FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

[GARLIC HAS SOME BENEFITS, BUT IT'S NO "WONDER DRUG"!]

Question: My husband has had several heart attacks. I give him garlic, both fresh and garlic extract, to help his heart. Is fresh garlic more effective than the odor-free garlic extract capsules in helping the heart?

Answer: Garlic has been recommended for generations by naturopaths and herbalists with the hope of treating and/or preventing a variety of conditions. In the past few years there has been greater acceptance of its use by "mainstream" medical practitioners. The mechanism by which it might promote good health and the exact benefits you should expect from its use are still being debated.

My mother, who was also an osteopathic physician, told me that garlic's primary benefit is in the reduction of heart disease. She believed that you can only derive this benefit by eating large quantities of it on a daily basis. She attributed this herb's health benefits to the resulting "garlic breath" that kept other people from getting close enough to aggravate you, thereby reducing stress and its consequences. Perhaps this is true, but there are also other interesting consequences of eating garlic.

Garlic reportedly reduces the risk of cancer, lowers blood pressure, reduces total cholesterol and raises HDL (the desirable component of cholesterol), helps fight bacterial, viral and fungal infections, and reduces the tendency of blood to form clots. None of these benefits have been repeatedly shown in scientific studies when conducted on widely differing groups of people. Some benefits, however, have been observed in sufficient numbers of studies to make "believers" of some physicians.

The main "ingredient" in garlic is allicin. It is responsible for the "garlic odor" as well as the plant's reported therapeutic effects. Allicin is present in garlic extract, dried garlic and in the fresh plant, so using any form provides the same benefit. The garlic capsule, however, releases the allicin lower in the digestive tract and, thereby, reduces - but not eliminates - the amount of aroma on the breath. One the other hand, it doesn't taste as good as the fresh garlic.

Regular use of 8 mg of allicin daily or eating one clove of fresh garlic provides the effective dose. This may lower the cholesterol modestly, about 9-12 percent. It usually take 2 to 4 months to see these benefits, if you are going to experience them. Garlic can also lower blood pressure as much as 20 mm Hg for the systolic (top number) and 10 - 15 for the diastolic (bottom number).

The specific mechanism by which garlic causes these beneficial changes isn't clear. Its safety, however, is well established. It is consumed by millions - or perhaps billions - of people every day. Like any product, however, garlic may cause some minor problems. It can increase the risk of bleeding for those who take anticoagulants like Coumadin, and it can produce stomach upset in some individuals. The most consistent problem is its characteristic odor - no surprise here!

It is important to remember that garlic isn't a wonder drug. To receive these heart, blood pressure and cholesterol benefits, it must be used in conjunction with a proper diet that has modest restrictions in caffeine, salt, saturated fats and simple sugars.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.