Garlic Supplements

October 19, 2012 Written by JP       [Font too small?]

The issue of garlic supplementation is clouded by seemingly contradictory research. For instance, a current summary article in the esteemed Cochrane Database of Systematic Reviews concluded that “evidence currently available is insufficient to determine whether garlic provides a therapeutic advantage versus placebo in terms of reducing the risk of cardiovascular morbidity and mortality”. A separate meta-analysis in the journal Science of Food and Agriculture notes that, in general, garlic consumption reduces total cholesterol and triglycerides. However, differences may be apparent based on the form of garlic used: aged garlic, garlic oil or powdered garlic. Nevertheless, the concluding remark of the latter review states that these effects “should benefit patients with risk of cardiovascular diseases”.

On occasion, I recommend garlic supplements to my clients. In the majority of instances, I opt for aged garlic extracts (AGE). In recent years the preponderance of positive research on garlic has been based on AGE. In fact, several studies published within the last year alone reveal that AGE: a) possesses potent antioxidant activity which may “reduce the risk of stroke and neurodegenerative damage”; b) reduces cold and flu incidence and severity by enhancing immune cell function; c) lowers cardiovascular risk factors (decreased arterial calcium build up, systemic inflammation and improved vascular elasticity) when combined with CoEnzyme Q10 (120 mg/day) and/or exercise. The dosage of aged garlic extract used in most of the research ranged from 1,200 mg to 2,560 mg daily.

Of late, three other studies have employed un-aged garlic supplements with notable results. The first reports that the use of twice daily garlic tablets modulate a pro-inflammatory cytokine (tumor necrosis factor alpha or TNF-a) in postmenopausal women with osteoporosis. This may be of importance because excess inflammation can contribute to the loss of bone density. The second trial utilized a popular garlic supplement known as KWAI. The findings of that intervention indicate that using KWAI alongside a conventional diabetic medication (Metformin) improves various markers of cardiometabolic health including: a greater reduction in fasting blood sugar, LDL (“bad”) and total cholesterol while markedly increasing HDL (“good”) cholesterol. However, it’s important to note that not all garlic research turns up smelling like a rose. The third and final study involved an analysis of garlic supplementation in female patients living with HIV. Combining garlic with standard care failed to produce beneficial effects in relation to immune function (CD4+ cell counts) or HIV viral load.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Click on the following links to learn more about the studies referenced in today’s column:

Study 1 - Garlic for the Prevention of Cardiovascular Morbidity and Mortality (link)

Study 2 - A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials(link)

Study 3 - The Antioxidant Mechanisms Underlying the Aged Garlic Extract (link)

Study 4 - Supplementation w/ Aged Garlic Extract Improves Both NK and γδ-T Cell (link)

Study 5 - Aged Garlic Extract and Coenzyme Q10 Have Favorable Effect on (link)

Study 6 – Beneficial Effects of Aged Garlic Extract and Coenzyme Q10 on Vascular (link)

Study 7 – Independent Beneficial Effects of Aged Garlic Extract Intake w/ Regular (link)

Study 8 - The Effect of Garlic Tablet on Pro-inflammatory Cytokines in (link)

Study 9 - Garlic (Allium sativum) Supplementation w/ Standard Antidiabetic Agent (link)

Study 10 - Short-term Garlic Supplementation and Highly Active Antiretroviral (link)

Aged Garlic Extract (AGE) May Protect Against Degenerative Diseases

Source: Oxidative Medicine and Cellular Longevity Volume 2012 (link)

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Posted in Food and Drink, Heart Health, Nutritional Supplements

7 Comments & Updates to “Garlic Supplements”

  1. JP Says:

    Update 07/13/15:

    J Int Soc Sports Nutr. 2015 May 14;12:23.

    The effects of acute garlic supplementation on the fibrinolytic and vasoreactive response to exercise.

    BACKGROUND: The purpose of this project was to examine the effects of acute garlic supplementation on fibrinolysis and vasoreactivity both at rest and following maximal exercise.

    METHODS: Eighteen healthy trained males (20.9 ± 2.2 years, 178 ± 7.7 cm, 75.5 ± 9.6 kg, VO2max = 59.8 ± 6.7 ml • kg(-1) • min(-1)) performed a graded treadmill test to volitional exhaustion. Blood samples were taken at rest, within two minutes post-exercise, and one hour post-exercise. Eleven of the subjects also had a brachial vasoreactivity test performed immediately after the blood sample to assess flow-mediated dilation (FMD) of the brachial artery. Participants were randomly assigned to ingest either 900 mg of powdered garlic or a placebo three hours before the exercise session. The supplement was distributed in a double-blind, crossover fashion. Participants repeated the protocol with the other treatment after a 14-day washout period. Paired t-tests were used to compare VO2max between the two trials. A two-factor (treatment and time) repeated measures analysis of variance (ANOVA) was used to assess changes in FMD, tPA activity, tPA antigen, and PAI-1 activity. A priori statistical significance was set at P <0.05.

    RESULTS: VO2max was greater for the garlic treatment trial vs. placebo (Placebo = 59.8 ± 6.7 ml • kg(-1) • min(-1); Garlic = 61.4 ± 6.6 ml • kg(-1) • min(-1)). There was no main effect for treatment and no treatment x time interaction for FMD or any fibrinolytic variables examined.

    CONCLUSION: Acute garlic supplementation does not alter vasoreactivity, fibrinolytic potential or the fibrinolytic response to exercise in young healthy trained males. Acute garlic supplementation does, however, cause a small but statistically significant increase in VO2max. It remains unclear if this increase in VO2max is of functional importance.

    Be well!


  2. JP Says:

    Update 07/13/15:

    Int J Cardiol. 2013 Oct 3;168(3):2310-4.

    Aged garlic extract with supplement is associated with increase in brown adipose, decrease in white adipose tissue and predict lack of progression in coronary atherosclerosis.

    BACKGROUND: Aged garlic extract with supplement (AGE-S) significantly reduces coronary artery calcium (CAC). We evaluated the effects of AGE-S on change in white (wEAT) and brown (bEAT) epicardial adipose tissue, homocysteine and CAC.

    METHODS: Sixty subjects, randomized to a daily capsule of placebo vs. AGE-S inclusive of aged garlic-extract (250 mg) plus vitamin-B12 (100 μg), folic-acid (300 μg), vitamin-B6 (12.5mg) and L-arginine (100mg) underwent CAC, wEAT and bEAT measurements at baseline and 12 months. The postcuff deflation temperature-rebound index of vascular function was assessed using a reactive-hyperemia procedure. Vascular dysfunction was defined according to the tertiles of temperature-rebound at 1 year of follow-up. CAC progression was defined as an annual-increase in CAC>15%.

    RESULTS: From baseline to 12 months, there was a strong correlation between increase in wEAT and CAC (r(2)=0.54, p=0.0001). At 1 year, the risks of CAC progression and increased wEAT and homocysteine were significantly lower in AGE-S to placebo (p<0.05). Similarly, bEAT and temperature-rebound were significantly higher in AGE-S as compared to placebo (p<0.05). Strong association between increase in temperature-rebound and bEAT/wEAT ratio (r(2)=0.80, p=0.001) was noted, which was more robust in AGE-S. Maximum beneficial effect of AGE-S was noted with increase in bEAT/wEAT ratio, temperature-rebound, and lack of progression of homocysteine and CAC.

    CONCLUSIONS: AGE-S is associated with increase in bEAT/wEAT ratio, reduction of homocysteine and lack of progression of CAC. Increases in bEAT/wEAT ratio correlated strongly with increases in vascular function measured by temperature-rebound and predicted a lack of CAC progression and plaque stabilization in response to AGE-S.

    Be well!


  3. JP Says:

    Update 07/13/15:

    Eur J Clin Nutr. 2013 Jan;67(1):64-70.

    Aged garlic extract reduces blood pressure in hypertensives: a dose-response trial.

    BACKGROUND/OBJECTIVES: Hypertension affects about 30% of adults worldwide. Garlic has blood pressure-lowering properties and the mechanism of action is biologically plausible. Our trial assessed the effect, dose-response, tolerability and acceptability of different doses of aged garlic extract as an adjunct treatment to existing antihypertensive medication in patients with uncontrolled hypertension.

    SUBJECTS/METHODS: A total of 79 general practice patients with uncontrolled systolic hypertension participated in a double-blind randomised placebo-controlled dose-response trial of 12 weeks. Participants were allocated to one of three garlic groups with either of one, two or four capsules daily of aged garlic extract (240/480/960 mg containing 0.6/1.2/2.4 mg of S-allylcysteine) or placebo. Blood pressure was assessed at 4, 8 and 12 weeks and compared with baseline using a mixed-model approach. Tolerability was monitored throughout the trial and acceptability was assessed at 12 weeks by questionnaire.

    RESULTS: Mean systolic blood pressure was significantly reduced by 11.8±5.4 mm Hg in the garlic-2-capsule group over 12 weeks compared with placebo (P=0.006), and reached borderline significant reduction in the garlic-4-capsule group at 8 weeks (-7.4±4.1 mm Hg, P=0.07). Changes in systolic blood pressure in the garlic-1-capsule group and diastolic blood pressure were not significantly different to placebo. Tolerability, compliance and acceptability were high in all garlic groups (93%) and highest in the groups taking one or two capsules daily.

    CONCLUSIONS: Our trial suggests aged garlic extract to be an effective and tolerable treatment in uncontrolled hypertension, and may be considered as a safe adjunct treatment to conventional antihypertensive therapy.

    Be well!


  4. JP Says:

    Updated 08/12/15:

    Neurochem Int. 2015 Jun 26.

    On the antioxidant, neuroprotective and anti-inflammatory properties of S-allyl cysteine: An update.

    Therapeutic approaches based on isolated compounds obtained from natural products to handle central and peripheral disorders involving oxidative stress and inflammation are more common nowadays. The validation of nutraceutics vs. pharmaceutics as tools to induce preventive and protective profiles in human health alterations is still far of complete acceptance, but the basis to start more solid experimental and clinical protocols with natural products has already begun. S-allyl cysteine (SAC) is a promising garlic-derived organosulfur compound exhibiting a considerable number of positive actions in cell models and living systems. An update, in the form of review, is needed from time to time to get access to the state-of-the-art on this topic. In this review we visited recent and refreshing evidence of new already proven and potential targets to explain the benefits of using SAC against toxic and pathological conditions. The broad spectrum of protective actions covered by this molecule comprises antioxidant, redox modulatory and anti-inflammatory activities, accompanied by anti-apoptotic, pro-energetic and signaling capacities. Herein, we detail the evidence on these aspects to provide the reader a more complete overview on the promising aspects of SAC in research.

    Be well!


  5. JP Says:

    Updated 08/12/15:

    Jundishapur J Microbiol. 2015 May 31;8(5):e14814.

    Fresh Garlic Extract Enhances the Antimicrobial Activities of Antibiotics on Resistant Strains in Vitro.

    BACKGROUND: Infections caused by strains with multi-drug resistance are difficult to treat with standard antibiotics. Garlic is a powerful remedy to protect against infections of many bacteria, fungi and viruses. However, little is known about the potentials of fresh garlic extract (FGE) to improve the sensitivity of multi-drug resistant strains to antibiotics.

    OBJECTIVES: In this study, we used the disk diffusion method to investigate the antimicrobial activities of FGE and the combination of antibiotics with FGE, on methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa and Candida albicans, to evaluate the interactions between antibiotics and FGE.

    MATERIALS AND METHODS: Clinical isolates were isolated from clinical specimens obtained from the inpatients at the First Affiliated Hospital of Xi’an Jiaotong University Health Science Center. The isolates consisted of MRSA, (n = 30), C. albicans (n = 30) and P. aeruginosa (n = 30). Quality control for CLSI (Clinical and Laboratory Standards Institute) disk diffusion was performed using S. aureus ATCC®25923, C. albicans ATCC®90028 and P. aeruginosa ATCC®27853. The 93 microorganisms were divided into four groups in a factorial design: control (deionized water), FGE, antibiotics without FGE, and antibiotics with FGE. Next, antibacterial activity was evaluated by measuring the diameter of inhibition zones according to performance standards for antimicrobial susceptibility testing of the Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS).

    RESULTS: Fresh garlic extract displayed evident inhibition properties against C. albicans and MRSA, yet weak inhibition properties against P. aeruginosa. Additionally, FGE showed the potential to improve the effect of antibiotics on antibiotic resistant pathogens. The synergism of fluconazole and itraconazole with FGE on C. albicans yielded larger sized inhibition zones compared with fluconazole and itraconazole without FGE (P < 0.01). The factorial analysis represents intense positive interaction effects (P < 0.01). The synergism of cefotaxime and ceftriaxone with FGE on P. aeruginosa yielded larger sized inhibition zones than cefotaxime and ceftriaxone without FGE (P < 0.01). The factorial analysis represents intense positive interaction effects (P < 0.01).

    CONCLUSIONS: The results suggest that FGE can improve the antibiotic sensitivity of these pathogens to some antibiotics.

    Be well!


  6. JP Says:

    Updated 08/12/15:

    J Clin Biochem Nutr. 2015 May;56(3):179-85.

    Therapeutic administration of an ingredient of aged-garlic extracts, S-allyl cysteine resolves liver fibrosis established by carbon tetrachloride in rats.

    S-allyl cysteine (SAC) is the most abundant compound in aged garlic extracts (AGEs). AGE has been reported to ameliorate the oxidative damage implicated in a variety of diseases. However, the effects of SAC have not been established in liver cirrhosis. The aim of this study was to examine the effect of therapeutic administration of SAC in liver cirrhosis by chronic carbon tetrachloride (CCl4) administration in rats. SAC or other cysteine compounds were administered from 4 weeks when liver fibrosis was confirmed to be in process. CCl4 administration elevated plasma alanine aminotransferase, plasma lipid peroxidation, liver hydroxyproline, and liver transforming growth factor (TGF)-β at 12 weeks. SAC prevented these changes induced by CCl4. Furthermore, SAC improved survival in a dose-dependent manner following consecutive CCl4 administration. The inhibitory mechanisms may be associated with a decrease in the profibrogenic cytokine, TGF-β as well as the antioxidative properties of SAC.

    Be well!


  7. JP Says:

    Updated 11/11/15:

    Singapore Med J. 2015 Oct;56(10):567-72.

    Comparison of the therapeutic effects of Garcin(®) and fluconazole on Candida vaginitis.

    INTRODUCTION: This study aimed to determine and compare the effects of garlic tablets (Garcin(®)) and fluconazole on Candida vaginitis in women who presented to a health centre in Koohdasht, Iran, from August 2011 to March 2012.

    METHODS: The clinical trial was conducted on 110 married women (aged 18-44 years) who had complaints of itching or a burning sensation in the vaginal area. Candida vaginitis was diagnosed by pH measurement of vaginal secretions, direct microscopic evaluation and Sabouraud dextrose agar cultures of the vaginal discharge. On confirmation of diagnosis, the patients were randomly divided into two groups (n = 55). One group received 1,500 mg of Garcin tablets daily and the other received fluconazole tablets 150 mg daily, over a period of seven days. Four to seven days after the completion of treatment, patients were examined for treatment response and possible side effects.

    RESULTS: Complaints related to the disease improved by about 44% in the Garcin group and 63.5% in the fluconazole group (p < 0.05). The overall symptoms of the disease (i.e. redness of vulva and vagina, cheesy discharge, pustulopapular lesions and abnormal cervix) improved by about 60% in the Garcin group and 71.2% in the fluconazole group (p > 0.05). Results of microscopic evaluation and vaginal discharge culture showed significant differences before and after intervention in both groups (p < 0.05).

    CONCLUSION: The present study shows that Garcin tablets could be a suitable alternative to fluconazole for the treatment of Candida vaginitis.

    Be well!


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