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Psyllium (Plantago psyllium, P. ovata)

These tiny seeds and their husks are so rich in fibre that they've been prescribed for constipation and a wide range of other digestive ailments for more than 500 years.  New research has found that psyllium offers an added benefit; it lowers blood cholesterol safely and effectively.

What it is?

Odourless and nearly tasteless, psyllium comes from the small, reddish brown to black seeds of the Plantago psyllium plant.  Also known as the plantain, it should not be confused with the edible, banana-like fruit of the same name (Musa paradisiaca) or with the herb plantain (P. lanceolata) sometimes used for coughs.  Plantago grows as a weed in numerous places around the world and is commercially cultivated in Spain, France, India, Pakistan and other countries.  Various species of the plant are used in herbal medicine, most commonly the seeds of P. psyllium and P. ovata.  The tiny seeds are generally dried and ground, and sold in the form of powders, capsules or chewable tablets.  Psyllium is sometimes added to breakfast cereals.

What it does?

When mixed with water, the fibrous husks of psyllium seeds form a gel-like mass that absorbs excess water from the intestines and creates larger, softer stools.  Psyllium helps to lower cholesterol by binding to cholesterol-rich bile in the digestive tract, causing the body to draw cholesterol from the bloodstream.  As an inexpensive source of soluble fibre (the kind of fibre that blends with water), it's particularly suitable for people who don't eat enough fibre-rich foods, such as whole grains (oats are particularly rich in soluble fibre), beans, fruits and vegetables.

Major Benefits

Psyllium can help to normalize bowel function in a wide variety of disorders, including constipation, diarrhoea, diverticulosis, haemorrhoids and irritable bowel syndrome.  It does so by a single mechanism: absorbing water, which lends bulk to stools.  In the case of constipation, the added water and bulk help to soften stools, making them easier to pass.  And, though it doesn't cure haemorrhoids, passing softer stools reduces irritation in the tender area.  In one study, 84% of haemorrhoid sufferers receiving a supplement containing psyllium reported less bleeding and pain.  Psyllium has also been reported to have a soothing effect on those with irritable bowel syndrome.  In people with diverticular disease – in which small pockets in the lining of the intestine trap faecal particles and become susceptible to infection – psyllium bulks the stools and hastens their passage through the intestine, helping to alleviate the problem.  And psyllium's ability to absorb large amounts of excess water from loose stools is an effective treatment of diarrhoea.

Additional Benefits

Although psyllium has been used for constipation for centuries, only in the 1980s did scientists discover another benefit: psyllium reliably lowers blood cholesterol, especially the 'bad' LDL cholesterol that can stick to artery walls and lead to heart disease.  In several studies of men and women with high cholesterol levels, 10 g or more of psyllium daily for six weeks or longer lowered LDL 6-20% more than the cholesterol-lowering effect of a low-fat diet.  sometimes, simply adding psyllium to your diet can be enough to eliminate the need for cholesterol-lowering medications.

The fibre source may also play a role in weight-loss programs.  By absorbing water, it fills the stomach, providing a sense of fullness.  It also delays the emptying of food from the stomach, thus extending the time you feel full.  In a small British study, women who took psyllium with water three hours before a meal consumed less fat and fewer kilo joules during the meal.  Whether this effect persists and leads to long-term weight-loss, however, is unknown.  And psyllium can help to stabilize levels of glucose (sugar) in the blood, which may control food cravings.

Common Uses

  • Relieves constipation, diarhhoea.
  • Treats diverticular disease and irritable bowel syndrome.
  • Helps to prevent gallstones.
  • Reduces haemorrhoid pain.
  • May lower cholesterol.
  • Facilitates weight loss.

Forms

  • Powder/husks.
  • Capsule.
  • Wafer.

Caution!

  • Always take psyllium with plenty of liquid.  Without lots of fluid, it is possible to develop an intestinal blockage, causing severe, painful constipation.
  • Some people are allergic to psyllium.  Reactions are often quick, marked by a rash, itching and, in severe cases, difficulty in breathing and swallowing.  Get immediate medical help.
  • Reminder:  If you have a medical condition, talk to your doctor before taking supplements.

How to take it?

Dosage:

The usual dosage is 1-3 tablespoons (or up to 10 g) two or three times a day.  Some formulas are more concentrated, so check the label.  Don't exceed 30 g a day.

Guidelines for use:

Relief of constipation usually occurs in 12-24 hours, though it can take as long as three days.  Because psyllium absorbs water, always take it with large amounts of fluid.  Dissolve psyllium powder in water (or juice), drink it, and then drink another glass of water or juice.  In addition, drink six to eight glasses of water a day.  Take psyllium two hours or more after taking medications or other supplements so that it doesn't delay their absorption.  If you're pregnant, check with your doctor before using psyllium.

Possible side effects

Psyllium can cause temporary bloating and increased flatulence because it supplies fibre.  Avoid these problems by slowly increasing psyllium intake over several days.  Amounts of psyllium larger than the recommended does may reduce the absorption of certain minerals.  Allergic reactions are rare, but can be life-threatening.  If you develop difficulty in swallowing or breathing, seek medical help straight away.

Facts and Tips

  • In 1998, the US Food and Drug Administration (FDA) allowed breakfast cereals that contain psyllium to claim that they reduce the risk of heart disease as part of a diet low in saturated fat and cholesterol.  To qualify, a cereal must contain 1.7 g of soluble fibre from psyllium per serving.  Four servings a day deliver 7 g of soluble fibre, enough to lower blood cholesterol significantly.  Manufacturers in Australia and New Zealand are not permitted to make such claims, but these are useful guidelines.  Combining a psyllium-enriched cereal with a whole-oat cereal may be an even more effective strategy for lowering cholesterol levels.

Latest Findings

  • Not only may psyllium aid in weight loss by suppressing appetite – it may also prevent gallstones.  A Mexican study of obese patients on very low-kilo joule diets, which put them at increased risk of gallstones, found that psyllium helped to avert this sometimes acutely painful condition.
  • Psyllium lowers cholesterol even in children.  In a study of 25 children and teenagers aged 6-18 who had high cholesterol levels, adding a cereal containing psyllium to a low-fat diet reduced 'bad' (LDL) cholesterol by an additional 7%.

Did you know?

In Europe during the Middle Ages, Arab physicians sold a constipation remedy called diagridium.  Psyllium was one of its main ingredients.