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:
Superfood, Plants
Active ingredients:
Fibers
Sterols
Choline
Indications
Scoring methodology
EFSA approval.
Constipation ✪✪✪✪✪
Blond psyllium is recognized as effective as a laxative for treating constipation and promoting bowel movements. rnrnSome data suggest that blond psyllium alone can relieve constipation and improve stool consistency as effectively as preparations containing blond psyllium and senna.rnrnSome clinical evidence suggests that daily intake of a combined product containing blond psyllium, aloe vera, and celandine for 28 days may improve stool frequency and consistency and reduce dependence on laxatives compared with placebo in people suffering from chronic constipation. Other clinical evidence suggests that daily intake of a combined product containing blond psyllium, acacia fiber, and fructose for 8 weeks may improve constipation symptoms in 78% of children with chronic functional constipation. rnrnThe European Medicines Agency has regarded the use of psyllium seeds as "well established" for "the treatment of habitual constipation, as well as all situations in which the passage of soft stools is necessary."rnrnThe World Health Organization has regarded psyllium seeds or the bran of these seeds 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."rnrnBlond psyllium has been used at doses of 7 to 24 g per day, as single or divided doses, for 8 weeks. rnrn
Posologie
By mouth: 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 multicenter, 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 improves overall well-being. rnrnThe majority of the data show that the husk of blond psyllium can relieve constipation and improve abdominal pain, diarrhea, and the overall well-being of patients with irritable bowel syndrome (IBS). rnrnAn analysis of clinical trials suggests that blond psyllium may reduce the risk of persistent IBS symptoms by 22% compared with placebo. rnrnBlond psyllium was used at 6.4 to 30 grams per day, in divided doses, for up to 4 months. rnrnThe World Health Organization has regarded psyllium seeds or the husk of these seeds as "a laxative capable of restoring and maintaining regular bowel transit in chronic constipation, ensuring the treatment of constipation during pregnancy, or in conditions such as irritable bowel syndrome.rnrn
Posologie
Oral: 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 ✪✪✪✪✪
The daily intake of psyllium supplements helps to lower cholesterol and triglyceride levels in people with mild to moderate hypercholesterolemia. Indeed, the husk or seed of blond psyllium, added to food or taken as a separate supplement at about 10 to 12 g per day, in combination with either a low-fat or a 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. The reduction in total cholesterol and "bad" cholesterol (LDL) would be observed from 5 g of psyllium per day and would increase with dose. Psyllium's effect is observed even in people who control their hypercholesterolemia with statins. The World Health Organization has considered psyllium seed husk to be recognized as a dietary supplement for controlling hypercholesterolemia, reducing cardiovascular risk, and reducing the rise in postprandial blood glucose. However, the European Food Safety Authority (EFSA) and the European Commission have concluded that psyllium-based products cannot claim to contribute to lowering blood cholesterol levels. The husk or seed of blond psyllium has been used at doses of 3 to 20.4 grams per day, alone or in cereals, for up to 26 weeks.
Posologie
Oral route: 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 Counseling 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
Randomized Study to Compare the Efficacy and Safety of Isapgol Plus Atorvastatin Versus Atorvastatin Alone in Subjects With Hypercholesterolemia
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 Fiber With Lovastatin on Serum Lipids in Normal Human Subjects
Type 2 Diabetes ✪✪✪✪✪
In a meta-analysis of 8 studies conducted in people with type 2 diabetes, taking blond psyllium at 3.4 to 15 grams per day for 8 to 20 weeks was associated with significant reductions in fasting blood glucose, glycated hemoglobin (HbA1c), LDL cholesterol, and triglycerides. rnrnBlond psyllium also appears to lower postprandial glucose levels in patients with type 1 diabetes. rnrnThe maximal effect of blond psyllium on glucose levels occurs when psyllium is mixed with and consumed with food. Moreover, it does not lower postprandial glucose in people who are not diabetic. rnrnA dose of 10.2 to 22 grams per day of blond psyllium, in divided doses for 8 to 20 weeks, has also been used. rnrn
Posologie
Oral: 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 about 40 grams, psyllium behaves like an antidiarrheal by greatly thickening the consistency of the fecal bolus. It thus slows transit. rnrn
Posologie
Oral: 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, officinal practice, science and therapeutics - 2nd edition. Paris: Ed. Tee & doc-Lavoisier; Cachan: Ed. médicales internationales, 2003. - 692 p.
Supplementation with dietary fiber improves fecal incontinence.
Hemorrhoids ✪✪✪✪✪
The bran of psyllium seeds may have a beneficial effect on hemorrhoid flare-ups by softening stools, thereby reducing the pain and bleeding of hemorrhoids related to constipation. A dose of 11.7 to 20 grams per day was used, given in multiple doses and for 40 days. rnrn
Posologie
By mouth: 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.
High blood pressure ✪✪✪✪✪
Oral intake of blond psyllium appears to modestly reduce blood pressure in adults. Indeed, preliminary clinical research shows that taking blond psyllium can reduce systolic and diastolic blood pressure from baseline in overweight patients with hypertension. rnrnBlond psyllium was used at 3.7 to 15 grams per day, as single or divided doses, for 4 weeks to 6 months. rnrn
Posologie
By mouth: seed, husk
7 - 15 g
6 - months
infusion
Weight control ✪✪✪✪✪
Preliminary studies suggest that psyllium may facilitate 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 psyllium supplement and fibers from a healthy diet produced the greatest improvements in metabolic syndrome risk factors.
Posologie
Oral: 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 the case of ulcerative colitis, psyllium has been shown to be as effective as mesalamine (an anti-inflammatory drug used in certain inflammatory diseases of the colon and intestine) because it increases butyric acid levels. Psyllium seeds can also be used as an adjuvant treatment for the painful component of spasmodic colitis.
Posologie
Oral: seed, husk
3.5 - 10 g
4 - months
infusion
Colorectal cancer ✪✪✪✪✪
Clinical research suggests that a higher dietary intake of blond psyllium is associated with a reduction in colorectal cancer mortality. rnrn
Posologie
Oral: seed, husk
25 - 40 g
infusion
Properties
Laxative
Ispaghul (seed and seed husk) and psyllium (seed) are classified in the 'bulk-forming laxatives' category. They have a purely mechanical effect related to their mucilage. The polysaccharide macromolecules of the husk are very poorly fermentable. They absorb a large volume of water, producing in the colon a bulky gel that increases stool mass, moisture content and acidity. This stimulates peristalsis and facilitates evacuation without altering transit time (in the absence of constipation). In cases of constipation, the fibers decrease gastrointestinal transit time and increase stool weight. Psyllium is especially useful in the treatment of constipation caused by insufficient peristaltic movements.
Usages associés
Digestive effect
The mucilage is not depolymerized in the small intestine and is only very partially degraded by colonic bacteria. Since psyllium fibers are not absorbed in the intestine, they form a protective layer on the digestive mucosae. Psyllium may therefore have a useful role in gastric ulcer, colitis and gastroenteritis. Psyllium can be used to treat diarrhea as well as constipation. Indeed, in patients with diarrhea, the soluble fibers of psyllium increase water-holding capacity and stool viscosity, which delays gastric emptying and improves stool consistency. Psyllium also prolongs gastrointestinal transit time, possibly by delaying the production of gaseous fermentation products.
Usages associés
Hypoglycemic
Psyllium reduces postprandial blood glucose by delaying digestion time and carbohydrate absorption. By modifying the structure, texture and viscosity of food in the intestine, it lowers the meal's glycemic index.rnrnIn people with diabetes, the mucilage would lead to a reduction in postprandial hyperglycemia by increasing viscosity in the small intestine, which would slow sugar absorption. However, psyllium does not appear to reduce postprandial blood glucose when administered to non-diabetic people. rnrn
Usages associés
Cholesterol-lowering
Psyllium has an effect in people with elevated cholesterol. It causes a reduction in total cholesterol, LDL-C and apoB. rnrnIndeed, the mucilage would increase the fecal excretion of bile acids and cholesterol and decrease their intestinal reabsorption. In human studies, psyllium reduces cholesterol absorption by rather affecting the enterohepatic circulation of bile acids. Psyllium lowers LDL-C primarily by stimulating bile acid synthesis. Human and animal studies suggest that the main mechanism by which soluble fibers reduce cholesterol is an increase in bile acid synthesis and their fecal excretion, leading to increased hepatic cholesterol turnover and thus lowering serum cholesterol. Soluble fibers that form viscous gels in the digestive tract appear to be more effective at lowering LDL-C than those that do not have this property.rrn
Usages associés
Anticancer
Psyllium has activity against colorectal cancer. Indeed, the psyllium seeds, as they degrade, produce large amounts of butyrate and acetate. It has been found that butyric acid (the primary oxidative substrate of colon cells) has antineoplastic activity in the case of colon cancer.
Usages associés
Antihypertensive
Clinical studies in animals show that psyllium attenuates salt-accelerated hypertension by a possible mechanism of reducing gastrointestinal absorption of sodium and increasing its fecal excretion. In humans, dietary proteins and fiber supplements lower blood pressure by an additive effect in hypertensive individuals. Fiber probably has a slight hypotensive effect.
Usages associés
Safe dosage
Adult (12 years and older): 25 g - 40 g (infusion)
Whole psyllium seeds or powder are taken in 3 doses. rnrnDrink a sufficient amount of liquid (30 ml per gram of psyllium).rnrn
Child (6 to 12 years): 12 g - 25 g (infusion)
Whole psyllium seeds or powder to be taken in 3 doses. rnrnDrink with a sufficient amount of liquid (30 ml per gram of psyllium).rnrn
Pregnant women: 25 g - 40 g (infusion)
The use of psyllium to treat constipation during pregnancy and breastfeeding is considered safe.rnrn
Breastfeeding women: 25 g - 40 g (infusion)
The use of psyllium to treat constipation during pregnancy and breastfeeding is considered safe.rnrn
Interactions
Médicaments
Antidiabetic: moderate interaction
Psyllium reduces blood glucose in patients with type 2 diabetes; its action could interfere with that of antidiabetic medications.
Antihypertensive: moderate interaction
Psyllium reduces blood pressure; taking it together with antihypertensive treatment could have additive effects.
Carbamazepine: moderate interaction
Psyllium husk (blond) reduces the absorption of carbamazepine. A delay of at least two hours should be observed between taking psyllium seeds and taking medications.
Digoxin: minor interaction
Psyllium husk (blond) may reduce the absorption of digoxin. A delay of at least two hours should be observed between taking psyllium seeds and taking medications.
Lithium: moderate interaction
Psyllium husk (blond) may reduce the absorption of lithium. A delay of at least two hours should be observed between taking psyllium seeds and taking medications.
Warfarin: moderate interaction
Psyllium husk (blond) may reduce the absorption of warfarin. A delay of at least two hours should be observed between taking psyllium seeds and taking medications.
Plantes ou autres actifs
Psyllium husk (blond): minor interaction
Psyllium appears to slightly reduce the absorption of riboflavin by about 5%, but it is unlikely to be clinically significant.
Hypoglycemic agent: moderate interaction
Psyllium husk (blond) lowers blood glucose in patients with type 2 diabetes; its action could interfere with that of hypoglycemic agents.
Antihypertensive: moderate interaction
Psyllium husk (blond) lowers blood pressure; taking it together with antihypertensive agents could have additive effects.
Psyllium husk (blond): moderate interaction
Psyllium may reduce the absorption of iron.
Contraindications
Intestinal obstruction: contraindicated
People with a condition that alters the diameter or motility of the intestine (stenosis, ileus, intestinal paralysis, megacolon, etc.) or who have blood in their stools should refrain from taking psyllium seeds.rnrn
