Aged garlic extract -how much to take, why isn't it in ITP?

#1

Aged garlic has more potent antiglycation and antioxidant properties compared to fresh garlic extract in vitro

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5209668/

It reduces oxidized LDL and fructosamine

But I feel standard dosages are too low

This process causes loss of allicin and increases activity of other water-soluble organosulphur compounds, such as S-allyl cysteine (SAC), S-allyl mercaptocysteine (SAMC), allixin and selenium, all of which are antioxidants8,10. Another antioxidant present in aged garlic extract is N-fructosyl arginine, which is not present in raw or heat-treated garlic preparations

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#2

Still, oxidized cholesterol is what’s bad and he didn’t mention it. LDL id not inherently bad and

#3

I aim to take Allicin in Allicin Max as an HS donor. Not sure it has any effect on me, however.

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#4

Blueprint / Bryan Johnson’s protocol is

First and last meal, so 2 x per day:

Think the first one is “fresh” and the second one is aged.

What are people’s and @L_H @scta123 @A_User @Bicep @medaura s thoughts on its ability to stop and reverted plaque in arteries and arterial hardening?

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#5

I think its role as an HS donor is making building new mitochondria easier.

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#6

It probably reduces LDL cholesterol a little bit, but not much.

What do you mean with inherently?

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#7

Not valuing the Apo B a/ LDL lowering that much here as we can take care of that in more powerful ways (and I am) - more integrated in the benefits around offsetting and reversing plaque, artery hardening and positive effects on inflammation and oxidation.

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#8

How do you know that’s happening though for sure relative to LDL reduction?

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#9

Would the ITP even detect a longevity benefit in mice with any cardiovascular medication/supplement? They mice strains used don’t typically develop plaque. 90% of them die from cancer.

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#10

There are very good indications that lowering LDL-C below a certain treshold reduces plaque volume.

Intensive lipid lowering agents and coronary atherosclerosis: Insights from intravascular imaging - PMC (nih.gov)

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#11

I wanted to learn about it, that is why I asked that very question:

What are people’s and @L_H @scta123 @A_User @Bicep @medaura s thoughts on its ability to stop and reverted plaque in arteries and arterial hardening?

That is how I opened this sub-discussion…

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#12

Hi @Virilius - Not sure why you are asking me that - I 100% agree that this is a huge issue with any studies that use rodents to model human longevity, and I have said so in the past.

At the same time, I think if there is support that in humans it lowers plaque / even reverses it then it’s exciting to look into more;

Yes, aged garlic extract (AGE) can reduce low attenuation plaque (LAP), also known as “soft plaque”, in coronary arteries. LAP is more likely to break off and cause a blockage that leads to a heart attack.

In a 2016 study published in the Journal of Nutrition, 55 patients with metabolic syndrome who took 2,400 milligrams of AGE every day for a year experienced an 80% reduction in total plaque accumulation and a reduction in soft plaque. Another study found that one year of AGE therapy was associated with a regression of LAP in patients with diabetes.

AGE is made by soaking garlic slices in alcohol for up to 20 months, which produces more potent antioxidants than fresh garlic extract. Garlic also contains sulfur-containing compounds that may help fight heart disease and prevent some cancers.

  • This is for informational purposes only. For medical advice or diagnosis, consult a professional. Generative AI is experimental.
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#13

I guess we’ll have to wait for someone to post a mechanistic speculation study in MDPI.
Especially if you ask about buzzwords like offsetting plaque, reversing plaque, reversing artery hardening, improving inflammation, improving oxidation.

It requires follow up questions like (1) what do you mean with stop plaque in arteries and how do you measure it, (2) what do you mean with revert plaque, what are the established thresholds… etc… What are the goal posts…?

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#14

The studies are small but promising.
This is quite a good overview on garlic and aged garlic.

I can confirm it’s delicious.

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#15

My framework is that the evidence burden can be lower for things that less likely to have risks (filter one’s water, avoid plastics, avoid processed food, eat some berries and a variety of veggies, work on good sleep routines, excesses across strength and cardio, etc) vs other things (like my decision to take Rephatha, to do water only fasts, and to consider rapa and cana).

In between, but closer to first type of decision are things like supplementing Omega 3 and Vit D (from good, well researched sources).

I think taking garlic (in non-crazy dosages) is around that low-ish risk bucket. Hence the certainty around benefit can be smaller for it still do be a bet to take today. Of course future data may then update that decision.

But yes, I wanted to see if some people in our hive mind might already have looked into this and have any more insight beyond that it seems that Blueprints process led them to decide it’s a worthwhile risks/reward.

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#16

I read this a few years ago:

So I take 2 of these per day:

Then I take aged garlic also, though I don’t know why:

https://www.amazon.com/Micro-Ingredients-Organically-Antioxidant-Supplement/dp/B0812DJRSK/

I agree that I take it because I believe the benefit is likely and the risk is essentially zero.

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#17

They still have costs.

#18

Yes, but not crazy ones here.

#19

I smell some of it after taking it which is actually really good reiforcement

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#20

OK, I’m late to the game and have just stumbled upon this video (it’s from July 2025), and while I know it’s been posted before, here is the analysis to go with it. I’m not at high risk, but I wonder if perhaps there is value in pulsing something like this periodically (just in case).

Aged Garlic Extract (AGE) SHRINKS Plaque

Gemini Pro AI Summary and Analysis:

Here is the adversarial summary and analysis of the transcript.

A. Executive Summary

The provided transcript discusses the potential of garlic supplements—specifically Aged Garlic Extract (AGE)—to slow or reverse atherosclerosis. The speaker distinguishes between two types of plaque: calcified plaque (hard, stable, visible on standard calcium scans) and low-attenuation plaque (soft, necrotic core, high-risk for rupture).

While early studies (circa 2004) showed AGE slowed the accumulation of arterial calcium, recent advanced imaging (CCTA) has revealed a more critical finding: high-dose AGE (2,400 mg/day) may significantly reduce “low-attenuation plaque” (the dangerous necrotic core) in high-risk populations like diabetics. The transcript cites a 2020 study where diabetic patients on AGE saw a 29% reduction in this dangerous plaque subtype compared to a 57% increase in the placebo group. The core thesis is that while calcium scores are useful proxies, stabilizing and shrinking the “soft” necrotic core is the true therapeutic goal, and AGE appears to be a viable, evidence-based adjunct for this purpose.

B. Bullet Summary

  • Plaque Duality: Arterial plaque exists in two main forms: Calcified (hard/stable) and Non-calcified/Low-Attenuation (soft/vulnerable).
  • The Calcium Score Paradox: Calcium scores indicate total atherosclerotic burden, but calcified plaque is actually more stable and less likely to rupture than soft plaque.
  • Early Findings (Calcium): Studies from ~20 years ago showed AGE slowed the rate of calcium accumulation (approx. 3x slower than placebo).
  • Total Plaque Volume: Older trials using 900 mg of garlic powder showed a halt in total plaque growth, with significant effects seen primarily in women.
  • The “Necrotic Core”: The most dangerous part of a plaque is the “necrotic core”—a center of dead cells and lipids. On CT scans, this appears as “Low Attenuation Plaque” (LAP).
  • 2020 Diabetic Study: A pivotal trial (Shaikh et al.) involved diabetic patients taking 2,400 mg/day of AGE.
  • Regression of Risk: In the 2020 study, the placebo group’s necrotic core grew by 57%, while the AGE group’s shrank by 29%.
  • Metabolic Syndrome: Similar regression of low-attenuation plaque was observed in patients with metabolic syndrome in a separate trial (Matsumoto et al.).
  • Mechanism of Action: Likely involves anti-inflammatory pathways, improved endothelial function, and reduction of oxidative stress rather than just lowering cholesterol.
  • Biomarkers: AGE consistently shows modest reductions in blood pressure and cholesterol, though plaque regression may occur independent of these changes.
  • Safety Profile: AGE is generally well-tolerated but has blood-thinning properties (anti-platelet), necessitating caution with anticoagulants.
  • Surrogate Endpoints: The speaker correctly notes that while plaque regression is promising, it is a “surrogate marker.” Large-scale trials confirming a reduction in actual heart attacks (hard events) are still pending.

D. Claims & Evidence Table (Adversarial Peer Review)

Claim from Video Speaker’s Evidence Scientific Reality (Best Available Data) Evidence Grade Verdict
“Garlic supplement slowed calcium accumulation” Cites 20-year-old study Supported by Budoff et al. (2004). AGE reduced calcium progression (7.5% vs 22.2% in placebo). Budoff, Prev Med 2004 B (Small RCT) Strong Support
“Garlic powder (900mg) reduced total plaque volume” Cites 4-year study (women) Likely refers to Koscielny et al. (1999). Showed plaque regression with 900mg garlic powder (Kwai). Koscielny, Atherosclerosis 1999 B (RCT) Strong Support
“AGE (2.4g) decreased low attenuation plaque (necrotic core) by 29% in diabetics” Cites 2020 trial Accurate. Shaikh et al. (2020) confirmed significant regression of LAP in diabetics using 2,400mg Kyolic AGE. Shaikh, Exp Ther Med 2020 B (RCT) Verified / Strong
“Low attenuation plaque (necrotic core) is ‘nastier’ and causes infarcts” General cardiology consensus Consensus. Lipid-rich necrotic cores are the hallmark of “vulnerable plaque” prone to rupture. Virmani et al., Arterioscler Thromb Vasc Biol A (Pathology Consensus) Fact
“Garlic reduces biomarkers like BP and Cholesterol” Cites “historical trials” Meta-analyses confirm modest BP reduction (7-9 mmHg systolic) and Cholesterol reduction (~10%). Ried et al., 2016 A (Meta-analysis) Strong Support

Safety Check:

  • Bleeding Risk: Garlic has significant anti-platelet activity. High doses (2.4g) combined with blood thinners (Warfarin, Plavix, Aspirin) increase bleeding risk. “Safety Data Absent” in transcript regarding drug interactions.
  • Gastrointestinal: High dose AGE is generally better tolerated than raw garlic, but can still cause GI upset in some users.

E. Actionable Insights (Pragmatic & Prioritized)

The “Soft Plaque” Protocol
Use this information to discuss specific adjunct therapies with a cardiologist, especially if you have a non-zero Calcium Score.

  • Top Tier (High Confidence): Aged Garlic Extract (AGE)

  • The Protocol: The specific formulation used in the successful regression trials (Shaikh 2020, Matsumoto 2016) is Aged Garlic Extract (specifically the brand Kyolic is often used in these studies).

  • The Dose: To replicate the “plaque shrinking” results seen in the 2020 diabetic study, the dose was 2,400 mg per day.

  • Note: Standard over-the-counter doses are often 600–1,200 mg. The trial used a therapeutic high dose.

  • Target Audience: Individuals with Metabolic Syndrome, Type 2 Diabetes, or known soft plaque on CTA.

  • Experimental (Prevention): Garlic Powder

  • The Protocol: For general prevention or total plaque volume management (especially in women), 900 mg standardized garlic powder has historical support.

  • Caveat: Powder is less standardized than AGE and may cause more body odor/GI distress.

  • Safety Constraint (Crucial):

  • Stop before Surgery: Discontinue garlic supplements 2 weeks before any surgery due to bleeding risk.

  • Medication Check: Do not combine high-dose garlic with Warfarin (Coumadin) or other anticoagulants without strict medical monitoring.

H. Technical Deep-Dive

Low Attenuation Plaque (LAP) vs. Calcified Plaque

The transcript hinges on the distinction between these two plaque phenotypes:

  1. Calcified Plaque (>350 Hounsfield Units):
  • Appearance: Bright white on CT scans.
  • Biology: Represents “healed” or “scarred” atherosclerosis. While a high calcium score indicates you have disease, the calcium itself is hard and unlikely to rupture.
  • Garlic’s Effect: Slows the rate of new calcification (Budoff 2004).
  1. Low Attenuation Plaque (<30 Hounsfield Units):
  • Appearance: Dark/translucent spots within the artery wall on CCTA.
  • Biology: This is the Necrotic Core. It consists of dead macrophages, oxidized LDL, and cholesterol crystals covered by a thin fibrous cap.
  • Risk: This is “Vulnerable Plaque.” If the thin cap breaks, the necrotic contents spill into the blood, triggering a clot (thrombosis) and a heart attack.
  • Garlic’s Effect: The 2020 study suggests AGE helps clear this necrotic debris or promote healing, shrinking the dangerous soft core even if the hard calcium remains.

I. Fact-Check Important Claims

  • Claim: “Calcium score measures the amount of calcium… but calcified plaque is more stable.”

  • Fact: TRUE. This is a common point of confusion. A Calcium Score (CAC) predicts risk because it proves atherosclerosis is present. However, on a per-plaque basis, the calcified nodules are stable. The risk comes from the non-calcified plaque that usually accompanies the calcium.

  • Claim: “Garlic rescued [plaque growth] in women.”

  • Fact: Context Required. The Koscielny (1999) study did show a more pronounced effect in women, but this may be due to the smaller baseline plaque volume in the men recruited for that specific era of study. Recent AGE trials (Budoff/Shaikh) show benefits across genders.

Length of Trial

In the primary trial cited in the transcript (Shaikh et al., 2020, and the related Budoff/Matsumoto trials), the participants took the Aged Garlic Extract (AGE) supplement daily for 52 weeks (1 year).

Here is the breakdown of the specific trial parameters:

  • Study: Shaikh et al. (2020) / Experimental and Therapeutic Medicine
  • Target: Patients with Diabetes
  • Dosage: 2,400 mg of Aged Garlic Extract (Kyolic) per day.
  • Duration: 12 months (1 year).
  • Outcome: 29% reduction in Low-Attenuation Plaque (necrotic core).

It is important to note that this was a long-term intervention. The plaque regression effects were not observed in weeks, but rather required a full year of sustained high-dose supplementation to achieve the measurable 29% reduction in necrotic core volume.

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