Psyllium, also called psyllium seed, is a soluble fiber that comes from a
perennial weed, a relative of the common plantain herb of the family
Plantaginaceae, of which there are about 250 species worldwide. (It is not the
same as the edible plantain Musa paradisiaca.) Psyllium seeds are coated
in mucilage, 1.5 to 3.5 mm, oval or boat-shaped, and dark ruddy brown in color,
and produce no odor and almost no taste.
Psyllium seeds or husks can be purchased in bulk from health stores or
pharmacies. Psyllium can also be found as an ingredient in commercially prepared
laxative products such as Metamucil (which contains psyllium hydrophilic
muciloid), which undergo more processing than all-natural products.
Used as a dietary fiber, psyllium is a bowel tonic and gentle bulk laxative
that attracts water and creates larger, softer stools. Doctors and herbalists
recommend psyllium as a stool softener and bulking agent to relieve
constipation, diarrhea, hemorrhoids, irritable bowel syndrome, and Crohn's
disease. Considered a good intestinal cleanser and stool softener, psyllium is
one of the most popular fibers available. Unlike bran fiber, psyllium does not
cause excessive gas and bloating.
Soluble fibers such as psyllium can help prevent the intestine from absorbing
cholesterol, and several studies have found that adding psyllium to the diet can
produce a significant reduction in serum cholesterol in the absence of other
dietary modifications and can increase cholesterol reduction when coupled with
High-fiber foods, including psyllium, aid in reducing the risk of
hypertension, heart disease, and even some cancers. Studies examining the
effects of psyllium husks on colon cancer have found that the fiber strongly
reduces the ability of a carcinogen to cause colon cancer. Animal studies found
that rats fed psyllium husks produced the highest fecal bacteria counts and the
bulkiest and most moist stools. Animal studies also showed that the greater the
fiber intake, the lower the rate of fatal colon disease. Other studies have
shown that high-fiber diets appear to be protective against breast and other
cancers as well.
Several studies have shown that adding fiber to the diet can significantly
increase weight loss even in the absence of calorie restriction. Clinical
studies have shown that fiber supplements enhance blood sugar control and reduce
calorie absorption by as much as 30 to 180 calories a day, which would result in
a 3- to 18-pound weight loss over the course of a year. Both soluble and
insoluble fibers aid weight loss. Water-soluble fibers such as psyllium, taken
with water before meals, create a feeling of fullness by expanding to a
gelatinous mass in the stomach, causing the dieter to consume smaller quantities
of food. Fiber supplements also aid blood sugar and insulin control. Because
fiber supplements absorb water rapidly, people who use fiber as a
weight-reducing aid must take care to be well hydrated by drinking at least six
to eight full glasses of water each day.
Psyllium seed or husk (from plantain herb)
Psyllium is available as psyllium seed or husk, or as a combination of the
two. Its constituents include acids, alkaloids, amino acids, fixed oil, protein,
iridoids, tannins, flavonoids, and a variety of sugar and polysaccharide
components and other plant carbohydrates in the seed
Psyllium is an ingredient in some commercially prepared laxatives, including
It is also found in some combination herbal remedy products, such as Aerobic
Bulk Cleanse (ABC), which contains blond psyllium seed husks and licorice and
hibiscus herbs. ABC is used to heal and cleanse the colon and to treat diarrhea
- Relieves constipation as a stool softener and gentle, bulk
- Relieves diarrhea
- Cleanses and helps heal the colon
- Acts as a fiber supplement
- Lowers cholesterol
- Treats irritable bowel syndrome
- Treats hemorrhoids
- Aids weight reduction
- Acts as a cancer inhibitor
|Dosage Ranges and Duration of
There is no RDA for psyllium, but herbal and health professionals recommend
using ½ to 2 tsp. of psyllium one or two times a day.
Add ½ to 2 tsp. of psyllium seed to 1 cup (8 oz.) of warm water, mix well,
then drink immediately (before it becomes too thick to consume; psyllium
thickens rapidly when exposed to water). It may be beneficial to begin with a
low dose, such as 1 tsp. in an 8-oz. glass of water, then increase to 2 tsp. if
For irritable bowel syndrome, take psyllium fiber daily, starting with 1 tsp.
in water once a day, then gradually increase psyllium intake: every three or
four days, increase the amount by 1 tsp. in another glass of water up to a
maximum of four glasses every day.
Psyllium may be taken first thing in the morning or at
If taken at the same time or within one hour of taking medications, psyllium
can interfere with their absorption and effectiveness.
It is possible to develop sensitivity to psyllium in breakfast cereal,
according to a 1990 Journal of the American Medical Association report,
which described a nurse who had in the past dispensed laxatives that contained
psyllium and later suffered anaphylaxis upon exposure to a breakfast cereal that
Use in children only under the direction of a qualified health care
Psyllium must always be taken with at least a full 8 oz. (1 cup) of
Do not take guar, another soluble fiber supplement whose mechanism is
similar, at the same time as psyllium; use one or the other, but not both.
Diabetics should use caution when taking herbs such as psyllium (also
marshmallow root and flax) that have a high mucilage content because they may
affect blood sugar.
In a study with 4 healthy male volunteers, administration of carbamazepine
(200 mg po) with ispaghula husk (3.5 g) reduced the bioavailability of the drug
by 1.22 mg/mL and delayed achievement of maximum plasma concentrations (Etman
1995). The decrease in carbamazepine absorption due to fiber consumption could
lead to subclinical concentrations of the drug. However, there were no adverse
effects reported with the use of psyllium hydrophilic mucilloid (3.4 g bid) in a
patient taking carbamazepine (1000 mg/day) (Ettinger et al. 1992). If psyllium
is used to ease constipation associated with carbamazepine therapy, the patient
should be monitored carefully to assure that plasma concentrations of the drug
remain within therapeutic
Preclinical and clinical data suggest that psyllium powder can be combined
with bile acid sequestrants for the treatment hyperlipidemias. In a study of
cholesterol-fed hamsters, various levels of cholestyramine resin were
administered with or without psyllium powder (Turley et al. 1996). Although
high-dose cholestyramine (3% of diet) was most effective in lowering blood and
liver cholesterol, the combination of cholestyramine and psyllium was almost as
effective, especially at higher psyllium doses (4% of diet). The combination
therapy was more effective in promoting fecal bile acid excretion and inhibiting
intestinal cholesterol absorption than the resin alone.
Clinically, a randomized, double-blind controlled trial of 121 patients with
moderate hypercholesterolemia examined the effects of colestipol (5 g tid),
psyllium (5 g tid), and a combination of colestipol (2.5 g tid) and psyllium
(2.5 g tid) for 10 weeks (Spence et al. 1995). Combination therapy was tolerated
better than colestipol monotherapy and was as effective as either agent
A study with six healthy male volunteers ages 28 to 40 investigated the
effects of psyllium on lithium sulfate treatment (12 mEq in 100 mL of water/day)
(Toutoungi et al. 1990). Concomitant administration of lithium and psyllium
reduced lithium absorption approximately 14%. A single case report of an
interaction between psyllium and lithium supports these findings (Perlman 1990).
In spite of increasing oral doses, blood lithium levels remained within
sub-therapeutic range until psyllium (1 tsp bid) was discontinued. Withdrawal of
psyllium caused a prompt increase in blood lithium levels. To minimize the
effects on absorption, psyllium should be taken at least one hour after taking
lithium. Lithium levels should be monitored frequently whenever psyllium is
introduced or withdrawn.
Alabaster O, Tang ZC, Frost A, Sivapurkar N. Potential synergism between
wheat brain and psyllium: enhanced inhibition of colon cancer. Cancer
Ashraf W, Park F, Lof J, Quigley EM. Effects of psyllium therapy on stool
characteristics, colon transit and anorectal function in chronic idiopathic
constipation. Aliment Pharmacol Ther. 1995;9:639-647.
Balch J, Balch P. Prescription for Nutritional Healing. 2nd ed. Garden
City Park, NY: Avery Publishing Group; 1997.
Etman MA. Effect of a bulk forming laxative on the bioavailability of
carbamazepine in man. Drug Dev Ind Pharm. 1995;21(16):1901-1906.
Ettinger AB, Shinnar S, Sinnett MJ, Moshe SL. Carbamazepine-induced
constipation. J Epilepsy. 1992;5(3):191-193.
Fernandez-Banares F, Hinojosa J, Sanchez-Lombrana JL, et al. Randomized
clinical trials of Platago ovata seeds (dietary fiber) as compared with
mesalaminein maintaining remission in ulcerative colitis. Am J Gastroenterol.
Giller R, Matthews K. Natural Prescriptions. New York, NY: Carol
Southern Books; 1994.
Kirschmann G, Kirschman J. Nutrition Almanac. 4th ed. New York, NY:
McRorie JW, Daggy BP, Morel JG, Diersing PS, Miner PB, Robinson M. Psyllium
is superior to docusate sodium for treatment of chronic constipation. Aliment
Pharmacol Ther. 1998;12:491-497.
Moss R. Cancer Therapy. Brooklyn, NY: Equinox Press, Inc.; 1992.
Murray M. Encyclopedia of Nutritional Supplements. Rocklin, Calif:
Prima Publishing; 1996.
Perlman BB. Interaction between lithium salts and ispaghula husk [letter].
Rodrigues-Moran M, Guerrero-Romero F, Lazcano-Burciaga G. Lipid- and
glucose-lowering efficacy of Plantago Psyllium in type II diabetes. J
Diabetes Complications. 1998;12:273-278.
Spence JD, Huff MW, Heidenheim P et al. Combination therapy with colestipol
and psyllium mucilloid in patients with hyperlipidemia. Ann Intern Med.
The Review of Natural Products. St. Louis, Mo: Facts and Comparisons;
Toutoungi M, Schulz P, Widmer J, et al. Probable interaction of psyllium and
lithium. Therapie. 1990;45(4):358-360.
Turley SD, Daggy BP, Dietschy JM. Effect of feeding psyllium and
cholestyramine in combination on low density lipoprotein metabolism and fecal
bile acid excretion in hamsters with dietary-induced hypercholesterolemia. J
Copyright © 2000 Integrative Medicine
CommunicationsThis publication contains
information relating to general principles
of medical care that should not in any event be construed as specific
instructions for individual patients. The publisher does not accept any
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