Plant Comparison
Garlic vs Perforate St John’s-wort
A side-by-side comparison of two medicinal plants — every documented constituent, action, use, safety note and cited source, assembled automatically from the Omnia Sana database.
At a glance
Garlic and Perforate St John’s-wort: they share 6 indicated uses (arthritis / joint pain, cold & flu, infection (general), …); 2 pharmacological actions in common.
Evidence face-off — shared uses
| Condition | Garlic | Perforate St John’s-wort | Verdict |
|---|---|---|---|
| Arthritis / joint pain | 9/10 | 1/10 | Stronger for Garlic |
| Cold & flu | 9/10 | 1/10 | Stronger for Garlic |
| Infection (general) | 8/10 | 1/10 | Stronger for Garlic |
| Inflammation (general) | 9/10 | 1/10 | Stronger for Garlic |
| Skin irritation | 9/10 | 1/10 | Stronger for Garlic |
| Wounds | 8/10 | 1/10 | Stronger for Garlic |
Evidence scores (1–10) are computed from the tier of each cited source. “Comparable” means the two scores are within one point. Follow a score to its detailed sources.
Key Constituents
Allicin (diallyl thiosulfinate), formed enzymatically when raw garlic is crushed, together with ajoene and the aged-garlic compound S-allyl-cysteine, are the principal bioactives behind garlic's antimicrobial and cardiovascular effects — acting partly by raising nitric oxide and by targeting microbial thiol-containing enzymes.
Red pigments historically used to standardise extracts; contribute to antiviral activity and are the compounds responsible for photosensitivity risk.
Considered the principal compound behind the antidepressant activity and the main driver of the herb's potent CYP3A4/P-glycoprotein induction and drug-interaction profile.
Antioxidant flavonoids contributing to overall activity.
Pharmacological Actions
Garlic organosulfur compounds (allicin, diallyl trisulfide, ajoene, S-allylcysteine) induce apoptosis and cell-cycle arrest and inhibit proliferation, invasion and metastasis across leukaemia, breast, colon and other cancers (preclinical); a randomized trial found garlic supplementation reduced gastric-cancer mortality.
Traditional & Indicated Uses
inferred from anti-inflammatory action
inferred from antidiabetic action
Garlic and its organosulfur compounds show broad preclinical anticancer/chemopreventive activity (apoptosis, cell-cycle arrest, anti-invasion); in the randomized Shandong Intervention Trial, 7 years of garlic supplementation significantly reduced gastric-cancer mortality over 22-year follow-up (preclinical + RCT).
inferred from immunomodulator action
inferred from antifungal action
inferred from anti-inflammatory action
inferred from antidiabetic action
inferred from anti-inflammatory action
inferred from anti-inflammatory action
inferred from antiviral action
inferred from anti-inflammatory action
inferred from sedative action
inferred from anti-inflammatory action
Safety, Cautions & Contraindications
Garlic is generally very safe at culinary and supplemental doses for most healthy adults. Raw garlic contains allicin (formed when crushed) at concentrations that can irritate the gastrointestinal tract — nausea, heartburn, flatulence, and diarrhoea are the most common side effects, especially with large amounts of raw garlic on an empty stomach. Garlic may inhibit platelet aggregation and enhance anticoagulant effects of warfarin — use caution with blood-thinning medications, especially before surgery (stop 7–10 days prior). May lower blood pressure and blood sugar — caution when combined with antihypertensive or antidiabetic medications. Topical raw garlic can cause chemical burns (contact dermatitis) and should not be applied undiluted to skin for prolonged periods. Odour (from allicin metabolites) affects breath and perspiration. Pregnancy: culinary amounts safe; avoid medicinal-dose supplements due to blood-thinning risk (National Center for Complementary and Integrative Health, 2021).
Duke (2002) rates garlic as +++ with exceptional clinical evidence (score 3) for antiseptic activity, and score 2 for anti-aggregant (antiplatelet), antiatherosclerotic, antiatherogenic, antibacterial, and antimycotic effects — among the most clinically validated herbal medicines. Commission E approves garlic for arteriosclerosis prevention and elevated blood lipids. Dose: 4 g (1 clove) fresh garlic daily, or 300 mg standardized dry powder extract (1.3% allicin) three times daily. Important interaction: garlic significantly potentiates anticoagulant medications (warfarin, aspirin) due to its anti-aggregant effects; use with caution in patients on blood thinners (Duke, 2002).
Significant drug interactions: strongly induces CYP3A4 and P-glycoprotein, reducing plasma levels of many drugs including oral contraceptives, antiretrovirals, cyclosporine, warfarin, and digoxin. May cause photosensitivity (fair-skinned individuals). Do not combine with SSRIs, SNRIs, or MAOIs (serotonin syndrome risk). Avoid in bipolar disorder.
Duke (2002) rates St. John's wort as ++ (raised from earlier editions) and notes antidepressant, antiviral, antibacterial, and wound-healing activities at experimental and clinical levels. Hypericin and hyperforin are identified as key active constituents. Clinical evidence (score 2) confirms antidepressant efficacy in mild-to-moderate depression, and WHO/Commission E provide approval for this indication. Dose: 300 mg standardized extract (0.3% hypericin, 3–5% hyperforin) three times daily. Duke emphasizes the critical drug interaction: St. John's wort is a potent CYP3A4 inducer and can significantly reduce blood levels of many medications including oral contraceptives, cyclosporine, antiretrovirals, and warfarin. Avoid combined use with SSRIs (serotonin syndrome risk) and pharmaceutical antidepressants (Duke, 2002).
External Ids
Botanical Description
Bulbous perennial herb usually grown as an annual, forming an underground compound bulb ('head') of several angular cloves wrapped in papery white to purplish skin. The leaves are flat, narrow and strap-shaped, greyish-green, arising from the bulb. A tall, leafless flowering stem (scape) may rise from the bulb bearing a rounded umbel of small pink-white flowers, often mixed with small bulbils, though cultivated garlic rarely sets true seed.[1]
Erect, branching perennial herb with paired, oval leaves dotted with tiny translucent oil glands that look like pinpricks when held to the light (giving the species name 'perforatum'). Bright yellow, five-petalled flowers with numerous stamens and black dots along the petal edges are borne in flat-topped clusters, and release a reddish pigment when crushed.[4]
Habitat
Believed to originate in Central Asia; cultivated worldwide in temperate and subtropical climates as a garden and field crop, thriving in well-drained, sunny sites.[1]
Grows in grassland, roadsides, woodland clearings and waste ground on well-drained soils; native to Europe, Western Asia and North Africa and widely naturalised elsewhere, including North America and Australia.[4]
Harvesting
Bulbs are lifted in mid- to late summer once the leaves have yellowed and died back, then cured (dried) in a warm, airy place before storage; young leaves and immature flower scapes ('sprouts') can be cut earlier in the season.
The flowering tops (flower and upper leaf) are cut in summer as the flowers open, around the traditional St John's Day period, and dried quickly in a warm, shaded, airy place to preserve the hypericin and hyperforin content.[4]
Traditional Uses
Garlic has one of the longest continuous medicinal histories of any plant, used across many traditional systems (Ayurvedic, Chinese, Egyptian, Greco-Roman and European folk medicine) as an antimicrobial, cardiovascular and respiratory remedy, for colds and infections, and as a digestive and immune tonic. This traditional reputation is now among the most extensively clinically studied of all herbal medicines.[1, 9]
St John's wort has a centuries-long European folk reputation as a wound-healing and nerve tonic herb, traditionally used for mild wounds, burns and nerve pain and to lift low mood; this traditional mood-supporting use is now one of the most extensively clinically studied applications of any herbal medicine, with standardised extracts shown comparable to conventional antidepressants for mild-to-moderate depression.[1, 4]
Preparations
Flowering-top extract standardised to hypericin and/or hyperforin content, taken as tablets or capsules; the best-studied clinical form for mood support.
Dosage
The WHO monograph on Bulbus Allii Sativi gives an average daily dose of 2-5 g of fresh garlic (roughly one to two cloves), alongside 0.4-1.2 g of dried powder, 2-5 mg of oil and 300-1000 mg of extract as solid material. The EU herbal monograph gives no posology for fresh cloves, so WHO is the source here. Educational reference only, not a prescription.
The EU herbal monograph gives, for adults and elderly, powdered herbal substance at a single dose of 300-750 mg for a daily dose of 900-1380 mg divided into 3 to 5 doses; liquid extract 110-220 mg four times daily; and, for the second indication, dry extract 100-200 mg 1-2 times daily (daily dose 100-400 mg). Garlic is CONTRAINDICATED in patients on saquinavir/ritonavir therapy. Not recommended under 18 years for the first indication. Educational reference only, not a prescription.
Clinical trials for mild-to-moderate depression commonly use around 300 mg of standardised extract three times daily (900 mg/day total); given extensive drug interactions, use should be discussed with a healthcare provider, especially alongside other medicines. Educational reference only, not a prescription.
References
Drug Class Interactions
Pairings
Garlic and ginger both reduce blood clotting/platelet stickiness, so taking them together may add up and raise the risk of bruising or bleeding — use caution, especially before surgery or alongside blood-thinning drugs.[30, 31]
Garlic and ginseng both reduce blood clotting/platelet stickiness, so taking them together may add up and raise the risk of bruising or bleeding — use caution, especially before surgery or alongside blood-thinning drugs.[30]
Garlic and feverfew both reduce blood clotting/platelet stickiness, so taking them together may add up and raise the risk of bruising or bleeding — use caution, especially before surgery or alongside blood-thinning drugs.[30, 32]
Garlic and black seed (Nigella sativa) can each mildly lower blood pressure, so taking them together — especially alongside blood-pressure medicines — may add up and lower blood pressure more than expected. Monitor your blood pressure.[29, 33]
St John's wort raises serotonin activity and can cause serotonin syndrome when combined with other serotonin-boosting agents; pairing it with another mood-active, serotonergic herb such as saffron may add to this risk.[30]
St John's wort is a strong enzyme inducer and increases serotonin activity; combining it with another antidepressant-type herb such as rhodiola may add to serotonergic effects and unpredictably change how each is handled by the body.[30]
St John's wort speeds up the breakdown of many substances and also raises serotonin activity; pairing it with a sedative herb such as valerian may add to drowsiness and can unpredictably change how each is handled by the body.[30, 31]
St John's wort is a strong enzyme inducer and kava is a liver-metabolised sedative; combining them may add to central-nervous-system effects and alter how kava is processed, so combined use warrants caution.[30, 31]
Lookalikes Review
Dangerous Lookalikes
Not documented
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https://doi.org/10.1016/j.lfs.2004.04.005 - Liu, Y., Jiang, Y., Huang, R., Yang, J., Xiao, B. and Dong, J (2013) 'Hypericum perforatum L. preparations for menopause: a meta-analysis of efficacy and safety', Climacteric, 17(4), pp. 325-335. doi:10.3109/13697137.2013.861814 Meta-analysis / review
https://doi.org/10.3109/13697137.2013.861814 - Wurglics, M. and Schubert-Zsilavecz, M (2006) 'Hypericum perforatum: a 'modern' herbal antidepressant: pharmacokinetics of active ingredients', Clinical Pharmacokinetics, 45(5), pp. 449-468. doi:10.2165/00003088-200645050-00002 Meta-analysis / review
https://doi.org/10.2165/00003088-200645050-00002 - Kasper, S (2001) 'Hypericum perforatum - a review of clinical studies', Pharmacopsychiatry, 34(Suppl 1), pp. S51-S55. doi:10.1055/s-2001-15467 Meta-analysis / review
https://doi.org/10.1055/s-2001-15467 - Nathan, P (1999) 'The experimental and clinical pharmacology of St John's Wort (Hypericum perforatum L.)', Molecular Psychiatry, 4(4), pp. 333-338. doi:10.1038/sj.mp.4000557 Meta-analysis / review
https://doi.org/10.1038/sj.mp.4000557 - Verotta, L (2003) 'Hypericum perforatum, a source of neuroactive lead structures', Current Topics in Medicinal Chemistry, 3(2), pp. 187-201. doi:10.2174/1568026033392589 Meta-analysis / review
https://doi.org/10.2174/1568026033392589 - Linde, K. et al (2008) 'St John'. Traditional / reference
https://scholar.google.com/scholar?q=St%20John - Natural Standard (2013) 'Hypericum perforatum (St'. Traditional / reference
https://scholar.google.com/scholar?q=Hypericum%20perforatum%20%28St - Duke, J.A (2002) 'Handbook of Medicinal Herbs, Second Edition'. Traditional / reference
https://scholar.google.com/scholar?q=Handbook%20of%20Medicinal%20Herbs%2C%20Second%20Edition - Zhou, S., Chan, E., Pan, S.Q., Huang, M. and Lee, E.J.D (2004) 'Pharmacokinetic interactions of drugs with St John's wort', Journal of Psychopharmacology, 18(2), pp. 262-276. doi:10.1177/0269881104042632 Meta-analysis / review
https://doi.org/10.1177/0269881104042632 - Izzo, A.A. and Ernst, E (2009) 'Interactions between herbal medicines and prescribed drugs: an updated systematic review', Drugs, 69(13), pp. 1777-1798. doi:10.2165/11317010-000000000-00000 Meta-analysis / review
https://doi.org/10.2165/11317010-000000000-00000 - Borrelli, F. and Izzo, A.A (2009) 'Herb-drug interactions with St John's wort (Hypericum perforatum): an update on clinical observations', The AAPS Journal, 11(4), pp. 710-727. doi:10.1208/s12248-009-9146-8 Meta-analysis / review
https://doi.org/10.1208/s12248-009-9146-8 - Nicolussi, S., Drewe, J., Butterweck, V. and Meyer zu Schwabedissen, H.E (2020) 'Clinical relevance of St. John's wort drug interactions revisited', British Journal of Pharmacology, 177(6), pp. 1212-1226. doi:10.1111/bph.14936 Meta-analysis / review
https://doi.org/10.1111/bph.14936 - Piscitelli, S.C., Burstein, A.H., Chaitt, D., Alfaro, R.M. and Falloon, J (2000) 'Indinavir concentrations and St John's wort', Lancet, 355(9203), pp. 547-548. doi:10.1016/S0140-6736(99)05712-8 Clinical study
https://doi.org/10.1016/S0140-6736(99)05712-8 - Barone, G.W., Gurley, B.J., Ketel, B.L., Lightfoot, M.L. and Abul-Ezz, S.R (2000) 'Drug interaction between St. John's wort and cyclosporine', Annals of Pharmacotherapy, 34(9), pp. 1013-1016. doi:10.1345/aph.10088 Clinical study
https://doi.org/10.1345/aph.10088 - Murphy, P.A., Kern, S.E., Stanczyk, F.Z. and Westhoff, C.L (2005) 'Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding', Contraception, 71(6), pp. 402-408. doi:10.1016/j.contraception.2004.11.004 Clinical study
https://doi.org/10.1016/j.contraception.2004.11.004 - Murphy, P.A., Kern, S.E., Stanczyk, F.Z. and Westhoff, C.L (2005) 'Interaction of St. John's Wort with oral contraceptives: effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding', Contraception, 71(6), pp. 402-408. doi:10.1016/j.contraception.2004.11.004 Clinical study
https://doi.org/10.1016/j.contraception.2004.11.004 - Pfrunder, A., Schiesser, M., Gerber, S., Haschke, M., Bitzer, J. and Drewe, J (2003) 'Interaction of St John's wort with low-dose oral contraceptive therapy: a randomized controlled trial', British Journal of Clinical Pharmacology, 56(6), pp. 683-690. doi:10.1046/j.1365-2125.2003.02005.x Randomized trial
https://doi.org/10.1046/j.1365-2125.2003.02005.x - Johne, A., Brockmoller, J., Bauer, S., Maurer, A., Langheinrich, M. and Roots, I (1999) 'Pharmacokinetic interaction of digoxin with an herbal extract from St John's wort (Hypericum perforatum)', Clinical Pharmacology and Therapeutics, 66(4), pp. 338-345. doi:10.1053/cp.1999.v66.a101944 Clinical study
https://doi.org/10.1053/cp.1999.v66.a101944 - Mathijssen, R.H.J., Verweij, J., de Bruijn, P., Loos, W.J. and Sparreboom, A (2002) 'Effects of St. John's wort on irinotecan metabolism', Journal of the National Cancer Institute, 94(16), pp. 1247-1249. doi:10.1093/jnci/94.16.1247 Randomized trial
https://doi.org/10.1093/jnci/94.16.1247 - Smith, P., Bullock, J.M., Booker, B.M., Haas, C.E., Berenson, C.S. and Jusko, W.J (2004) 'The influence of St. John's wort on the pharmacokinetics and protein binding of imatinib mesylate', Pharmacotherapy, 24(11), pp. 1508-1514. doi:10.1592/phco.24.16.1508.50958 Clinical study
https://doi.org/10.1592/phco.24.16.1508.50958 - Izzo, A.A (2004) 'Drug interactions with St. John's Wort (Hypericum perforatum): a review of the clinical evidence', International Journal of Clinical Pharmacology and Therapeutics, 42(3), pp. 139-148. doi:10.5414/cpp42139 Meta-analysis / review
https://doi.org/10.5414/cpp42139 - Caus, M.N., Lupoae, M. and Chitescu, C.L (2026) 'Efficacy and Safety of Herbal Supplements with Anxiolytic, Antidepressant, and Sedative Action: A Review of Clinical Data and Toxicological Risks', Pharmaceuticals, 19(3), pp. 399. doi:10.3390/ph19030399 Meta-analysis / review
https://doi.org/10.3390/ph19030399
Generated automatically from the Omnia Sana plant database and its cited sources. For educational purposes only — not medical advice. Always consult a qualified practitioner before using medicinal plants.