Psyllium
Uses
Parts Used & 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.
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3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
This supplement has been used in connection with the following health conditions:
| Used for | Why |
|---|---|
3 Stars Constipation 5 to 10 grams daily in water, followed by a second glass of water | Psyllium is a mild bulk-forming laxative that’s best suited for long-term use in people with constipation. The laxatives most frequently used world-wide come from plants. Herbal laxatives are either bulk-forming or stimulating. Bulk-forming laxatives come from plants with a high fiber and mucilage content that expand when they come in contact with water; examples include , flaxseed, and fenugreek. As the volume in the bowel increases, a reflex muscular contraction occurs, stimulating a bowel movement. These mild laxatives are best suited for long-term use in people with constipation. Many doctors recommend taking 7.5 grams of psyllium seeds or 5 grams of psyllium husks, mixed with water or juice, one to two times per day. Some doctors use a combination of senna (18%) and psyllium (82%) for the treatment of chronic constipation. This has been shown to work effectively for people in nursing homes with chronic constipation. |
3 Stars Diverticular Disease 7 grams daily in water, followed by a second glass of water | A preliminary trial found that psyllium, a good source of fiber, was effective in relieving the symptoms associated with diverticular disease and constipation. A preliminary trial of the herb supports the use of this type of fiber in relieving the symptoms associated with diverticular disease and constipation. |
3 Stars High Cholesterol 2 to 20 grams (about ½–4 teaspoons) per day with meals | Psyllium husk has been shown to be effective at lowering total and LDL-cholesterol levels. husk is rich in viscous soluble fiber and is used as a supplement to lower high cholesterol levels, as well as improve digestive function. Psyllium has been shown in multiple clinical trials and meta-analyses to lower high total, LDL-, and non-HDL-cholesterol levels. One meta-analysis included data from 28 randomized controlled trials with a combined total of 1,924 participants and found psyllium, at doses ranging from about 2.4–20.4 grams per day for at least three weeks, lowered LDL- and non-HDL-cholesterol levels in both those with high and normal baseline cholesterol levels. In another meta-analysis that examined data from eight randomized controlled trials with a total of 395 subjects with type 2 diabetes, psyllium use was found to lower LDL-cholesterol and triglyceride levels. In a meta-analysis of three trials, psyllium was further found to enhance the cholesterol-lowering effects of statin drugs to a degree comparable to doubling the medication dose. Psyllium has even been found to be safe and effective for treating children and adolescents with high cholesterol levels. |
3 Stars Irritable Bowel Syndrome 3.25 grams taken three times per day | Some people with IBS may benefit from bulk-forming laxatives. Psyllium has helped regulate normal bowel activity and improved symptoms in some people with IBS. Some people with IBS may benefit from bulk-forming laxatives. seeds (3.25 grams taken three times per day) have helped regulate normal bowel activity in some people with IBS. Psyllium has improved IBS symptoms in double-blind trials. |
3 Stars Type 2 Diabetes 5 grams (about 1 teaspoon) twice daily with meals | Supplementing with psyllium has been shown to be a safe and well-tolerated way for people with type 2 diabetes to improve control of blood glucose and cholesterol levels. Supplementing with psyllium has been shown to be a safe and effective way to improve control of blood glucose and cholesterol. A large review and meta-analysis that included 35 randomized controlled trials found that long-term psyllium use, at a dose of 10.2 grams per day taken before meals, reduces fasting glucose an average of 37 mg/dL and HgbA1c an average of 0.97% in people with type 2 diabetes, with greater improvements seen in those with higher baseline fasting blood glucose levels. |
2 Stars Diarrhea 9 to 30 grams daily | Psyllium seed (an excellent source of fiber) makes stool more solid and can help resolve diarrhea symptoms. While fiber from dietary or herbal sources is often useful for constipation, it may also play a role in alleviating diarrhea. For example, 9–30 grams per day of (an excellent source of fiber) makes stool more solid and can help resolve symptoms of non-infectious diarrhea. Alginic acid, one of the major constituents in bladderwrack(Fucus vesiculosus), is a type of dietary fiber and as a result may potentially help relieve diarrhea. However, human studies have not been done on how effective bladderwrack is for this condition. |
2 Stars Hemorrhoids 7 grams three times daily in water, followed by a second glass of water | Taking psyllium, an herb high in fiber, may help relieve constipation. Constipation is believed to worsen hemorrhoid symptoms, and thus, bulk-forming fibers are often recommended for those with hemorrhoids. A double-blind trial reported that 7 grams of , an herb high in fiber, taken three times daily reduced the pain and bleeding associated with hemorrhoids. Some healthcare professionals recommend taking two tablespoons of psyllium seeds or 1 teaspoon of psyllium husks two or three times per day mixed with water or juice. It is important to maintain adequate fluid intake while using psyllium. |
2 Stars High Triglycerides 15 grams daily | Psyllium seeds and husks have shown a modest ability to lower blood triglyceride levels in some clinical trials. seeds and husks have shown a modest ability to lower blood triglyceride levels in some, but not all, clinical trials. Further research is needed to assess the effect of psyllium on triglyceride levels more closely, as much of the study so far has focused on lowering cholesterol levels. |
2 Stars Ulcerative Colitis Refer to label instructions | Taking psyllium may help people with ulcerative colitis maintain remission. In a preliminary trial, people with UC remained in remission just as long when they took 20 grams of ground psyllium seeds twice daily with water as when they took the drug mesalamine. The combination of the two was slightly more effective than either alone. Controlled trials are now needed to confirm and therapeutic effect of psyllium of UC. |
1 Star Parkinson’s Disease and Constipation 3 to 5 grams taken at night with a one to two glasses of fluid | Preliminary research has shown that psyllium seed husks improve constipation and bowel function in people with Parkinson’s disease and constipation. Doctors recommend that people with Parkinson’s disease supplement with fiber and maintain adequate fluid intake to reduce constipation associated with this disease.Preliminary research has shown that seed husks improve constipation and bowel function in people with Parkinson’s disease and constipation. A typical recommendation for psyllium seed husks is 3 to 5 grams taken at night with a one to two glasses of fluid. |
Traditional Use (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.
How It Works
How It Works
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 effect.
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 to Use It
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.
Interactions
Interactions with Supplements, Foods, & Other Compounds
Interactions with Medicines
Certain medicines interact with this supplement.
Replenish Depleted Nutrients
none
Reduce Side Effects
- Orlistat
In a group of obese women taking orlistat three times per day, ingestion of 6 grams of psyllium with each dose of orlistat significantly reduced the gastrointestinal side effects of the drug.
Support Medicine
- AtorvastatinIn one study, supplementation with 15 grams of psyllium per day for eight weeks enhanced the cholesterol-lowering effect of simvastatin.
- Fluvastatin
- LovastatinIn one study, the addition of psyllium (10 grams per day) enhanced the cholesterol-lowering effect of lovastatin
- Mesalamine
Taking 20 grams of psyllium seeds together with mesalamine for 12 months was more effective at maintaining remission of ulcerative colitis than taking either the drug or herb alone. People taking mesalamine should consult with their healthcare practitioner to determine whether they should add psyllium seeds to their treat regimen.
- PravastatinIn one study, the addition of psyllium (10 grams per day) enhanced the cholesterol-lowering effect of lovastatin.
- RosuvastatinIn one study, the addition of psyllium (10 grams per day) enhanced the cholesterol-lowering effect of lovastatin.
- Simvastatin
In one study, supplementation with 15 grams of psyllium per day for eight weeks enhanced the cholesterol-lowering effect of simvastatin.
Reduces Effectiveness
- Lithium
Addition of psyllium (Plantago ovata) husk two times per day to the regimen of a woman treated with lithium was associated with decreased lithium blood levels and lithium levels increased after psyllium was stopped.
Potential Negative Interaction
none
Explanation Required
none
Side Effects
Side Effects
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.
References
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. Olson 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.
Last Review: 05-24-2015
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