Garlic is one of the biggest stars of folk medicine. It gets added to soup when suffering from a cold, ground into salads, spread on bread, and is also marketed in concentrated capsules. Some of its health effects have been studied seriously, mainly in the context of blood pressure, blood lipids, and inflammatory processes. But precisely because it is perceived as completely natural, many forget that even a natural substance can have a pharmaceutical effect.
The active ingredients in garlic, led by sulfur compounds such as allicin and other breakdown products, may affect blood platelet activity. Platelets are tiny blood cells essential for forming a clot and stopping bleeding. This effect is particularly significant when dealing with concentrated garlic supplements, exceptional consumption, or in combination with medications that affect clotting. Garlic as a regular spice in food is not expected to cause a problem for most people, but for those taking blood thinners or facing surgery, natural supplements should also be part of the conversation with the doctor.
Garlic as a spice in food is not dangerous for most people. A few cloves of garlic in a cooked dish, salad, or sauce are not a cause for concern. The problem begins mainly with excessive consumption, daily use of very large amounts, or concentrated garlic supplements where the dosage bears no resemblance to what enters a standard plate. A "natural" capsule can contain a significant concentration of active ingredients.
The risk increases among people taking anticoagulant medications, such as warfarin or newer drugs, as well as those taking aspirin, clopidogrel, or other medications affecting the coagulation system. People with clotting disorders, liver diseases, a tendency to bleed, or those about to undergo surgery should also report the use of garlic supplements to their doctor.
Before surgeries, anesthesiologists and surgeons sometimes ask about regular medications but do not always receive information about dietary supplements. Many patients do not view garlic, ginkgo, ginger, or omega 3 capsules as "medication," and therefore do not mention them. This is a mistake. From the operating room's perspective, any substance that affects clotting is important.
Why doctors need to know about supplements
Symptoms that could hint at a bleeding problem include recurrent nosebleeds, large bruises without significant trauma, prolonged bleeding from a small cut, blood in the stool or urine, or unusual gum bleeding. Of course, such symptoms have many causes, but in a person starting a high dose of garlic supplement, they should raise a question.
Garlic can also cause additional side effects: Heartburn, abdominal pain, strong body and breath odor, nausea, and occasionally allergic reactions. In people with reflux or gastritis, raw garlic may worsen a burning sensation. Here too, the dosage and form of consumption are very important. Cooked garlic in a dish is not similar to raw garlic crushed in large quantities.
Should garlic be avoided? No. For most people, garlic as part of a varied Mediterranean diet is an excellent food. The problem is not the garlic in the matbucha, but the belief that if a little is good, a lot is necessarily better. In the human body, even healthy substances can reach a point of excess.
Those taking blood thinners or facing a medical procedure should ask their doctor or pharmacist about garlic supplements. One does not stop medications because of garlic, and one does not start a supplement because of garlic without checking suitability. Sometimes the recommendation will be to stop a supplement before surgery, sometimes to avoid certain combinations, and sometimes there is no problem at all.
Garlic will continue to be one of the strongest and most beloved flavors in the kitchen. But when it transitions from the frying pan into a concentrated capsule, it is no longer just a spice. It becomes an active substance that must receive the same cautious approach we give to a medication.
Dr. Itay Gal is a specialist in pediatrics, sports and aviation medicine, and the medical commentator for Maariv. For additional articles on various medical and technological topics, click here