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Psyllium

Psyllium

Uses

Common names:
Flea Seed, Ispaghula, Psyllium Husk, Spogel
Botanical names:
Plantago ispaghula, Plantago ovata

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.

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For 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
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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 psyllium , 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.1

3 Stars
Diverticular Disease
7 grams daily in water, followed by a second glass of water
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A preliminary trial of the herb psyllium supports the use of this type of fiber in relieving the symptoms associated with diverticular disease and constipation.2

3 Stars
High Cholesterol
5 to 10 grams per day with meals
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Use of psyllium has been extensively studied as a way to reduce cholesterol levels. An analysis of all double-blind trials in 1997 concluded that a daily amount of 10 grams psyllium lowered cholesterol levels by 5% and LDL cholesterol by 9%.3 Since then, a large controlled trial found that use of 5.1 grams of psyllium two times per day significantly reduced serum cholesterol as well as LDL-cholesterol.4 Generally, 5 to 10 grams of psyllium are added to the diet per day to lower cholesterol levels. The combination of psyllium and oat bran may also be effective at lowering LDL cholesterol.5

3 Stars
Irritable Bowel Syndrome
3.25 grams taken three times per day
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Some people with IBS may benefit from bulk-forming laxatives. Psyllium seeds (3.25 grams taken three times per day) have helped regulate normal bowel activity in some people with IBS.6 Psyllium has improved IBS symptoms in double-blind trials.7 , 8

3 Stars
Type 2 Diabetes
5.1 grams daily with meals
Learn More
Supplementing with psyllium has been shown to be a safe and well-tolerated way to improve control of blood glucose and cholesterol. In a double-blind trial, men with type 2 diabetes who took 5.1 grams of psyllium per day for eight weeks lowered their blood glucose levels by 11 to 19.2%, their total cholesterol by 8.9%, and their LDL (bad) cholesterol by 13%, compared with a placebo.9
2 Stars
Diarrhea
9 to 30 grams daily
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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 psyllium seed (an excellent source of fiber) makes stool more solid and can help resolve symptoms of non-infectious diarrhea.10 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
Learn More

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 psyllium , an herb high in fiber, taken three times daily reduced the pain and bleeding associated with hemorrhoids.11 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
Learn More

Psyllium seeds and husks have shown a modest ability to lower blood triglyceride levels in some,12 , 13 but not all,14 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
Learn More
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.15 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
Learn More

Doctors recommend that people with Parkinson’s disease supplement with fiber and maintain adequate fluid intake to reduce constipation associated with this disease.16Preliminary research has shown that psyllium seed husks improve constipation and bowel function in people with Parkinson’s disease and constipation.17 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

Common names:
Flea Seed, Ispaghula, Psyllium Husk, Spogel
Botanical names:
Plantago ispaghula, Plantago ovata

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.18

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.19 Numerous double-blind trials have found that supplementation with psyllium can lower total cholesterol and LDL (“bad”) cholesterol.20 However, levels of HDL (“good”) cholesterol are not affected by psyllium supplementation.21 The cholesterol-lowering effect of psyllium has been reported in children,22 as well as in adults.23 Psyllium supplementation has also improved blood sugar levels in some people with diabetes .24 , 25 , 26 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.27 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.28 This is stirred into a large glass of water or juice and drunk immediately before it thickens.29 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

Common names:
Flea Seed, Ispaghula, Psyllium Husk, Spogel
Botanical names:
Plantago ispaghula, Plantago ovata

Interactions with Supplements, Foods, & Other Compounds

At the time of writing, there were no well-known supplement or food interactions with this supplement.

Interactions with Medicines

Certain medicines interact with this supplement.

Types of interactions: Beneficial Adverse Check

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.33

Support Medicine

  • Atorvastatin
    In one study, supplementation with 15 grams of psyllium per day for eight weeks enhanced the cholesterol-lowering effect of simvastatin.30
    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Fluvastatin
    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Lovastatin
    In one study, the addition of psyllium (10 grams per day) enhanced the cholesterol-lowering effect of lovastatin31
    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • 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.32 People taking mesalamine should consult with their healthcare practitioner to determine whether they should add psyllium seeds to their treat regimen.

  • Pravastatin
    In one study, the addition of psyllium (10 grams per day) enhanced the cholesterol-lowering effect of lovastatin.34
    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Rosuvastatin
    In one study, the addition of psyllium (10 grams per day) enhanced the cholesterol-lowering effect of lovastatin35.
    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Simvastatin

    In one study, supplementation with 15 grams of psyllium per day for eight weeks enhanced the cholesterol-lowering effect of simvastatin.36

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required

  • 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.37

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Common names:
Flea Seed, Ispaghula, Psyllium Husk, Spogel
Botanical names:
Plantago ispaghula, Plantago ovata

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.38 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. 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.

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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.

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

9. Anderson JW, Allgood LD, Turner J, et al. Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr 1999;70:466–73.

10. 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.

11. 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.

12. 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.

13. 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.

14. 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.

15. 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.

16. Kempster PA, Wahlqvist ML. Dietary factors in the management of Parkinson’s disease. Nutr Rev 1994;52:51–8 [review].

17. Ashraf W, Pfeiffer RF, Park F, et al. Constipation in Parkinson’s disease: objective assessment and response to psyllium. Mov Disord 1997;12:946–51.

18. 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.

19. Voderholzer WA, Schatke W, Mühldorfer BE, et al. Clinical response to dietary fiber treatment of chronic constipation. Am J Gastroenterol 1997;92:95–8.

20. 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.

21. 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.

22. 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.

23. 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.

24. 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.

25. 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.

26. 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.

27. 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.

28. 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.

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

30. Moreyra AE, Wilson AC, Koraym A. Effect of combining psyllium fiber with simvastatin in lowering cholesterol. Arch Intern Med 2005;165:1161–6.

31. Agrawal AR, Tandon M, Sharma PL. Effect of combining viscous fibre with lovastatin on serum lipids in normal human subjects. Int J Clin Pract 2007;61:1812-8

32. 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. Spanish Group for the Study of Crohn’s disease and Ulcerative Colitis (GETECCU). Am J Gastroenterol 1999;94:427–33.

33. Cavaliere H, Floriano I, Medeiros-Neto G. Gastrointestinal side effects of orlistat may be prevented by concomitant prescription of natural fibers (psyllium mucilloid). Int J Obes Relat Metab Disord 2001;25:1095–9.

34. Agrawal AR, Tandon M, Sharma PL. Effect of combining viscous fibre with lovastatin on serum lipids in normal human subjects. Int J Clin Pract 2007;61:1812-8.

35. REF:Agrawal AR, Tandon M, Sharma PL. Effect of combining viscous fibre with lovastatin on serum lipids in normal human subjects. Int J Clin Pract 2007;61:1812-8.

36. Moreyra AE, Wilson AC, Koraym A. Effect of combining psyllium fiber with simvastatin in lowering cholesterol. Arch Intern Med 2005;165:1161–6.

37. Perlman BB. Interaction between lithium salt and ispaghula husk. Lancet 1990;335:416.

38. 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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