Garlic is gaining increasing popularity as a nutritional supplement, especially in odorless capsule form, although extracts and powders are used often for therapeutic administration .
One of garlic's primary therapeutic properties is a powerful antimicrobial effect. It is antibiotic, antifungal, and antiviral. It inhibits most common infectious agents, from Staphylococcus and Streptococcus to Candida albicans and the influenza viruses. In one remarkable trial it was effective even against clinical cryptococcal meningitis.
Garlic lowers cholesterol levels, helping prolong the effectiveness of arthritis treatments. It inhibits platelet aggregation; and it displays reliable fibrinolytic and hypotensive properties. All of these effects lead to improved cardiovascular health.
Another basic quality of garlic is its ability to affect the course of bronchial infections and asthmatic conditions. Garlic lowers blood sugar, or at least prevents its rise, in diabetic conditions. It has demonstrated various other effects as well, including anti-toxic, anti-cancer, and anthelmintic actions.
Method of Action
The main active principle of garlic was at first believed to be allicin.
However, other sulfurous chemicals, similar to allicin, are now credited with the beneficial effects.
This has ended the debate regarding the effectiveness of odor-free garlic because of the chemical alteration of the product required to remove the odor. If allicin were the odor-causing component responsible for the benefits; by eliminating it from odorless garlic supplements, it would necessarily be inoffensive but also ineffective.
Several recent studies have asserted that allicin is deactivated within the body and cannot reach target organs. Further investigation is required to identify the active principles derived from garlic.
One court case between manufacturers of different garlic products has led to a statement from the Advertising Standards Authority (February,1995) which gave the following ruling:
"It is the sulphides and not allicin which is the active ingredient of garlic."
In an effort to keep clear of the commercial battle, it did not specify any clear benefit from a specific product whether the form of the product or the type of delivery (capsule/ powder/ oil etc.).
One five-year study conducted in China suggests the herb's effectiveness may be due to a combination of fungistatic and immunologic action. In this study, 16 of 21 cases of cryptococcal meningitis were treated with garlic alone and 5 with garlic and other drugs. Of the 16, 6 were cured and 5 improved, giving an effective rate of 68.75%. In these 11 cases, appetite improved, headache, vomiting and neurologic signs gradually subsided and body temperature returned to normal within 3-4 days of treatment. The researchers conclude garlic is more effective than amphotericin B. It is especially effective in early cases. In the six completely cured cases the duration of illness was less than 2 months.
Several experiments on rats to determine the mode of action showed garlic infusions enhance the phagocytic function of peritoneal macrophages. And in further experiments with humans, they found the rate of macrophage phagocytosis and T and B lymphocyte conversion rates were all raised after garlic therapy.
Crude juices and powdered preparations of garlic are antimicrobial against many gram positive and gram negative organisms, including Escherischia coli, Pseudomonas pyocyaneus, Salmonella typhi and Bacillus subtilis, Brucella abortus, Staphylococcus aureus, Streptococcus viridans, S. haemolyticus, Klebsiella pneumoniae, Proteus vulgaris, Providencia sp., Citrobacer sp., hafnia sp., Aermonas sp. at concentrations as low as 1:125,000.
This activity is probably due to various phytoncides. Many organisms from patients resistant to the most widely used antibiotics and chemotherapeutics were sensitive to garlic preparations. In doses which have no bactericidal effect, these preparations can cause morphological changes in the diptheria bacillus so as to render it nontoxigenic in a titer of 1:1 million. Apparently organisms do not develop any resistance at all to garlic's antimicrobial principles.
Garlic has excellent antimicrobial action
Garlic preparations are equally, if not more, effective against various fungi. Its action against Candida albicans, the organism reportedly responsible for vaginal yeast infection, is noteworthy. In one study, sixty-one yeasts, including 16 strains of C. albicans isolated from vaginal, cervical and buccal swabs of vaginitis patients and from pollinating bees, were subject to a fresh garlic extract. Only two strains of C. albicans were resistant.
In another study, an extract of a dehydrated commercial product was inhibitory and lethal to 22 strains of yeast organisms, including some isolated from clinical sources. This extract was found to be more stable than extracts of fresh garlic.
Chicks infected with C. albicans via oral inoculation, and subsequently fed 2-4% garlic were cured after 10 days, while untreated controls continued to decline instead of showing any improvement. Garlic extract has been shown to be more effective than nystatin, gentian violet, methylene blue, even allicin, against C. albicans and other pathogenic yeasts. This study also demonstrated that garlic is 10-100 times more effective against dermatophytes and yeasts than against bacteria.
Other types of fungi are also inhibited by garlic, including the yeasts Rhodotorula, Torulopsis and Trichosporon. Various species of dermatophytes, including Microsporum canis, M. gypseum, Epidermophyton flocossum, Trichophyton verrucosum, T. violaceum, T. rubum, T. mentagrophytes, and T. schoenleini, are also inhibited. Aspergillus and Penicillin are also susceptible to garlic.
Garlic has antiviral action
In vivo tests on rabbits and guinea pigs, inoculated with M. canis and T. rubrum, showed garlic extract was significantly better than controls in curing lesions caused by these organisms. Garlic extract has also been shown to protect mice from infection with intranasally-inoculated influenza virus, and to enhance the production of neutralizing antibody when given simultaneously with the influenza vaccine.
Intranasal or intramuscular administration of a water extract of garlic to mice infected with influenza virus A/PR8/34 (HIN1) significantly decreased hemagglutinating titer, but did not affect mortality. This prophylactic treatment was followed by a moderate increase in mean survival length. This antiviral effect as potentiated by NaF.
Solutions of phytoncides have been tried clinically for throat spraying in angina. Hyperemia of the glottic region was rapidly reduced and the drop of body temperature was accelerated. The results exceeded what is commonly expected from penicillin. Experiments in treating the grippe by peroral route with alcohol extracts compared well sulfa therapy. Other conditions were also favorably treated, including sciatica, chronic colitis and gastritis, and in reducing whooping cough symptoms.
Garlic is hypocholesterolemic
Garlic appears to have excellent hypocholesterolemic properties. Garlic oil has been shown to prevent fat induced alimentary hyperlipemia in cholesterol fed animals. The method of action is not clear, but since there was increased excretion of bile acids and L.B. sterols in the feces and diminished tissue lipids, it is possible the herb works both through the excretion of cholesterol and products as well as by affecting the endogenous synthesis in liver, kidney and adrenals.
Research on the hypocholesterolemic effect led naturally to studies on the ability of garlic to prevent, treat and cure atherosclerosis. It was found that garlic protects against cholesterol induced atherosclerosis without side effects or toxicity.
In a comparison trial, garlic outperformed clofibrate. The essential oils of onion and garlic equivalent to 1 g/kg/day proved more effective than 33 mg/kg/day (the usual clinical dose) of clofibrate in preventing a rise in serum cholesterol in cholesterol-fed rabbits.
There is some evidence to suggest daily ingestion of garlic over a period of weeks or months will lower serum cholesterol in normal people. A daily dose of 3 grams of raw garlic for a month produced a decrease in serum cholesterol of 29.2 mg%. In animals, garlic fed to normal guinea pigs (1 gm/kg/day) lowered serum cholesterol by 31% after six weeks. And when garlic was fed to cholesterol-induced hyperlipemic rabbits after the diet was stopped, in four weeks it had reduced serum levels by 30%. These findings indicate perhaps garlic can be used to treat atherosclerosis.
Garlic, while preventing rises in serum cholesterol, also prevents atherosclerotic lesions, or atheromata, from appearing. In a demographic study of the Jain community (a vegetarian group) in India, the following findings were made: Jains who ate liberal amounts of garlic and onion daily differed little from those who did not (since no meat was in the diet, this would be expected). However, serum triglycerides, beta lipoproteins, phospholipids and plasma-fibrinogen levels were significantly higher in those persons who did not eat garlic or onion (or did so very infrequently). All subjects were given complete physicals to rule out diabetes mellitus, hypertension and ischeamic heart disease.
In most of the hypocholesterolemic trials, other effects of garlic were observed, including increased fibrolynic activity and inhibition of platelet aggregation. These properties have been addressed directly in further experimental trials.
In one study, 20 healthy individuals and 20 suffering from coronary artery disease with old myocardial infarction were administered essential oil of garlic for a period of 3 months at a dose of 3g/kg/day. Garlic increased fibrinolytic activity by 130% in the healthy subjects and by 83% in the others. In the controls, alpha lipoproteins increased by 31% and beta lipoproteins decreased by 7.5%. No such effect was observed in the experimental group.
In another study, twenty patients of acute myocardial infarction were followed for 40 days with alternate patients receiving either essential oil of garlic (1 gram of raw garlic/kg/day) or placebo during the first 20 days. After 10 and 20 days, garlic increased fibrinolytic activity by 63% and 95.5% respectively (control group increased by 24%).
This boost to the fibrinolytic system began literally within hours after the first administration uring the critical early post-infarction period, whereas spontaneous fibrinolytic recovery did not begin until late in the 3rd week.
Water extracts of garlic have been found to inhibit platelet aggregation induced by ADP, epinephrine, collagen and arachidonate in a dose-dependent manner in vitro. They also inhibit biosynthesis of prostacyclin in rat aorta from labelled arachidonic acid. Garlic inhibits platelet aggregation in human and animal subjects. Antiplatelet inhibitors have been isolated from homogenates of fresh garlic and were shown to inhibit both platelet aggregation and thromboxane synthesis.
The active principle has been called ajoene, a form of allicin. It has been suggested ajoene works by inhibiting fibrinogen receptors on platelets, thereby producing a strong antithrombotic effect. There may an interaction of hydrocarbon, sulfur-oxygen and sulfur-sulfur groups of ajoene with chemically complementary groups on the surface of the platelets which would otherwise bond with fibrinogen. Ajoene has never been detected in any garlic preparation except fresh garlic. It is probably destroyed during processing.
Garlic affects the cardiovascular system in other ways
Garlic has other effects on the cardiovascular system. When rabbits are given 0.015 ml/kg of garlic juice intravenously, they exhibit a decrease in blood pressure persisting for an hour. With a second dose of 0.02 ml/kg the blood pressure decreases and persists for three hours. No side effects are noted. Human influenza patients given a nose spray (ChEMZ) containing garlic, St. Johnswort, mint, eucalyptus and procaine, experience a drop in blood pressure. The active principle is probably methyla allyl trisulfide.
Garlic is useful in bronchial problems
One hundred twenty-two patients with acute pneumonia, aggravated chronic pneumonia or chronic bronchitis were treated with inhalations of garlic juice diluted with physiological saline or a 0.25% solution of procaine. 86.7% of the patients experienced a good or satisfactory result.
Thirty two patients, 16-60 years old, with bronchial asthma and chronic pneumonia were treated with courses of 10-38 inhalations of an aerosol of garlic juice diluted 1:3 with water, either with six drops of euspiran per 2 ml of garlic juice or without it. In 8 of 21 patients garlic with euspiran caused remission in bronchial asthma, improved the variables of pulmonary respiration, and reduced the intensity of the inflammation in the lungs. Garlic with euspiran caused deterioration of the variables of pulmonary respiration and caused coughing and, in some patients, attacks of bronchial asthma.
Using a garlic preparation called "Alliofil" in pediatric patients, it was found oral administration yield good results in cases of recurrent catarrhs of the upper air passages, chronic bronchitis, bronchial asthma in paroxysmal stage, as well as diarrhea in infants and adults. Very good results were also obtained locally especially in skin abscesses and fistula of staphylococcal origin, as well as chronic otitis media. No toxic or side effects were noted. Cellular, anti-cancer, anti-toxic and athelmintic properties. On a cellular level, garlic oil impairs oxidative phosphorylation in hepatic mitochondria. This finding has important implications for the possible use of garlic oil in insecticide preparations, a practice already begun.
In vivo research has found garlic oil enhances the incorporation of (14C) glucose into hepatic glycogen, produces a temporary rise in blood glucose levels and depletes liver glycogen. Renal glycogen levels and incorporation of (14C) glucose into renal glycogen remain unchanged. Oxidative phosphorylation associated with the oxidation of ascorbate into hepatic mitochondria was partially impaired without affecting the P/O ratio during the oxidation of glutamate and succinate. Therefore, in vivo, garlic appears not to interfere significantly with oxidative phosphorylation in hepatic mitochondria, and garlic oil cannot be classified as harmful to mammalian systems.
Preincubation of certain concentrations of enzymatically prepared allicin, from garlic, with tumor cells resulted in complete inhibition of tumor growth. Single or multiple treatments with up to 30 mg of either allicin or alliin per kg of mouse did not produce any consistent and significant tumor inhibition. Garlic extract was also ineffective.
Strain DDD mice immunized with Ehrlich ascites tumor cells, syngeneic tumors, spontaneous tumor of C3H mouse, and 3-methylcholanthrene-induced sarcoma of male DDD mouse, attenuated with fresh garlic extract, showed a resistance against subsequently injected viable tumor cells. A similar action against Ehrlich ascites tumor cells has been demonstrated with garlic sugar solutions.
Administration of garlic to workers demonstrating signs of lead poisoning (elevated porphyrin level in urine and basoplulogranular erythrocytes in the blood) led to a normalization of both hematological shifts and of the porphyrin content in the urine. The hypotensive effect was attributed to a drop in arterial pressure.
Noticed in several studies and directly studied in others is the ability of garlic to lower blood sugar levels. In alloxan-induced diabetic rabbits, garlic extracts had a significant hypoglycemic effect, with the ethyl ether extract being the most potent. The mechanism of action is uncertain. Garlic may potentiate the insulin effect of plasma by increasing either the pancreatic secretion of insulin from the beta cells or its release from bound insulin.
Garlic is also effective in controlling the hyperglycemia produced by glucose feeding.
In another study, orally administered allicin was found to produce hypoglycemic action comparable to tolbutamide in rabbits with mild alloxan diabetes. It significantly improved the serum insulin effect and glucose tolerance as observed with the standard drug tolbutamide. Its effect on liver glycogen synthesis has also been found to be significant. It is postulated that garlic reduces the insulin requirement of diabetics and enhances their serum insulin effect. It may be observed garlic is given as medicine against diabetes in Norway and middle Europe.
Even the anthelmintic property of garlic has received some experimental support. Ether or diluted alcoholic extracts of a maceration of garlic showed similar good anthelmintic properties against Ascaris lumbricoides. The effect was attributed to sulfurous compounds.
Frequent handling of raw garlic can produce contact dermatitis in sensitive or allergic individuals. But the herb is very safe when taken orally.
Therapeutic doses of garlic, which may also coincide with some people's taste in food, are typically in excess of 3 cloves per day. Because of the odor associated with this, many people in modern societies prefer processed capsules, just 1 gm daily.
The use of large amounts of garlic on a continuous basis may partially block the digestion, absorption or resorption of a wide variety of drugs and fat-soluble vitamins.
Garlic may potentiate the effects of oral coumarin anticoagulants, such as warfarin and dicumarol, to the extent it stimulates the liver to catabolize and excrete cholesterol and its by-products via the biliary route.
Cyclopropane or halogenated hydrocarbon anesthetics may sensitize the myocardium to the cardiotonic effects of garlic, although the chances of such happenings are very few. Veratrum alkaloids may potentiate the activity of garlic up to 50%. The hypotensive effect of garlic may be potentiated by anorectic drugs, such as fenfluramine, whose effects are mediated by brainstem 5HT.
Garlic should not be used with methotrimeprazine, a potent CNS-depressant analgesic, and colchicine may increase sensitivity or enhance the response to garlic.
The antituberculous activity of garlic may potentiate the adverse effects of other antituberculous drugs, especially ethionamide. Additive effects may occur between the hypotensive property of garlic and that of dopamine receptor agonists, such as bromocriptine mesylate.
The weak antithrombotic effect of garlic may be increased by concomitant administration of anabolic steroids, antidiabetics, clofibrate, dextrothyroxine, disulfiram, phenlybutazone, salicylates, and thyroid preparations. Other agents which may increase those antithrombotic effects include allopurinol, aminoglycosides, chloramphenicol, ethacrynic acid, and glucagon.
By sequestering garlic, mineral oil may reduce the herb's anthelmintic effect. The same may be true, to a lesser extent, of antacids.
The anti-inflammatory activity of garlic can be seriously inhibited by phenobarbital and certain other sedatives and hypnotics, such as chloral hydrate and meprobamate. This is also true of beta-adrenergic blocking agents, such as propranolol.
To minimize central nervous system depression and possible synergism, it would be wise to avoid using garlic with procarbazine antineoplastic drugs. It should also be noted drugs utilized for the treatment of angina pectoris, such as nadolol and propranolol HCl, may reduce AV conduction induced by garlic.
There is evidence to show combining bactericidal and bacteriostatic agents will lower the effectiveness of the bacteriostatic agent. However, how this finding applies to herbal anti-infectives is still unknown.
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