Two hundred-ten patients with Helicobacter pylori infection, as determined by gastric biopsies, were randomly assigned to one of seven treatment groups: 1) standard eradication treatment (lansoprazole, clarithromycin, and amoxicillin for 14 days), 2) standard treatment plus 1,000 mg/day of ascorbic acid, 3) 1,000 mg/day of ascorbic acid for 14 days, 4) standard treatment plus 120 mg/day of beta-carotene, 5) 120 mg/day of beta-carotene for 14 days, 6) standard treatment plus allicin, or 7) allicin for 14 days. The dose of allicin used was reported as both 1,200 and 4,200 mcg/day throughout the study, so it is not clear what the actual dose was. Gastric biopsies were repeated four weeks after the end of the treatment period. The eradication rate was 66.7% with standard treatment, 50% with standard treatment plus ascorbic acid, 10% with ascorbic acid alone, 50% with standard treatment plus beta-carotene, 0% with beta-carotene alone, 90% with standard treatment plus allicin, and 23.3% with allicin alone. Thus, 1,000 mg/day of ascorbic acid for 14 days resulted in an eradication rate of 10%, but the addition of ascorbic acid to standard treatment did not increase the eradication rate, compared with standard treatment alone. Allicin produced an eradication rate of 23.3%, and the addition of allicin to standard treatment increased the eradication rate from 66.7% to 90%. Beta-carotene was ineffective.

Comment: The search for effective natural alternatives to standard triple-therapy for patients with H. pylori infection has so far been frustrating (see Gaby AR. Altern Med Rev 2001;6:355-366). Although some treatments (such as mastic) are claimed to be beneficial, the research has been done only in vitro, which does not necessarily translate to effectiveness in vivo. In a previous report (Eur J Cancer Prev 1998;7:449-454) supplementation with 5 g/day of vitamin C was said to eradicate H. pylori in 30% of cases. In that study, however, the patients were assessed at the end of the treatment period, rather than the more appropriate 30 days after treatment was discontinued. Consequently, it was not possible to distinguish between transient suppression of H. pylori and true eradication.

In the present study, both vitamin C and allicin (a component of garlic) eradicated H. pylori in a small proportion of patients. As each of these treatments is safe, they may be considered as alternatives to conventional therapy, which has a higher incidence of side effects. Higher doses of vitamin C might be more effective than the 1 g/day used in this study. Of course, patients should be followed up, to determine whether re-treatment with conventional therapy is necessary.

Kockar C, et al. Helicobacter pylori eradication with beta carotene, ascorbic acid and allicin. Acta Medica 2001;44:97-100.