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Nutritional Supplement

Psyllium

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.

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.7,8,3 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.

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. 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.

10. Hotz J, Plein K. Effectiveness of plantago seed husks in comparison with wheat bran no stool frequency and manifestations of irritable colon syndrome with constipation. Med Klin 1994;89:645-51.

11. Jalihal A, Kurian G. Ispaghula therapy in irritable bowel syndrome: improvement in overall well-being is related to reduction in bowel dissatisfaction. J Gastroenterol Hepatol 1990;5:507-13.

12. Prior A, Whorwell PJ. Double blind study of ispaghula irritable bowel syndrome. Gut 1987;11:1510-3.

13. Passmore AP, Wilson-Davies K, Flanagan PG, et al. Chronic constipation in long stay elderly patients: a comparison of lactulose and senna-fiber combination. BMJ 1993; 307:769-71.

14. Ewerth S, Ahlberg J, Holmstrom B, et al. Influence on symptoms and transit-time of Vi-SiblinR in diverticular disease. Acta Chir Scand Suppl 1980;500:49-50.

15. Eherer AH, Porter J, Fordtran JS. Effect of psyllium, calcium polycarbophil, and wheat bran on secretory diarrhea induced by phenolphthalein. Gastroenterol 1993;104:1007-12.

16. 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.

17. 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.

18. Romero AL, Romero JE, Galaviz S, Fernandez ML. Cookies enriched with psyllium or oat bran lower plasma LDL cholesterol in normal and hypercholesterolemic men from Northern Mexico. J Am Coll Nutr 1998;17:601-8.

19. Jenkins DJA, Wolever TMS, Vidgen E, et al. Effect of psyllium in hypercholesterolemia at two monounsaturated fatty acid intakes. Am J Clin Nutr 1997;65:1524-33.

20. Ganji V, Kies CV. Pysllium husk fiber supplementation to the diets rich in soybean or coconut oil: Hypocholesterolemic effect in healthy humans. Int J Food Sci Nutr 1996;47:103-10.

21. Davidson MH, Maki KC, Kong JC, et al. Long-term effects of consuming foods containing psyllium seed husk on serum lipids in subjects with hypercholesterolemia. Am J Clin Nutr 1998;67:367-76.

22. Gibb R, McRorie J, Jr., Russell D, et al. Psyllium fiber improves glycemic control proportional to loss of glycemic control: a meta-analysis of data in euglycemic subjects, patients at risk of type 2 diabetes mellitus, and patients being treated for type 2 diabetes mellitus. Am J Clin Nutr 2015;102:1604–14.

23. Moesgaard F, Nielsen ML, Hansen JB, Knudsen JT. High-fiber diet reduces bleeding and pain in patients with hemorrhoids. Dis Colon Rectum 1982;25:454-6.

24. 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.

25. Foster S. Herbs for Your Health. Loveland, CO: Interweave Press, 1996, 74-5.

26. 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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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2020.