Psyllium (black or blond) – The benefits for your health

psyllium

The psyllium seeds, black, brown or blond depending on the species, are tiny (1000 seeds weigh less than 2 g) hence their name from the Greek word psyllia, which means chip. Psyllium is mainly grown in India, but also in several countries in Europe and the former Soviet Union, as well as in Pakistan.

Psyllium belongs to the category of laxatives said from the east (or mass) which consist of fibers having the property of absorbing several times their weight in water.

Psyllium: the benefits on your health

Experts agree that the psyllium, whether black or blond, owes its medicinal properties to the mucilage it contains. The mucilage is a vegetable substance which swells on contact with water giving a viscous liquid. Apart from the species of Plantago which are the subject of this fact sheet, it is reasonable to believe that the other species of psyllium have similar medicinal properties, provided that they contain the same quantities and the same type of mucilage.

Note that the food industry uses the mucilage of envelope blond psyllium like thickening or stabilizer in certain prepared foods, especially frozen dairy products.

Common names : psyllium, blond psyllium, black psyllium, ispaghul.
Botanical names: Plantago ovata (or P. ispaghula), P.afra (or P. psyllium), P. arenaria (or P. indica), P. asiatica, family of plantaginaceae.
English names: psyllium, blonde psyllium (blond plantago, indian plantago, Englishman’s Foot), brown psyllium, black psyllium (fleaseed, french psyllium, spanish psyllium).
Chinese name: Che Qian Zi (seeds).

Parts used: the seed and its covering.
Habitat and origin: blond psyllium (Plantago ovata) is native to India and Iran, while black psyllium (P. psyllium and P. indica) is a native of the Mediterranean basin and the Middle East. These annual plants tolerate cold as well as heat and drought, and are content with relatively poor soil.

Benefits of Psyllium

  • Fight constipation
  • Slightly reduce blood cholesterol
  • Prevent cardiovascular disease
  • Treat diarrhea
  • Relieve symptoms of irritable bowel syndrome
  • Reduce blood sugar in diabetes
  • Relieve symptoms of ulcerative colitis
  • Treat constipation, diarrhea, inflammatory bowel disease
  • reduce blood cholesterol and glucose levels and prevent coronary artery disease.

Psyllium dosage

When taking psyllium, it is important to drink plenty of fluids to avoid blockage of the digestive tract.

When we take it as unprocessed seeds, soak them for a few hours in lukewarm water before consuming them. When we take it as powder (Metamucil®, for example), just mix it with water or juice and drink it within a few minutes.

Constipation or diarrhea

  • Take 2.5 to 7.5 g, 3 times a day, with a full glass of water (at least 30 ml per gram of psyllium). Start with the smallest dose and increase it until you get the desired effect. It may be necessary to continue treatment for 2 to 3 days before benefiting from an optimal laxative effect.
  • In case of diarrhea, it may be necessary to increase the dose up to 40 g per day (4 doses of 10 g each). Consult a doctor if the diarrhea persists beyond 3 days.

Hypercholesterolemia

  • Take 10 g to 20 g per day in 2 or 3 doses.

Irritable bowel syndrome, ulcerative colitis, diverticulitis, duodenal ulcer.

  • Take 10 g, 2 to 3 times a day.

Diabetes (reduce blood sugar)

  • Take 10 g to 20 g per day, during meals.
Warning. Self-medication in case of diabetes can cause serious problems. When starting a treatment that has the effect of changing your blood glucose level, you must monitor your blood sugar very closely. It is also necessary to notify your doctor, so that he can, if necessary, review the dosage of conventional hypoglycemic drugs.

History of psyllium

More than 10 centuries BC, Egyptian doctors already used the psyllium as laxative and to treat inflammation of the urinary tract. It has also been known for centuries in Europe, Asia and North Africa. In India and China, psyllium has traditionally been used to treat diarrhea, the hemorrhoids and the hypertension.

In 1998, the blond psyllium had its heyday in the United States when the Food and Drug Administration (FDA) authorized Kellogg to mention the therapeutic properties of some of its products on its packaging. Thus, food products containing at least 1.7 g of soluble fiber psyllium have the right to indicate on the packaging: “when combined with a low fat and cholesterol diet, the soluble fibers from the psyllium seed coats contained in this product can reduce the risk of cardiovascular disease” .

Psyllium research

  • Constipation. Psyllium is a ballast laxative. The mucilaginous substances it contains absorb water from food. In the intestines, they then form a “gel” which increases the weight of the stools, improves their consistency and accelerates their transit. Psyllium is widely used to fight constipation, especially when it is chronic. Compared to other ballast laxatives, psyllium is more effective than the calcium polycarbophile, methylcellulose or wheat bran. It also causes less bloating and flatulence than other plant fibers. However, according to gastroenterology specialists, its effectiveness remains moderate.
  • Less powerful than stimulants like senna or bisacodyl, psyllium has the advantage of being better tolerated and not causing their side effects. Furthermore, although moderate, its effects would be as important, if not more, than the emollient laxatives (sodium or calcium docusate). Only some osmotic laxatives (lactulose, polyethylene glycol) and synthetic drugs have been found to be more effective.
  • In patients with neurological diseases, who have a higher risk of constipation, the results obtained with psyllium are encouraging, but not yet conclusive enough to suggest a treatment protocol.
  • Hypercholesterolemia. Taking psyllium supplements daily helps to decrease cholesterol level and of triglycerides people prone to mild or moderate hypercholesterolemia. The reduction of total cholesterol and “bad” cholesterol (LDL) would be observed from 5 g of psyllium per day and would increase with dose. Simultaneous monitoring of a low fat diet, if not essential, increases the effectiveness of supplements. In addition, the effect of psyllium is exerted even in people who control their hypercholesterolemia with medicines based on statins (lovastatin, simvastatin, atorvastatin).
    It should be noted that psyllium would have no effect in people with near-normal cholesterol levels.
  • Cardiovascular illnesses. In addition to its benefits on blood lipid levels (see research on hypercholesterolemia) and blood sugar (see research on diabetes), psyllium acts on other components of the metabolic syndrome, a condition that predisposes to cardiovascular disease. Thus, in 2005, 2 independent meta-analyzes came to the conclusion that fiber supplementation (approximately 10 g per day) contributed to reducing the arterial pressure, especially in hypertensive individuals. Two years later, a clinical trial showed that a diet incorporating 3.5 g of psyllium, 3 times a day for 6 months, significantly lowered the blood pressure of overweight and hypertension people.

    It should be noted that in the United States, since 1998, the Food and Drug Administration allows products containing psyllium to indicate that there is a relationship between the soluble fibers of psyllium and the reduction of the risk of disease coronary.

  • Diarrhea. Although it may seem contradictory, psyllium can be used to treat diarrhea in addition to constipation. Indeed, the mucilage it contains absorbs part of the excess water and allows the liquid stool to become more consistent. Trials to date have shown that psyllium may be useful in the treatment of incontinence fecal and diarrhea induced by certain drugs. These properties may also help relieve symptoms of irritable bowel syndrome and some ulcerative colitis.
  • Irritable bowel syndrome. Like all inflammatory phenomena that affect the digestive tract, irritable bowel syndrome has a large part of psychosomatic effects and, therefore, the placebo effect can be very important in this disorder. It is therefore rather difficult to provide clinical proof of the effectiveness of one or other of the treatments intended to relieve the symptoms.
    Despite everything, prebiotics, and more precisely fibers soluble, can play an important role in the prevention and treatment of inflammatory diseases of intestines. By modifying the composition of the intestinal flora, these fibers create beneficial conditions for the intestine. Psyllium, in particular, alleviates the symptoms of irritable bowel syndrome, with the exception of pain for which it remains ineffective. Clinical research has established that the optimal doses are between 20 g and 30 g of psyllium per day.
  • Diabetes. By studying the effects of psyllium on patients with type 2 diabetes, researchers have found that it not only helps normalize blood lipids, but also lowers blood sugar.To get the most out of this effect, it seems better to consume psyllium at meal times, mixed with food, rather than taking it between meals as a supplement. By changing the structure, texture and viscosity of food in the gut, it decreases the glycemic index of the meal (for more information, see our text Glycemic index and glycemic load). Psyllium also creates a feeling of satiety which can help reduce food intake and therefore control weight.
    As the author of a summary published in 2003 points out, obese children and adolescents with diabetes could benefit from a diet enriched in psyllium. However, he said more trials will be needed to confirm a real long-term effect.
  • Ulcerative colitis. In the 1990s, two small studies observed that psyllium could not only reduce the symptoms of ulcerative colitis in patients in remission, but that it could also prolong this remission as effectively as conventional treatment with mesalazine. Recently, Japanese researchers have shown that the use of a symbiotic – the combination of a prebiotic (psyllium) and a probiotic (Bifibobacterium longum) – had a greater effect on patients’ quality of life than each of the supplements taken alone. It was also the only one to reduce inflammation in the gut.
  • Constipation, diarrhea, inflammatory bowel disease. Committee E recognizes the use of the blond psyllium in case of constipation and in situations requiring improved intestinal transit and softening of stools: pregnancy, anal fissures, hemorrhoids or rectal surgery. It also approves its use for the treatment of diarrhea and as a complementary treatment for irritable bowel syndrome.

    Commission E and ESCOP recognize the use of black psyllium to treat the chronic constipation and the irritable bowel syndrome.

    All of the above uses are also approved by the World Health Organization (WHO) which does not distinguish between black and blonde psyllium. On the other hand, it adds duodenal ulcer and diverticulitis to the list of diseases that can benefit from the effects of psyllium.

  • Hypercholesterolemia, glycemia and coronary artery disease. ESCOP recognizes the use of the envelope blond psyllium to lower blood cholesterol. WHO adds to these effects the reduction of blood sugar after a meal and the prevention of coronary artery disease.

Precautions with psyllium

Warning

  • The diabetes is a serious illness the treatment of which requires medical monitoring. Self-medication for diabetes can cause serious problems. When starting a treatment that has the effect of changing your blood glucose level, you must monitor your blood sugar very closely. It is also necessary to notify your doctor so that he can, if necessary, review the dosage of conventional hypoglycemic drugs.

Contraindications

  • Intestinal or esophageal stenosis or any other type of real or suspected gastrointestinal obstruction.

Side effects

  • Rare cases of allergic reactions have been reported.

Psyllium interactions

With plants or supplements

  • Some experts have speculated that taking psyllium could cause a vitamin and mineral deficiency. Data from a clinical trial seem to invalidate this hypothesis.

With medication

  • Regular use of psyllium may require adjustment of the anti-diabetic medication.
  • It is generally believed that the consumption of psyllium can prevent the complete absorption of certain drugs, but this hypothesis was recently refuted in the case of ethinylestradiol (an anovulant) during a study in rabbits. The only documented interaction is that of psyllium with lithium, whose absorption it decreases.

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