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From the National Institutes of HealthNational Institutes of Health

Blond psyllium


What is it?

Blond psyllium is an herb. The seed and the outer covering of the seed (husk) are used to make medicine.

Blond psyllium is used 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, diabetes, cancer, weight control, and serious renal disease.

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:

Effective for...

  • Relieving constipation and softening stools. Some evidence suggests that blond psyllium alone can relieve constipation and improve stool consistency as effectively as preparations containing blond psyllium plus senna or docusate sodium.

Likely effective for...

  • Lowering cholesterol in people with high cholesterol. Taking blond psyllium 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) 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.
    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 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. But don’t adjust the dose of your medication without consulting your healthcare provider.

Possibly effective for...

  • Irritable bowel syndrome (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.
  • Lowering blood sugar after eating a meal in people with diabetes (type 1 and type 2). 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.
  • High blood pressure. Taking psyllium fiber (husks) with soy protein seems to help reduce the top number in a blood pressure reading (systolic blood pressure) by about 8 mmHg and the bottom number (diastolic blood pressure) by about 2 mmHg in adult men and women.
  • 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.
  • Diarrhea.
  • Preventing ulcerative colitis symptoms.
  • Hemorrhoids.

Possibly ineffective for...

  • Skin 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.

Insufficient evidence to rate effectiveness for...

  • Preventing fat redistribution in people with HIV disease.
  • Some types of cancer.
  • Some types of skin conditions.
  • Other conditions.
More evidence is needed to rate blonde psyllium for these uses.

How does it work?

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The husks of the psyllium seed absorb water and form a large mass. In people with constipation, this mass stimulates the bowel to move. In people with diarrhea, it can slow down the bowel and reduce bowel movements.

Are there safety concerns?

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Blond psyllium is LIKELY SAFE for most people when taken with plenty of fluids. Drink at least 8 ounces of fluids for every 3-5 grams of husk or 7 grams of seed. In some people, blond psyllium might cause gas, stomach pain, diarrhea, constipation, and nausea. It has also been linked to reports of headache, backache, runny nose, cough, and sinus problems.

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 used appropriately.

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.

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: Don’t use blond psyllium if you have problems swallowing. Blond psyllium might increase your risk of choking.

Are there interactions with medications?

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Moderate

Be cautious with this combination.

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).

Lithium
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.

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.

Minor

Be watchful with this combination.

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?

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Iron
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.

Riboflavin
Psyllium seems to slightly reduce the amount of riboflavin that the body absorbs, but it's probably not important.

Are there interactions with foods?

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Fat
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?

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It’s important to take enough water when taking blond psyllium. Not taking enough fluid could lead to choking or obstruction of the esophagus (the food passage connecting the throat and the stomach) or bowel. Take at least 240 mL per 5 grams or less of blond psyllium husk or 7 grams of blond psyllium seed. To minimize some of the common GI side effects, start with a low dose and increase to the needed amount.

The following doses have been studied in scientific research:

BY MOUTH:
  • As a laxative for constipation: 7-40 grams of blond psyllium seed per day, in 2-4 divided doses.
  • For diarrhea: 7-18 grams of blond psyllium, in 2-3 divided doses or 5 grams 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: up to 30 grams of blond psyllium daily in divided doses of 2.5-7.5 grams per dose. 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 irritable bowel syndrome (IBS): 10-30 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 keeping symptoms of ulcerative colitis under control: 10 grams of blond psyllium seeds, taken twice daily.
  • For relieving bleeding from hemorrhoids: 3.5 grams of psyllium seed husk, twice daily for three months.
  • For high cholesterol: 3.4 grams of blond psyllium seed husk three times daily or 5.1 grams twice daily. However, doses up to 20.4 grams per day have been tried. Cereal with added psyllium that provides 12 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. In children with high cholesterol: cereal containing 5-10 grams of psyllium daily.
  • For type 2 diabetes and high cholesterol: 15 grams of blond psyllium in three divided doses.
  • For reducing the glycemic index of food in patients with type 2 diabetes: 15 grams of blond psyllium in three divided doses with a carbohydrate meal has been used.
  • For high blood pressure: 15 grams of blond psyllium husks daily for 8 weeks.

Other names

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Balle de Psyllium, Blond Plantago, Blonde Psyllium, Che Qian Zi, Dietary Fiber, Englishman's Foot, Fibre Alimentaire, Indian Plantago, Ipágula, Isabgola, Isabgul, Ispaghul, Ispaghula, Ispagol, Pale Psyllium, Plantaginis Ovatae Semen, Plantaginis Ovatae Testa, Plantago decumbens, Plantago fastigiata, Plantago insularis, Plantago ispaghula, Plantago ovata, Psilio, Psillium Blond, Psyllium, Psyllium Blond, Psyllium Husk, Sand Plantain, Spogel.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Blond psyllium page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/866.html.

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