Kyolic® (Aged Garlic Extract — Wakunaga)

Allium sativum
Evidence Level
Moderate
3 Clinical Trials
8 Documented Benefits
3/5 Evidence Score

Kyolic® is the branded aged garlic extract from Wakunaga (Japan) — the aged garlic extract used in most published human trials of this ingredient. That much is checkable and true. The bigger numbers are not: as of August 2026 a PubMed search returns 386 records for aged garlic extract and 20 that name Kyolic directly, so the company figure above 850 is counting laboratory work, animal studies, conference abstracts and non-indexed publications rather than published human trials. The proprietary aging process (20+ months at controlled temperature and humidity) transforms raw garlic's unstable thiosulfinates into stable S-allyl cysteine (SAC) and related water-soluble organosulfur compounds. Standardized to consistent SAC content across batches. The clinical evidence base for aged garlic extract supplementation in cardiovascular health is built primarily on Kyolic® research — including trials on blood pressure and on the progression of arterial calcification. Cholesterol is the exception and it points the other way: the largest and longest trial, a six-month study at Stanford in 192 adults with raised LDL, tested aged garlic extract head to head against raw garlic, powdered garlic and placebo and found no significant effect on LDL, HDL or triglycerides. An older and much smaller crossover trial at a far higher dose did report about a 6 percent fall in total cholesterol, so the picture is mixed rather than uniformly negative, but the most rigorous test of it was negative. The honest framing: Kyolic does have an unusual number of human trials for a branded supplement ingredient, which is real and worth crediting. But nearly all of them are small, they measure surrogate markers such as blood pressure and coronary calcium scores rather than heart attacks or strokes, and nearly every trial with a positive result was funded by the manufacturer or used product the manufacturer supplied. The one large trial run independently by an academic group was negative for cholesterol. No trial has tested whether this product changes cardiovascular events. Generic aged garlic standardized to S-allyl cysteine is chemically similar and less verified in trials, but that is not the same as knowing the branded product is better for you.

Studied Dose 1,200-2,400 mg/day in divided doses.
Active Compound Aged garlic extract standardized for S-allyl cysteine (SAC) content (20+ month aging process).

Benefits

Blood pressure reduction (extensive trial evidence)

Multiple Kyolic® clinical trials and meta-analyses document blood pressure reduction in adults with elevated BP — reductions of roughly 5 to 10 mmHg systolic in people who already have hypertension. A 2016 meta-analysis of 20 controlled trials in 970 people found an average of 5.1 mmHg systolic and 2.5 mmHg diastolic overall, rising to about 8.7 mmHg systolic in those with hypertension, so the larger single-trial numbers are the top of the range rather than the typical result. In the Australian trial, people whose systolic pressure was already below 140 mmHg showed no significant change. Most of this evidence comes from one research group in Australia, in people already taking prescribed blood pressure medication, using product supplied by the manufacturer, although a separate Swedish trial also recorded systolic pressure falling from 148 to 140 mmHg over a year.

Arterial calcification progression slowing

Four one-year randomized trials using repeat coronary CT scans reported slower progression of coronary artery calcium or of low-attenuation plaque compared with placebo. Their size is the thing to hold on to: 19 completers in the 2004 study, which called itself a small pilot, 65 in the 2009 trial that combined the extract with B vitamins, folate and arginine so the garlic contribution cannot be separated out, 55 in a 2016 metabolic syndrome trial, and 104 in a 2020 Swedish trial. A calcium score is a picture of an artery, not a heart attack or a stroke, and no trial has tested whether this extract changes those outcomes. All four were funded by the manufacturer or used product it supplied.

Cholesterol: mixed, and null in the largest trial

This is the weakest cardiovascular claim on the page. The biggest and longest test, a six-month trial at Stanford in 192 adults with LDL cholesterol between 130 and 190 mg/dL, gave aged garlic extract, raw garlic, powdered garlic or placebo and found no significant effect of any of them on LDL, HDL, triglycerides or the cholesterol ratio. The 2004 coronary calcium study likewise found no significant difference in any individual cholesterol measure. Older and smaller work points the other way: a crossover trial in 41 men taking 7.2 g a day, several times the usual supplement dose, reported total cholesterol about 6 percent lower and LDL about 5 percent lower than placebo, and pooled analyses of garlic in general report small reductions in people with mildly raised cholesterol. The honest summary is that the effect is inconsistent and absent in the most rigorous trial, so lowering cholesterol is not a good reason to choose this product.

Endothelial function and arterial elasticity

The results here are mixed and the trials are very small. A crossover study in 15 men with coronary artery disease found flow-mediated dilation, a measure of how well an artery relaxes, improved by 44 percent over two weeks of the extract, and the GarGIC trial in 49 people with hypertension found lower central blood pressure and lower arterial stiffness. Against that, a crossover trial in 26 adults with type 2 diabetes found no effect on endothelial function at all. The proposed mechanism is support of the nitric oxide pathway and reduced vascular oxidative stress, but both trials that measured oxidative stress markers alongside these outcomes found no change in them, so the second half of that mechanism is not confirmed in people.

Immune system support

One 90-day randomized trial in 120 healthy adults taking 2.56 g a day found better proliferation of natural killer cells and gamma delta T cells at 45 days, and at 90 days a 21 percent lower cold and flu symptom score, 61 percent fewer days functioning below normal and 58 percent fewer missed days of work or school. Read the direction carefully: the number of people who caught a cold or flu did not differ between the groups. What changed was how bad and how long the illness was, not whether it happened. The natural killer cell finding has appeared in two other small trials, one in 50 patients with advanced cancer in Japan and one in 51 adults with obesity, but the cold and flu result itself has never been repeated, that trial was co-funded by the manufacturer, and a 2014 Cochrane review of garlic for the common cold concluded the overall trial evidence is insufficient. This is much thinner than the blood pressure evidence.

What the research base actually contains

A count of papers is not something you can feel, so here is what the count actually contains. As of August 2026, PubMed indexes 386 records for aged garlic extract and 20 that name Kyolic. The manufacturer cites a figure above 850, which sweeps in laboratory and animal studies, conference abstracts and publications that are not indexed at all. Randomized trials in people are a much smaller slice: PubMed tags 38 records as randomized controlled trials, most of them enrolling fewer than 120 people, and the ones with positive results were largely funded by the manufacturer or used product it supplied. Research volume is not the same as research strength, and this page rates the strength rather than the volume.

Reproducible SAC standardization

Kyolic® provides consistent S-allyl cysteine content batch-to-batch through the controlled proprietary aging process. Consistent standardization is what makes it possible for one research group to repeat another group's trial, and that is a genuine advantage over unstandardized garlic products. It is a manufacturing property rather than a health effect, though, and the amount of S-allyl cysteine actually delivered still varied between the trials on this page, from about 1.2 mg to 2.4 mg a day.

Odorless formulation (a convenience, not a health effect)

The aging process converts the pungent sulfur compounds responsible for garlic breath into odorless water-soluble ones, so this form is close to odorless, and it was tolerated well in trials running from 12 weeks up to a year. That is a real practical reason people manage to keep taking it. It is a property of the formulation rather than an effect on health, and it should not be counted as evidence that the product works.

Mechanism of action

1

S-allyl cysteine bioavailability

Kyolic®'s 20+ month aging process converts the unstable thiosulfinates of raw garlic and its gamma-glutamyl-S-allylcysteine precursor into stable, water-soluble S-allyl cysteine (SAC). One correction worth making: SAC is not formed from allicin, which is itself unstable and breaks down into other compounds. SAC is well absorbed and produces reproducible blood levels, which is why the trials use it as a marker of whether participants actually took their capsules. Good absorption of a marker compound is not, by itself, evidence that any health outcome changes.

2

Cardiovascular pathway support

Kyolic® components support nitric oxide pathway, reduce vascular oxidative stress, modulate platelet aggregation, and improve endothelial function. Most of these are proposed mechanisms drawn from laboratory and animal work; the exception is the effect on platelet aggregation, which has been measured directly in people and is also the basis for the bleeding caution in the safety section. The human trials measured outcomes such as blood pressure and coronary calcium scores, and none of them established which of these pathways, if any, is doing the work.

3

Antioxidant capacity enhancement

Aged garlic extract has significantly higher antioxidant capacity than raw garlic — the aging process concentrates polyphenols and Maillard reaction products with antioxidant activity. This is a laboratory measurement made on the extract itself, and it has not carried through into people. The two placebo-controlled trials that measured antioxidant status and oxidative stress directly in humans swallowing the extract, one in 26 adults with type 2 diabetes and one in 15 men with coronary artery disease, both found no significant change. Older work is weaker and mixed: a seven-day study reported that LDL taken from supplemented people resisted oxidation better in a test tube, which is again a laboratory measurement rather than a health outcome. Higher antioxidant capacity in a test tube is not the same thing as lower oxidative stress in a person, which is why this page no longer carries an antioxidant category.

Clinical trials

1
Blood pressure in treated but uncontrolled hypertension (Ried 2010 and GarGIC 2018)

Two double-blind randomized placebo-controlled trials of Kyolic aged garlic extract in adults whose blood pressure stayed high despite medication. Ried 2010 (Maturitas) gave 960 mg a day providing 2.4 mg S-allyl cysteine for 12 weeks. The GarGIC trial (Front Nutr 2018) gave 1.2 g a day providing 1.2 mg S-allyl cysteine for 12 weeks.

Ried 2010: 50 adults in Australian general practice whose records showed treated but uncontrolled hypertension. GarGIC 2018: 49 adults with uncontrolled hypertension who completed the trial. Both are small, both enrolled a diagnosed disease under medical care with the extract added on top of prescribed drugs, both came from the same research group, and both used product supplied by the manufacturer.

In Ried 2010, systolic blood pressure averaged 10.2 mmHg lower than placebo over 12 weeks among the 50 participants who started at 140 mmHg or above; in those already below 140 mmHg, the difference was not significant. In GarGIC, blood pressure among the 49 participants with uncontrolled hypertension fell 10 mmHg systolic and 5.4 mmHg diastolic against placebo, with lower arterial stiffness and a shift in gut bacteria. The limits that matter: both trials enrolled fewer than 60 people, both were adjuncts to prescribed antihypertensive drugs rather than replacements, neither ran long enough to see a heart attack or a stroke, and the wider 2016 meta-analysis of 20 trials found a smaller average effect of 5.1 mmHg systolic.

2
Coronary calcium and plaque on CT (Budoff 2004 and 2009, Matsumoto 2016, Wlosinska 2020)

Four randomized double-blind placebo-controlled trials, each roughly a year long, used repeat CT scanning to measure change in coronary artery calcium or plaque: Budoff 2004 (4 mL a day added to statin therapy), Budoff 2009 (250 mg a day combined with vitamin B12, folic acid, vitamin B6 and L-arginine), Matsumoto 2016 (2,400 mg a day) and Wlosinska 2020 (2,400 mg a day).

Budoff 2004: 23 patients on statin therapy enrolled, 19 completed. Budoff 2009: 65 patients at intermediate cardiovascular risk, average age 60, 79 percent male. Matsumoto 2016: 55 patients with metabolic syndrome, average age 59, 71 percent male. Wlosinska 2020: 104 patients at increased cardiovascular risk in Sweden. All four are patient populations under medical care, not healthy adults, and all four were manufacturer funded or manufacturer supplied.

Budoff 2004 reported calcium scores rising 7.5 percent in the extract group against 22.2 percent on placebo over a year, and described itself as a small pilot study. Budoff 2009 reported slower calcium progression and better vascular reactivity, but the capsule combined the extract with B vitamins, folate and arginine, so no part of the result can be attributed to garlic on its own. Matsumoto 2016 found less low-attenuation plaque but no significant difference in total plaque volume, non-calcified plaque or dense calcium. Wlosinska 2020 reported slower calcium progression along with lower interleukin-6 and blood glucose. What none of them show: a calcium score is an imaging marker, not a clinical event, and no trial has tested whether this extract prevents heart attacks, strokes or deaths. Budoff 2004 also found no significant difference in any individual cholesterol measure.

3
Immune cell function and cold and flu severity (Nantz 2012)

Randomized, double-blind, placebo-controlled trial of aged garlic extract at 2.56 g a day for 90 days, with immune cell measurements at 45 days and daily self-reported illness diaries through the cold and flu season (Clinical Nutrition, 2012; registered as NCT01390116).

120 healthy adults aged 21 to 50 at a United States university, 60 per group. Note that these were healthy volunteers rather than patients, which is unusual on this page, and that the trial was co-funded by the manufacturer, which also supplied the capsules.

At 45 days, natural killer cells and gamma delta T cells from the supplemented group proliferated better than those from the placebo group. Over the 90 days, that group reported a 21 percent lower cold and flu symptom score, 61 percent fewer days functioning below normal and 58 percent fewer missed days of work or school. The direction that matters most: the number of cold and flu episodes did not differ between groups, so this trial supports milder and shorter illness rather than fewer illnesses. The natural killer cell result has been seen by other groups, including a 50-person Japanese trial in advanced cancer, but the cold and flu finding has not been repeated, and a 2014 Cochrane review of garlic for the common cold concluded the overall trial evidence is insufficient.

Side effects and drug interactions

Common Potential side effects

Generally well-tolerated across long-term clinical use.
Odorless — aging process eliminates the harsh sulfur compounds responsible for garlic breath.
Mild GI discomfort possible at higher doses in sensitive individuals.
May modestly enhance bleeding tendency. Garlic inhibits platelet aggregation, so take care alongside warfarin, clopidogrel, aspirin and other anticoagulant or antiplatelet drugs, and stop it roughly seven to ten days before planned surgery or a dental extraction, as surgical guidance generally advises for garlic supplements. Aged garlic extract looks gentler here than raw garlic or allicin products: a 12-week study in 48 people taking warfarin found no increase in bleeding, and a 2017 systematic review found garlic did not meaningfully change warfarin blood levels. That study was small and partly authored by the manufacturer, so treat it as reassurance rather than clearance, and tell your prescriber before starting if you take an anticoagulant.
Pregnant women should consult healthcare providers for high-dose supplementation.
Well tolerated in the trials run so far, but those trials mostly ran from 12 weeks to one year, and the ones cited on this page enrolled only a few hundred people between them, which is not enough to pick up uncommon harms.

Important Drug interactions

Anticoagulants (warfarin, heparin) — may modestly enhance bleeding tendency; monitor INR.
Antiplatelet medications (aspirin, clopidogrel): possible additive effect on bleeding time; stop garlic supplements about seven to ten days before any planned surgery or dental procedure.
Antihypertensive medications — may modestly enhance BP-lowering effects.
HIV protease inhibitors (saquinavir): garlic supplements cut saquinavir blood levels by about half in a 2002 study in 10 healthy volunteers, which is a clinically serious drop. That study used garlic powder caplets rather than aged garlic extract, so the finding is borrowed from a different garlic preparation and has not been tested with the aged extract. Do not combine without talking to an HIV specialist.
Generally minimal interactions with most common medications.

Frequently asked questions about Kyolic® (Aged Garlic Extract — Wakunaga)

What is Kyolic?

Kyolic® is the branded aged garlic extract from Wakunaga (Japan) — the aged garlic extract used in most published human trials of this ingredient. That much is checkable and true.

What is Kyolic used for?

Kyolic is researched primarily for Cardiovascular and Immune Support. Multiple Kyolic® clinical trials and meta-analyses document blood pressure reduction in adults with elevated BP — reductions of roughly 5 to 10 mmHg systolic in people who already have hypertension.

What is the recommended dosage of Kyolic?

The clinically studied dose is 1,200-2,400 mg/day in divided doses. Always follow the product label and check with a healthcare provider for personal advice.

Is Kyolic safe, and does it have side effects?

For most healthy adults, Kyolic is well tolerated at studied doses. Reported effects can include: Generally well-tolerated across long-term clinical use. Odorless — aging process eliminates the harsh sulfur compounds responsible for garlic breath. It may also interact with some medications. Kyolic is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Kyolic interact with any medications?

Possible interactions include: Anticoagulants (warfarin, heparin) — may modestly enhance bleeding tendency; monitor INR. Antiplatelet medications (aspirin, clopidogrel): possible additive effect on bleeding time; stop garlic supplements about seven to ten days before any planned surgery or dental procedure. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Kyolic?

NutraSmarts rates the evidence for Kyolic as Moderate (3 out of 5). It is backed by 3 clinical trials and 17 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(17 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Ried K, Frank OR, Stocks NP Aged garlic extract lowers blood pressure in patients with treated but uncontrolled hypertension: a randomised controlled trial Maturitas. 2010;67(2):144-50. doi: 10.1016/j.maturitas.2010.06.001.PubMedUsed to support: Double-blind randomized placebo-controlled trial in 50 Australian general-practice patients whose hypertension was treated but still uncontrolled; four capsules a day of aged garlic extract, 960 mg providing 2.4 mg S-allyl cysteine, for 12 weeks lowered systolic blood pressure by an average of 10.2 mmHg against placebo among those starting at 140 mmHg or above. Honesty: only 50 people and only 12 weeks; the change was not significant in people whose systolic pressure was already below 140 mmHg; the extract was added on top of prescribed drugs rather than replacing them, and this is a diagnosed disease that needs medical care; and the product was manufacturer supplied.
  2. Budoff MJ, Takasu J, Flores FR, Niihara Y, Lu B, Lau BH, et al. Inhibiting progression of coronary calcification using Aged Garlic Extract in patients receiving statin therapy: a preliminary study Prev Med. 2004;39(5):985-91. doi: 10.1016/j.ypmed.2004.04.012.PubMedUsed to support: Backs the slowed coronary-artery-calcium-progression claim for Aged Garlic Extract added to statins. Honesty: explicitly a small preliminary study; surrogate (calcium-score) endpoint, not clinical events.
  3. Budoff MJ, Ahmadi N, Gul KM, Liu ST, Flores FR, Tiano J, et al. Aged garlic extract supplemented with B vitamins, folic acid and L-arginine retards the progression of subclinical atherosclerosis: a randomized clinical trial Prev Med. 2009;49(2-3):101-7. doi: 10.1016/j.ypmed.2009.06.018.PubMedUsed to support: Supports slowed progression of subclinical atherosclerosis. Honesty: the AGE was combined with B vitamins, folate and L-arginine, so the effect cannot be attributed to garlic alone; surrogate imaging endpoints.
  4. Ried K, Travica N, Sali A The Effect of Kyolic Aged Garlic Extract on Gut Microbiota, Inflammation, and Cardiovascular Markers in Hypertensives: The GarGIC Trial Front Nutr. 2018;5:122. doi: 10.3389/fnut.2018.00122.PubMedUsed to support: Backs blood-pressure and gut-microbiota/inflammation effects of Kyolic Aged Garlic Extract in hypertensives. Honesty: small trial, Wakunaga (Kyolic) involvement; BP and biomarker effects were modest.
  5. 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. Arch Intern Med. 2007;167(4):346-53..PubMedUsed to support: Six-month randomized trial in 192 adults with LDL cholesterol between 130 and 190 mg/dL, run by an academic group at Stanford, comparing raw garlic, a powdered garlic supplement, aged garlic extract and placebo at a dose equivalent to about one 4 g clove a day, six days a week. None of the three garlic forms produced a significant change in LDL, HDL, triglycerides or the total-to-HDL ratio. This is the largest and longest test of aged garlic extract for cholesterol and it was negative, which is why the cholesterol claim on this page is now presented as mixed rather than established. Limitations: it enrolled people with moderately raised cholesterol rather than severe hyperlipidaemia, and the clove-equivalent dosing is lower than the 1,200 to 2,400 mg a day used in the cardiovascular trials.
  6. Nantz MP, Rowe CA, Muller CE, et al. Supplementation with aged garlic extract improves both NK and γδ-T cell function and reduces the severity of cold and flu symptoms: a randomized, double-blind, placebo-controlled nutrition intervention. Clin Nutr. 2012;31(3):337-44..PubMedUsed to support: Randomized, double-blind, placebo-controlled trial in 120 healthy adults taking 2.56 g a day of aged garlic extract for 90 days. Natural killer cells and gamma delta T cells proliferated better in the supplemented group at 45 days, and over the season that group reported a 21 percent lower cold and flu symptom score, 61 percent fewer days functioning below normal and 58 percent fewer missed days of work or school. Read the direction carefully: the number of cold and flu episodes did not differ between the groups, so this supports milder and shorter illness, not fewer illnesses. Limitations: the cold and flu result has never been repeated by another group, the trial was co-funded by the manufacturer using capsules it supplied, and the illness outcomes were self-reported rather than laboratory confirmed.
  7. Atkin M, Laight D, Cummings MH The effects of garlic extract upon endothelial function, vascular inflammation, oxidative stress and insulin resistance in adults with type 2 diabetes at high cardiovascular risk. A pilot double blind randomized placebo controlled trial. J Diabetes Complications. 2016;30(4):723-7..PubMedUsed to support: Double-blind placebo-controlled crossover trial in 26 adults with type 2 diabetes at high cardiovascular risk, given 1,200 mg a day of aged garlic extract for four weeks with a four-week washout. It measured total antioxidant status, the glutathione ratio, lipid hydroperoxides, C-reactive protein, insulin resistance and endothelial function, and found no significant effect on any of them. It is the main reason this page no longer carries an antioxidant category: when antioxidant status was actually measured in people swallowing the extract, it did not move. Limitations: small, short at four weeks, and conducted in a diagnosed disease population under medical care.
  8. Williams MJ, Sutherland WH, McCormick MP, et al. Aged garlic extract improves endothelial function in men with coronary artery disease. Phytother Res. 2005;19(4):314-9..PubMedUsed to support: Randomized placebo-controlled crossover trial in 15 men with coronary artery disease confirmed by angiography, given aged garlic extract for two weeks. Flow-mediated dilation of the brachial artery, a measure of how well blood vessels relax, improved by 44 percent during the extract phase. Markers of oxidant stress and of systemic inflammation did not change, which is the second human result arguing against an antioxidant claim. Limitations: only 15 men, only two weeks, a diagnosed disease population, and a surrogate measure of vessel function rather than any clinical outcome.
  9. Ried K Garlic Lowers Blood Pressure in Hypertensive Individuals, Regulates Serum Cholesterol, and Stimulates Immunity: An Updated Meta-analysis and Review. J Nutr. 2016;146(2):389S-396S..PubMedUsed to support: Meta-analysis pooling 20 randomized controlled trials with 970 participants on garlic preparations and blood pressure. The average reduction was 5.1 mmHg systolic and 2.5 mmHg diastolic across all participants, rising to about 8.7 mmHg systolic in those who already had hypertension. These pooled figures are smaller than the headline numbers from the individual trials, and they are the ones the blood pressure claims on this page follow. Limitations: it pools several different garlic preparations rather than the branded aged extract alone, the author has also run several of the aged garlic extract trials it includes using manufacturer-supplied product, and it appeared in a journal supplement devoted to garlic research whose chair and vice-chair both held research grants and honoraria from the manufacturer.
  10. Wlosinska M, Nilsson AC, Hlebowicz J, et al. The effect of aged garlic extract on the atherosclerotic process - a randomized double-blind placebo-controlled trial. BMC Complement Med Ther. 2020;20(1):132..PubMedUsed to support: Randomized double-blind placebo-controlled trial in 104 patients at increased cardiovascular risk in Sweden, given 2,400 mg a day of aged garlic extract for one year with CT scanning at both ends. Coronary artery calcium progressed more slowly than on placebo, and interleukin-6, blood glucose and systolic blood pressure (148 down to 140 mmHg) also fell. This is the nearest thing to a replication of the earlier American calcium-score trials, at a different centre in a different country. The limitation that matters most: the senior author disclosed a research grant from Wakunaga of America, the manufacturer, so it is not an independent replication, and a calcium score is an imaging marker rather than a heart attack or a stroke.
  11. Matsumoto S, Nakanishi R, Li D, et al. Aged Garlic Extract Reduces Low Attenuation Plaque in Coronary Arteries of Patients with Metabolic Syndrome in a Prospective Randomized Double-Blind Study. J Nutr. 2016;146(2):427S-432S..PubMedUsed to support: Prospective randomized double-blind trial in 55 patients with metabolic syndrome, given 2,400 mg a day of aged garlic extract for about a year with CT angiography before and after. The proportion of low-attenuation plaque, the softer plaque thought to be more rupture-prone, fell 1.5 percent in the extract group and rose slightly on placebo. Read the rest of the result too: there was no significant difference between groups in total plaque volume, non-calcified plaque volume or dense calcium. Limitations: 55 people, a disease population under medical care, a surrogate imaging endpoint, and publication in a journal supplement issue devoted to garlic research by a group funded by the manufacturer.
  12. Macan H, Uykimpang R, Alconcel M, et al. Aged garlic extract may be safe for patients on warfarin therapy. J Nutr. 2006;136(3 Suppl):793S-795S..PubMedUsed to support: Twelve-week study in 48 patients already taking warfarin, given 5 mL of aged garlic extract twice daily or placebo and monitored for bleeding and clotting problems. There was no evidence of increased haemorrhage in either group, and minor complaints such as headache and fatigue occurred equally often. This is the specific evidence behind the safety section saying the aged extract looks gentler on bleeding risk than raw garlic. Limitations: a small pilot, several authors affiliated with the manufacturer, everyone was under INR monitoring, and it says nothing about surgery, so the usual advice to stop garlic supplements about a week before a planned operation still stands.
  13. Choi S, Oh DS, Jerng UM A systematic review of the pharmacokinetic and pharmacodynamic interactions of herbal medicine with warfarin. PLoS One. 2017;12(8):e0182794..PubMedUsed to support: Systematic review of nine randomized trials of herbal medicines taken alongside warfarin. Garlic, including aged garlic extract, did not significantly change how the body handles warfarin, whereas St John's wort and echinacea did; reported adverse events were few and none were major. Limitations: the included trials were small and of low methodological quality, the herbal preparations varied in composition, and a review of warfarin blood levels cannot rule out an added effect on platelet function, which is the separate mechanism behind the advice to stop garlic before surgery.
  14. Lissiman E, Bhasale AL, Cohen M Garlic for the common cold. Cochrane Database Syst Rev. 2014;2014(11):CD006206..PubMedUsed to support: Cochrane review of garlic for preventing or treating the common cold. Only one trial met the quality threshold, and although it reported fewer colds in the garlic group, the reviewers concluded there is insufficient clinical trial evidence and that claims of effectiveness rest largely on poor-quality work. This is the honest counterweight to the single positive immune trial cited on this page. Limitation specific to this page: the trial the review relies on used a garlic allicin supplement rather than the aged extract, so it is a different garlic preparation and does not test this product directly.
  15. Steiner M, Khan AH, Holbert D, et al. A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids. Am J Clin Nutr. 1996;64(6):866-70..PubMedUsed to support: Double-blind crossover trial in 41 men with moderately raised cholesterol, 220 to 290 mg/dL, who took 7.2 g a day of aged garlic extract for six months and placebo for four months. Total cholesterol was about 6 percent lower and LDL about 5 percent lower than during the placebo period, and systolic blood pressure fell about 5.5 percent. This is the positive side of the mixed cholesterol picture the benefits section now describes. Limitations: only 41 people and no women, a dose several times higher than the 1,200 to 2,400 mg a day this page lists, and a much larger six-month trial at ordinary supplement doses later found no lipid effect at all.
  16. Ishikawa H, Saeki T, Otani T, et al. Aged garlic extract prevents a decline of NK cell number and activity in patients with advanced cancer. J Nutr. 2006;136(3 Suppl):816S-820S..PubMedUsed to support: Randomized double-blind trial in 50 patients with inoperable liver, pancreatic or colorectal cancer, given aged garlic extract or placebo for six months by a Japanese university group. Natural killer cell number and activity rose significantly in the extract group, while quality of life did not improve and no adverse effects were seen. It is the reason the immune section can say the natural killer cell finding has been seen by more than one research group. Limitations: 50 people, an advanced cancer population under medical care, a laboratory immune measure rather than fewer infections, and publication in a journal supplement devoted to garlic research.
  17. Munday JS, James KA, Fray LM, et al. Daily supplementation with aged garlic extract, but not raw garlic, protects low density lipoprotein against in vitro oxidation. Atherosclerosis. 1999;143(2):399-404..PubMedUsed to support: Small human supplementation study comparing 2.4 g a day of aged garlic extract, 6 g of raw garlic and vitamin E over seven days, then testing how well each protected LDL particles against oxidation in the laboratory. LDL from the aged extract and vitamin E groups resisted oxidation better than LDL from unsupplemented people, while raw garlic did not. This is the strongest antioxidant-related human result for the extract and the page discloses it rather than hiding it, but it is still an oxidation test run on a blood sample rather than a measure of oxidative stress inside the body. Limitations: seven days only, an unsupplemented comparison group rather than a placebo, and the two placebo-controlled trials that measured antioxidant status in the body found no change.