Psyllium

Uses

Supplement Forms/Alternate Names

  • black psyllium (plantago psyllium, psyllium seed); blonde psyllium (plantago ovata, ispaghula or psyllium husk)

Introduction

Psyllium is a fiber that comes from the seeds of the Plantago ovata herb. There are two types of psyllium: black and blonde. It has been used to control blood glucose and help stool pass. Psyllium can be taken as a pill, powder, or extract. It can also be made into a tea.

Dosages

5 to 15 grams daily

What Research Shows

Likely Effective

  • Constipation—may help regulate passing of stool A1, A2
  • Diabetes—likely to help control blood glucose when used with standard treatment B1-B4
  • High cholesterol—likely to help remove cholesterol from the body E1-E4

May Be Effective

  • Fecal incontinence—may reduce number of instances C1, C2
  • Irritable bowel syndrome (IBS)—may reduce symptoms and improve quality of life F1, F2
  • Obesity—may help control blood glucose and fat levels in the blood G1, G2

Not Enough Data to Assess

  • Gastroesophageal reflux disease D1
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Safety Notes

It is likely safe to take psyllium in small doses for a short time, but allergic reaction may occur. H1, H2 Not enough studies have been done to say whether it is safe to use for a long period.
Interactions
Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:
  • People with problems swallowing should talk to their doctor before using psyllium. Choking may occur.

References

A Constipation
A1 Gabrielli F, Macchini D, et al. Psyllium fiber vs. placebo in early treatment after STARR for obstructed defecation: a randomized double-blind clinical trial. Minerva Clin. 2016;71(2):98-105.
A2 Erdogan A, Rao SS, et al. Randomised clinical trial: mixed soluble/insoluble fibre vs. psyllium for chronic constipation. Aliment Pharmacol Ther. 2016 Jul;44(1):35-44.
B Diabetes
B1 Sartore G, Reitano R, et al. The effects of psyllium on lipoproteins in type II diabetic patients. Eur J Clin Nutr. 2009 Oct;63(10):1269-1271.
B2 Gibb RD, McRorie JW Jr, et al. Psyllium fiber improves glycemic control proportional to loss of glycemic control: a meta-analysis of data in euglycemic subjects, patients at risk of type 2 diabetes mellitus, and patients being treated for type 2 diabetes mellitus. Am J Clin Nutr. 2015;102(6):1604-1614.
B3 Abutair AS, Naser IA, et al. Soluble fibers from psyllium improve glycemic response and body weight among diabetes type 2 patients (randomized control trial). Nutr J. 2016 Oct 12;15(1):86.
B4 Noureddin S, Mohsen J, et al. 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 Oct;40:1-7.
C Fecal Incontinence
C1 Bliss DZ, Savik K, et al. Dietary fiber supplementation for fecal incontinence: a randomized clinical trial. Res Nurs Health. 2014;37(5):367-378.
C2 Markland AD, Burgio KL, et al. Loperamide Versus Psyllium Fiber for Treatment of Fecal Incontinence: The Fecal Incontinence Prescription (Rx) Management (FIRM) Randomized Clinical Trial. Dis Colon Rectum. 2015 Oct;58(10):983-993.
D Gastroesophageal Reflux Disease
D1 Morozov S, Isakov V, et al. Fiber-enriched diet helps to control symptoms and improves esophageal motility in patients with non-erosive gastroesophageal reflux disease. World J Gastroenterol. 2018 Jun 7;24(21):2291-2299.
E High Cholesterol
E1 Ribas SA, Cunha DB, et al. Effects of psyllium on LDL-cholesterol concentrations in Brazilian children and adolescents: a randomised, placebo-controlled, parallel clinical trial. Br J Nutr. 2015 Jan 14;113(1):134-141.
E2 Peng D, Fong A, et al. Original research: The effects of red yeast rice supplementation on cholesterol levels in adults. Am J Nurs. 2017 Aug;117(8):46-54.
E3 Jovanovski E, Yashpal S, et al. Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2018 Sep 15.
E4 Brum J, Ramsey D, et al. Meta-analysis of usefulness of psyllium fiber as adjuvant antilipid therapy to enhance cholesterol lowering effects of statins. Am J Cardiol. 2018 Oct 1;122(7):1169-1174.
F Irritable Bowel Syndrome
F1 Bijkerk CJ, de Wit NJ, et al. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ. 2009;339:3154.
F2 Shulman RJ, Hollister EB, et al. Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial. Clin Gastroenterol Hepatol. 2017 May;15(5):712-719.e4.
G Obesity
G1 Pal S, Khossousi A, 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(1):90-100.
G2 Pal S, Ho S, et al. Effect on Insulin, Glucose and Lipids in Overweight/Obese Australian Adults of 12 Month Consumption of Two Different Fibre Supplements in a Randomised Trial. Nutrients. 2017;9(2).
H Safety
H1 Freeman GL. Psyllium hypersensitivity. Ann Allergy. 1994 Dec;73(6):490-492.
H2 Vaswani SK, Hamilton RG, et al. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy. 1996 Apr;51(4):266-268.
H3 Brum JM, Gibb RD, et al. Satiety effects of psyllium in healthy volunteers. Appetite. 2016 Oct 1;105:27-36.

Revision Information

  • Reviewer: EBSCO NAT Review Board Eric Hurwitz, DC
  • Review Date: 07/2019
  • Update Date: 04/10/2020