Allium sativum

Scientific name: Allium sativum L.

Botanical family: AMARYLLIDACEAE

Vernacular names

(In territories with significant traditional TRAMIL use)

Guadeloupe:

ail
lay

Dominican Republic:

ajo

Guatemala:

ajo

Barbados:

garlic

Saint Lucia:

lay

Haiti:

lay

Other vernacular names

Guadeloupe:

ail
ail

Colombia:

ajo

Cuba:

ajo

Honduras:

ajo

Panama:

ajo

ajo

Venezuela:

ajo

Haiti:

ajo/lay
lay

Antigua and Barbuda:

garlic

Barbados:

garlic

St Vincent and Grenadines:

garlic

Martinique:

lay, ail

Geographical distribution

Of Eurasian origin, cultivated in many parts of the world.

Botanical description

Herbaceous plant with bulbs divided and wrapped in a whitish skin. Flattened leaves, 2-3 cm in width. Inflorescence in scape about 50 cm; dense umbel; pink flowers with oblong-ovoid ovary.

Voucher(s)

Faujour,14,BAR

Girón,254,CFEH

Jiménez,1519,JBSD

Fuentes,4635,ROIG

Boulogne,TB1&TH2,UAG

nausea

bulb, decoction, orally^1-7

fever

bulb, decoction, orally³

flatulence

bulb, decoction, orally^1-7

toothache

bulb, fresh, local application^1-2

bad blood

bulb, crushed, applied on the forehead²

gastric heaviness

bulb, decoction, orally^1-7

intestinal parasites

bulb, decoction, orally⁴^,7

earache

crushed bulb, poultice, local application³

candidiasis

crushed bulb, bath and friction¹

skin conditions

crushed bulb, bath and friction¹

pruritus

crushed bulb, bath and friction¹

The Allium sativum L. bulb is a condiment of relatively widespread human consumption.

Garlic bulbs for medicinal purposes should be consumed with meals to prevent gastrointestinal problems⁶⁸.

For fever, intestinal parasites, gastric heaviness, nausea or flatulence:
Prepare a decoction with 1-2.5 cloves (2-5 grams) of fresh garlic ⁶⁸ or 0.4-1.2 grams of dry garlic powder ⁶⁸ in 1 cup (250 millilitres) of water, boil for 10 minutes in a covered container. Leave to cool, strain (filter) and drink 1 cup 3 times a day.

For skin conditions, pruritus, candidiasis, toothache or earache:
Peel and wash 1-2.5 cloves (2-5 grams) of fresh garlic, crush and apply them over the affected area twice a day.

Preparations must never be stored for more than 24 hours, even if refrigerated.

According to the information available:

The use for skin conditions, pruritus, candidiasis, toothache, earache is classified as REC based on the significant traditional use documented in the TRAMIL surveys, the toxicity studies and the scientific information published.

All topical application must follow strict hygiene measures in order to prevent contamination or additional infection.

If deterioration is observed in the patient or if the skin conditions, pruritus or candidiasis persist for more than 5 days in adults and 3 days in children, if the toothache persists for more than 3 days or the earache persists for more than 2 days, seek medical attention.

Because of the risk that an earache may be due to otitis media or interna, an initial medical assessment is recommended. Its use is contraindicated in the presence of secretions from the ear and/or possible perforation of the eardrum.

The use for fever is classified as REC based on the significant traditional use documented in the TRAMIL surveys, the toxicity and validation studies and the scientific information published.

If deterioration is observed in the patient or the fever persists for more than 2 days, seek medical attention.

We do not have an experimental model for validation for bad blood to support this traditional use.

The use for intestinal parasites, gastric heaviness, nausea and flatulence is classified as REC based on the significant traditional use documented in the TRAMIL surveys, toxicity studies and the scientific information published.

It can produce hypersensitivity reactions via the oral and topical route with anaphylactic effects⁸. It has an anticoagulant effect and it is recommended that its use be discontinued before surgery or dental surgery^8-9. It can cause gastroenteritis¹⁰ and cause oesophageal reflux¹⁰.

Use is contraindicated in hyperthyroidism¹¹, in acute or chronic stomach inflammation or a marked irritation or inflammation of other mucosa¹⁰; also in people with hypoglycemic (oral or insulin)^12-13, anticholesterolemic, antihypertensive^8,10, anticoagulant^8-14, non-steroidal anti-inflammatory (ibuprofen, naproxen) treatment and with herbs or supplements such as Ginkgo biloba because of the risk of increasing bleeding time⁸.

It interacts with anticholesterolemic drugs (lovastatin or other “statins”, HMGCoA reductase inhibitors) increasing their effect¹⁴, and decreasing plasma concentration of antiretrovirals¹³.

The bulb taken orally can cause irritation of the urinary tract in people presenting with specific sensitivity¹⁵.

Levels of the drug saquinavir, used in the treatment of HIV, can be reduced if garlic is used, thereby reducing its effectiveness¹⁶. No effect on other antiviral drugs such as ritonavir has been demonstrated¹⁷, nor have alterations in the levels of drugs metabolised by the CYP450 liver enzyme system¹⁸.

Various studies have suggested that it may cause uterine contractions^8,10.

Not for use during pregnancy because it can cause miscarriage, nor while breastfeeding or in children under 8 years of age.

TRAMIL Work⁵⁴
The fresh bulb peeled and crushed topically (patch with 0.6 g/6 cm² skin/4 hours), in New Zealand albino rabbits (3 males), Draize’s acute dermal irritability model, the area was washed, erythema and oedema readings were made at the time of patch removal and 1, 24, 48 and 72 hours, after patch removal. An index of 0.55 was obtained, which is classified as slightly irritant.

TRAMIL Work⁵⁵
The aqueous extract (30% decoction) of fresh crushed unpeeled bulb (4.46 mg/ml total solids) orally (2 ml/100 g body weight) in rats, in the acute toxic class model, did not cause death or evident signs of toxicity during the 14 days of observation, nor did it show changes in the histopathological studies.

The bulb extract, externally in poultice with high concentrations can cause skin necrosis⁵⁶ and allergenic activity⁵⁷. The above has also been verified with the internal administration of the aqueous extract orally, in rats and sensitive humans⁵⁸.

The LD₅₀ of the bulb orally and subcutaneously in rats of both sexes was greater than 30 ml/kg⁵⁹.

The bulb extract orally (2 g/kg/5 times a week/6 months) in rats showed no toxic effects⁶⁰.

The aqueous extract of the bulb orally (100 mg/day/3 months) in male and female rats did not cause a change in body weight, nor did it show any anatomopathological alterations in the liver, heart or seminal vesicles of the male. The white and red blood cell count was unchanged⁶¹.

The bulb juice added to the drinking water (5%) in the rat diet did not cause any obvious toxic effects⁶².

Doses of 350 mg/person (both sexes from 30 to 62 years) orally twice a day did not produce toxic manifestations⁶³.

In a double-blind clinical study, randomised with a placebo group, with 30 children between 8-18 years old who received an extract of commercial garlic orally for 8 weeks (Lichtwer Pharma, Germany) in doses of 300 mg 3 times a day, there were no significant differences between the groups ⁶⁴.

The raw bulb orally in 20 patients increased fibrinolytic activity by 72% and the cooked bulb by 63%, 6 hours after administration⁶⁵.

The aqueous extract of the bulb caused uterotonic activity in vitro in pregnant female uteri⁶⁶.

The essential oil (1 g/kg) orally is attributed with anticoagulant activity in rabbits⁶⁷.

There is no information available documenting the safety of medicinal use in children, during pregnancy or breastfeeding.

The bulb contains:

alkaloids^19-22: nicotinic acid; trigonelline 100-890 ppm

carbohydrates^21-24: 27.4 %

allium fructans; pectins^21-24

phytic acid^21-24: 3000 ppm

diterpenes: gibberellic acid or gibberellins A-3 and A-7²⁵

lipids^19,21-22,26: arachidonic acid; cerebrosides; linoleic acid: 1200-7800 ppm; myristic acid: 614 ppm; oleic acid: 60-1200 ppm; palmitic acid: 400-3600 ppm

monoterpenes²²: β-phellandrene; α-phellandrene

phenylpropanoids²²: caffeic acid: 10-20 ppm; ferulic acid: 7-27 ppm; p-coumaric acid: 2-58 ppm; sinapinic acid (hydroxy-dimethoxy
cinnamic acid): 2 ppm

β-sitosterol²²: 13-555 ppm

sulfur compounds^22,27,28-30: 2-propene-1-sulfonic acid; 2-propene-1-sulfonic acid, 2-propenyl ester; ajoene and derivatives; allyl methyl trisulfide and derivatives; allyl methyl disulfide and derivatives; allicin: 1500-27800 ppm; allyl 1 propenyl thiosulfinate; cycloalliin and derivatives; diallyl sulfide and derivatives: 16-643 ppm; diallyl sulfide: 2-99 ppm; diallyl tetrasulfide: 119 ppm

presence of aldehydes: particularly acetaldehyde²²

allyl alcohol

benzenoids: p-hydroxybenzoic acid: 13 ppm; vanillic acid: 6 ppm

flavonoids²²: apigenin (a citrus bioflavonoid): 693 ppm; myricetin: 693 ppm; quercetin: 0.08-200 ppm

prostaglandin²¹

terpenoids: citral, geraniol, linalool

phloroglucinol²²

amino acids^21,^22,29,31: 5 butyl cysteine sulfoxide derivatives (sulfur-containing amino acids); glycine: 2000-4800 ppm; alliin (sulfur-containing amino acids): 13000 ppm; tryptophan

enzymes^21,^22,29,31: endolysin: 0.096 ppm; muramidase : 0.096 ppm;

salicylates²²: 1-4 ppm; salicylic acid²²: 1 ppm

sapogenins^22,32,33: eruboside and derivatives; eruboside-B: 0.5-13 ppm; sativoside and tigonine

vitamins^21,22: ascorbic acid 100-788 ppm; biotin 22 ppm; allithiamine 0-3 ppm; pantothenic acid 2.6-7.5 ppm; niacin 4-17 ppm; thiamine 0-8 ppm

Proximate analysis of 100 g of the bulb²¹: calories: 117; water: 67.8%; protein: 3.5%; fat: 0.3%; carbohydrates: 27.4%; fibre: 0.7%; ash: 1%; calcium: 18 mg; phosphorus: 88 mg; iron: 1.5 mg; sodium: 18 mg; potassium: 373 mg; carotene: 0 μg; thiamine: 0.24 mg; riboflavin: 0.05 mg; niacin: 0.4 mg; ascorbic acid: 10 mg.

TRAMIL Work³⁴
The aqueous extract (decoction 30%) of the fresh crushed bulb, orally (1 and 5 g of plant material/kg), in male Wistar rats, 8 animals/group, model fever induced by (15% in water; 1 ml/100 g) subcutaneously, the control received paracetamol (150 mg/kg p.o.) and each animal was its own control. Statistically significant antipyretic activity was obtained until the third hour after the administration of both doses, with paracetamol showing a significant effect during the 4 h of evaluation.

The aqueous bulb extract was active in vitro against Escherichia coli and Staphylococcus aureus³⁵.

The aqueous extract of the fresh bulb, in vitro by the agar dilution method, inhibited the growth dose dependently of Candida albicans and other Candida sp. as well as 35 strains of various dermatophytes³⁶.

The hydroalcoholic extract (50%) from a freshly crushed bulb (20 or 50% weight/volume), in concentrations of 50 and 100 μl/well, showed significant activity in vitro against Staphylococcus aureus and Escherichia coli³⁷.

The hydromethanolic extract (50%)³⁸ and ethanolic tincture (10%)³⁹ of dry bulb (30 μl/disc) showed activity against gram + and gram - microorganisms. The tincture was also active against Staphylococcus aureus³⁹.

The bulb, in vitro, showed antifungal activity on dermatophytes and yeasts pathogenic to humans⁴⁰, inhibition of Candida albicans⁴¹.

The aqueous extract of the bulb, in vitro, agar plate, showed an antifungal effect against Microsporum gypseum⁴², Trichophyton rubrum (0.5%)⁴³ and Candida albicans (0.8 mg/ml)⁴².

The hydroalcoholic extract (50%) from a freshly crushed bulb (20 or 50% weight/volume), in concentrations of 50 and 100 μl/well, showed significant activity in vitro against Candida albicans, Epidermophyton floccosum and Trichophyton rubrum³⁷.

The bulb juice, applied externally to rabbits, showed antifungal activity on Microsporum canis⁴⁴ and on the genera Epidermophyton and Trichosporon³⁷.

The hydroalcoholic extract (50%) of crushed dry bulb (20-50% weight/volume), in topical application twice a day for 4 weeks, in 60 patients per group (15-60 years) of both sexes, with a mycological diagnosis of dermatophytes (direct and culture), showed significant antifungal effect, compared with salicylic acid 3% as control⁴⁵.

Bulb extract (20%) applied twice/day/10 to 20 days, in 6 human adults affected by Trichophyton rubrum and T. mentagrophytes showed an antifungal effect⁴⁶.

The oil with a crushed clove of garlic, in local application, is known as an otic analgesic and the garlic clove bitten into a cavity to fill it is used to counteract toothache⁴⁷.

The aqueous extract of the bulb in vitro, but not in vivo in rats, had antihelminthic activity against cestodes (Hymenolepis diminuta, H. microstoma, Taenia taeniaeformis) and trematodes (Fasciola hepatica, Echinostoma caproni)⁴⁸.

The minimum lethal concentration (MLC) in vitro on adult Hymenolepis nana of raw garlic extract in serial dilutions was 1/20⁴⁹.

The garlic bulb was administered orally to albino mice before and after inoculation with Schistosoma mansoni; after 7 weeks a necropsy was performed on all animals as well as parasitology of the liver and ileum, and all parasites collected were analysed ultrastructurally. There was a reduction in the number of eggs, in the amount of live parasites and several ultrastructural alterations in the integument including interruption, oedema, vesiculation, ulcers and vacuolisation of other structures. This study suggests that A. sativum is useful as a prophylactic and therapeutic agent against S. mansoni infection⁵⁰.

The aqueous extract (1 g/ml) of the bulb orally (50 mg/kg body weight for 2 weeks) in 8 male Swiss mice, showed antiparasitic activity against Cryptosporidium sp.⁵¹.

The raw bulb orally (5 ml/100 ml of water) twice a day for three days in 10 children infected with Hymenolepis nana and 26 infected with Giardia lamblia was effective and had no signs of toxicity⁴⁹.

The bulb orally (0.64 g/person) twice/day/2 weeks, in 29 patients with heaviness, flatulence and nausea, showed a carminative effect⁵².

Allicin showed activity against most human intestinal parasites such as Entamoeba histolytica, Ascaris lumbricoides and Giardia lamblia⁵³.

Pharmacopoeia

Ed.3

References

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Allium sativum. WHO Monographs on selected medicinal plants. Volume 1. Bulbis Alii Sativi. Ginebra, Suiza, Oct.28,2004. URL: www.who.int/medici- nes/library/trm/medicinalplants/monograph_volume_one.shtml

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Allium sativum

Vernacular names

Guadeloupe:

Dominican Republic:

Guatemala:

Barbados:

Saint Lucia:

Haiti:

Guadeloupe:

Colombia:

Cuba:

Honduras:

Panama:

Venezuela:

Haiti:

Antigua and Barbuda:

Barbados:

St Vincent and Grenadines:

Martinique:

Geographical distribution

Botanical description

Voucher(s)

Pharmacopoeia

References

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