Blond Psyllium: Benefits, Dosage, Contraindications
Other name(s)
Indian Plantain, Ispaghul, Che Qian Zi
Scientific name(s)
Plantago ovata, P. ispaghula, P.afra, P. psyllium, P. arenaria
Family or group:
Super Food, Plants
Active ingredients:
Fiber
Sterols
Choline
Indications
Rating methodology
EFSA approval.
Constipation ✪✪✪✪✪
Blond psyllium is recognized as effective as a laxative to treat constipation and facilitate transit. Some data suggest that blond psyllium alone can relieve constipation and improve stool consistency as effectively as preparations containing blond psyllium and senna. Some clinical evidence suggests that taking a daily combined product containing blond psyllium, aloe vera, and celandine for 28 days can improve stool frequency and consistency and reduce laxative dependence compared to placebo in people with chronic constipation. Other clinical evidence suggests that taking a daily combined product containing blond psyllium, acacia fiber, and fructose for 8 weeks can improve the symptoms of constipation in 78% of children with functional chronic constipation. The European Medicines Agency has considered the use of psyllium seeds to be 'well-established' for 'the treatment of habitual constipation as well as in all conditions where a soft stool is desirable.' The World Health Organization has considered psyllium seeds or their bran as 'a laxative capable of restoring and maintaining regular transit in chronic constipation, ensuring the treatment of constipation during pregnancy, or in conditions such as irritable bowel syndrome.' Blond psyllium has been used in doses of 7 to 24 g per day, in single or divided doses, for 8 weeks.
Posologie
Oral: seed, husk
7 - 24 g
8 - weeks
Infusion
Synergies
Effects of psyllium vs. placebo on constipation, weight, glycemia, and lipids: A randomized trial in patients with type 2 diabetes and chronic constipation.
A multi-centre, general practice comparison of ispaghula husk with lactulose and other laxatives in the treatment of simple constipation.
Constipation in Parkinson's disease: objective assessment and response to psyllium.
Effect of Flaxseed or Psyllium vs. Placebo on Management of Constipation, Weight, Glycemia, and Lipids: A Randomized Trial in Constipated Patients With Type 2 Diabetes
[The efficacy of Plantago ovata as a regulator of intestinal transit. A double-blind study compared to placebo].
Effects of psyllium therapy on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation.
Mechanisms of constipation in older persons and effects of fiber compared with placebo.
Comparative laxation of psyllium with and without senna in an ambulatory constipated population.
Irritable Bowel Syndrome ✪✪✪✪✪
Blond psyllium improves symptoms of irritable bowel syndrome: constipation, diarrhea, abdominal pain, and enhances general well-being. Most data shows that blond psyllium husk can relieve constipation and improve abdominal pain, diarrhea, and overall well-being in patients with irritable bowel syndrome (IBS). An analysis of clinical trials suggests that blond psyllium can reduce the risk of chronic IBS symptoms by 22% compared to placebo. Blond psyllium has been used within a range of 6.4 to 30 grams per day, in divided doses, for up to 4 months. The World Health Organization considered psyllium seeds or their husk as “a laxative able to restore and maintain regular transit in chronic constipation and ensure the treatment of constipations during pregnancy, or conditions like irritable bowel syndrome.
Posologie
Orally: seed, husk
6.4 - 30 g
4 - months
infusion
Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial
Different therapeutic regimens in irritable bowel syndrome.
Role of ispaghula husk in the management of irritable bowel syndrome (a randomized double-blind crossover study).
Ispaghula therapy in irritable bowel syndrome: improvement in overall well-being is related to reduction bowel dissatisfaction.
Treatment of irritable bowel syndrome with lorazepam, hyoscine butylbromide, and ispaghula husk.
[Effectiveness of plantago seed husks in comparison with wheat brain on stool frequency and manifestations of irritable colon syndrome with constipation]
Double blind study of ispaghula in irritable bowel syndrome.
Long-term treatment of irritable bowel syndrome: results of a randomized controlled trial.
Hypercholesterolemia ✪✪✪✪✪
Daily intake of psyllium supplements helps to lower cholesterol and triglycerides levels in people with mild to moderate hypercholesterolemia. Blond psyllium husk or seed, when added to food or taken as a separate supplement, at around 10 to 12 grams per day, in conjunction with a low-fat or high-fat diet, can reduce total cholesterol levels by 3 to 14%, low-density lipoprotein (LDL) cholesterol by 5 to 11%, and apolipoprotein B by 8.8% after 7 weeks or more of treatment. Reduction in total cholesterol and “bad” cholesterol (LDL) is observed from 5 grams of psyllium per day and increases with dosage. Psyllium's effect occurs even in people controlling their hypercholesterolemia with statin-based medications. The World Health Organization acknowledged psyllium seed husk as a dietary supplement in controlling hypercholesterolemia, reducing cardiovascular risk, and lowering the rise of postprandial blood glucose levels. However, EFSA (European Food Safety Authority) and the European Commission stated that psyllium-based products cannot claim to reduce blood cholesterol levels. Blond psyllium husk or seed has been used at a range of 3 to 20.4 grams per day, alone or in cereals, for up to 26 weeks.
Posologie
Orally: seed, husk
3 - 20.4 g
26 - weeks
infusion, dry extract
Effect of Time of Administration on Cholesterol-Lowering by Psyllium: A Randomized Cross-Over Study in Normocholesterolemic or Slightly Hypercholesterolemic Subjects
Dietary Counselling for Dyslipidemia in Primary Care: Results of a Randomized Trial
Psyllium-enriched Cereals Lower Blood Total Cholesterol and LDL Cholesterol, but Not HDL Cholesterol, in Hypercholesterolemic Adults: Results of a Meta-Analysis
Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia.
Effect of Combining Psyllium Fiber With Simvastatin in Lowering Cholesterol
Psyllium Supplementation in Adolescents Improves Fat Distribution & Lipid Profile: A Randomized, Participant-Blinded, Placebo-Controlled, Crossover Trial
Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials.
Efficacy of psyllium in reducing serum cholesterol levels in hypercholesterolemic patients on high- or low-fat diets.
Effect of Flaxseed or Psyllium vs. Placebo on Management of Constipation, Weight, Glycemia, and Lipids: A Randomized Trial in Constipated Patients With Type 2 Diabetes
Randomised Study to Compare the Efficacy and Safety of Isapgol Plus Atorvastatin Versus Atorvastatin Alone in Subjects With Hypercholesterolaemia
Time- And Dose-Dependent Effect of Psyllium on Serum Lipids in Mild-To-Moderate Hypercholesterolemia: A Meta-Analysis of Controlled Clinical Trials
Effect of Combining Viscous Fibre With Lovastatin on Serum Lipids in Normal Human Subjects
Type 2 Diabetes ✪✪✪✪✪
In a meta-analysis of 8 studies conducted on people with type 2 diabetes, consuming blond psyllium at 3.4 to 15 grams per day over 8 to 20 weeks was associated with significant reductions in fasting blood glucose, glycated hemoglobin (HbA1c), LDL cholesterol, and triglycerides. Blond psyllium also appears to lower postprandial glucose levels in patients with type 1 diabetes. The maximum effect of blond psyllium on glucose levels occurs when psyllium is mixed and consumed with food. Moreover, it does not lower postprandial glucose in non-diabetic individuals. A dose of 10.2 to 22 grams per day of blond psyllium, in divided doses over 8 to 20 weeks, has also been used.
Posologie
Orally: seed, husk
3.4 - 15 g
20 - weeks
infusion
Effect of Flaxseed or Psyllium vs. Placebo on Management of Constipation, Weight, Glycemia, and Lipids: A Randomized Trial in Constipated Patients With Type 2 Diabetes
Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia.
Psyllium fiber reduces rise in postprandial glucose and insulin concentrations in patients with non-insulin-dependent diabetes.
Effect of method of administration of psyllium on glycemic response and carbohydrate digestibility.
Diarrhea ✪✪✪✪✪
At approximately 40 grams, psyllium acts as an antidiarrheal by significantly thickening the consistency of the fecal mass, thus slowing down the transit.
Posologie
Orally: seed, husk
40 g
infusion
An unfermented gel component of psyllium seed husk promotes laxation as a lubricant in humans.
Effect of psyllium, calcium polycarbophil, and wheat bran on secretory diarrhea induced by phenolphthalein.
WICHTL Max, ANTON Robert Therapeutic plants: tradition, pharmaceutical practice, science, and therapy - 2nd edition Paris: Ed. Tee & doc-Lavoisier; Cachan: Ed. medical international, 2003.- 692p.
Supplementation with dietary fiber improves fecal incontinence.
Hemorrhoids ✪✪✪✪✪
Psyllium seed husk may have a beneficial effect on hemorrhoid crises by softening the stools, thereby reducing the pain and bleeding of hemorrhoids related to constipation. A dosage of 11.7 to 20 grams per day has been used, in several doses over 40 days.
Posologie
Orally: seed, husk
11.7 - 20 g
40 - days
infusion
High-fiber diet reduces bleeding and pain in patients with hemorrhoids: a double-blind trial of Vi-Siblin. Dis Colon Rectum.
Effect of fiber supplements on internal bleeding hemorrhoids.
Hypertension ✪✪✪✪✪
Oral intake of blond psyllium seems to modestly reduce blood pressure in adults. Preliminary clinical research shows that taking blond psyllium can reduce systolic and diastolic blood pressure compared to baseline in overweight patients suffering from hypertension. Blond psyllium has been used at doses of 3.7 to 15 grams per day, in single or divided doses, for 4 weeks to 6 months.
Posologie
Orally: seed, husk
7 - 15 g
6 - months
infusion
Weight Control ✪✪✪✪✪
Preliminary studies suggest that psyllium may aid in weight loss by reducing appetite in overweight and/or obese individuals. Indeed, high-viscosity fibers decrease the absorption of macronutrients which leads to increased insulin sensitivity and thus increased satiety. A high-fiber diet consisting of a supplement of psyllium and fibers from a healthy diet provided the greatest improvements in metabolic syndrome risk factors.
Posologie
Oral route: seed, husk
6 - 36 g
5 - months
infusion
Effect of Flaxseed or Psyllium vs. Placebo on Management of Constipation, Weight, Glycemia, and Lipids: A Randomized Trial in Constipated Patients With Type 2 Diabetes
Chronic inflammatory bowel diseases ✪✪✪✪✪
In cases of ulcerative colitis, psyllium has proven to be as effective as mesalamine (an anti-inflammatory drug used in certain inflammatory diseases of the colon and intestines) because it increases butyric acid levels. Psyllium seeds can also be used as an adjunct treatment for the painful component of spastic colitis.
Posologie
Oral route: seed, husk
3.5 - 10 g
4 - months
infusion
Colorectal cancer ✪✪✪✪✪
Clinical research suggests that a higher dietary intake of blonde psyllium is associated with a reduction in colorectal cancer mortality.
Posologie
Oral route: seed, husk
25 - 40 g
infusion
Properties
Laxative
Ispaghul (seed and seed husk) and psyllium (seed) are classified as 'bulk-forming' laxatives. They have a purely mechanical effect related to their mucilage. The polysaccharide macromolecules of the envelope are very slightly fermentable. They absorb a large volume of water, giving a bulky gel in the colon that increases the mass, moisture, and acidity of the fecal bolus. This stimulates peristalsis and facilitates excretion without altering transit time (in the absence of constipation). In case of constipation, the fibers decrease gastrointestinal transit time and increase stool weight. Psyllium is mainly useful in treating constipation due to insufficient peristaltic movements.
Usages associés
Digestive Effect
Mucilage is not depolymerized in the small intestine and is only very partially degraded by colon bacteria. Since psyllium fibers are not absorbed in the intestine, they form a protective layer on digestive mucous membranes. Psyllium can thus play a useful role in stomach ulcers, colitis, and gastroenteritis. Psyllium can be used for treating diarrhea as well as constipation. For patients with diarrhea, the soluble fibers of psyllium increase water retention capacity and stool viscosity, which delays gastric emptying and improves stool consistency. Psyllium also prolongs gastrointestinal transit time, possibly delaying the production of gaseous fermentation byproducts.
Usages associés
Hypoglycemic
Psyllium lowers postprandial blood glucose by delaying digestion time and carbohydrate absorption. By altering the structure, texture, and viscosity of foods in the intestine, it reduces the glycemic index of the meal. In diabetic subjects, mucilage would lead to a decrease in postprandial hyperglycemia by increasing viscosity in the small intestine, thereby slowing sugar absorption. However, psyllium does not seem to reduce postprandial blood glucose when administered to non-diabetic individuals.
Usages associés
Hypocholesterolemic
Psyllium acts on people with raised cholesterol. It leads to a decrease in total cholesterol, LDL-C, and apoB. Mucilage would indeed increase fecal elimination of bile acids and cholesterol and reduce their intestinal reabsorption. In human studies, psyllium decreases cholesterol absorption by affecting the enterohepatic circulation of bile acids. Psyllium reduces LDL-C mainly by stimulating bile acid synthesis. Studies in humans and animals suggest that the primary mechanism through which soluble fibers lower cholesterol is the increase in bile acid synthesis and fecal excretion, thus increasing hepatic cholesterol synthesis, which lowers serum cholesterol. Soluble fibers that form viscous gels in the digestive tract appear more effective in lowering LDL-C than those that do not have this property.
Usages associés
Anticancer
Psyllium has activity against colorectal cancer. Indeed, the psyllium seeds, when degraded, produce large amounts of butyrate and acetate. It has been found that butyric acid (the main oxidative substrate of colon cells) has anti-neoplastic activity in colon cancer.
Usages associés
Antihypertensive
Animal clinical studies show that psyllium attenuates salt-accelerated hypertension through a possible mechanism of reducing gastrointestinal sodium absorption and increasing its fecal excretion. In humans, dietary proteins and fiber supplements reduce blood pressure through an additive effect in hypertensive individuals. Fibers likely have a slight antihypertensive effect.
Usages associés
Safety dosage
Adults from 12 years: 25 g - 40 g (infusion)
Whole or powdered psyllium seeds are taken in 3 doses. A sufficient amount of liquid should be consumed (30 ml per gram of psyllium).
Children from 6 to 12 years: 12 g - 25 g (infusion)
Whole or powdered psyllium seeds should be taken in 3 doses. Drink with a sufficient amount of liquid (30 ml per gram of psyllium).
Pregnant woman: 25 g - 40 g (infusion)
The use of psyllium to treat constipation during pregnancy and breastfeeding is considered safe.
Breastfeeding woman: 25 g - 40 g (infusion)
The use of psyllium to treat constipation during pregnancy and breastfeeding is considered safe.
Interactions
Médicaments
Antidiabetic: moderate interaction
Blonde psyllium reduces blood sugar levels in patients with type 2 diabetes, its action could interfere with that of antidiabetic drugs.
Antihypertensive: moderate interaction
Blonde psyllium reduces blood pressure, its consumption together with an antihypertensive treatment could have additive effects.
Carbamazepine: moderate interaction
Blonde psyllium reduces the absorption of carbamazepine. A gap of at least two hours should be respected between the intake of psyllium seeds and the medication.
Digoxin: weak interaction
Blonde psyllium may reduce the absorption of digoxin. A gap of at least two hours should be respected between the intake of psyllium seeds and the medication.
Lithium: moderate interaction
Blonde psyllium may reduce the absorption of lithium. A gap of at least two hours should be respected between the intake of psyllium seeds and the medication.
Warfarin: moderate interaction
Blonde psyllium may reduce the absorption of Warfarin. A gap of at least two hours should be respected between the intake of psyllium seeds and the medication.
Plantes ou autres actifs
Blonde psyllium: weak interaction
Psyllium appears to slightly reduce the absorption of riboflavin by about 5%, but it is unlikely to be clinically significant
Hypoglycemic: moderate interaction
Blonde psyllium reduces blood sugar levels in patients with type 2 diabetes, its action could interfere with that of hypoglycemic substances.
Hypotensive: moderate interaction
Blonde psyllium reduces blood pressure, its concomitant use with substances against hypertension could have additive effects.
Blonde psyllium: moderate interaction
Psyllium may reduce iron absorption.
Contraindications
Intestinal obstruction: prohibited
Individuals with a problem affecting the diameter or motility of the intestine (stenosis, ileus, intestinal paralysis, megacolon, etc.) or having blood in the stool should abstain from taking psyllium seeds.
