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300 mg per day in two or three divided doses is most likely appropriate. Garlic is one of the most commonly ingested herbal supplements with a wide range of reported health benefits.  Its role in cardio- vascular disease has mainly focused on reducing choles- terol levels, but it has also been suggested that garlic may play a role in lowering blood pressure and prevent- ing plaque build-up in the body's arteries.  Studies have suggested that garlic supplementation can reduce age-related vascular changes including plaque formation within the heart arteries, also known as ath- erosclerosis, and may pre- vent recurrent heart attack and death following an initial heart attack (79,80). Additional randomized trials are necessary before these claims can be fully support- ed. When choosing to take garlic, remember it is the ability of the supplement to yield allicin that confers ben- efit.  When selecting a garlic preparation, make sure that it is stomach coated in order to avoid being broken down by stomach acid.  Lastly, some "odor free" garlic preparations may have no active ingredients at all (81). The typical dosage is 900 mg daily, given in three divided doses or 4 grams of fresh garlic. Hawthorn's potential bene- fits and its uses in cardiovas- cular disease have mainly focused on congestive heart failure rather than CHD. Research has suggested that hawthorn supplementation can increase the blood flow through heart arteries, but this has not yet been linked to any clear benefit in people with CHD (82). L-Carnitine may give the heart a boost.  It is also known as simply carnitine. Manufactured in the liver, kid- neys, and brain, this B vita- min is important in the trans- portation of energy mole- cules within heart muscle cells.  For people living with CHD, L-Carnitine levels have been identified as reduced in heart muscle during periods of activity, and its supplementation has been shown to reduce chest pain attributed to the heart (angina), improve exercise tolerance, and improve the electrocardio- graphic changes frequently identified in CHD patients during exercise (83,84).  L- Carnitine 1 gram taken twice a day has been sug- gested as the appropriate dose.  It is important not to take D- or DL-carnitine which are found in some over-the-counter prepa- rations and may lead to some severe side effects or symptoms suggestive of L-Carnitine deficiency (70). Folic Acid Vitamin B12 Vitamin B6 Vitamin E Magnesium Coenzyme Q10 L-Carnitine Daily Supplementation Levels for Coronary Heart Disease 1200 mcg 1000 mcg or 1 mg 100 mg 400 I.U. 600-1000 mg 200-300 mg in 2 or 3 divided doses 2 grams taken in 2 doses

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