The effectiveness of garlic (Allium sativum) extract in improving fatigue and quality of life in patients with multiple sclerosis (MS): a randomized single-blind placebo-controlled clinical trial

Vahid Shaygannejad, Omid Mirmosayyeb, Rasool Soltani, Masoud Sadeghi Dinani, Mohaddeseh Shfiee, Afsaneh Mohsenzadeh

Abstract


Background and purpose: Multiple sclerosis (MS) is a degenerative disease of the central nervous system. Fatigue is one of the most common and disabling symptoms of MS. Garlic is a plant whose anti-fatigue effects have been shown. The present study aimed to investigate the potential effectiveness of garlic on fatigue and quality of life in MS patients.

Experimental approach: In a randomized, single-blind, placebo-controlled clinical trial, adult MS patients were randomly divided into two groups: of drug (garlic) group and a placebo. The drug group received 400-mg tablets of garlic extract (equivalent to 1,200 µg of allicin) twice a day for 4 weeks, while the patients in the placebo group received placebo tablets at the same frequency and duration. Before and after the intervention, scores on a 36-item survey form (SF-36) and fatigue severity scale (FSS) questionnaires were recorded for all patients and compared between the groups. 

Findings/Results: Garlic consumption was significantly associated with an increase in energy/fatigue, pain, general health, and physical health subscales scores at the end of the intervention compared to the placebo group. The scores of FSS were significantly reduced in both groups; however, the change in the drug group was remarkably higher than in the placebo group.

Conclusion and implications: Garlic extract promotes fatigue and improves the quality of life in MS patients. Therefore, garlic can be considered a potential remedy to overcome fatigue and improve the quality of life in these patients.

 

 


Keywords


Allicin; Clinical trial; Fatigue; Garlic; Multiple sclerosis.

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References


Fraser R, Ehde D, Amtmann D, Verrall A, Johnson KL, Johnson E, et al. Self-management for people with multiple sclerosis: report from the first international consensus conference, November 15, 2010. Int J MS Care. 2013;15(2):99-106. DOI: 10.7224/1537-2073.2012-044.

Payab N, Mahnam K, Shakhsi-Niaei M. Computational comparison of two new fusion proteins for multiple sclerosis. Res Pharm Sci. 2018;13(5):394-403.DOI: 10.4103/1735-5362.236832.

Oliva Ramirez A, Keenan A, Kalau O, Worthington E, Cohen L, Singh S. Prevalence and burden of multiple sclerosis-related fatigue: a systematic literature review. BMC Neurol. 2021;21(1):468. DOI: 10.1186/s12883-021-02396-1.

Schreurs KM, de Ridder DT, Bensing JM. Fatigue in multiple sclerosis: reciprocal relationships with physical disabilities and depression. J Psychosom Res. 2002;53(3):775-781.DOI: 10.1016/s0022-3999(02)00326-4.

Finlayson M, Akbar N, Turpin K, Smyth P. A multi-site, randomized controlled trial of MS INFoRm, a fatigue self-management website for persons with multiple sclerosis: rationale and study protocol. BMC Neurol. 2019;19(1):142,1-9.DOI: 10.1186/s12883-019-1367-6.

Hartz A, Bentler S, Watson D. Measuring fatigue severity in primary care patients. J Psychosom Res. 2003;54(6):515-521.DOI: 10.1016/s0022-3999(02)00600-1.

Ghaffari S, Hatami H, Dehghan G. Saffron ethanolic extract attenuates oxidative stress, spatial learning, and memory impairments induced by local injection of ethidium bromide. Res Pharm Sci. 2015;10(3):222-332.PMID: 26600849.

Etemadifar M, Sayahi F, Abtahi SH, Shemshaki H, Dorooshi GA, Goodarzi M, et al. Ginseng in the treatment of fatigue in multiple sclerosis: a randomized, placebo-controlled, double-blind pilot study. Int J Neurosci. 2013;123(7):480-486.DOI: 10.3109/00207454.2013.764499.

Johnson SK, Diamond BJ, Rausch S, Kaufman M, Shiflett SC, Graves L. The effect of Ginkgo biloba on functional measures in multiple sclerosis: a pilot randomized controlled trial. Explore (NY). 2006;2(1): 19-24.PMID: 16781604.

Morihara N, Ushijima M, Kashimoto N, Sumioka I, Nishihama T, Hayama M, et al. Aged garlic extract ameliorates physical fatigue. Biol Pharm Bull. 2006;29(5):962-966.DOI: 10.1248/bpb.29.962.

Ushijima M, Sumioka I, Kashi-moto N, Yokoyama K, Uda N, Matsuura H, et al. Effect of garlic and garlic preparations on physiological and psychological stress in mice. Phytother Res. 1997;11(3):226-230. DOI: 10.1002/(SICI)1099-1573(199705)11:3<226: :AID-PTR85>3.0.CO;2-E

Sookvanichsilp N, Tiangda C, Yuennan P. Effects of raw garlic on physical performance and learning behaviour in rats. Phytother Res. 2002;16(8):732-736.DOI: 10.1002/ptr.1048.

Moutia M, Seghrouchni F, Abouelazz O, Elouaddari A, Al Jahid A, Elhou A, et al. Allium sativum L. regulates in vitro IL-17 gene expression in human peripheral blood mononuclear cells. BMC Complement Altern Med. 2016;16(1):377,1-10.DOI: 10.1186/s12906-016-1365-9.

Mathew B, Biju R. Neuroprotective effects of garlic a review. Libyan J Med. 2008;3(1):23-33.DOI: 10.4176/071110.

Valko PO, Bassetti CL, Bloch KE, Held U, Baumann CR. Validation of the fatigue severity scale in a Swiss cohort. Sleep. 2008;31(11):1601-7.DOI: 10.1093/sleep/31.11.1601.

Merkelbach S, Dillmann U, Kölmel C, Holz J, Müller M. Cardiovascular autonomic dysregulation and fatigue in multiple sclerosis. Mult Scler. 2001;7(5):320-326.DOI: 10.1177/135245850100700508.

Fereshtehnejad SM, Hadizadeh H, Farhadi F, Shahidi GA, Delbari A, Lökk J. Reliability and validity of the Persian version of the fatigue severity scale in idiopathic Parkinson's disease patients. Parkinsons Dis. 2013;2013:935429,1-7. DOI: 10.1155/2013/935429.

Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Qual Life Res. 2005;14(3):875-882.DOI: 10.1007/s11136-004-1014-5.

Piatkowski J, Kern S, Ziemssen T. Effect of BEMER magnetic field therapy on the level of fatigue in patients with multiple sclerosis: a randomized, double-blind controlled trial. J Altern Complement Med. 2009;15(5):507-511.DOI: 10.1089/acm.2008.0501.

Moosavian SP, Paknahad Z, Habibagahi Z, Maracy M. The effects of garlic (Allium sativum) supplementation on inflammatory biomarkers, fatigue, and clinical symptoms in patients with active rheumatoid arthritis: a randomized, double-blind, placebo-controlled trial. Phytother Res. 2020;34(11):2953-2962.DOI: 10.1002/ptr.6723.

Verma SK, Rajeevan V, Jain P, Bordia A. Effect of garlic (Allium sativum) oil on exercise tolerance in patients with coronary artery disease. Indian J Physiol Pharmacol. 2005;49(1):115-118.PMID: 15881870.

Hwang KA, Hwang YJ, Hwang IG, Heo W, Kim YJ. Effects of low temperature-aged garlic on exercise performance and fatigue in mice. J Med Food. 2019;22(9):944-951.DOI: 10.1089/jmf.2018.4294.

Anim-Nyame N, Sooranna SR, Johnson MR, Gamble J, Steer PJ. Garlic supplementation increases peripheral blood flow: a role for interleukin-6? J Nutr Biochem. 2004;15(1):30-36. DOI: 10.1016/j.jnutbio.2003.09.008.

Cavagnaro PF, Camargo A, Galmarini CR, Simon PW. Effect of cooking on garlic (Allium sativum L.) antiplatelet activity and thiosulfinates content. J Agric Food Chem. 2007;55(4):1280-1288. DOI: 10.1021/jf062587s.

Morihara N, Hayama M, Fujii H. Aged garlic extract scavenges superoxide radicals. Plant Foods Hum Nutr. 2011;66(1):17-21. DOI: 10.1007/s11130-011-0216-6.

Saravanan G, Prakash J. Effect of garlic (Allium sativum) on lipid peroxidation in experimental myocardial infarction in rats. J Ethnopharmacol. 2004;94(1):155-158. DOI: 10.1016/j.jep.2004.04.029.

Morihara N, Nishihama T, Ushijima M, Ide N, Takeda H, Hayama M. Garlic as an anti-fatigue agent. Mol Nutr Food Res. 2007;51(11):1329-1334.DOI: 10.1002/mnfr.200700062.

Heesen C, Nawrath L, Reich C, Bauer N, Schulz K, Gold S. Fatigue in multiple sclerosis: an example of cytokine mediated sickness behaviour? J Neurol Neurosurg Psychiatry. 2006;77(1):34-39.DOI: 10.1136/jnnp.2005.065805.

Arreola R, Quintero-Fabián S, López-Roa RI, Flores-Gutiérrez EO, Reyes-Grajeda JP, Carrera-Quintanar L, et al. Immunomodulation and anti-inflammatory effects of garlic compounds. J Immunol Res. 2015;2015:401630,1-14. DOI: 10.1155/2015/401630.

Dehghani S, Alipoor E, Salimzadeh A, Yaseri M, Hosseini M, Feinle-Bisset C, et al. The effect of a garlic supplement on the pro-inflammatory adipocytokines, resistin and tumor necrosis factor-alpha, and on pain severity, in overweight or obese women with knee osteoarthritis. Phytomedicine. 2018;48:70-75. DOI: 10.1016/j.phymed.2018.04.060.


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