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"The natural force within each of us isthe greatest healer of disease"
- Hippocrates
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Psyllium
Psyllium
Latin binomial: Plantago psyllium, Plantago ovata, Plantago indica. Members of these three species of plantago are commonly referred to as Psyllium.1,2
Synonyms:
P.psyllium: Flea seeds, Dark Psyllium
P.ovata: Blond Psyllium, Ispaghula, Indian Plantago, Spogel
P.indica: Black Psyllium 1,2
Parts Used: Dried ripe seeds including husks 1
Constituents: Ten to 30% mucilage comprised mainly of d-xylose based polysaccharides, monoterpene alkaloids (boschniakine, indicainine), triterpenes (stigmasterol, beta-sitosterol, sitosterol) and a fixed oil which is rich in polyunsaturated fats.2,3
Medicinal Action: Demulcent, Laxative, Hydrophillic bulking agent
Pharmacology
Most of Psyllium's medicinal action can be attributed to its hydrophilic nature, rapidly resulting in an absorption of fluid and subsequent increase in its volume. This increased volume results in both a promotion of peristalsis and hydration of feces. Depending upon the amount of fluid present, Psyllium can either expand into a bulking agent/laxative or absorb excess water in the colon and act as an astringent. In addition, the mucilage has been shown in animal studies to be hepatoprotective against some organic solvents.2,3
Indications  | As a bulking laxative for the treatment of constipation. Complementary medical practitioners commonly use Psyllium as part of a 'detox' program | | To reduce both total cholesterol and LDL cholesterol levels suggesting a use in hypercholesterolemia and possibly atherosclerosis 4 | | discount hotels in Arnheim Hyperglycemia, to reduce both postprandial glucose elevation and serum insulin levels 5 | | Crohn's Disease due to its demulcent nature 6 | | Diarrhea due to its astringent properties | | Varicose veins and hemorrhoids through decreased straining during defecation 7 |
Toxicity and Contraindications
As with most bulk laxatives, its use should be avoided in patients with intestinal obstruction and colonic atony. Proprietary medicines containing Psyllium pose the risk of a hypersensitivity reaction which may manifest as rhinitis, wheezing, urticaria and in some instances anaphylaxis.8
Due to Psyllium's action on lowering blood glucose, controlled diabetics should be monitored closely.9
Drug Interactions
With the exception of lithium salts and oral hypoglycemic agents, Psyllium appears to have little effect on drug absorption. Given this, it would seem prudent to monitor patients taking drugs with a low therapeutic index and advise them against simultaneous administration with Psyllium.9-15
Administration
Dosage: 5 to 10 gm of seeds (3 gm in children) which have been soaked for several hours in warm water, taken up to three times daily 1 or one or more teaspoonsful of powder as directed. Any Psyllium product should be taken mixed with water and fluid intake should be increased.
Official formulae of members of the Plantago genus exist, P.psyllium and P.indica being combined to form Psyllium BPC and P. ovata as Ispaghula Husk BPC.16
Psyllium is often combined with other laxatives particularly Cassia acutifolia (Senna) or Rhamnus purshiana (Cascara sagrada). It is also available with other sources of fibre such as oat bran.
As mentioned before, Psyllium is popular as a component of 'detox' programs where it may be combined with antiparasitic herbs e.g. Juglans nigra (Black Walnut) or antimicrobial herbs e.g. Hydrastis canadensis (Goldenseal).
References
1. British Herbal Pharmacopeia (1983). Page 165-166
2. Wren R.C. (1988). Potter's New Encyclopaedia of Botanical Drugs and Preparations. Page 225-226. C.W. Daniel Company, Saffron Walden, UK
3. Willard T. (1991). Wild Rose Scientific Herbal. Page 277-278. Wild Rose College of Natural Healing, Calgary
4. Leven E.G. et al. (1990). Comparison of psyllium hydrophilic mucilloid and cellulose as adjuncts to a prudent diet in the treatment of mild to moderate hypercholesterolemia. Arch Intern Med 150: 1822-7 reviewed by Werbach J. (1993). Nutritional Influences on Illness. A sourcebook for clinical research. 2nd Edition. Page 65. Third Line Press, Tarzana, California
5. Pastors J.G. et al. (1991). Psyllium fibre reduces rise in postprandial glucose and insulin concentration in patients with non-insulin-dependent diabetes. Am J Clin Nutr 53:1431-5
6. Weiss R. (1988). Herbal Medicine. Beaconsfield Publishers Ltd. Page 114
7. Webster D.J., Gough D.C. and Craven J.L. (1978). The use of bulk evacuation in patients with haemorrhoids. Br J Surg 65 291-2
8. Martindale (1993). Pharmaceutical Press. 13th Edition. Page 886.
9. Stockley 1. (1994). Drug Interactions. A sourcebook of adverse interactions, their mechanisms, clinical importance and management. 3rd Edition. Page 57 1. Blackwell Scientific Press, Cambridge, UK
Austria Information 10. Stockley 1. ibid. Page 174
11. Stockley 1. ibid. Page 256
12. Stockley 1. ibid. Page 624
13. Stockley 1. ibid. Page 513
14. Stockley 1. ibid. Page 831
15. USP DI (1994). 14th Edition. Page 1705-1706. US Pharmaceutical Convention Inc., Rockland, Maryland
16. Evans, W. C. (1992). Pharmacognosy. 13th Edition. Page 374. Bailliere Tindall, London
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