psyllium

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):
Science Ratings - Health Concerns
*** - Constipation
*** - Diverticular disease
*** - High cholesterol
*** - Irritable bowel syndrome
*** - Type 2 diabetes
** - Atherosclerosis
** - Diarrhea
** - Hemorrhoids
** - 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 health benefit.
* - 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 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 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 interact with psyllium: Some interactions may increase the need for psyllium (+), other interactions may be negative (-) and indicate psyllium should not be taken without first speaking with your physician or pharmacist, others may require further explanation (?). Refer to the individual drug article for specific details about an interaction.
Note: The following list only includes the generic or class name of a medicine. To find a specific brand name, use the Medicines index.
HMG-CoA Reductase Inhibitors (Statins) (+)
Lithium (-)
Mesalamine (+)
Orlistat (+)
Simvastatin (+)
Source: www.cncahealth.com