Psyllium is a fiber that comes from a plant called
(blonde psyllium). The plant has tiny, gel-coated seeds. Psyllium is found in the seeds’ husk. Psyllium is soluble, meaning that it can dissolve in water. When preparing psyllium for commercial use, the seeds are first harvested and cleaned. In some formulations, the husks are separated from the seeds and processed; in others, the husk remains intact. Black psyllium (
), another variety of the seed, is also available.
Psyllium can be found as a dry seed or husk. It is a common ingredient in many popular
laxatives and is available in powder, capsule, tablet, and wafer form.
Dosages are specific to the product containing psyllium. Therefore, it is best to check
the product label for the appropriate dosage. However, below is general dosage information
for powdered psyllium.
Adults may take 3-6 grams of psyllium (1-2 teaspoons) in or with 8 ounces of water 2-3
Always take psyllium with a full glass of water (8 ounces).
Also, drinking 6-8 full glasses of water each day will help prevent
Children six years and older may take 1.5-3 grams of psyllium (1 teaspoon) in or with
4-8 ounces of water 2-3 times/day.
Do not take psyllium for longer than one week without first consulting your
Psyllium is primarily used to manage constipation, especially in people who do not eat
enough fiber. It can be helpful for people who just had rectal surgery, are recovering from
, are on prolonged bed rest, or any other circumstance where straining during
bowel movements is not advised. Patients experiencing other conditions where easy, soft
bowel movements would be desirable (eg, anal fissures,
) may find
psyllium helpful. Finally, psyllium can also be used to treat certain kinds of watery
Psyllium works by mixing with water in the intestines to create a gel-like substance,
which helps move bowels down the intestinal tract.
Psyllium has also been studied in the management of
A 2011 review of 3 trials with 283 subjects comparing psyllium (approximately 10 g daily) to placebo found consistently favorable results.
In one of the studies, for example, 2 weeks of psyllium (3.6 g, 3 times daily) produced a significantly greater improvement in symptoms over placebo. Numerous other studies have also shown psyllium to be effective in relieving constipation in
Another small study looked at the effect of combining different laxatives to treat
chronic constipation. Thirty-five men and women were randomized to either placebo or
capsules containing celandine,
, and psyllium. Researchers found that those
who had received the capsules had more frequent bowel movements and softer
A larger study has also shown psyllium to effectively treat chronic constipation. The
multi-site, randomized, double-blind study followed 170 adults with chronic constipation.
The study compared psyllium and another laxative and found in favor of psyllium for
better stool softening.
(However, this study was funded by the maker of a psyllium
Some researchers have investigated psyllium’s ability to lower cholesterol, and
conclusions have been mixed.
study found that psyllium did not have a significant cholesterol-lowering effect in
subjects with normal or slightly elevated cholesterol levels. However, two separate
reviews of multiple studies found in favor of psyllium’s ability to reduce both total
cholesterol and LDL (“bad”) cholesterol, particularly in subjects with mild to moderate
elevations on low-fat diets.
An additional study found psyllium to have a modest but
significant improvement for total and LDL cholesterol levels in people on low- or high-fat
Another small study suggested that psyllium would be beneficial for postmenopausal
women in lowering cholesterol and reducing the risk for heart diseases.
Fiber has long been a mainstay in the treatment of constipation in patients with
irritable bowel syndrome. However, it is unclear which type of fiber is more beneficial,
soluble (psyllium) or insoluble (eg, bran). Two studies suggest an answer. In a
systematic review of 17 studies, the authors concluded that psyllium improved certain irritable bowel syndrome
symptoms more than insoluble fibers.
This conclusion was supported by a
subsequent randomized trial involving 275 adults, which found that psyllium was more
effective than either bran or placebo for irritable bowel syndrome symptom relief.
Some studies have suggested psyllium may reduce blood pressure in individuals with
and improve glucose levels in patients with
type 2 diabetes.
Do not use psyllium if you have difficulty swallowing, unexplained abdominal pain,
, or vomiting. If you have kidney disease, talk to your doctor before taking psyllium.
When consuming any type of fiber,
and bloating are possible side effects.
Also, drink plenty of fluids when taking psyllium.
Some side effects specific to psyllium include cramps, difficulty swallowing, nausea,
vomiting, skin rash, itching, and difficulty breathing.
Some people may be sensitive to psyllium. Try to avoid inhaling psyllium
particles (eg, powder), since it may cause allergic reactions, such as difficulty breathing
and itchy, red eyes.
Since the absorption of many drugs can be affected by psyllium, talk to your doctor
before using psyllium if you are taking any medicine.
particular concern include:
Antidepressant medicines—tricyclics Amitriptyline (Elavil)Doxepin (Sinequan)Imipramine (Tofranil)
Bile acid sequestrantsDiabetes medicines
Do not take psyllium at the same time you take your medicines. Psyllium should be
taken at least two hours before taking your medicines or 2-4 hours afterward.
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Last reviewed August 2013 by EBSCO CAM Review Board
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