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| EVIDENCE FOR EFFICACY (HUMAN DATA) |
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Clinical Trials
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Meta analysis of 8 studies including 384 people taking 10.2 g psyllium/d found it lowered serum total cholesterol by 4%, LDL cholesterol by 7% and the ratio of apo B to apo A-I by 6% compared to placebo
Anderson 2000
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Serum total and LDL-cholesterol were 8.9% and 13.0% lower and all-day and postlunch postprandial glucose were 11.0% and 19.2% lower after 8 weeks of 5.1 g psyllium in a randomized controlled study of 34 men with type 2 diabetes
Anderson 1999
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Meta-analysis of 67 controlled trials pectin, oat bran, guar gum, and psyllium finds that they provide similar modest benefit on cholesterol levels; 3 oz oatmeal lowers cholesterol by around 0.13 mmol/L
Brown 1999
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105 ulcerative colitis in remission randomized to Plantago ovata seeds (10 g b.i.d.), mesalamine (500 mg t.i.d.), or Plantago + mesalamine for 12 months had failure rates of 40%, 35% or 30%
Fernandez-Banares 1999
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Treatment guidelines for hypercholesterolaemia: time to consider soluble fibre.
MacMahon 1999
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Recommendations for dietary fiber intake for adults are 20-35 g/day, or 10-13 g/1,000 kcal but common serving sizes of grains, fruits, and vegetables contain only 1-3 g of dietary fiber
Slavin 1999
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Decreases in total cholesterol (3.2%), LDL (5.4%) but unchanged triglyceride was found with Minolest (guar gum and psyllium) at 16.5 g/day for 3 months vs. controls in a study with 83 hypercholesterolaemia patients
Tai 1999
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10.2 g psyllium for 24 weeks lowered LDL 5% compared to controls in a double blind study of 286 people
Davidson 1998
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Constipation treatment with Ispaghula husk resulted in more normal, well-formed stools and fewer hard stools than other laxatives (mainly lactulose) and incidences of soiling, diarrhoea and abdominal pain were lower in a study with 394 patients
Dettmar 1998
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Ispaghula and diet modification together reduced total cholesterol by 7.7-8.9% and LDL by 10.6-13.2% during the 6-month trial with 340 hypercholesterolaemia patients
MacMahon 1998
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Constipation treatment with psyllium (5.1 g b.d.) was superior to docusate (100 mg b.d.) in a study of 170 patients
McRorie 1998
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Plasma glucose, total cholesterol, LDL and triglycerides decreased while good HDL increased by 5-g psyllium, three per day (before meals) for 6 weeks compared with placebo in a study with 125 type II diabetics
Rodriguez-Moran 1998
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Cholesterol reduction by psyllium or oat bran in a study of 66 men
Romero 1998
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Small bowel transit was unaltered whereas progression through the colon was delayed in 8 people taking lactulose plus psyllium
Washington 1998
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Rehydration of children with acute diarrheal diseases was faster with 50 g/l of plantain flour and 3.5 g/l of NaCl (4.9 hr, n=121) than WHO-ORS (5.3 hr, n=117)
Arias 1997
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Meta-analysis of 12 studies finds psyllium lowered total cholesterol and LDL by 5% and 9%, respectively
Olson 1997
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Review of laxatives (bran, psyllium, prucara, cascara, dioctyl sodium, lactulose, lactitol) in the elderly
Petticrew 1997
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Chronic constipation was improved in less than half taking psyllium, 15-30 g/day, for 6 weeks in a study of 149 patients
Voderholzer 1997
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Plantago ovata seeds treatment, 15-30 g/day, for 149 patients with chronic constipation showed 80% of patients with slow transit & 63% of patients with a disorder of defecation did not respond to dietary fiber treatment, whereas 85% of patients with no pathological finding improved.
Voderholzer 1997
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Oral intake of Plantago ovata seeds adapted the colonic flora to increase the production of butyrate (an antineoplastic) from this fibre and increased faecal concentrations of butyrate was observed by 42% in patients resected for colonic cancer.
Nordgaard 1996
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Addition of dietary fiber Plantago Ovata improved internal bleeding hemorrhoids in 22 patients with no immediate effect. It is suggested that Fiber addition should be ensured in patients who refuse invasive treatment, waiting for a more defined form of treatment, or with contraindications.
Perez-Miranda 1996
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Bleeding hemorrhoids were reduced by psyllium added to the diet in a study with 50 patients
Perez-Miranda 1996
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Literature review reveals that psyllium lowers total and LDL cholesterol by 4-8% and 6-13%, respectively, compared with lovastatin, which lowers them by 30% and 40%
Chan 1995
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A combination of 2.5 g psyllium plus 2.5 g colestipol was better tolerated and as effective as 5 g of either alone, in a study with 121 hypercholesterolemia patients
Spence 1995
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Psyllium-containing laxatives are used by 4 million Americans daily. Psyllium is also used for hypercholesterolemia and for prevention of colon cancer
Freeman 1994
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Effectiveness of taking psyllium between meals is less than when included in cereal, in a study with 18 modestly hypercholesterolemic patients
Wolever 1994
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Hepatitis B treated with Jiedu Yanggan Gao consisting of Artemisia, Taraxacum mongolicum, Plantago seed, Cephalanoplos, Hedyotis, Chrysanthemi, Smilax, Astragalus, Salviae, Fructus Polygonii, Paeoniae, Polygonatum sibiricum, etc.) [Article in Chinese]
Chen 1990
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Double blind trial of ispaghula/poloxamer in the Irritable Bowel Syndrome.
Arthurs 1983
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Comparison of combination of ispaghula/poloxamer 188 and placebo on gastrointestinal transit time.
Connaughton 1982
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Pregnancy termination with Isaptent, a cervical dilator prepared from granulated Plantago ovata husks. It gave satisfactory dilatation in 94% of 750 women
Khanna 1980
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Observational Studies/Case Reports
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Blood glucose was lower after 50 g of glucose was accompanied by 10.5 g of Ispaghula husk in 7 healthy women [Article in Spanish]
Sierra Vega 1999
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Ispaghula husk (Fybogel Orange) for 4 weeks to 69 healthy people increased stool frequency
Davies 1998
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Glucose assimilation was less with 200 mg acarbose (1.9) or 15 g P. psyllium mucilage (4.3) than controls (7.4 mmol/L) in 12 non-insulin diabetics
Frati Munari 1998
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Hunger feelings and energy intake and rises in serum glucose and triglycerides were less during psyllium treatment of 14 normal volunteers
Rigaud 1998
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Hunger and food consumption was less after insoluble fiber (wheat bran) breakfast than after the soluble fiber (psyllium gum) breakfast cereal in 16 men
Delargy 1997
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Gallstones in the obese during a diet were reduced nearly as much by 15 gm Psyllium as by 750 mg ursodeoxycholic acid [Article in Spanish]
Moran 1997
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Faecal concentration of butyrate increased 42% (from 13.2 to 19.3 mmol/l) in colon patients taking 20 g/d of psyllium for a month. Also, acetate was up 25% and propionate increased 28%
Nordgaard 1996
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Total fat intake was decreased in the day after after ingesting 20 g psyllium in a study of 17 women
Turnbull 1995
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Psyllium was superior to wheat bran for stool frequency and abdominal distension in 30 patients with irritable bowel syndrome [Article in German]
Hotz 1994
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Faecal wet and dry weights rose whereas gut transit time and gas excretion in breath and flatus were unchanged in 7 healthy people given 18 g/day ispaghula, a mucilage from Plantago ovata composed mainly of arabinoxylans
Marteau 1994
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Fermentability of dietary fibers: cellulose and Inolaxol (sterculia) very low, Fiberform (wheat bran) was low, Vi-Siblin and Lunelax (both psyllium) were intermediate, and pectin was highly fermentable
Mortensen 1993
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Frequency of stools increased from 2.5 to 8 stools per week for chronic constipation patients by psyllium [Article in Spanish]
Tomas-Ridocci 1992
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Dietary fibre and renal failure: comparison of sterculia and ispaghula.
Little 1991
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Glycemic response is reduced by Psyllium when sprinkled onto or incorporated into the cereal, but not when taken in water before the cereal
Wolever 1991
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Reductions of 8% in total cholesterol and 11% in LDL cholesterol by psyllium and low fat diet in 14 hypercholesterolemic patients [Article in Spanish]
Lerman Garber 1990
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Glucose (75g) assimilation was slowed by psyllium (20-30 g) in 8 people [Article in Spanish]
Frati-Munari 1989
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MgOH, compared with psyllium, results in less hypomagnesaemia, and may have benefits for lipid disorders, impaired glucose tolerance and hyperuricaemia in magnesium deficiency due to diuretics
Kinnunen 1989
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Plantago ovata and guar gum decreased serum cholesterol, mainly LDL, associated with increased cholesterol precursors, methylsterols and demethylated precursor sterols, whereas cholestanol (saturated cholesterol derivative) decreased
Miettinen 1989
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Tinnitus was reduced by TCM herbmix of Uncariae, Chrysanthemi, Akebia, Polygonum, Liquidambar, Rehmanniae, Scrophulariae, Glycyrrhizae, Plantaginis and Vaccariae in 32 cases [Article in Chinese]
Yang 1989
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Decreases of pain, constipation and diarrhea for 20 irritable bowel patients given Plantago ovata fiber [Article in Spanish]
Soifer 1987
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Gastrointestinal transit time was normalized in 88% of 100 patients by 2 tsp/d of Agiolax (psyllium + senna) for 3 months [Article in Italian]
Bossi 1986
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Fasting glucose was lowered from 204 to 127 by switching to vegetable protein diet with 35 g psyllium fiber
Uribe 1985
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Decrease in serum lipids, glycemia and body weight by Plantago psyllium in obese and diabetic patients.
Frati-Munari 1983
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Chronic constipation improved in 20 patients by replacing laxative with swelling substance [Article in German]
Matek 1982
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Decreases in serum cholesterol of 17% and triglyceride of 52% in 13 hyperlipoproteinaemia patients given psyllium for 2-29 months
Danielsson 1979
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Anal fissures were cured within 4-8-weeks by conservative nonsurgical treatment
Shub 1978
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Adverse Effects & Toxicity
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Atmospheric surveys carried out in different parts of India for the common environmental allergens causing respiratory allergy revealed that, 17 pollens including Alanus nitida, Caraica papaya, Plantago ovata etc., are the allergenically important pollens of the country.
Singh 2002
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A 31 year-old atopic woman, who handled and prepared at home, twice daily, a laxative containing Plantago ovata seeds prescribed to her paralytic mother developed symptoms asthma due to the effect of psyllium powder acting as an inhalant allergen. [Article in Spanish].
Aleman 2001
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"Emerging" food allergens include spices and condiments, exotic fruits (kiwi, avocado, cashew and pecan nuts, Brazil nuts), sesame seeds, psyllium, sunflower seeds
Dutau 1999
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An association between sensitization to plantain pollen and melon hypersensitivity was found
Caballero 1998
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A 5-year-old boy without history of atopy developed severe atopic dermatitis and new sensitization to wheat, Dermatophagoides, birch and plantain pollens after bone marrow transplantation from his HLA-identical sister
Bellou 1997
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Allergens of melon blotting were inhibited by grass and Plantago pollen extracts and conversely, melon extract inhibited IgE-binding to various allergens of Dactylis and Plantago
Garcia Ortiz 1996
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Cross-allergenicity of plantain (Plantago lanceolata) pollen and psyllium (Plantago ovata) husk dust is minimal although both are inhalant allergens
Morgan 1995
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Clinical experience indicates some association between plantain pollen allergy with sensitization to latex [Article in French]
Drouet 1994
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Immunoelectrophoresis of psyllium-seed fractions (husk, endosperm and embryo) indicated that all three contain antigens. Microscope reveals commercial psyllium contained endosperm and embryo particles
Arlian 1992
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Three cases of psyllium allergy with sneezing to chest congestion and wheezing
Ford 1992
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Of 125 pharmaceutical workers with laxatives 7.6% were allergic to ispaghula and 15.3% were allergic to senna
Marks 1991
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Of 130 employees of a company producing psyllium hydrophilic mucilloid, 39 had a history of occupational asthma, 23 showed a skin wheal to psyllium, 31 had increased specific IgE antibodies
Bardy 1987
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Common airborne pollens in Anchorage Alaska are birch, alder, poplar, spruce, grass pollen, Cladosporium, and fungus spores. Lesser pollens are sorrel, willow, pine, juniper, sedge, lamb's-quarters, wormwood, plantain, etc
Anderson 1985
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IgE antibodies specific to psyllium were demonstrated by RAST in a patient with work-place-related reactions. Antibodies were not cross-reactive with the related plant, English plantain
Gauss 1985
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Occupational hazard of handling Ispaghula powder by pharmaceutical handlers and nurses is reduced by products with smaller amounts of airborne particles
Machado 1983
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A case of anaphylactic reaction caused by ingestion of psyllium laxative. The hypersensitivity to Plantago ovata was confirmed by skin testing and RAST
Suhonen 1983
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IgE antibodies in individuals allergic to English plantain may cross react to psyllium
Rosenberg 1982
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Occupational allergy in nurses to finely ground psyllium from dust generated while dispensing it
Machado 1979
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Interactions
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Soluble fibres (including guar gum and psyllium) can decrease the absorption of drugs
Fugh-Berman 2000
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Influence of some pharmaceutical adjuvants on the syneresis of Plantago albicans (psyllium) seed gum gels.
Mattha 1977
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Interaction of warfarin and nonsystemic gastrointestinal drugs.
Robinson 1971
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Animal Studies
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Plantago ovata diets adjusted to a total of 12.5 g/100 g fiber with cellulose, in Male Hartley guinea pigs (n = 30) exerts its hypolipidemic effect by affecting bile acid absorption and altering hepatic cholesterol metabolism.
Romero 2002
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Plantago ovata aqueous extract(0.5 g/kg) after oral administration, in rabbits, showed a decrease in anti-HD antibody titre in primary response & intraperitoneal injection of 0.25 g/kg in mice prior to immunisation with sheep RBC resulted in a decrease in hemagglutinating antibody titre.
Rezaeipoor 2000
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Fermentation of high-amylose cornstarch shifts toward the distal colon and fecal butyrate increases in rats fed psyllium at 15 g/kg
Morita 1999
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Cholesterol gallstones were decreased in prairie dogs given 5% psyllium
Schwesinger 1999
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Cholesterol and triacylglycerol lowering by 4 or 6% psyllium was comparable to 1% cholestyramine in hamsters on a lithogenic diet. Fecal bile was 4 fold with psyllium or 11 fold with cholestyramine
Trautwein 1999
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Psyllium increases cholesterol 7 alpha-hydroxylase mRNA, bile acid biosynthesis and excretion of fecal bile acids in rats
Buhman 1998
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Ethinylestradiol availability was decreased 29 - 35% in rabbits by dietary fiber, either Plantago seeds and hulls or a mixture of wheat bran, fruit fiber and guar gum
Fernandez 1998
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Psyllium, cholestyramine, or combined, increased total bile acid excretion by 26%, 57%, and 79%, respectively, in rats. Psyllium affected only unconjugated bile acid excretion, cholestyramine also increased excretion of conjugated and primary bile acids
Daggy 1997
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MNU induced cancer in rats was reduced maximally by the combination of psyllium (soluble) + wheat bran (insoluble) at 4% of the diet
Cohen 1996
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A comparative pharmacological evaluation of sea buckthorn, rose and plantain oils in chemical eye burns [Article in Russian]
Nikulin 1992
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The effect of a plantain preparation on the efficacy of the irradiation of experimental animals with tumors [Article in Russian]
Razina 1992
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Beta-glucuronidase (EC 3.2.1.31) activity is reduced by Plantago ovata, but not by wheat bran suggesting psyllium is a partly-fermentable dietary fibre supplement
Leng-Peschlow 1991
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Experimental study on the articular sac of the rabbit after an injection of aqueous extract of Plantago asiatica [Article in Chinese]
Chen 1986
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Effects of mucilage extracted from the seeds of Plantago sp. on the digestive tract [Article in Romanian]
Moisa 1977
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Local anti-inflammatory and anti-actinic action of oil extracted from Plantago sp. seeds [Article in Romanian]
Moisa 1975
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Pharmacodynamics
|
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Mucopolysaccharides of the husk of psyllium (Plantago ovata) have optimal properties like fluid absorption, bacterial adherence, biocompatibility, stimulation of macrophages, irritancy response and allergenicity which are beneficial for wound cleansing and healing and also limit scar formation.
Westerhof 2001
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Fenugreek fiber (Fenufibers), psyllium husk (Metamucil) or wheat bran (Wheat Chex) are little digested by human colonic bacterium Bacteroides ovatus after 48 hr so are good sources of roughage
Al-Khaldi 1999
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Plantago drugs in regulation of gastrointestinal tract activity[Article in Russian]
Rumiantsev 1997
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Taurocholic bile acid binding capacity of a human faecal culture was 92% for glucose, 79% for pectin, 60% for wheat bran, 59% for ispaghula seed, 53% for ispaghula husk and 26% for control
Gelissen 1995
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Homologous and heterologous crossed immunoelectrophoresis performed using commercial English plantain pollen extract and an extract of psyllium seed embryo indicated that there is little cross-allergenicity between them.
Morgan 1995
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Inhibition of the formation of carcinogenic nitroso by pectin, plantastin, tiliaflan and cholosas [Article in Russian]
Rubenchik 1985
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Pharmacognostic studies on 3 types of Plantago seeds [Article in Chinese]
Feng 1983
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Pharmacological studies of Chinese herbs. (8) Pharmacological effects of Plantaginis Semen (author's transl) [Article in Chinese]
Chen 1980
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Analytical Chemistry
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Plantasioside (phenylethanoid glycoside) was isolated from aerial parts of Plantago asiatica
Nishibe 1995
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Glucomannan had the highest soluble fiber (97%) followed by dried Opuntia (28%) and Psyllium (13%), whereas wheat bran and soy isolate had the highest insoluble fiber (95 and 92%, respectively) [Article in Spanish]
Rosado 1995
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HPLC measurement of plantaginin in Shazenso (Plantago asiatica L.) extracts and isolation of plantamajoside
Komoda 1989
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Mucilage in seeds of Plantago ovata and its wild allies.
Sharma 1986
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The constituents of the essential oil from Plantago asiatica L (author's transl) [Article in Japanese]
Kameoka 1979
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Rheological studies on Plantago albicans (Psyllium) seed gum dispersions. II. Effect of some pharmaceutical additives.
Mattha 1977
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Fatty oil from 4 plants of the genera Digitalis and Plantago [Article in Ukrainian]
Dolia 1976
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Data on the chemical composition of the fatty oil from plantago seeds [Article in Romanian]
Grigorescu 1975
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Polysaccharides of some species of plantain [Article in Ukrainian]
Maksiutina 1974
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Phytochemical studies of Egyptian Plantago species. (Lipids).
Ahmed 1968
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The structures of alkaloids from Pedicularis olgae Regel (Scrophulariaceae) and Plantago indica (P. ramosa, Plantaginaceae).
Torssell 1968
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Homoplantaginin, a new flavonoid glycoside in leaves of Plantago asiatica Linnaeus.
Aritomi 1967
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Phytochemical studies of Egyptian Plantago species (glucides).
Ahmed 1965
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Studies on the constituent of Plantago asiatica Linne. (1). On the acidic and neutral components [Article in Japanese]
Torigoe 1965
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Cleaning composition made less viscous, flowable and pumpable by the addition of psyllium husks;
US Patent 5,462,688
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Pharmacokinetics (ADME)
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Compartmental and noncompartmental analyses of plasma concentrations, in rabbits, revealed that presence of fiber Plantago ovata seeds(65%) and cuticles(2.2%), decreased between 29% and 35% the extent of ethinylestradiol absorbed without affecting rate of absorption process.
Fernandez 1998
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Genetics & Molecular Biology
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Reticuloendothelial system-potentiating and alkaline phosphatase-inducing activities were enhanced when the mucilage from the seed of Plantago asiatica was de-O-acetylated
Tomoda 1991
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P. ovata seeds or husks had less effect on gastrointestinal enzymes than wheat bran, alfalfa, pectin or xylan
Leng-Peschlow 1989
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Plantagoside, a flavanone glucoside in Plantago asiatica seeds, inhibits alpha-mannosidase (IC50=5 microM) and suppressed antibody response to sheep red blood cells and concanavalin A induced lymphocyte proliferation
Yamada 1989
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Electron-microscopic examination of chromosomes from Plantago ovata and Lycopersicon esculentum
Stack 1984
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Contemporary Formulas
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Psyllium stored 8 mo at 40 degrees had decreased solution viscosity but remained effective at lowering cholesterol in rats
Arjmandi 1997
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Agiolax (5.4 g P. ovata seeds/husks combined with 1.2 g senna pod with a sennoside content of 30 mg) reverses loperamide prolonged colonic transit time
Ewe 1993
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Proposals for the drug part of DAB 7. 37. Herba plantaginis [Article in German]
Luckner 1968
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Folk Blends
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Meniere's disease inner ear edema is improved by Rhizoma Alismatis Mixture (Alismatis, Plantaginis, Ligusticum & Leonurus), a Chinese remedy to promote diuresis to eliminate wetness-evil and activate blood circulation [Article in Chinese]
Lin 1991
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Patents
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Conduct a search on "Plantago psyllium or ovata" in the title, abstract or claims section of the
USpatent database
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Reduced seed breakage while dehusking by milling impact speeds of 5-40 m/sec.
US Patent 5,232,697
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As a solidifying or gel-forming agent in a preparation for the once-daily, percutaneous administration of nicotine.
US patent 4,946,853
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Antidiarrheal composition of bismuth subsalicylate and a polymeric hydroabsorptive agent selected from psyllium and glucomannan;
US Patent 4,588,589
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Psyllium gum and polyol polyesters are administered orally to reduce blood cholesterol levels;
US Patent 4,849,222
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Rendering husks by mixing with benzyl alcohol, propylene glycol and/or triacetin;
US Patent 4,978,529
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Laxative which consists of psyllium husk (less than 50 mesh), apple fiber, fructose, gum arabic and flavorants;
US Patent 5,073,370
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Purifying psyllium husk using liquid fluorinated hydrocarbons with different densities as separation means;
US Patent 5,085,785
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Psyllium-containing cookies have a reduced tendency to stick to and/or form a film on teeth during ingestion;
US Patent 5,126,150
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Glycerin, sweeteners and flavorants to improve texture, mouthfeel, and palatability of psyllium;
US Patent 5,143,728
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Soluble salts at a level sufficient to reduce the gellation rate of the psyllium when dispersed in an aqueous solution;
US Patent 5,232,698
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Drink mix compositions of psyllium with divalent cation salts of strong inorganic acids (magnesium sulfate, calcium sulfate, calcium chloride, zinc sulfate, zinc chloride);
US Patent 5,234,916
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Improved mixability and dispersibility in liquids with maltodextrin-containing agglomerates of psyllium husk comprising citric acid uniformly dispersed throughout the maltodextrin coating;
US Patent 5,340,580
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Psyllium husk-containing drink mix compositions comprising calcium citrate malate;
US Patent 5,356,618
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Laxative composed of dioctyl sulfosuccinate and bulk fiber selected from psyllium, methylcellulose, polycarbophil, calcium polycarbophil, bran, malt soup extract, karaya, and/or guar gum;
US Patent 5,516,524
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Composition of 1-75% psyllium and 1-65% cholestyramine where their ratio is between 3:1-6;
US Patent 5,601,837
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Combining a bulk-forming laxative (psyllium hydrophilic mucilloid) with an osmotic laxative such as lactitol;
US Patent 5,651,988
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Weight loss with 50% psyllium, 40% glucosamine and glucomannan, apple pectin, and stearic acid;
US Patent 5,891,441
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Cholestyramine, psyllium, and, optionally, polyol polyesters are administered orally to reduce blood cholesterol levels;
US Patent 5,910,317
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Baking dough incorporating a therapeutically effective dose of metamucil for regulating bowel function;
US Patent 5,955,123
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Lubricating shave cream of a basic water-alcohol mix combined with wetable mucilate, preferably psyllium fiber;
US Patent 5,958,394
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Burn and wound ointment composed of Chelidonium majus, Plantago major, Matricaria, Achillea, Calendula, Hypericum, Eucalyptus in oil and bees wax;
US Patent 5,997,876
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Breakfast cereal with 2 - 37% psyllium and about 5 - 15% insoluble fiber
US Patent RE36,067
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Cultivation, Conservation & Ecology
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Plantago as a host of economically important viruses.
Hammond 1982
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A selective role for potassium in the phytotoxicity of thallium.
Siegel 1975
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Phytochemical and microbiological control of some plant species used in folk medicine. II. Plantago lanceolata L., Plantago media L., Plantago major L
Grigorescu 1973
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Improvement in the hereditary qualities of the drug crop plants, medicinal chamomile, field restharrow and greater plantain[Article in Ukrainian]
Shelud'ko 1973
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