encyclopedia

Psyllium

Scientific Names:
Plantago psyllium L., P. ovata L., P. afra L. or P. indica L [Fam. Plantaginaceae]

Forms:
Black or blonde whole or ground psyllium seeds; Blonde psyllium husks

Traditional Usage:
– Anal Fissures

– Anti-inflammatory

– Antioxidant

– Astringent

– Blood Sugar Control

– Breathing Disorders

– Cellular Regeneration

– Cholesterol Reduction

– Cleansing

– Colitis

– Constipation

– Cystitis

– Detoxifying

– Diarrhea

– Digestive Upsets

– Diverticulitis

– Dysentery

– Gastritis

– Hemorrhoids/Piles

– High Triglycerides (in men)

– Hormone Balancing

– Hypercholesterolemia

– Hyperlipidemia

– Inflammatory Bowel Disease

– Insulin Requirement Reduction

– Irritable Bowel Syndrome

– Laxative

– Poultice

– Reducing LDL Cholesterol

– Soothing Agent (emollient, demulcent)

– Sore Throat

– Ulcers

– Urinary Tract Disorders

– Vascular Disorders

– Weight Control

– Weight Loss

Overview:
Psyllium products, also known as ispaghula, consist of the dried, ripe seed of Plantago psyllium L. (or P. ovata L., P. afra L. or P. indica L) [Fam. Plantaginaceae], as well as preparations of the ground seed and husks. Psyllium has a long history of traditional use as a medicine in the US, Europe, India, and China. Psyllium seed was traditionally used for treating chronic or occasional constipation, as a soothing, non-irritating bulk laxative, as an absorbent fiber for treating diarrhea and for alleviating irritable bowel syndrome, gastritis and diverticulitis. Some other uses of psyllium in traditional medicine include as an emollient, demulcent and diuretic. A randomized, double-blind, controlled trial comparing psyllium mucilloid with a synthetic cholesterol lowering drug called colestipol found psyllium to be an effective treatment for hyperlipidemia. A strategy was used to see if psyllium might make bile acid sequestrants, which are seldom used because they cause adverse effects such as bloating and constipation, more tolerable and less expensive. The results showed that combination therapy reduced the ratio of total cholesterol to HDL significantly more than did colestipol alone or psyllium alone. With 5 grams of each drug or drug combination being taken three times daily before meals for 10 weeks, the ratio of total cholesterol to high-density lipoprotein cholesterol (HDL) was reduced by 18.2% with the combination of 2.5 grams psyllium and 2.5 grams colestipol; by 10.6% with colestipol alone; by 6.1% with psyllium alone; and by 0.1% with cellulose placebo. Based on a 30-day human, placebo controlled clinical trial, taking 15g of psyllium husk/day lowered plasma LDL-cholesterol levels by 7-9%. The same dosage of psyllium husk significantly reduced blood glucose and especially insulin requirements. Researchers also found that seriously overweight women who took psyllium before meals lost more weight than those who didn’t.

Active Ingredients:
Psyllium seeds (P. psyllium) contain: 10-30% mucilage, mainly concentrated in the husk or outer epidermis of the seed coat. This soluble fiber is largely made up of xylose, galacturonic acid, arabinose and rhamnose. The seeds also contain: hemicellulose; 15-20% protein; 5-13% fixed oil with linoleic and oleic acid esters (omega-6 and 9 fatty acids); phytosterols; triterpenes; aucubin (iridoid glycoside); and the alkaloids plantagonine, indicaine and indicamine. Variations exist in the concentration of constituents between the different species and varieties of psyllium (black and blonde) and also between whole seed and husks. For instance, blonde psyllium husks (P. ovata) contain only 2.5% fixed oil with linoleic, oleic and palmitic acids compared with 5-13% fixed oil in black psyllium seed (P. psyllium).

Suggested Amount:
Psyllium seed: As a laxative or source of soluble fibre and mucilage: 1 heaping teaspoonful (ca. 5g) of whole or ground seed is mixed or shaken with 100 ml of liquid and this is taken one to four times daily, each time followed by drinking at least 200ml of fluid. Psyllium husk: The husk is recommended with the dosage of: 1 heaping teaspoonful (ca. 4-5 grams) stirred into 150ml of water and taken one to four times daily followed by generous amounts of liquid (i.e. drink an additional 150ml of water for every 5 grams of psyllium husk taken). For sugar control, seeds are said to be better than husks and less irritating to the gastrointestinal tract, but both seed and husks are effective.

Drug Interactions:
As with any other laxative and/or significant source of mucilage, the absorption of other drugs may be negatively affected, and so psyllium should not be taken within 2 hours of taking any other medicine.

Contraindications:
Whole seed and presscake products are contraindicated in the case of impacted bowel or bowel blockage of any origin. Psyllium is also contraindicated in cases of stenosis of the esophagus or the gastrointestinal tract. Difficulties in regulating insulin requirements and blood sugar control in diabetes mellitus may also be exacerbated by inconsistent presence of psyllium in the diet. Laxatives should not be used if abdominal pain, nausea or vomiting and fever are present. Keep psyllium and all other medications out of reach of children. If constipation persists for more than seven days, consult your doctor. AVOID INHALATION.

Side Effects:
Psyllium, as with other bulking agents, can cause bloating but does not cause serious adverse effects when taken as prescribed except for relatively rare allergic reactions to psyllium preparations. If sufficient amounts of liquid (1:10) are taken, as indicated in the dosage section above, then there are no known side effects other than occasional bloating. As with any type of fibre, it is important not to take too much all at once and over do it. If fibre is taken above the recommended dosage, or without adequate amounts of liquid, then impacted bowel can and may result causing related infections and thereby leading to the need for hospitalization – so don’t over do it and drink lots of liquids when taking any source of fibre. Seeds contain more mucilage than husks and are also less irritating to bowel. Taking psyllium without adequate fluid may cause it to swell and block your throat or esophagus and may cause choking. Do not take psyllium if you have trouble swallowing. If you have chest pain, vomiting or difficulty in swallowing or breathing after taking psyllium, seek immediate medical attention.

References:

Blumenthal M, Goldberg A, Brinckmann J 2000. Herbal Medicine: Expanded Commission E Monographs. Copyright American Botanical Council. Publ. by Integrative Medicine Communications, 1029 Chestnut Street, Newton, MA 02464. Pp. 314-321.

Burke V, Hodgson JM, Beilin LJ, Giangiulioi N, Rogers P, Puddey IB. 2001. Dietary protein and soluble fiber reduce ambulatory blood pressure in treated hypertensives. Hypertension 2001 Oct; 38(4): 821-6.

Sierra M, Garcia JJ, Fernandez N, Diez MJ, Calle AP, Sahagun AM. 2001. Effects of ispaghula husk and guar gum on postprandial glucose and insulin concentrations in healthy subjects. Eur J Clin Nutr 2001 Apr ;55(4): 235-43.

Spence JD; Huff MW; Heidenheim P; Viswanatha A; Munoz C; Lindsay R; Wolfe B; Mills D. 1995. Combination therapy with colestipol and psyllium mucilloid in patients with hyperlipidemia. Ann Intern Med 1995 Oct 1; 123(7): 493-9.

Vega-Lopez S, Vidal-Quintanar RL, Fernandez ML. 2001. Sex and hormonal status influence plasma lipid responses to psyllium. Am J Clin Nutr 2001 Oct; 74(4): 435-41.