What is it?
Blond psyllium is used orally as a laxative and for softening stools in people with hemorrhoids, anal fissures, and after anal surgery. It is also used for diarrhea, irritable bowel syndrome (IBS), ulcerative colitis, and dysentery. Other uses include high cholesterol, high blood pressure, heart disease, diabetes, and other conditions.
Some people apply blond psyllium to the skin as a poultice for boils.
In food manufacturing, blond psyllium is used as a thickener or stabilizer in some frozen dairy desserts.
Some foods that contain blond psyllium carry a label that claims these foods, when consumed as part of a low-fat diet, may reduce the risk of heart disease. The FDA allows this claim if the food contains at least 1.7 grams of psyllium per serving. The key word in this claim is "may." It is true that blond psyllium can help lower cholesterol levels; but there's no proof yet that taking blond psyllium reduces the risk of developing heart disease. Despite its effectiveness in lowering cholesterol levels, blond psyllium has not yet been included in the stepwise approaches to dietary therapy such as the American Heart Association Step I or Step II diets for high cholesterol. Most clinical studies have used a specific blond psyllium powder preparation (Metamucil) or food that contains psyllium seed husk, such as cereals, breads, or snack bars.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for BLOND PSYLLIUM are as follows:
- Constipation. Some evidence suggests that taking blond psyllium by mouth, alone or as a combination product, can relieve constipation and improve stool consistency.
Likely effective for...
- High levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia). Taking blond psyllium by mouth reduces cholesterol levels in people with mild to moderate high cholesterol. Blond psyllium seed husk or seed added to food or as a separate supplement in a dose of approximately 10-12 grams daily, in combination with a low-fat or a high-fat diet, can reduce levels of total cholesterol by 3% to 14% and low density lipoprotein (LDL or "bad") cholesterol by 5% to 10 after 7 weeks or more of treatment. Blond psyllium also does not seem to lower other blood fats called triglycerides. Lower doses of blond psyllium (no more than 6 grams daily) may not be effective.
In children with high cholesterol, taking psyllium can further decrease LDL cholesterol levels by 7% to 15% when added to a low-fat, low-cholesterol diet such as the National Cholesterol Education Program (NCEP) Step 1 diet. Interestingly, taking blond psyllium along with a stricter low-fat, low-cholesterol diet such as the NCEP Step 2 diet may have less of an additional effect in lowering LDL cholesterol.
Psyllium seems to be less effective in older people. There is some evidence that it lowers LDL cholesterol levels to a lesser degree in people 60 years or older compared to people under 60.
Some evidence suggests that psyllium seed might be more effective than the seed husk for lowering total cholesterol and increasing levels of high density lipoprotein (HDL or "good") cholesterol.
Blond psyllium seems to be most effective when taken with foods at mealtime. Breakfast cereal containing blond psyllium can decrease total cholesterol and LDL cholesterol by 5% and 9%, respectively.
There is some evidence that taking blond psyllium for high cholesterol makes it possible to reduce the dose of certain medications used to lower cholesterol. For example, taking 15 grams of blond psyllium (Metamucil) along with 10 mg of simvastatin (Zocor) daily seems to lower cholesterol about as well as taking a higher dose (20 mg) of simvastatin daily. Similarly, a combination of blond psyllium with colestipol (Colestid) at half their usual doses seems to be as effective as colestipol alone. Blond psyllium also seems to reduce colestipol and cholestyramine (Questran, Questran Light, Cholybar) side effects such as constipation and abdominal pain. However, do not adjust the dose of your medication without consulting your healthcare provider.
Possibly effective for...
- Diabetes. Blond psyllium's maximum effect on the blood sugar levels occurs when psyllium is mixed with or taken with foods. In addition to lowering blood sugar, blond psyllium seed husk also lowers cholesterol in people with diabetes who have high cholesterol. Some studies show blond psyllium can lower total cholesterol by about 9%, and LDL cholesterol by 13%. Blond psyllium does not lower after-meal blood sugar levels in people who do not have diabetes.
- Diarrhea. Taking blond psyllium by mouth seems to reduce diarrhea symptoms.
- Hemorrhoids. Taking blond psyllium by mouth seems to relieve bleeding and pain in people with hemorrhoids.
- High blood pressure. Taking blond psyllium by mouth, alone or in combination with soy protein, seems to lower blood pressure in adults.
- A long-term disorder of the large intestines that causes stomach pain (irritable bowel syndrome or IBS). While not all studies agree, there is evidence that blond psyllium seed husk can relieve constipation and improve abdominal pain, diarrhea, and overall well-being. It may take up to four weeks of treatment to get the best results.
- Obesity. While not all studies agree, there is early evidence that blond psyllium might reduce body weight and appetite in people who are overweight or obese.
- Treating side effects of a drug called Orlistat (Xenical, Alli). Taking blond psyllium with each dose of orlistat seems to relieve orlistat side effects such as gas, stomach rumbling, stomach cramps, and oily spotting without decreasing the weight-reducing effect of orlistat.
- A type of inflammatory bowel disease (ulcerative colitis). There is some evidence that taking blond psyllium seeds by mouth might be effective for preventing a relapse of inflammatory bowel disease. Blond psyllium also appears to relieve symptoms of this condition.
Possibly ineffective for...
- Non-cancerous growths in the large intestine and rectum (colorectal adenoma). Taking 3.5 grams of blond psyllium per day does not seem to reduce the risk of colorectal adenoma. There is some evidence that it might actually increase the risk of adenoma recurrence, particularly in people who get a lot of calcium from their diet. However, more evidence is needed to determine the relationship of psyllium and calcium to colorectal adenoma.
- Serious kidney disease (end-stage renal disease or ESRD). Taking blond psyllium by mouth does not improve serious kidney disease.
Insufficient evidence to rate effectiveness for...
- Colon cancer, rectal cancer. Population research suggests that people who consume more blond psyllium in the diet might have a lower chance of dying from colorectal cancer.
- A type of inflammatory bowel disease (Crohn disease). Early research suggests that taking blond psyllium daily along with probiotics improves symptoms of Crohn disease.
- Changes in how fat is distributed in the body in people taking HIV medications. Eating a high fiber diet might prevent fat redistribution in people with HIV.
- Persistent heartburn. Early research shows that taking blond psyllium for 10 days may help control symptoms of persistent heartburn in some people.
- Some types of cancer.
- Some types of skin conditions.
- Other conditions.
How does it work?
Are there safety concerns?
Some people can have an allergic response to blond psyllium with symptoms such as swollen nasal passages, sneezing, swollen eyelids, hives, and asthma. Some people can also become sensitized to psyllium through exposure at work or repeated use of psyllium. Stop using blond psyllium and get medical attention immediately if you develop symptoms such as flushing, severe itching, shortness of breath, wheezing, swelling of the face or body, chest and throat tightness, or loss of consciousness.
Special precautions & warnings:Pregnancy and breast-feeding: Blond psyllium is LIKELY SAFE when taken by mouth appropriately.
Growths in the large intestine and rectum (colorectal adenoma): Blond psyllium might increase the risk of adenoma recurrence in people with a history of colorectal adenoma. People who have had this condition should avoid blond psyllium.
Diabetes: Blond psyllium can lower blood sugar levels in people with type 2 diabetes. Monitor blood sugar levels closely. Doses of conventional antidiabetes medications may need adjustment. Another consideration is that some commercial blond psyllium products can contain added sugars that might increase blood sugar levels.
Gastrointestinal (GI) disorders: Don't use blond psyllium if you tend to develop hard stools in the rectum due to ongoing constipation (fecal impaction), GI tract narrowing, obstruction, or conditions that can lead to obstruction, such as spastic bowel.
Allergy: Some patients can have severe hypersensitivity reactions to blond psyllium. This is more likely to occur in patients with previous occupational exposure to blond psyllium. Don't use blond psyllium if you are sensitive to it.
Low blood pressure: Blond psyllium can lower blood pressure in people with high and normal blood pressure. Taking blond psyllium might make blood pressure drop too low in people who already have low blood pressure.
Phenylketonuria: Some blond psyllium preparations are sweetened with aspartame (Nutrasweet) and should be avoided in patients with phenylketonuria.
Surgery: Blond psyllium might affect blood sugar levels, making blood sugar control more difficult during and after surgery. Stop taking blond psyllium at least 2 weeks before a scheduled surgery.
Swallowing disorders: Do not use blond psyllium if you have problems swallowing. Blond psyllium might increase your risk of choking.
Are there interactions with medications?
- Carbamazepine (Tegretol)
- Blond psyllium contains large amounts of fiber. Fiber can decrease how much carbamazepine (Tegretol) the body absorbs. By decreasing how much carbamazepine (Tegretol) the body absorbs blond psyllium might decrease the effectiveness of carbamazepine (Tegretol).
- Blond psyllium contains large amounts of fiber. Fiber can decrease how much lithium the body absorbs. Taking lithium along with blond psyllium might decrease the effectiveness of lithium. To avoid his interaction take blond psyllium at least one hour after lithium.
- Medications for diabetes (Antidiabetes drugs)
- Blond psyllium might decrease blood sugar by decreasing the absorption of sugars from food. Diabetes medications are also used to lower blood sugar. Taking blond psyllium with diabetes medications might cause your blood sugar to be too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
- Medications for high blood pressure (Antihypertensive drugs)
- Blond psyllium might decrease blood pressure in some people. Taking blond psyllium along with medications used for lowering high blood pressure might cause your blood pressure to go too low. However, it's not known if this is a big concern. Do not take too much blond psyllium if you are taking medications for high blood pressure.
Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.
- Metformin (Glucophage)
- Blond psyllium might change how much metformin the body absorbs. This might increase or decrease the effectiveness of metformin. To avoid this interaction, take blond psyllium at least 2 hours before or 2 hours after taking metformin.
- Warfarin (Coumadin)
- Warfarin (Coumadin) is used to slow blood clotting. Some people worry that blond psyllium may decrease warfarin (Coumadin) absorption and its effectiveness, which could increase the risk of clotting. But blond psyllium does NOT seem to affect warfarin (Coumadin) absorption or effectiveness.
- Digoxin (Lanoxin)
- Blond psyllium is high in fiber. Fiber can decrease the absorption and decrease the effectiveness of digoxin (Lanoxin). As a general rule, any medications taken by mouth should be taken one hour before or four hours after blond psyllium to prevent this interaction.
- Ethinyl estradiol
- Ethinyl estradiol is a form of estrogen that's in some estrogen products and birth control pills. Some people worry that psyllium can decrease how much ethinyl estradiol the body absorbs. But it is unlikely that psyllium will significantly affect ethinyl estradiol absorption.
Are there interactions with herbs and supplements?
- Herbs and supplements that might lower blood pressure
- Blond psyllium might lower blood pressure. Using it along with other herbs and supplements that have this same effect might increase the risk of blood pressure dropping too low in some people. Some of these products include andrographis, casein peptides, cat's claw, coenzyme Q-10, fish oil, L-arginine, lyceum, stinging nettle, theanine, and others.
- Herbs and supplements that might lower blood sugar
- Blond psyllium might lower blood sugar. Using it along with other herbs and supplements that have the same effect might cause blood sugar to drop too low in some people. Some of these products include alpha-lipoic acid, bitter melon, chromium, devil's claw, fenugreek, garlic, guar gum, horse chestnut, Panax ginseng, psyllium, Siberian ginseng, and others.
- Use of blond psyllium with iron supplements can reduce the amount of iron that the body absorbs. Take iron supplements one hour before or four hours after psyllium to avoid this interaction.
- Psyllium seems to slightly reduce the amount of riboflavin that the body absorbs, but it's probably not important.
Are there interactions with foods?
- Fats and fat-containing foods
- Psyllium can make dietary fat more difficult to digest and can increase the amount of fat lost is the stool when taken in combination with dietary fats such as soybean oil or coconut oil.
What dose is used?
The following doses have been studied in scientific research:
- As a laxative for constipation: 7 grams to 24 grams of blond psyllium per day, in 2-4 divided doses.
- For diarrhea: 7 grams to 18 grams of blond psyllium, in 2-3 divided doses or 5 grams twice a day of a combination of blond psyllium, calcium carbonate, and calcium phosphate (in ratio of 4:1:1 by weight).
- For decreasing diarrhea in patients receiving tube feedings: 14 grams of blond psyllium daily in divided doses. It may be given through the feeding tube, either mixed with the nutritional formula or all at once followed by a flush with water. However, use care, because psyllium might clog the feeding tube.
- For chronic diarrhea after gall bladder surgery: 6.5 grams of blond psyllium three times daily.
- For diarrhea that sometimes accompanies the use of a medicine called misoprostol: 3.4 grams of blond psyllium twice daily.
- For a long-term disorder of the large intestines that causes stomach pain (irritable bowel syndrome or IBS): 6.4 grams to 30 grams of blond psyllium seed husk in two to three divided doses daily. 10 grams of blond psyllium seed husk twice daily with 15 mg of propantheline three times daily has also been used.
- For reducing the gastrointestinal (GI) side effects of a medicine called orlistat: 6 grams of blond psyllium three times daily with each orlistat dose.
- For a type of inflammatory bowel disease (ulcerative colitis): 3.5-10 grams of blond psyllium, taken twice daily.
- For relieving bleeding from hemorrhoids: 10.5 grams to 20 grams seed husk daily in divided doses.
- For high levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia): 3.4 grams of blond psyllium seed husk three times daily or 5.1 grams twice daily are the most commonly used doses. However, doses up to 20.4 grams per day have been tried. Cereal with added psyllium that provides up to 15 grams of soluble fiber per day has also been used. A mixture of 2.1 grams of psyllium, 1.3 grams of pectin, 1.1 grams of guar gum and 0.5 grams of locust bean gum has been used three times daily. A combination of 2.5 grams of blond psyllium powder (Metamucil) with 2.5 grams of colestipol, taken three times daily has also been used. A combination of simvastatin (Zocor) 10 mg and blond psyllium (Metamucil) 15 grams daily has also been used.
- For diabetes: 10.2 grams to 22 grams of blond psyllium in divided doses.
- For high blood pressure: 10.5 grams to 15 grams of blond psyllium husks daily for up to 6 months.
- For obesity: 6 grams to 36 grams daily in divided doses with meals, in addition to reducing calories.
- For high cholesterol: Cereal containing 3.2 grams to 10 grams of psyllium daily.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.
- Noureddin S, Mohsen J, Payman A. Effects of psyllium vs. placebo on constipation, weight, glycemia, and lipids: A randomized trial in patients with type 2 diabetes and chronic constipation. Complement Ther Med. 2018;40:1-7. View abstract.
- Morozov S, Isakov V, Konovalova M. Fiber-enriched diet helps to control symptoms and improves esophageal motility in patients with non-erosive gastroesophageal reflux disease. World J Gastroenterol. 2018;24:2291-2299. View abstract.
- Diez R, Garcia JJ, Diez MJ, Sierra M, Sahagun AM, Fernandez N. Influence of Plantago ovata husk (dietary fiber) on the bioavailability and other pharmacokinetic parameters of metformin in diabetic rabbits. BMC Complement Altern Med. 2017 Jun 7;17:298. View abstract.
- Lipsky H, Gloger M, Frishman WH. Dietary fiber for reducing blood cholesterol. J Clin Pharmacol 1990;30:699-703. View abstract.
- Solà R, Godàs G, Ribalta J, et al. Effects of soluble fiber (Plantago ovata husk) on plasma lipids, lipoproteins, and apolipoproteins in men with ischemic heart disease. Am J Clin Nutr 2007;85:1157-63. View abstract.
- López JC, Villanueva R, Martínez-Hernández D, Albaladejo R, Regidor E, Calle ME. Plantago ovata consumption and colorectal mortality in Spain, 1995-2000. J Epidemiol 2009;19:206-11. View abstract.
- Garcia JJ, Fernandez N, Carriedo D, et al. Hydrosoluble fiber (Plantago ovata husk) and levodopa I: experimental study of the pharmacokinetic interaction. Eur Neuropsychopharmacol 2005;15:497-503. View abstract.
- Fernandez-Martinez MN, Hernandez-Echevarria L, Sierra-Vega M, et al. A randomised clinical trial to evaluate the effects of Plantago ovata husk in Parkinson patients: changes in levodopa pharmacokinetics and biochemical parameters. BMC Complement Altern Med 2014;14:296. View abstract.
- Fernandez N, Lopez C, Díez R, et al. Drug interactions with the dietary fiber Plantago ovata husk. Expert Opin Drug Metab Toxicol 2012;8:1377-86. View abstract.
- Bernedo N, García M, Gastaminza G, et al. Allergy to laxative compound (Plantago ovata seed) among health care professionals. J Investig Allergol Clin Immunol 2008;18:181-9. View abstract.
- Cicero, A. F., Derosa, G., Manca, M., Bove, M., Borghi, C., and Gaddi, A. V. Different effect of psyllium and guar dietary supplementation on blood pressure control in hypertensive overweight patients: a six-month, randomized clinical trial. Clin.Exp.Hypertens. 2007;29:383-394. View abstract.
- Tai ES, Fok AC, Chu R, Tan CE. A study to assess the effect of dietary supplementation with soluble fibre (Minolest) on lipid levels in normal subjects with hypercholesterolaemia. Ann Acad.Med Singapore 1999;28:209-213. View abstract.
- Khossousi A, Binns CW, Dhaliwal SS, Pal S. The acute effects of psyllium on postprandial lipaemia and thermogenesis in overweight and obese men. Br J Nutr 2008;99:1068-75. View abstract.
- Turnbull WH, Thomas HG. The effect of Plantago ovate seed containing preparation on appetite variables, nutrient and energy intake. Int J Obese Relat Metab Disord 1995;19:338-42. View abstract.
- Enzi G, Inelmen EM, Crepaldi G. Effect of a hydrophilic mucilage in the treatment of obese patients. Pharmatherapeutica 1980;2:421-8. View abstract.
- Pal S, Khossousi A, Binns C, et al. The effect of a fibre supplement compared to a healthy diet on body composition, lipids, glucose, insulin and other metabolic syndrome risk factors in overweight and obese individuals. Br J Nutr 2011;105:90-100. View abstract.
- Shrestha S, Volek JS, Udani J, et al. A combination therapy including psyllium and plant sterols lowers LDL cholesterol by modifying lipoprotein metabolism in hypercholesterolemic individuals. J Nutr 2006;136:2492-7. View abstract.
- Flannery J, Raulerson A. Hypercholesterolemia: a look at low-cost treatment and treatment adherence. J Am Acad Nurse Pract 2000;12:462-6. View abstract.
- Lerman Garber I, Lagunas M, Sienra Perez JC, et al. The effect of psyllium plantago in slightly to moderately hypercholesterolemic patients. Arch Inst Cardiol Mex 1990;60:535-9. View abstract.
- Anderson JW, Floore TL, Geil PB, et al. Hypocholesterolemic effects of different bulk-forming hydrophilic fibers as adjuncts to dietary therapy in mild to moderate hypercholesterolemia. Arch Intern Med. 1991 Aug;151:1597-602. View abstract.
- Neal GW, Balm TK. Synergistic effects of psyllium in the dietary treatment of hypercholesterolemia. South Med J 1990;83:1131-7. View abstract.
- Gupta RR, Agrawal CG, Singh CP, Ghatak A. Lipid-lowering efficacy of psyllium hydrophilic mucilloid in non insulin dependent diabetes mellitus with hyperlipidaemia. Indian J Med Res 1994;100:237-41. View abstract.
- 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. View abstract.
- Levin EG, Miller VT, Muesing RA, et al. Comparison of psyllium hydrophilic mucilloid and cellulose as adjuncts to a prudent diet in the treatment of mild to moderate hypercholesterolemia. Arch Intern Med 1990;150:1822-7. View abstract.
- Weingand KW, Le NA, Kuzmak BR, et al. Effects of psyllium on cholesterol and low-density lipoprotein metabolism in subjects with hypercholesterolemia. Endocrinology and Metabolism 1997;4:141-50.
- Bell LP, Hectorn KJ, Reynolds H, Hunninghake DB. Cholesterol-lowering effects of soluble-fiber cereals as part of a prudent diet for patients with mild to moderate hypercholesterolemia. Am J Clin Nutr. 1990 Dec;52:1020-6. View abstract.
- Summerbell CD, Manley P, Barnes D, Leeds A. The effects of psyllium on blood lipids in hypercholesterolaemic subjects. Journal Of Human Nutrition & Dietetics. 1994:7:147-151.
- MacMahon M, Carless J. Ispaghula husk in the treatment of hypercholesterolaemia: a double-blind controlled study. J Cardiovasc Risk. 1998 Jun;5:167-72. View abstract.
- Wei ZH, Wang H, Chen XY, et al. Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled clinical trials. Eur J Clin Nutr. 2009 Jul;63:821-7. View abstract.
- Chapman ND, Grillage MG, Mazumder R, et al. A comparison of mebeverine with high-fibre dietary advice and mebeverine plus ispaghula in the treatment of irritable bowel syndrome: an open, prospectively randomised, parallel group study. Br J Clin Pract. 1990 Nov;44:461-6. View abstract.
- Ford AC1, Talley NJ, Spiegel BM, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ. 2008 Nov 13;337:a2313. View abstract.
- Arthurs Y, Fielding JF. Double blind trial of ispaghula/poloxamer in the Irritable Bowel Syndrome. Ir Med J. 1983 May;76:253. View abstract.
- Nigam P, Kapoor KK, Rastog CK, et al. Different therapeutic regimens in irritable bowel syndrome. J Assoc Physicians India. 1984 Dec;32:1041-4. View abstract.
- Hotz J, Plein K. [Effectiveness of plantago seed husks in comparison with wheat brain on stool frequency and manifestations of irritable colon syndrome with constipation]. Med Klin (Munich). 1994 Dec 15;89:645-51. View abstract.
- Bijkerk CJ, de Wit NJ, Muris JW, et al. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ. 2009 Aug 27;339:b3154. View abstract.
- Golechha AC, Chadda VS, Chadda S, et al. Role of ispaghula husk in the management of irritable bowel syndrome (a randomized double-blind crossover study). J Assoc Physicians India. 1982 Jun;30:353-5. View abstract.
- Ritchie JA, Truelove SC. Treatment of irritable bowel syndrome with lorazepam, hyoscine butylbromide, and ispaghula husk. Br Med J. 1979 Feb 10;1:376-8. View abstract.
- Quitadamo P, Coccorullo P, Giannetti E, et al. A randomized, prospective, comparison study of a mixture of acacia fiber, psyllium fiber, and fructose vs polyethylene glycol 3350 with electrolytes for the treatment of chronic functional constipation in childhood. J Pediatr. 2012 Oct;161:710-5.e1. View abstract.
- Odes HS, Madar Z. A double-blind trial of a celandin, aloevera and psyllium laxative preparation in adult patients with constipation. Digestion. 1991;49:65-71.View abstract.
- Attaluri A, Donahoe R, Valestin J, et al. Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. Aliment Pharmacol Ther. 2011 Apr;33:822-8.View abstract.
- Dettmar PW, Sykes J. A multi-centre, general practice comparison of ispaghula husk with lactulose and other laxatives in the treatment of simple constipation. Curr Med Res Opin. 1998;14:227-33. View abstract.
- Tomás-Ridocci M, Añón R, Mínguez M, et al. [The efficacy of Plantago ovata as a regulator of intestinal transit. A double-blind study compared to placebo]. Rev Esp Enferm Dig. 1992 Jul;82:17-22. View abstract.
- Ashraf W, Park F, Lof J, et al. Effects of psyllium therapy on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation. Aliment Pharmacol Ther. 1995 Dec;9:639-47. View abstract.
- Fujimori S, Tatsuguchi A, Gudis K, et al. High dose probiotic and prebiotic cotherapy for remission induction of active Crohn's disease. J Gastroenterol Hepatol. 2007 Aug;22:1199-204. View abstract.
- Pal S, Khossousi A, Binns C, et al. The effects of 12-week psyllium fibre supplementation or healthy diet on blood pressure and arterial stiffness in overweight and obese individuals. Br J Nutr. 2012 Mar;107:725-34. View abstract.
- Frape DL, Jones AM. Chronic and postprandial responses of plasma insulin, glucose and lipids in volunteers given dietary fibre supplements. Br J Nutr. 1995 May;73:733-51. View abstract.
- Sartore G1, Reitano R, Barison A, et al. The effects of psyllium on lipoproteins in type II diabetic patients. View abstract.
- Ziai SA, Larijani B, Akhoondzadeh S, et al. Psyllium decreased serum glucose and glycosylated hemoglobin significantly in diabetic outpatients. J Ethnopharmacol. 2005 Nov 14;102:202-7. View abstract.
- Perez-Miranda M, Gomez-Cedenilla A, León-Colombo T, et al. Effect of fiber supplements on internal bleeding hemorrhoids. Hepatogastroenterology. 1996 Nov-Dec;43:1504-7. View abstract.
- Moesgaard F, Nielsen ML, Hansen JB, et al. High-fiber diet reduces bleeding and pain in patients with hemorrhoids: a double-blind trial of Vi-Siblin. Dis Colon Rectum. 1982 Jul-Aug;25:454-6. View abstract.
- Ganji V, Kies CV. Psyllium husk fibre supplementation to soybean and coconut oil diets of humans: effect on fat digestibility and faecal fatty acid excretion. Eur J Clin Nutr 1994;48:595-7. View abstract.
- Moreyra AE, Wilson AC, Koraym A. Effect of Combining Psyllium Fiber With Simvastatin in Lowering Cholesterol. Arch Intern Med 2005;165:1161-6. View abstract.
- Uribe M, Dibildox M, Malpica S, et al. Beneficial effect of vegetable protein diet supplemented with psyllium plantago in patients with hepatic encephalopathy and diabetes mellitus (abstract). Gastroenterology 1985;88:901-7. View abstract.
- 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 (abstract). Acta Med Scand 1982;212:237-9. View abstract.
- Sierra M, Garcia JJ, Fernandez N, et al. Therapeutic effects of psyllium in type 2 diabetic patients. Eur J Clin Nutr 2002;56:830-42. View abstract.
- Hendricks KM, Dong KR, Tang AM, et al. High-fiber diet in HIV-positive men is associated with lower risk of developing fat deposition. Am J Clin Nutr 2003;78:790-5. View abstract.
- Garcia JJ, Fernandez N, Diez MJ, et al. Influence of two dietary fibers in the oral bioavailability and other pharmacokinetic parameters of ethinyloestradiol. Contraception 2000;62:253-7. View abstract.
- Robinson DS, Benjamin DM, McCormack JJ. Interaction of warfarin and nonsystemic gastrointestinal drugs. Clin Pharmacol Ther 1971;12:491-5. View abstract.
- FDA Talk Paper. FDA Allows Foods Containing Psyllium To Make Health Claim On Reducing Risk Of Heart Disease. 1998. Available at: http://www.fda.gov/bbs/topics/ANSWERS/ANS00850.html.
- Burke V, Hodgson JM, Beilin LJ, et al. Dietary protein and soluble fiber reduce ambulatory blood pressure in treated hypertensives. Hypertension 2001;38:821-6.. View abstract.
- 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. View abstract.
- Nordstrom M, Melander A, Robertsson E, Steen B. Influence of wheat bran and of a bulk-forming ispaghula cathartic on the bioavailability of digoxin in geriatric in-patients. Drug Nutr Interact 1987;5:67-9.. View abstract.
- Strommen GL, Dorworth TE, Walker PR, et al. Treatment of suspected postcholecystectomy diarrhea with psyllium hydrophilic mucilloid. Clin Pharm 1990;9:206-8. View abstract.
- Marteau P, Flourie B, Cherbut C, et al. Digestibility and bulking effect of ispaghula husks in healthy humans. Gut 1994;35:1747-52.. View abstract.
- Anderson JW, Zettwoch N, Feldman T, et al. Cholesterol-lowering effects of psyllium hydrophilic mucilloid for hypercholesterolemic men. Arch Intern Med 1988;148:292-6. View abstract.
- Roe DA, Kalkwarf H, Stevens J. Effect of fiber supplements on the apparent absorption of pharmacological doses of riboflavin. J Am Diet Assoc 1988;88:211-3.. View abstract.
- 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.. View abstract.
- Frati Munari AC, Benitez Pinto W, Raul Ariza Andraca C, Casarrubias M. Lowering glycemic index of food by acarbose and Plantago psyllium mucilage. Arch Med Res 1998;29:137-41. View abstract.
- Ejderhamn J, Hedenborg G, Strandvik B. Long-term double-blind study on the influence of dietary fibres on faecal bile acid excretion in juvenile ulcerative colitis. Scand J Clin Lab Invest 1992;52:697-706.. View abstract.
- Rossander L. Effect of dietary fiber on iron absorption in man. Scand J Gastroenterol Suppl 1987;129:68-72.. View abstract.
- McRorie JW, Daggy BP, Morel JG, et al. Psyllium is superior to docusate sodium for treatment of chronic constipation. Aliment Pharmacol Ther 1998;12:491-7.. View abstract.
- Hallert C, Kaldma M, Petersson BG. Ispaghula husk may relieve gastrointestinal symptoms in ulcerative colitis in remission. Scand J Gastroenterol 1991;26:747-50.. View abstract.
- Daggy BP, O'Connell NC, Jerdack GR, et al. Additive hypocholesterolemic effect of psyllium and cholestyramine in the hamster: influence on fecal sterol and bile acid profiles. J Lipid Res 1997;38:491-502.. View abstract.
- Everson GT, Daggy BP, McKinley C, Story JA. Effects of psyllium hydrophilic mucilloid on LDL-cholesterol and bile acid synthesis in hypercholesterolemic men. J Lipid Res 1992;33:1183-92.. View abstract.
- Maciejko JJ, Brazg R, Shah A, et al. Psyllium for the reduction of cholestyramine-associated gastrointestinal symptoms in the treatment of primary hypercholesterolemia. Arch Fam Med 1994;3:955-60.. View abstract.
- Cheskin LJ, Kamal N, Crowell MD, et al. Mechanisms of constipation in older persons and effects of fiber compared with placebo. J Am Geriatr Soc 1995;43:666-9.. View abstract.
- Belknap D, Davidson LJ, Smith CR. The effects of psyllium hydrophilic mucilloid on diarrhea in enterally fed patients. Heart Lung 1997;26:229-37.. View abstract.
- Alabaster O, Tang Z, Shivapurkar N. Dietary fiber and the chemopreventive modelation of colon carcinogenesis. Mutation Res 1996;350:185-97.. View abstract.
- Jarjis HA, Blackburn NA, Redfern JS, Read NW. The effect of ispaghula (Fybogel and Metamucil) and guar gum on glucose tolerance in man. Br J Nutr 1984;51:371-8.. View abstract.
- Little P, Trafford L. Dietary fibre and renal failure: comparison of sterculia and ispaghula. Clin Nephrol 1991;36:309. View abstract.
- Schaller DR. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1073.
- Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3. View abstract.
- Arlian LG, Vyszenski-Moher DL, Lawrence AT, et al. Antigenic and allergenic analysis of psyllium seed components. J Allergy Clin Immunol 1992;89:866-76.. View abstract.
- James JM, Cooke SK, Barnett A, Sampson HA. Anaphylactic reactions to a psyllium-containing cereal. J Allergy Clin Immunol 1991;88:402-8.. View abstract.
- Wolever TM, Jenkins DJ, Mueller S, et al. Psyllium reduces blood lipids in men and women with hyperlipidemia. Am J Med Sci 1994;307:269-73. View abstract.
- Spence JD, Huff MW, Heidenheim P, et al. Combination therapy with colestipol and psyllium mucilloid in patients with hyperlipidemia. Ann Intern Med 1995;123:493-9. View abstract.
- Jensen CD, Haskell W, Whittam JH. Long-term effects of water-soluble dietary fiber in the management of hypercholesterolemia in healthy men and women. Am J Cardiol 1997;79:34-7. View abstract.
- Jenkins DJ, Kendall CW, Vuksan V. Viscous fibers, health claims, and strategies to reduce cardiovascular disease risk. Am J Clin Nutr 2000;71:401-2. View abstract.
- Bobrove AM. Misoprostol, diarrhea, and psyllium mucilloid. Ann Intern Med 1990;112:386. View abstract.
- Misra SP, Thorat VK, Sachdev GK, Anand BS. Long-term treatment of irritable bowel syndrome: results of a randomized controlled trial. Q J Med 1989:73:931-9. View abstract.
- Kumar A, Kumar N, Vij JC, et al. Optimum dosage of ispaghula husk in patients with irritable bowel syndrome: correlation of symptom relief with whole gut transit time and stool weight. Gut 1987;28:150-5. View abstract.
- Prior A, Whorwell PJ. Double blind study of ispaghula in irritable bowel syndrome. Gut 1987;28:1510-3. View abstract.
- Longstreth GF, Fox DD, Youkeles L, et al. Psyllium therapy in the irritable bowel syndrome. A double-blind trial. Ann Intern Med 1981;95:53-6. View abstract.
- Marlett JA, Li BU, Patrow CJ, Bass P. Comparative laxation of psyllium with and without senna in an ambulatory constipated population. Am J Gastroenterol 1987;82:333-7. View abstract.
- Heather DJ, Howell L, Montana M, et al. Effect of a bulk-forming cathartic on diarrhea in tube-fed patients. Heart Lung 1991;20:409-13. View abstract.
- Qvitzau S, Matzen P, Madsen P. Treatment of chronic diarrhoea: loperamide versus ispaghula husk and calcium. Scand J Gastroenterol 1988;23:1237-40. View abstract.
- Marlett JA, Kajs TM, Fischer MH. An unfermented gel component of psyllium seed husk promotes laxation as a lubricant in humans. Am J Clin Nutr 2000;72:784-9. View abstract.
- Bliss DZ, Jung HJ, Savik K, et al. Supplementation with dietary fiber improves fecal incontinence. Nurs Res 2001;50:203-13. View abstract.
- Eherer AJ, Santa Ana CA, Porter J, Fordtran JS. Effect of psyllium, calcium polycarbophil, and wheat bran on secretory diarrhea induced by phenolphthalein. Gastroenterology 1993;104:1007-12. View abstract.
- Alabaster O, Tang ZC, Frost A, Shivapurkar N. Potential synergism between wheat bran and psyllium: enhanced inhibition of colon cancer. Cancer Lett 1993;75:53-8. View abstract.
- Gerber M. Fiber and breast cancer: another piece of the puzzle--but still an incomplete picture. J Natl Cancer Inst 1996;88:857-8. View abstract.
- Shulman LM, Minagar A, Weiner WJ. Perdiem causing esophageal obstruction in Parkinson's disease. Neurology 1999;52:670-1. View abstract.
- Schneider RP. Perdiem causes esophageal impaction and bezoars. South Med J 1989;82:1449-50. View abstract.
- Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6. View abstract.
- Ho Y, Tan M, Seow-Choen F. Micronized purified flavonidic fraction compared favorably with rubber band ligation and fiber alone in the management of bleeding hemorrhoids. Dis Colon Rectum 2000;43:66-9. View abstract.
- Williams CL, Bollella M, Spark A, Puder D. Soluble fiber enhances the hypocholesterolemic effect of the step I diet in childhood. J Am Coll Nutr 1995;14:251-7. View abstract.
- 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. View abstract.
- Dennison BA, Levine DM. Randomized, double-blind, placebo-controlled, two-period crossover clinical trial of psyllium fiber in children with hypercholesterolemia. J Pediatr 1993;123:24-9. View abstract.
- Kwiterovich PO. The role of fiber in the treatment of hypercholesterolemia in children and adolescents. Pediatrics 1995;96:1005-9. View abstract.
- Jensen CD, Spiller GA, Gates JE, et al. The effect of acacia gum and a water-soluble dietary fiber mixture on blood lipids in humans. J Am Coll Nutr 1993;12:147-54. View abstract.
- Wolever TM, ter Wal P, Spadafora P, Robb P. Guar, but not psyllium, increases breath methane and serum acetate concentrations in human subjects. Am J Clin Nutr 1992;55:719-22. View abstract.
- Anderson JW, Jones AE, Riddell-Mason S. Ten different dietary fibers have significantly different effects on serum and liver lipids of cholesterol-fed rats. J Nutr 1994;124:78-83. View abstract.
- Gelissen IC, Brodie B, Eastwood MA. Effect of Plantago ovata (psyllium) husk and seeds on sterol metabolism: studies in normal and ileostomy subjects. Am J Clin Nutr 194;59:395-400. View abstract.
- Segawa K, Kataoka T, Fukuo Y. Cholesterol-lowering effects of psyllium seed associated with urea metabolism. Biol Pharm Bull 1998;21:184-7. View abstract.
- Jenkins DJ, Wolever TM, Vidgen E, et al. Effect of psyllium in hypercholesterolemia at two monosaturated fatty acid intakes. Am J Clin Nutr 1997;65:1524-33. View abstract.
- Bell LP, Hectorne K, Reynolds H, et al. Cholesterol-lowering effects of psyllium hydrophilic mucilloid. Adjunct therapy to a prudent diet for patients with mild to moderate hypercholesterolemia. JAMA 1989;261:3419-23. View abstract.
- Jenkins DJ, Kendall CW, Axelsen M, et al. Viscous and nonviscous fibres, nonabsorbable and low glycaemic index carbohydrates, blood lipids and coronary heart disease. Curr Opin Lipidol 2000;11:49-56. View abstract.
- Wolever TM, Vuksan V, Eshuis H, et al. Effect of method of administration of psyllium on glycemic response and carbohydrate digestibility. J Am Coll Nutr 1991;10:364-71. View abstract.
- Wolever TM, Jenkins DJ, Mueller S, et al. Method of administration influences the serum cholesterol-lowering effect of psyllium. Am J Clin Nutr 1994;59:1055-9. View abstract.
- Roberts DC, Truswell AS, Bencke A, et al. The cholesterol-lowering effect of a breakfast cereal containing psyllium fibre. Med J Aust 1994;161:660-4. View abstract.
- Anderson JW, Riddell-Mason S, Gustafson NJ, et al. Cholesterol-lowering effects of psyllium-enriched cereal as an adjunct to a prudent diet in the treatment of mild to moderate hypercholesterolemia. Am J Clin Nutr 1992;56:93-8. View abstract.
- Pastors JG, Blaisdell PW, Balm TK, et al. Psyllium fiber reduces rise in postprandial glucose and insulin concentrations in patients with non-insulin-dependent diabetes. Am J Clin Nutr 1991;53:1431-5. View abstract.
- Morgan MS, Arlian LG, Vyszenski-Moher DL, et al. English plantain and psyllium: lack of cross-allergenicity by crossed immunoelectrophoresis. Ann Allergy Asthma Immunol 1995;75:351-9. View abstract.
- Bonithon-Kopp C, Kronborg O, Giacosa A, et al. Calcium and fibre supplementation in prevention of colorectal adenoma recurrence: a randomised intervention trial. European Cancer Prevention Organisation Study Group. Lancet 2000;356:1300-6. View abstract.
- FDA, Ctr Food Safety, Applied Nutr. FDA allows foods containing psyllium to make health claim on reducing risk of heart disease. Available at: http://vm.cfsan.fda.gov/~lrd/tpsylliu.html
- 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. View abstract.
- 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. View abstract.
- Anderson JW, Davidson MH, Blonde L, et al. Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia. Am J Clin Nutr 2000;71:1433-8. View abstract.
- Leathwood PD, Chauffard F, Heck E, Munoz-Box R. Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Pharmacol Biochem Behav 1982;17:65-71. View abstract.
- Washington N, Harris M, Mussellwhite A, Spiller RC. Moderation of lactulose-induced diarrhea by psyllium: effects on motility and fermentation. Am J Clin Nutr 1998;67:317-21. View abstract.
- 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. View abstract.
- Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr 1999;69:30-42. View abstract.
- Wolever TM, Robb PA. Effect of guar, pectin, psyllium, soy polysaccharide, and cellulose on breath hydrogen and methane in healthy subjects. Am J Gastroenterol 1992:87:305-10. View abstract.
- Schwesinger WH, Kurtin WE, Page CP, et al. Soluble dietary fiber protects against cholesterol gallstone formation. Am J Surg 1999;177:307-10. View abstract.
- 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 colits (GETECCU). Am J Gastroenterol 1999;94:427-33. View abstract.
- Fernandez R, Phillips SF. Components of fiber bind iron in vitro. Am J Clin Nutr 1982;35:100-6. View abstract.
- Fernandez R, Phillips SF. Components of fiber impair iron absorption in the dog. Am J Clin Nutr 1982;35:107-12. View abstract.
- Freeman GL. Psyllium hypersensitivity. Ann Allergy 1994;73:490-2. View abstract.
- Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8. View abstract.
- Suhonen R, Kantola I, Bjorksten F. Anaphylactic shock due to ingestion of psyllium laxative. Allergy 1983;38:363-5. View abstract.
- Erratum. Am J Clin Nutr 1998;67:1286.
- Schectman G, Hiatt J, Hartz A. Evaluation of the effectiveness of lipid-lowering therapy (bile acid sepquestrants, niacin, psyllium and lovastatin) for treating hypercholesterolemia in veterans. Am J Cardiol 1993;71:759-65. View abstract.
- Sprecher DL, Harris BV, Goldberg AC, et al. Efficacy of psyllium in reducing serum cholesterol levels in hypercholesterolemic patients on high- or low-fat diets. Ann Intern Med 1993;119:545-54. View abstract.
- Chan EK, Schroeder DJ. Psyllium in hypercholesterolemia. Ann Pharmacother 1995;29:625-7. View abstract.
- Jalihal A, Kurian G. Ispaghula therapy in irritable bowel syndrome: improvement in overall well-being is related to reduction bowel dissatisfaction. J Gastroenterol Hepatol 1990;5:507-13. View abstract.
- Stoy DB, LaRosa JC, Brewer BK, et al. Cholesterol-lowering effects of ready-to-eat cereal containing psyllium. J Am Diet Assoc 1993;93:910-2. View abstract.
- 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. View abstract.
- Anderson JW, Allgood LD, Lawrence A, et al. Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials. Am J Clin Nutr 2000;71:472-9. View abstract.
- Agha FP, Nostrant TT, Fiddian-Green RG. Giant colonic bezoar: a medication bezoar due to psyllium seed husks. Am J Gastroenterol 1984;79:319-21. View abstract.
- Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416. View abstract.
- Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
- Cook IJ, Irvine EJ, Campbell D, et al. Effect of dietary fiber on rectosigmoid motility in patients with irritable bowel syndrome: A controlled, crossover study. Gastroenterology 1990;98:66-72. View abstract.
- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.