garlic (Allium sativum) extract on multidrug-resistant Streptococcus mutans. Journal of the Indian Society of Pedodontics and Preventive Dentistry. 2007;25(4):164-168.

Fleischauer AT, Arab L. Garlic and cancer: a critical review of the epidemiologic literature. Journal of Nutrition. 2001;131(Suppl 3):1032S-1040S.

Fleischauer AT, Poole C, Arab L. Garlic consumption and cancer prevention: meta-analyses of colorectal and stomach cancers. American Journal of Clinical Nutrition. 2000;72(4):1047-1052.

Fugh-Berman A. Herbs and dietary supplements in the prevention and treatment of cardiovascular disease. Preventive Cardiology. 2000;3(1):24-32.

Gadkari JV, Joshi VD. Effect of ingestion of raw garlic on serum cholesterol level, clotting time and fibrinolytic activity in normal subjects. Journal of Postgraduate Medicine. 1991;37(3):128-131.

Galeone C, Pelucchi C, Talamini R, et al. Onion and garlic intake and the odds of benign prostatic hyperplasia. Urology. 2007;70(4):672-676.

Gao CM, Takezaki T, Ding JH, Li MS, Tajima K. Protective effect of allium vegetables against both esophageal and stomach cancer: a simultaneous cross-referent study of a high-epidemic area in Jiangsu Province, China. Japanese Journal of Cancer Research. 1999;90(6):614-621.

Gapter LA, Yuin OZ, Ng KY. S-Allylcysteine reduces breast tumor cell adhesion and invasion. Biochemistry and Biophysics Research Communications. 2008;367(2):446-451.

Gardner CD, Chatterjee LM, Carkson JJ. The effect of a garlic preparation on plasma lipid levels in moderately hypercholesterolemic adults. Atherosclerosis. 2001;154(1):213-220.

Gardner CD, Lawson LD, Block E, et al. Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Archives of Internal Medicine. 2007;167(4):346-353.

Gardner CD, Messina M, Lawson LD, Farquhar JW. Soy, garlic, and ginkgo biloba: their potential role in cardiovascular disease prevention and treatment. Current Atherosclerosis Reports. 2003;5(6):468-475.

Gonen A, Harats D, Rabinkov A, et al. The antiatherogenic effect of allicin: possible mode of action. Pathobiology. 2005;72(6):325-334.

Gorinstein S, Jastrzebski Z, Namiesnik J, Leontowicz H, Leontowicz M, Trakhtenberg S. The atherosclerotic heart disease and protecting properties of garlic: contemporary data. Molecular Nutrition and Food Research. 2007;51(11):1365-1381.

Green M, Thomas R, Gued L, Sadrud-Din S. Inhibition of DES-induced DNA adducts by diallyl sulfide: implications in liver cancer prevention. Oncology Reports. 2003;10(3):767-771.

Grieve M. Garlic. In: A Modern Herbal. New York: Dover Publishers, 1971. Available at: http://www.botanical.com/botanical/mgmh/mgmh.html Posted 1995. Accessed December 19, 2002.

Groppo FC, Ramacciato JC, Motta RH, Ferraresi PM, Sartoratto A. Antimicrobial activity of garlic against oral streptococci. International Journal of Dental Hygiene. 2007;5(2):109-115.

Groppo FC, Ramacciato JC, Simoes RP, Florio FM, Sartoratto A. Antimicrobial activity of garlic, tea tree oil, and chlorhexidine against oral microorganisms. International Dental Journal. 2002;52(6):433-437.

Gupta VB, Rao KS. Anti-amyloidogenic activity of S-allyl-L-cysteine and its activity to destabilize Alzheimer's beta-amyloid fibrils in vitro. Neuroscience Letters. 2007;429(2-3):75-80.

Gurley BJ, Gardner SF, Hubbard MA, et al. Clinical assessment of effects of botanical supplementation on cytochrome P450 phenotypes in the elderly: St John's wort, garlic oil, Panax ginseng and Ginkgo biloba. Drugs and Aging. 2005;22(6):525-239.

Hammami I, Nahdi A, Mauduit C, et al. Crude garlic (allium sativum) feeding has inhibitory effects on adult male reproductive functions. Asian Journal of Andrology. 2008;10(4):593-601.

Harenberg J, Giese C, Zimmermann R. Effect of dried garlic on blood coagulation, fibrinolysis, platelet aggregation and serum cholesterol levels in patients with hyperlipoproteinemia. Atherosclerosis. 1988;74(3):247-249.

Harris JC, Cottrell SL, Plummer S, Lloyd D. Antimicrobial properties of Allium sativa (garlic). Applied Microbiology and Biotechnology. 2001;57(3):282-286.

Harauma A, Moriguchi T. Aged garlic extract improves blood pressure in spontaneously hypertensive rats more safely than raw garlic. Journal of Nutrition. 2006;136(3 Suppl):769S-773S.

Hassan ZM, Yaraee R, Zare N, et al. Immunomodulatory affect of R10 fraction of garlic extract on natural killer activity. International Immunopharmacology. 2003;3(10-11):1483-1489.

Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. American Journal of Health-Systems Pharmacists. 2000;57(13):1221-1227.

Herman-Antosiewicz A, Powolny AA, Singh SV. Molecular targets of cancer chemoprevention by garlic-derived organosulfides. Acta Pharmacologica Sineca. 2007;28(9):1355-1364.

Holden W, Joseph J, Williamson L. Use of herbal remedies and

potential drug interactions in rheumatology outpatients. [Letter] Annals of Rheumatic Diseases. 2005;64(5):790.

Hoshino T, Kashimoto N, Kasuga S. Effects of garlic preparations on the gastrointestinal mucosa. Journal of Nutrition. 2001;131(Suppl 3):1109S-1113S.

Hosseini M, Shafiee SM, Baluchnejadmojarad T. Garlic extract reduces serum angiotensin converting enzyme (ACE) activity in nondiabetic and streptozotocin-diabetic rats. Pathophysiology. 2007;14(2):109-112.

Howard EW, Lee DT, Chiu YT, Chua CW, Wang X, Wong YC. Evidence of a novel docetaxel sensitizer, garlic-derived S-allylmercaptocysteine, as a treatment option for hormone refractory prostate cancer. International Journal of Cancer. 2008;122(9):1941-1948.

Hu Z, Yang X, Ho PC, et al. Herb-drug interactions: a literature review. Drugs. 2005;65(9):1239-1282.

Ide N, Keller C, Weiss N. Aged garlic extract inhibits homocysteine-induced CD36 expression and foam cell formation in human macrophages. Journal of Nutrition. 2006;136(3 Suppl):755S-758S.

Ioannides C. Pharmacokinetic interactions between herbal remedies and medicinal drugs. Xenobiotica. 2002;32(6):451-478.

Isaachsohn JL, Moser M, Stein EA, et al. Garlic powder and plasma lipids and lipoproteins: a multicenter, randomized, placebo-controlled trial. Archives of Internal Medicine. 1998;158(11):1189-1194.

Islam MS, Choi H. Comparative Effects of Dietary Ginger (Zingiber officinale) and Garlic (Allium sativum) Investigated in a Type 2 Diabetes Model of Rats. Journal of Medicinal Food. 2008;11(1):152-159.

Izzo AA, Di Carlo G, Borrelli F, Ernst E. Cardiovascular pharmacotherapy and herbal medicines: the risk of drug interaction. International Journal of Cardiology. 2005;98(1):1-14.

Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs. 2001;61(15):2163-2175.

Jabbari A, Argani H, Ghorbanihaghjo A, Mahdavi R. Comparison between swallowing and chewing of garlic on levels of serum lipids, cyclosporine, creatinine and lipid peroxidation in renal transplant recipients. Lipids in Health and Disease. 2005. May 19;4:11.

Jain AK, Vargas R, Gotzkowsky S, McMahon FG. Can garlic reduce levels of serum lipids? A controlled clinical study. American Journal of Medicine. 1993;94(6):632-635.

Jalal R, Bagheri SM, Moghimi A, Rasuli MB. Hypoglycemic effect of aqueous shallot and garlic extracts in rats with fructose-induced insulin resistance. Journal of Clinical Biochemistry and Nutrition. 2007;41(3):218-223.

Jappe U, Bonnekoh B, Hausen BM, Gollnick H. Garlic-related dermatoses: case report and review of the literature. American Journal of Contact Dermatology. 1999;10(1):37-39.

Jellin JM, Gregory P, Batz F, Hitchens K, et al, eds. Pharmacist's Letter/Prescriber's Letter. Natural Medicines Comprehensive Database, 3rd Edition. Stockton CA: Therapeutic Research Facility, 2000.

Jelodar GA, Maleki M, Motadayen MH, Sirus S. Effect of fenugreek, onion and garlic on blood glucose and histopathology of pancreas of alloxan-induced diabetic rats. Indian Journal of Medical Science. 2005;59(2):64-69.

Kao SH, Hsu CH, Su SN, et al. Identification and immunologic characterization of an allergen, alliin lyase, from garlic (Allium sativum). Journal of Allergy and Clinical Immunology. 2004;113(1):161-168.

Kasuga S, Uda N, Kyo E, Ushijima M, Morihara N, Itakura Y. Pharmacologic activities of aged garlic extract in comparison with other garlic preparations. Journal of Nutrition. 2001;131(Suppl 3):1080S-1084S.

Kaur P, Singh R. In vivo interactive effect of garlic oil and vitamin E against stavudine induced genotoxicity in Mus musculus. Indian Journal of Experimental Biology. 2007;45(9):807-811.

Kendler BS. Garlic (Allium sativa) and onion (Allium cepa): a review of their relationship to cardiovascular disease. Preventive Medicine. 1987;16(5):670-685.

Khosla P, Karan RS, Bhargava VK. Effect of garlic oil on ethanol induced gastric ulcers in rats. Phytotherapy Research. 2004;18(1):87-91.

Kleijen J, Knipschild P, ter Rait G. Garlic, onions and cardiovascular risk factors. A review of the evidence from human experiments with emphasis on commercially available preparations. British Journal of Clinical Pharmacology. 1989;28(5):535-544.

Knox J, Gaster B. Dietary supplements for the prevention and treatment of coronary artery disease. Journal of Alternative and Complementary Medicine. 2007;13(1):83-95.

Kojuri J, Vosoughi AR, Akrami M. Effects of anethum graveolens and garlic on lipid profile in hyperlipidemic patients. Lipids in Health and Disease. 2007;6:5.

Koscielny J, Klussendorf D, Latza R, et al. The antiatherosclerotic effect of Allium sativum. Atherosclerosis. 2000;150(2):437-438.

Kyo E, Uda N, Kasuga S, Itakura Y. Immonumodulatory effects of aged garlic extract. Journal of Nutrition. 2001;131(Suppl 3):1075S-1079S.

Lachter J, Babich JP, Brookman JC, Factor AY. Garlic: a way out of work. Military Medicine. 2003;168(6):499-500.Lamm DL, Riggs DR. Enhanced immunocompetence by garlic: role in bladder cancer and other malignancies. Journal of Nutrition. 2001;131(Suppl 3):1067S-1070S.

Lamm DL, Riggs DR. The potential application of Allium sativum (garlic) for the treatment of bladder cancer. Urology Clinics of North America. 2000;27(1):157-162.

Lau BH. Suppression of LDL oxidation by garlic compounds is a possible mechanism of cardiovascular health benefit. Journal of Nutrition. 2006;136(3 Suppl):765S-768S.

Ledezma E, DeSousa L, Jorquera A, et al. Efficacy of ajoene, an organosulphur derived from garlic, in the short-term therapy of tinea pedis. Mycoses. 1996;39(9-10):393-395.

Ledezma E, Lopez JC, Marin P, et al. Ajoene in the topical short-term treatment of tinea cruris and tinea corporis in humans. Randomized comparative study with terbinafine. Arzneimittelforschung. 1999;49(6):544-547.

Ledezma E, Marcano K, Jorquera A, et al. Efficacy of ajoene in the treatment of tinea pedis: a double-blind and comparative study with terbinafine. Journal of the American Academy of Dermatology. 2000;43(5 Pt 1):829-832.

Lemiere C, Cartier A, Lehrer SB, Malo JL. Occupational asthma caused by aromatic herbs. Allergy. 1996;51(9):647-649.

Liu CT, Sheen LY, Lii CK. Does garlic have a role as an antidiabetic agent? Molecular Nutrition and Food Research. 2007;51(11):1353-1364.

Liu ZF, Fang F, Dong YS, Li G, Zhen H. Experimental study on the prevention and treatment of murine cytomegalovirus hepatitis by using allitridin. Antiviral Research. 2004;61(2):125-128.

Liu CT, Wong PL, Lii CK, Hse H, Sheen LY. Antidiabetic effect of garlic oil but not diallyl disulfide in rats with streptozotocin-induced diabetes. Food Chemistry and Toxicology. 2006;44(8):1377-1384.

Lohani M, Yadav S, Schiffmann D, Rahman Q. Diallylsulfide attenuates asbestos-induced genotoxicity. Toxicology Letter. 2003;143(1):45-50.

Luley C, Lehmann-Leo W, Moller B, Martin T, Schwartzkopff W. Lack of efficacy of dried garlic in patients with hyperlipoproteinemia. Arzneimittelforschung. 1986;36(4):766-768.

Macan H, Uykimpang R, Alconcel M, et al. Aged garlic extract may be safe for patients on warfarin therapy. Journal of Nutrition. 2006;136(3 Suppl):793S-795S.

Mader FH. Treatment of hyperlipidaemia [sic] with garlic-powder tablets. Evidence from the German Association of General Practitioners' multicentric placebo-controlled double-blind study. Arzneimittelforschung. 1990;40(10):1111-1116.

Maldonado PD, Barrera D, Medina-Campos ON, Hernandez-Pando R, Ibarra-Rubio ME, Pedraza-Chaverri J. Aged garlic extract attenuates gentamicin induced renal damage and oxidative stress in rats. Life Sciences. 2003;73(20):2543-2556.

Maldonado PD, Chanez-Cardenas ME, Pedraza-Chaverri J. Aged garlic extract, garlic powder extract, S-allylcysteine, diallyl sulfide and diallyl disulfide do not interfere with the antibiotic activity of gentamicin. Phytotherapy Research. 2005;19(3):252-254.

Malekzadeh F, Rose C, Ingvar C, Jernstrom H. Natural remedies and hormone preparations--potential risk for breast cancer patients. A study surveys the use of agents which possibly counteract with the treatment. [Article in Swedish] Lakartidningen. 2005;102(44):3226-3228 and 3230-3231.

Mansoor GA. Herbs and alternative therapies in the hypertension clinic. American Journal of Hypertension. 2001;14(9 Pt 1):971-975.

Markowitz JS, Devane CL, Chavin KD, Taylor RM, Ruan Y, Donovan JL. Effects of garlic (Allium sativum L.) supplementation on cytochrome P450 2D6 and 3A4 activity in healthy volunteers. Clinical Pharmacology and Therapeutics. 2003;74(2):170-177.

Matsuura H. Saponins in garlic as modifiers of the risk of cardiovascular disease. Journal of Nutrition. 2001;131(Suppl 3):1000S-1005S.

Matsuura N, Miyamae Y, Yamane K, et al. Aged garlic extract inhibits angiogenesis and proliferation of colorectal carcinoma cells. Journal of Nutrition. 2006;136(3 Suppl):842S-846S.

McCrindle BW, Helden E, Conner WT. Garlic extract therapy in children with hypercholesterolemia. Archives of Pediatric and Adolescent Medicine. 1998;152(11):1089-1094.

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;6(3):249-253.

Mennella JA, Johnson A, Beauchamp GK. Garlic ingestion by pregnant women alters the odor of amniotic fluid. Chemistry and the Senses. 1995;20(2):207-209.

Mills E, Montori V, Perri D, Phillips E, Koren G. Natural health product-HIV drug interactions: a systematic review. International Journal of STD and AIDS. 2005;16(3):181-186.

Milner JA. Preclinical perspectives on garlic and cancer. Journal of Nutrition. 2006;136(3 Suppl):827S-831S.

Miron T, Mironchik M, Mirelman D, Wilchek M, Rabinkov A. Inhibition of tumor growth by a novel approach: in situ allicin generation using targeted alliinase delivery. Molecular Cancer Therapy. 2003;2(12):1295-1301.

Miron T, Wilchek M, Sharp A, et al. Allicin inhibits cell growth and induces apoptosis through the mitochondrial pathway in HL60 and U937 cells. Journal of Nutritional Biochemistry. Epublished ahead of print. December 20, 2007.

Modak M, Dixit P, Londhe J, Ghaskadbi S, Paul A Devasagayam T. Indian herbs and herbal drugs used for the treatment of diabetes. Journal of Clinical Biochemistry and Nutrition. 2007 ;40(3):163-173.

Morcos NC, Camilo K. Acute and chronic toxicity study of fish oil and garlic combination. International Journal of Vitamin and Nutrition Research. 2001;71(5):306-312.

Morelli V, Zoorob RJ. Alternative therapies: Part II. Congestive heart failure and hypercholesterolemia. American Family Physician. 2000;62(6):1325-1330.

Morihara N, Nishihama T, Ushijima M, Ide N, Takeda H, Hayama M. Garlic as an anti-fatigue agent. Molecular Nutrition and Food Research. 2007;51(11):1329-1334.

Morihara N, Sumioka I, Ide N, Moriguchi T, Uda N, Kyo E. Aged garlic extract maintains cardiovascular homeostasis in mice and rats. Journal of Nutrition. 2006;136(3 Suppl):777S-781S.

Mousa AS, Mousa SA. Anti-angiogenesis efficacy of the garlic ingredient alliin and antioxidants: role of nitric oxide and p53. Nutrition and Cancer. 2005;53(1):104-110.

Mukherjee S, Banerjee SK, Maulik M, Dinda AK, Talwar KK, Maulik SK. Protection against acute Adriamycin-induced cardiotoxicity by garlic: Role of endogenous antioxidants and inhibition of TNF-alpha expression. BMC Pharmacology. 2003;3(1):16.

Nagini S. Cancer chemoprevention by garlic and its organosulfur compounds-panacea or promise? Anticancer Agents and Medical Chemistry. 2008;8(3):313-321.

Natural Medicines Comprehensive Database, Online Edition. Pharmacist's Letter/Prescriber's Letter. Stockton CA: Therapeutic Research Facility, 2006. Available at: http://www.pharmacistsletter.com/(S(ulqz3s45omt3ag55um4kj345))/home.aspx?li=1&st=1&cs=&s=ND.

Neil HA, Silagy CA, Lancaster T, et al. Garlic powder in the treatment of moderate hyperlipidaemia: a controlled trial and meta-analysis. Journal of the Royal College of Physicians London.1996;30(4):329-334.

Ngo SN, Williams DB, Cobiac L, Head RJ. Does garlic reduce risk of colorectal cancer? A systematic review. Journal of Nutrition. 2007;137(10):2264-2269.

O'Gara EA, Hill DJ, Maslin DJ. Activities of garlic oil, garlic powder, and their diallyl constituents against Helicobacter pylori. Applied and Environmental Microbiology. 2000;66(5):2269-2273.

Ohnishi ST, Ohnishi T. In vitro effects of aged garlic extract and other nutritional supplements on sickle erythrocytes. Journal of Nutrition. 2001;131(Suppl 3):1085S-1092S.

Orekhov AN, Grunwald J. Effects of garlic on atherosclerosis. Nutrition. 1997;13(7-8):656-663.

Pal R, Vaiphei K, Sikander A, Singh K, Rana SV. Effect of garlic on isoniazid and rifampicin-induced hepatic injury in rats. World Journal of Gastroenterology. 2006;12(4):636-639.

Patya M, Zahalka MA, Vanichkin A, et al. Allicin stimulates lymphocytes and elicits an antitumor effect: a possible role of p21(ras). International Immunology. 2004;16(2):275-281.

Pedraza-Chaverri J, Maldonado PD, Barrera D, Ceron A, Medina-Campos ON, Hernandez-Pando R. Protective effect of diallyl sulfide on oxidative stress and nephrotoxicity induced by gentamicin in rats. Molecular and Cellular Biochemistry. 2003;254(1-2):125-130.

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. Israel Medical Association Journal. 2003;5(9):637-640.

Perez-Pimiento AJ, Moneo I, Santaolalla M, de Paz S, Fernandez-Parra B, Dominguez-Lazaro AR. Anaphylactic reaction to young garlic. Allergy. 1999;54(6):626-629.

Pierre S, Crosbie L, Duttaroy AK. Inhibitory effect of aqueous extracts of some herbs on human platelet aggregation in vitro. Platelets. 2005;16(8):469-473.

Piscitelli SC, Burstein AH, Welden N, Gallicano KD, Falloon J. The effect of garlic supplements on the pharmacokinetics of saquinavir. Clinical Infectious Diseases. 2002;34(2):234-238.

Pittler MH, Ernst E. Complementary therapies for peripheral arterial disease: systematic review. Atherosclerosis. 2005;181(1):1-7.

Pittler MH, Ernst E. Clinical effectiveness of garlic (Allium sativum). Molecular Nutrition and Food Research. 2007;51(11):1382-1385.

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;57(4):279-280.

Prager-Khoutorsky M, Goncharov I, Rabinkov A, Mirelman D, Geiger B, Bershadsky AD. Allicin inhibits cell polarization, migration and division via its direct effect on microtubules. Cell Motility Cytoskeleton. 2007;64(5):321-337.

Rafaat M, Leung AK. Garlic burns. Pediatric Dermatology. 2000;17(6):475-476.

Rahman K. Effects of garlic on platelet biochemistry and physiology. Molecular Nutrition and Food Research. 2007;51(11):1335-1344.

Rahman K, Lowe GM. Garlic and cardiovascular disease: a critical review. Journal of Nutrition. 2006;136(3 Suppl):736S-740S.

Rajan TV, Hein M, Porte P, Wikel S. A double-blinded, placebo-controlled trial of garlic as a mosquito repellant: a preliminary study. Medical and Veterinary Entomology. 2005;19(1):84-89.

Rassoul F, Salvetter J, Reissig D, Schneider W, Thiery J, Richter V. The influence of garlic (Allium sativum) extract on interleukin 1alpha-induced expression of endothelial intercellular adhesion molecule-1 and vascular cell adhesion molecule-1. Phytomedicine. 2006;13(4):230-235.

Rivera JO, Hughes HW, Stuart AG. Herbals and asthma: usage patterns among a border population. Annals of Pharmacotherapy. 2004;38(2):220-225.

Roxas M, Jurenka J. Colds and influenza: a review of diagnosis and conventional, botanical, and nutritional considerations. Alternative Medicine Review. 2007;12(1):25-48.

Sabitha P, Adhikari PM, Shenoy SM, et al. Efficacy of garlic paste in oral candidiasis. Tropical Doctor. 2005;35(2):99-100.

Sasaki J, Kita J. Bacteriocidal activity of garlic powder against Bacillus anthracis. Journal of Nutrition Science and Vitaminology (Tokyo). 2003;49(4):297-299.

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. Journal of the Medical Association of Thailand. 2003;86(8):750-757.

Scharbert G, Kalb ML, Duris M, Marschalek C, Kozek-Langenecker SA. Garlic at dietary doses does not impair platelet function. Anesthesia and Analgesia. 2007;105(5):1214-1218.

Scoot-Hartland B. Common alternative therapies: garlic. Gay Men's Health Crisis Treatment Issues.1993/1994;7(11/12).

Sener G, Sehirli AO, Ipci Y, Cetinel S, Cikler E, Gedik N. Chronic nicotine toxicity is prevented by aqueous garlic extract. Plant Foods in Human Nutrition. 2005;60(2):77-86.

Sharifi AM, Darabi R, Akbarloo N. Investigation of antihypertensive mechanism of garlic in 2K1C hypertensive rat. Journal of Ethnopharmacology. 2003;86(2-3):219-224.

Shukla Y, Kalra N. Cancer chemoprevention with garlic and its constituents. Cancer Letters. 2007;247(2):167-181.

Silagy C, Neil A. Garlic as a lipid lowering agent--a meta-analysis.Journal of the Royal College of Physicians London.1994;28(1):39-45.

Silagy CA, Neil HA. A meta-analysis of the effect of garlic on blood pressure. Journal of Hypertension. 1994;12(4):463-468.

Simons LA, Balasubramaniam S, von Konigsmark M, Parfitt A, Simons J, Peters W. On the effect of garlic on plasma lipids and lipoproteins in mild hypercholesterolemia. Atherosclerosis. 1995;113(2):219-225.

Sivam GP. Protection against Helicobacter pylori and other bacterial infections by garlic. Journal of Nutrition. 2001;131(Suppl 3):1106S-1108S.

Snell SB. Garlic on the baby's breath. Lancet. 1973;2(7819):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 Diabetologica. 2008;45(1):1-6.

Song K, Milner JA. The influence of heating on the anticancer properties of garlic. Journal of Nutrition. 2001;131(Suppl 3):1054S-1057S.

Sonnichsen AC, Donner-Banzhoff N, Baum E. Food-drug interactions: an underestimated risk [Article in German] MMW Fortschr Med. 2005;147(44):31-34.

Spigelski D, Jones PJ. Efficacy of garlic supplementation in lowering serum cholesterol levels. Nutrition Reviews. 2001;59(7):236-241.

Staba EJ, Lash L, Staba JE. A commentary on the effects of garlic extraction and formulation on product composition. Journal of Nutrition. 2001;131(Suppl 3):1118S-1119S.

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. American Journal of Clinical Nutrition. 1996;64(6):866-870.

Steiner M, Li W. Aged garlic extract, a modulator of cardiovascular risk factors: a dose-finding study on the effects of AGE on platelet functions. Journal of Nutrition. 2001;131(Suppl 3):980S-984S.

Steiner M, Lin RS. Changes in platelet function and susceptibility of lipoproteins to oxidation associated with administration of aged garlic extract. Journal of Cardiovascular Pharmacology. 1998;31(6):904-908.

Steinmetz KA, Kushi LH, Bostick RM, Folsom AR, Potter JD. Vegetables, fruit, and colon cancer in the Iowa Women's Health Study. American Journal of Epidemiology. 1994;139(1):1-15.

Stevinson C, Pittler MH, Ernst E. Garlic for treating hypercholesterolemia. A meta-analysis of randomized clinical trials. Annals of Internal Medicine. 2000;133(6):420-429.

Stjernberg L, Berglund J. Garlic as a tick repellent. Journal of the American Medical Association. 2001;285(1):41-42.

Stjernberg L, Berglund J. Garlic as an insect repellent. Journal of the American Medical Association. 2000;284(7):831.

Sundaresan S, Subramanian P. Prevention of N-nitrosodiethylamine-induced hepatocarcinogenesis by S-allylcysteine. Molecular and Cellular Biochemistry. 2008;310(1-2):209-214.

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). Journal of the American College of Cardiology. 2000;35(2):321-326.

Takasu J, Uykimpang R, Sunga M, Amagase H, Niihara Y. Aged garlic extract therapy for sickle cell anemia patients. BMC Blood Disorders. 2002;2(1):3.

Tanaka S, Haruma K, Yoshihara M, et al. Aged garlic extract has potential suppressive effect on colorectal adenomas in humans. Journal of Nutrition. 2006;136(3 Suppl):821S-826S.

Tang JL, Armitage JM, Lancaster T, Silagy CA, Fowler GH, Neil HA. Systematic review of dietary intervention trials to lower blood total cholesterol in free-living subjects. British Medical Journal. 1998;316(7139):1213-1220.

Tattelman E. Health effects of garlic. American Family Physician. 2005;72(1):103-106.

Tessema B, Mulu A, Kassu A, Yismaw G. An in vitro assessment of the antibacterial effect of garlic (Allium sativum) on bacterial isolates from wound infections. Ethiopian Medical Journal. 2006;44(4):385-389.

Thomson M, Al-Qattan KK, Bordia T, Ali M. Including garlic in the diet may help lower blood glucose, cholesterol, and triglycerides. Journal of Nutrition. 2006;136(3 Suppl):800S-802S.

Tilli CM, Stavast-Kooy AJ, Vuerstaek JD, et al. The garlic-derived organosulfur component ajoene decreases basal cell carcinoma tumor size by inducing apoptosis. Archives of Dermatology Research. 2003;295(3):117-123.

Toulah FH, Al-Rawi MM. Efficacy of garlic extract on hepatic coccidiosis in infected rabbits (Oryctolagus cuniculus): histological and biochemical studies. Journal of the Egyptian Society of Parasitology. 2007;37(3):957-968.

Tsao SM, Hsu CC, Yin MC. Garlic extract and two diallyl sulphides [sic] inhibit methicillin-resistant Staphylococcus aureus infection in BALB/cA mice. Journal of Antimicrobial Chemotherapy. 2003;52(6):974-980.

Ulbricht CE. Herbs and supplements for the secondary prevention of cardiovascular disease. Pharmacy Practice News. 2004;31(4):32-36.

Velmurugan B, Bhuvaneswari V, Nagini S. Effect of S-allylcysteine on oxidant-antioxidant status during N-methyl-N'-nitro-N-nitrosoguanidine and saturated sodium chloride-induced gastric carcinogenesis in Wistar rats. Asia Pacific Journal of Clinical Nutrition. 2003;12(4):488-494.

Vimal V, Devaki T. Hepatoprotective effect of allicin on tissue defense system in galactosamine/endotoxin challenged rats. Journal of Ethnopharmacology. 2004;90(1):151-154.

Vorberg G, Schneider B. Therapy with garlic: results of a placebo-controlled, double-blind study. British Journal of Clinical Practice. Supplement. 1990;69:7-11.

Warshafsky S, Kamer RS, Sivak SL. Effect of garlic on total serum cholesterol. A meta-analysis. Annals of Internal Medicine. 1993;119(7 Pt 1):599-605.

Weiss N, Ide N, Abahji T, Nill L, Keller C, Hoffmann U. Aged garlic extract improves homocysteine-induced endothelial dysfunction in macro- and microcirculation. Journal of Nutrition. 2006;136(3 Suppl):750S-754S.

Wong K. Malaria and cancer cells yield to the same garlic compounds. November 14, 2001. Scientific American. Available at: http://213.276.1.196:800/Default/www.sciam.com/news/111401/1.html2136.1.196:800/Default/www.sciam.com/news/111401/1.html Accessed December 31, 2002.

Wongmekiat O, Thamprasert K. Investigating the protective effects of aged garlic extract on cyclosporin-induced nephrotoxicity in rats. Fundamental Clinical Pharmacology. 2005;19(5):555-562.

Yeh YY, Liu L. Cholesterol-lowering effects of garlic extracts and organosulfur compounds: human and animal studies. Journal of Nutrition. 2001;131(Suppl 3):989S-993S.

Yeh YY, Yeh SM. Homocysteine-lowering action is another potential cardiovascular protective factor of aged garlic extract. Journal of Nutrition. 2006;136(3 Suppl):745S-749S.

You WC, Blot WJ, Chang YS, et al. Allium vegetables and reduced risk of stomach cancer. Journal of the National Cancer Institute. 1989;81(2):162-164.

You WC, Brown LM, Zhang L, et al. Randomized double-blind factorial trial of three treatments to reduce the prevalence of precancerous gastric lesions. Journal of the National Cancer Institute. 2006;98(14):974-983.

You WC, Zhang L, Gail MH, et al. Helicobacter pylori infection, garlic intake and precancerous lesions in a Chinese population at low risk of gastric cancer. International Journal of Epidemiology. 1998;27(6):941-944.

Yu FL, Bender W, Fang Q, Ludeke A, Welch B. Prevention of chemical carcinogen DNA binding and inhibition of nuclear RNA polymerase activity by organosulfur compounds as the possible mechanisms for their anticancer initiation and proliferation effects. Cancer Detection and Prevention. 2003;27(5):370-379.

Yuncu M, Eralp A, Celik A. Effect of aged garlic extract against methotrexate-induced damage to the small intestine in rats. Phytotherapy Research. 2006;20(6):504-510.

Zahid Ashraf M, Hussain ME, Fahim M. Antiatherosclerotic effects of dietary supplementations of garlic and turmeric: Restoration of endothelial function in rats. Life Sciences. 2005;77(8):837-57.

Zhang L, Gail MH, Wang YQ, et al. 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. American Journal of Clinical Nutrition. 2006;84(4):912-919.

Zhou S, Gao Y, Jiang W, Huang M, Xu A, Paxton JW. Interactions of herbs with cytochrome P450. Drug Metabolism Review. 2003;35(1):35-98.

Last Revised April 11, 2008

Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.

In general, herbal products are not subject to review or approval by the U.S. Food and Drug Administration (FDA). They are not required to be standardized, meaning that the amounts of active ingredients or contaminants they contain may vary between brands or between different batches of the same brand. Not all of the risks, side effects, or interactions associated with the use of herbal products are known because few reliable studies of their use in humans have been done.

This information is provided for your education only. Please share this information with your healthcare provider and be sure that you talk to your doctor and pharmacist about all the prescription and non-prescription medicines you take before you begin to use any herbal product.

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