SupplementModerate evidenceImmunity

Garlic extract (cardiometabolic)

Meta-analysis signal for modest blood pressure and LDL reduction, distinct from the aged-garlic immune use already in the catalogue.

Why

Garlic (Allium sativum) has two distinct evidence streams in routine use. The aged garlic extract preparation has been used most for immune support (separate catalogue entry). For cardiometabolic outcomes, meta-analyses of garlic preparations (powder, aged, oil) report reductions in systolic blood pressure (~7–8 mmHg) in hypertensive patients and modest LDL cholesterol reductions, with aged garlic and standardised garlic powder having the most consistent positive signal.

How it works

Allicin and S-allyl cysteine increase nitric oxide synthase activity and reduce angiotensin-converting enzyme activity, combined effect drops systemic vascular resistance. Inhibits hepatic HMG-CoA reductase and increases cholesterol catabolism to bile acids, modestly lowering LDL.

Expected onset · BP effects over 4–12 weeks; lipid effects over 8–12 weeks

How to take

Dosage

Standardised garlic powder: 600–900 mg/day delivering 3.6–5.4 mg allicin. Aged garlic extract: 600–1,200 mg/day (Kyolic).

Timing

With meals; divided 2–3 times daily

On the label

Standardised garlic powder with stated allicin yield (e.g. Kwai, Garlique) or aged garlic extract (Kyolic). 'Garlic oil' has less consistent trial data.

Ideal for

Adults with mild hypertension or mild dyslipidaemia, particularly those reluctant to start prescription therapy.

Safety

Antiplatelet effect. Stop 2 weeks before surgery, caution with anticoagulants (warfarin, DOACs) and antiplatelets. Reduced plasma levels of saquinavir and some anti-HIV protease inhibitors documented. May lower blood glucose. Monitor in diabetes. Garlic breath, body odour, and GI upset are common at therapeutic doses. Pregnancy: culinary doses fine; therapeutic doses unstudied.

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Evidence

At a glance

Ried 2016 J Nutr meta-analysis (20 RCTs, n=970 hypertensives): garlic preparations reduced systolic BP by 8.7 mmHg and diastolic by 6.1 mmHg vs placebo in hypertensives, magnitude comparable to first-line antihypertensives. Ried 2013 Nutr Rev meta-analysis (39 RCTs): garlic reduced total cholesterol by 0.41 mmol/L and LDL by modest 0.21 mmol/L. EMA classifies the bulb as Traditional Use for mild cardiovascular complaints.

Where to get it

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