Garlic has mild antiplatelet activity and if used as a medi¬cine (100–1000 mg), it should not be administered con-comitantly with antiplatelet agents which include aspirin, clopidogrel, and nonsteroidal anti-inflammatory agents. Garlic must be avoided in patients on anticoagulants. The excessive use of garlic has been observed to cause increased postoperative bleeding and occasionally spontaneous hemo¬rrhage has been reported. Garlic supplements should be discontinued two weeks prior to surgical procedures.
E. Ginger (Zingiber officinale) 1. Benefits and Adverse Effects
Decreased platelet aggregation and inhibition of throm-boxane synthesis has been observed in in vitro studies, but clinical studies have not shown these effects and do not indicate beneficial or harmful effects on the cardiovas¬cular system. Ginger has been advocated mainly to relieve nausea and motion sickness. It is alleged to be a blood thinner, but this claim has not been substantiated.
F. Ginseng (Panax ginseng)
This is a well-known herb that is used to enhance wellness. But in China, where it is believed to have been used for more than 3000 years, it is now used in the management of heart failure, heart attack, angina, and left ventricular diastolic dysfunction with promising results. Panax appears to increase synthesis of nitric oxide, and this may be the explanation for its mild antihypertensive effect. The active substances in P. ginseng are heterogenous triterpene saponin glycosides or ginsenosides. The species includes Asian ginseng (P. ginseng), American ginseng (P. quinquefolius), and Japanese ginseng (P. japanicus). Another species is Siberian ginseng (Eleutherococcus senticosus), which is the root of an unrelated species and does not contain the same substances as panax and technically is not ginseng but has some similar effects. Ginseng, or ren shen in Mandarin, means root of man. It is so-called because the root of the plant has the shape of the human body. The word ginseng is derived from the Greek word for panacea.

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