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Garlic can cause heartburn, nausea, and loose stools at high doses, especially in those unaccustomed to it. Its most characteristic and troublesome side effect, however, is persisting breath odor, which no amount of tooth brushing will eradicate. Allicin and its odoriferous metabolic products are actually released into the lung alveoli and exhaled.

Allergic contact dermatitis and even burns from prolonged skin contact with the cloves have been reported. Systemic allergy with bronchospasm or hives from ingestion occurs rarely. There is some concern that chronic high doses may lead to decreased hemoglobin production.

Garlic should be avoided in gastroesophageal reflux disease and peptic ulcer disease. High doses should be avoided in pregnancy. Garlic does pass into breast milk but so far has not been shown to be harmful. Cases of botulism have been reported from chopped garlic or garlic oil left out for long periods at room temperature. Administration of garlic with anticoagulant and an-tiplatelet drugs should be avoided because of the risk of bleeding.

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