Psyllium (), also known as isabgol and ispaghula (), is any of several members of the plant genus Plantago whose seeds are used commercially for the production of mucilage. Psyllium is mainly used as a dietary fiber to relieve symptoms of both constipation and mild diarrhea, and occasionally as a food thickener. Allergy to psyllium is common in workers frequently exposed to the substance. It is generally safe and moderately effective as a laxative. Use of psyllium in the diet for three weeks or longer may lower blood cholesterol levels in people with elevated cholesterol, and may lower blood glucose levels in people with type 2 diabetes. Use of psyllium for a month or longer may produce a small reduction in systolic blood pressure. The plants from which the seeds are extracted tolerate damp and cool climates, and are mainly cultivated in northern India.
Uses
Preparation Psyllium is produced mainly for its mucilage content. The term mucilage describes a group of clear, colorless, gelling agents derived from plants. The mucilage obtained from psyllium comes from the seed coat. Mucilage is obtained by mechanical milling (i.e. grinding) of the outer layer of the seed. Mucilage yield amounts to about 25% (by weight) of the total seed yield. Plantago-seed mucilage is often referred to as husk, or psyllium husk. The milled seed mucilage is a white fibrous material that is hydrophilic, meaning that its molecular structure causes it to attract and bind to water.
Food Psyllium has been used as a thickener in ice cream and other frozen desserts. A 1.5% weight/volume ratio of psyllium mucilage exhibits binding properties that are superior to a 10% weight/volume ratio of starch mucilage. The viscosity of psyllium mucilage dispersions is relatively unaffected between temperatures of 20 and 50 °C (68 and 122 °F), by pH from 2 to 10, and by salt (sodium chloride) concentrations up to 0.15 M. Psyllium seed husks can also be used to improve texture in gluten-free baked goods, to bind meatballs, and to thicken sauces. Some people use them to manage symptoms of irritable bowel syndrome.
Human health
Weight loss Dietary supplements containing psyllium are sold mainly to aid weight loss, although there is little scientific evidence for such effects. A 2023 review concluded that psyllium supplementation for 12 weeks by people who were overweight or obese produced a minor amount of weight loss, although the studies assessed had only moderate to low evidence quality.
Constipation Psyllium is mainly used as a viscous, soluble dietary fiber that is not absorbed by the small intestine. The mechanical action of psyllium mucilage is to absorb excess water while stimulating normal bowel elimination. Although its main use has been as a laxative, it is more accurately regarded as a dietary fiber to reduce the symptoms of both constipation and mild diarrhea. The laxative properties of psyllium are attributed to the fiber: it absorbs water and subsequently softens the stool. It increases flatulence (gas) to some degree. Psyllium reduces straining during defecation by increasing the bulk of stools, thereby facilitating the transit of stools in the colon. When used to treat constipation, psyllium is taken in doses of from 3.5 grams per day to 11 grams twice daily. A 2021 review of over-the-counter treatments for constipation concluded that psyllium has modest effect in treating constipation and is generally safe and well-tolerated. Psyllium may be less effective compared to other products, such as polyethylene glycol, lactulose or fruits like prunes. Psyllium is more effective than docusate. A 2022 review found that psyllium, in doses of 10 grams per day for at least 4 weeks, was more effective than osmotic or stimulant laxatives for increasing the number of bowel movements per week.
High blood cholesterol In 1998, the U.S. Food and Drug Administration approved a health claim on food labels for dietary psyllium as a soluble fiber – if consumed regularly – that would reduce the risk of heart disease by lowering blood cholesterol. Clinical research demonstrated that seven grams or more per day of soluble fiber from psyllium seed husk would sufficiently lower total cholesterol and low-density lipoprotein cholesterol in people with hypercholesterolemia, two accepted biomarkers for risk of coronary heart disease. The findings were later confirmed in a meta-analysis that incorporated more evidence. To be eligible for the FDA-allowed health claim, one serving of a manufactured food or dietary supplement must contain at least 1.7 g of psyllium as soluble fiber. Whole oats, barley and foods containing beta-glucan soluble fiber were included as eligible sources for the label claim.
Type 2 diabetes In 2014, the U.S. Food and Drug Administration approved a qualified health claim for psyllium as a possible benefit for people with diabetes, requiring FDA-approved wording on a product label: "Psyllium husk may reduce the risk of type 2 diabetes, although the FDA has concluded that there is very little scientific evidence for this claim." A meta-analysis published after the FDA decision reported that psyllium provided before meals improved fasting blood glucose and glycated hemoglobin, but that the larger effect was seen in people diagnosed with and being treated for type 2 diabetes, and only a modest improvement for people classified as pre-diabetic.
Hypertension A 2019 meta-analysis found that use of supplemental psyllium for 8 weeks or longer reduced blood pressure by 2 mmHg in people with hypertension.
Veterinary medicine Psyllium is a commonly used fiber supplement for treating diarrhea and constipation in dogs. Psyllium fiber dietary supplements are used in veterinary medicine to treat sand impaction in horses to aid in elimination of sand from the horse's colon.
Adverse effects Fiber generally has few side effects.
Mild to moderate flatulence (gas). Mild to moderate abdominal distension (bloating) and abdominal pain. Choking is a hazard if psyllium is taken without adequate water as it thickens in the throat. Psyllium can cause bowel obstructions or bezoars, if taken without adequate amounts of water.
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