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Microsoft word - psyllium03_a engl.doc

Psyllium / Psyllium husk
Common names: Flea seed, Ispaghula, Spogel
Botanical names: Plantago ovata, Plantago ispaghula
Parts used and where grown
Psyllium is native to Iran and India and is currently cultivated in these countries. The
seeds are primarily used in traditional herbal medicine. Psyllium seed husks are mainly
used to treat constipation.
Psyllium has been used in connection with the following conditions (refer to the
individual health concern for complete information):
Health Concerns
Diverticular disease
High cholesterol
Irritable bowel syndrome
Type 2 diabetes
High triglycerides
Ulcerative colitis (to maintain remission)
Parkinson’s disease (for constipation)
Weight loss and obesity
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit. Historical or traditional use (may or may not be supported by scientific studies)
In addition to its traditional and current use for constipation, psyllium was also used
topically by herbalists to treat skin irritations, including poison ivy reactions and insect
bites and stings. It has also been used in traditional herbal systems of China and India to
treat diarrhea, hemorrhoids, bladder problems, and high blood pressure.
Active constituents
Psyllium is a bulk-forming laxative and is high in both fiber and mucilage. Psyllium seeds
contain 10–30% mucilage. The laxative properties of psyllium are due to the swelling of
the husk when it comes in contact with water. This forms a gelatinous mass that keeps feces hydrated and soft, provided it is taken with sufficient water. The resulting bulk stimulates a reflex contraction of the walls of the bowel, followed by emptying.1 Psyllium is a common ingredient in over-the-counter bulk laxative products. One
preliminary trial found that psyllium seeds relieved constipation when it was due to
lifestyle factors (e.g., inadequate fiber, sedentary lifestyle), but not when an actual
disease was the cause.2 Numerous double-blind trials have found that supplementation
with psyllium can lower total cholesterol and LDL (“bad”) cholesterol.3 However, levels
of HDL (“good”) cholesterol are not affected by psyllium supplementation.4 The
cholesterol-lowering effect of psyllium has been reported in children,5 as well as in
adults.6 Psyllium supplementation has also improved blood sugar levels in some people
with diabetes.7 8 9 The soluble fiber component of psyllium is believed to account for this
In a double-blind trial, people with ulcerative colitis had a reduction in symptoms such
as bleeding and remained in remission longer when they took 20 grams of ground
psyllium seeds twice daily with water compared to the use of the medication
mesalamine alone.10 Also, the combination of the two was slightly more effective than
either alone.
How much is usually taken?
The suggested intake of psyllium husks to treat constipation is 1 teaspoon
(approximately 5 grams) three times per day. Alternatively, some references suggest
taking 2–6 teaspoons (10–30 grams) of the whole seeds per day—typically taken in three
even amounts throughout the day.11 This is stirred into a large glass of water or juice and
drunk immediately before it thickens.12 It is best to follow label instructions on over-the-
counter psyllium products for constipation. It is important to maintain a high water
intake when using psyllium.
Are there any side effects or interactions?
Using psyllium in recommended amounts is generally safe. People with chronic
constipation should seek the advice of a healthcare professional. Some people with
irritable bowel syndrome feel worse when taking psyllium and may do better with
soluble fiber, such as in fruit. People with an obstruction of the bowel or people with
diabetes who have difficulty regulating their blood sugar should not use psyllium.13 Side
effects, such as allergic skin and respiratory reactions to psyllium dust, have largely been
limited to people working in factories manufacturing psyllium products.
Are there any drug interactions?
Certain medicines may interact with psyllium. Refer to drug interactions for a list of
those medicines.
1. Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2d ed. New York: John Wiley & Sons, 1996, 427–9. 2. Voderholzer WA, Schatke W, Mühldorfer BE, et al. Clinical response to dietary fiber treatment of chronic constipation. Am J Gastroenterol 1997;92:95–8. 3. Anderson JW, Allgood LD, Turner J, et al. Effects of psyllium on glucose and serum lipid response in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr 1999;70:466–73. 4. Oson BH, Anderson SM, Becker MP, et al. Psyllium-enriched cereals lower blood total cholesterol and LDL cholesterol, but not HDL cholesterol, in hypercholesterolemic adults: Results of a meta-analysis. J Nutr 1997;127:1973–80. 5. Davidson MH, Dugan LD, Burns JH, et al. A psyllium-enriched cereal for the treatment of hypercholesterolemia in children: A controlled, double-blind, crossover study. Am J Clin Nutr 1996;63:96–102. 6. Anderson JW, Davidson MH, Blonde L, et al. Long-term cholesterol-lowering effects as an adjunct to diet therapy in the treatment of hypercholesterolemia. Am J Clin Nutr 2000;71:1433–8. 7. Florholmen J, Arvidsson-Lenner R, Jorde R, Burhol PG. The effect of Metamucil on postprandial blood glucose and plasma gastric inhibitory peptide in insulin-dependent diabetics. Acta Med Scand 1982;212:237–9. 8. Rodriguez-Moran M, Guerrero-Romero F, Lazcano-Burciaga G. Lipid- and glucose-lowering efficacy of plantago psyllium in type II diabetes. J Diabetes Complications 1998;12:273–8. 9. Anderson JW, Allgood LD, Turner J, et al. Effects of psyllium on glucose and serum lipid response in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr 1999;70:466–73. 10. Fernandez-Banares F, Hinojosa J, Sanchez-Lombrana JL, et al. Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Am J Gastroenterol 1999;94:427–33. 11. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 190–2. 12. Foster S. Herbs for Your Health. Loveland, CO: Interweave Press, 1996, 74–5. 13. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, MA: Integrative Medicine Communications, 1998, 190–2.


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