The Benefits Of Psyllium Husk, And How To Use It 

psyllium husk

Jess says: Psyllium husk is a safe, natural and effective fibre that can revolutionise your digestion. This is probably one of the products I recommend the most to patients with digestive problems, including IBS, bowel disease, constipation or diarrhoea. 

It’s also great as a support alongside a healthy diet for losing weight and helping blood sugars in diabetics. I’ve seen it work wonderfully in my patients and it is a favourite for our family to keep everyone ‘regular’ and help stomach aches in the children. A wide range of clinical evidence is now backing up the effectiveness of psyllium husk. 

psyllium husk

Psyllium husk is traditionally used in Ayurvedic medicine, to help both diarrhoea and constipation. Psyllium (Plantago ovata/psyllium seed), or Isphagula husk has been used in Ayurvedic medicine (known as Isabgol) for thousands of years. Traditionally, it is taken to help ease both constipation and diarrhoea, and to help relieve bleeding haemorrhoids. It’s also used in traditional Indian medicine for dry coughs, where it is difficult to bring up sputum.

Psyllium is now much more widely used in conventional, alternative and functional medicine and there are over 100 clinical trials showing its benefits, and it is shown to be very safe. When taken for a year, a trial showed very few adverse effects (and these were mild), suggesting psyllium is a safe, long-term treatment for a range of conditions1.

it has been shown to be effective for the treatment of diarrhoea

Psyllium, given to patients who had drug-induced diarrhoea significantly improved while taking it.2 It has also been shown to be as effective as Loperamide (Imodium) at improving diarrhoea3 or faecal incontinence, with fewer side effects.4 Psyllium can also significantly improve symptoms, including diarrhoea and abdominal pain in patients with ulcerative colitis and Crohn’s disease, especially when taken alongside a probiotic5,6. A study showed that psyllium may be as effective as the leading medication to help prevent episodes of ulcerative colitis.7

psyllium can help constipation

Psyllium has been shown to effectively improve constipation when taken daily, in studies over a few weeks8 9 10 and has even been shown to be more effective than leading laxatives9. It has even been shown to improve constipation and recovery in patients after an obstruction; a very severe form of constipation that sometimes requires surgery.11 12 Visit our article on constipation for more support. 

it may help IBS and tummy pain in children

A study of 275 adult patients with IBS (Irritable Bowel Syndrome), showed a significant improvement in symptoms when taking psyllium husk.13 A study of 103 children with IBS showed an improvement in the number of episodes of abdominal pain, when taking psyllium husk.14

it has also been shown to lower LDL (bad cholesterol) and help with the loss of fat

Psyllium has a large number of studies showing its benefit in reducing LDL (bad cholesterol). Over four to eight weeks, it has been shown to significantly reduce LDL cholesterol in patients with high cholesterol,15 children and adolescents with high cholesterol,16 obese teenagers (who also had an improvement in body fat distribution)17 and the elderly with high cholesterol.18

Men with high cholesterol had an excellent response to taking psyllium for eight weeks, with a significant decrease in LDL, whilst continuing their normal diet19. It may have more benefit in lowering cholesterol when taken with food, or just before or after eating.20

Visit our cholesterol article for more support.

psyllium may help reduce hunger (and therefore snacking) between meals

Taking psyllium showed a significant decrease in hunger and an increase in feeling full between meals.21 This could reduce the amount of food you want to eat, which may make it a good aid for weight loss.22

it may help improve blood sugar and insulin levels, reducing the risk of diabetes

Psyllium can improve blood sugar and the body’s insulin response, and improve blood pressure and cholesterol levels, reducing risk factors for diabetes.23 Taking psyllium husk before meals significantly reduced the rise in blood sugar and insulin in type 2 diabetic patients, suggesting it is helpful for maintaining good blood sugar levels.24

Psyllium also reduced blood sugar and HbA1c levels (a blood marker of sugar over the longer term), in a well-conducted study of diabetics.25

other benefits of psyllium:

  •       Taken daily for 6 months, psyllium significantly reduced the blood pressure of patients with high blood pressure.26
  •       Patients recovered faster and had less pain and complications after surgery for haemorrhoids, when taking psyllium husk.27
  •       Psyllium husk taken regularly may reduce your risk of colon cancer.28

Discuss taking psyllium husk with your healthcare practitioner, if you wish to use it and have any history or risk of a bowel obstruction (e.g. inflammatory bowel disease, or bowel cancer). 

how to take psyllium husk

  • You can buy whole organic psyllium husk (non-organic psyllium can be high in pesticides) online and in health food shops. Add 1 teaspoon up to twice daily into yoghurt or porridge. We like to add it to our kefir smoothie recipe or our daily kefir yoghurt.
  • Powdered psyllium husk is a great addition to recipes like our flourless carrot muffins,  wraps and keto rolls.
  • You can also take psyllium husk in capsule form usually taking 1-2 capsules daily. 

Be careful to consume plenty of water during the day when taking psyllium and make sure not to take psyllium husk for up to four days before a colonoscopy (a camera test that looks at the bowel). 

q&a with Dr Jess:

what should I be aware of/look for when buying psyllium husk? 

Choose organic psyllium husk, and buy whole, as it is easy to grind in a food processor or coffee grinder to make psyllium husk powder for baking with. You can take it as a supplement from companies like cytoplan but we find it easier to use it whole, stirred into a kefir smoothie or yoghurt. 

how do I cook with it?

Psyllium husk is an excellent binder in cooking and baking. Add one teaspoon for every egg or 50g of wet ingredients, and let the wet mixture stand for 10-15 minutes to allow the psyllium husk to absorb the moisture (otherwise your cooking may be dry and powdery). It is excellent for low-carb baking (see recipes in our refresh programme), as it can work as a binding agent and help give texture in a way that gluten would work in regular breads. You can also add a teaspoon or two to a gravy or stew, to help to thicken the sauce. 

 

references:

  1. Oliver SD. The long-term safety and tolerability of ispaghula husk  J R Soc Promot Health. 2000 Jun;120(2):107-11. doi: 10.1177/146642400012000208. PMID: 10944885.
  2. Eherer AJ, Santa Ana CA, Porter J, Fordtran JS. Effect of psyllium, calcium polycarbophil, and wheat bran on secretory diarrhea induced by phenolphthalein Gastroenterology. 1993 Apr;104(4):1007-12. doi: 10.1016/0016-5085(93)90267-g. PMID: 8385040.
  3. Qvitzau S, Matzen P, Madsen P. treatment of chronic diarrhoea: loperamide versus ispaghula husk and calcium  Scand J Gastroenterol. 1988 Dec;23(10):1237-40. doi: 10.3109/00365528809090197. PMID: 3074458 
  4. Markland AD, Burgio KL, Whitehead WE, Richter HE, Wilcox CM, Redden DT, Beasley TM, Goode PS. 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):983-93. doi: 10.1097/DCR.0000000000000442. PMID: 26347971.
  5. Fujimori S, Gudis K, Mitsui K, Seo T, Yonezawa M, Tanaka S, Tatsuguchi A, Sakamoto C. A randomized controlled trial on the efficacy of synbiotic versus probiotic or prebiotic treatment to improve the quality of life in patients with ulcerative colitis Nutrition. 2009 May;25(5):520-5. doi: 10.1016/j.nut.2008.11.017. Epub 2009 Feb 8. PMID: 19201576.
  6. Fujimori S, Tatsuguchi A, Gudis K, Kishida T, Mitsui K, Ehara A, Kobayashi T, Sekita Y, Seo T, Sakamoto C. High dose probiotic and prebiotic cotherapy for remission induction of active Crohn’s disease J Gastroenterol Hepatol. 2007 Aug;22(8):1199-204. doi: 10.1111/j.1440-1746.2006.04535.x. PMID: 17688660.
  7. Fernández-Bañares F, Hinojosa J, Sánchez-Lombraña JL, Navarro E, Martínez-Salmerón JF, García-Pugés A, González-Huix F, Riera J, González-Lara V, Domínguez-Abascal F, Giné JJ, Moles J, Gomollón F, Gassull MA. Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn’s Disease and Ulcerative Colitis (GETECCU) Am J Gastroenterol. 1999 Feb;94(2):427-33. doi: 10.1111/j.1572-0241.1999.872_a.x. PMID: 10022641.
  8. Erdogan A, Rao SS, Thiruvaiyaru D, Lee YY, Coss Adame E, Valestin J, O’Banion M.Randomised clinical trial: mixed soluble/insoluble fibre vs. psyllium for chronic constipation Aliment Pharmacol Ther. 2016 Jul;44(1):35-44. doi: 10.1111/apt.13647. Epub 2016 Apr 29. PMID: 27125883; PMCID: PMC4891216
  9. McRorie JW, Daggy BP, Morel JG, Diersing PS, Miner PB, Robinson M. Psyllium is superior to docusate sodium for treatment of chronic constipation Aliment Pharmacol Ther. 1998 May;12(5):491-7. doi: 10.1046/j.1365-2036.1998.00336.x. PMID: 9663731.
  10. Ashraf W, Park F, Lof J, Quigley EM.Effects of psyllium therapy on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation Aliment Pharmacol Ther. 1995 Dec;9(6):639-47. doi: 10.1111/j.1365-2036.1995.tb00433.x. PMID: 8824651.
  11. Pucciani F, Raggioli M, Ringressi MN.Usefulness of psyllium in rehabilitation of obstructed defecation  Tech Coloproctol. 2011 Dec;15(4):377-83. doi: 10.1007/s10151-011-0722-4. Epub 2011 Jul 22. PMID: 21779973
  12. Gabrielli F, Macchini D, Guttadauro A, Frassani S, Bertolini A, Giussani C, DE Simone M, Cioffi U. Psyllium fiber vs. placebo in early treatment after STARR for obstructed defecation: a randomized double-blind clinical trial Minerva Chir. 2016 Apr;71(2):98-105. Epub 2015 Sep 1. PMID: 26325116.
  13. Bijkerk CJ, de Wit NJ, Muris JW, Whorwell PJ, Knottnerus JA, Hoes AW. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial BMJ. 2009 Aug 27;339:b3154. doi: 10.1136/bmj.b3154. PMID: 19713235; PMCID: PMC3272664.
  14. Shulman RJ, Hollister EB, Cain K, Czyzewski DI, Self MM, Weidler EM, Devaraj S, Luna RA, Versalovic J, Heitkemper M. 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. doi: 10.1016/j.cgh.2016.03.045. Epub 2016 Apr 11. PMID: 27080737; PMCID: PMC5064811.
  15. Anderson JW, Davidson MH, Blonde L, Brown WV, Howard WJ, Ginsberg H, Allgood LD, Weingand KW. Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia Am J Clin Nutr. 2000 Jun;71(6):1433-8. doi: 10.1093/ajcn/71.6.1433. PMID: 10837282.
  16. Ribas SA, Cunha DB, Sichieri R, Santana da Silva LC. 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):134-41. doi: 10.1017/S0007114514003419. Epub 2014 Nov 13. PMID: 25391814.
  17. de Bock M, Derraik JG, Brennan CM, Biggs JB, Smith GC, Cameron-Smith D, Wall CR, Cutfield WS. Psyllium supplementation in adolescents improves fat distribution & lipid profile: a randomized, participant-blinded, placebo-controlled, crossover trial PLoS One. 2012;7(7):e41735. doi: 10.1371/journal.pone.0041735. Epub 2012 Jul 27. PMID: 22848584; PMCID: PMC3407232.
  18. Stewart RB, Hale WE, Moore MT, May FE, Marks RG. Effect of psyllium hydrophilic mucilloid on serum cholesterol in the elderly. Dig Dis Sci. 1991 Mar;36(3):329-34. doi: 10.1007/BF01318205. PMID: 1995270.
  19. Anderson JW, Zettwoch N, Feldman T, Tietyen-Clark J, Oeltgen P, Bishop CW. Cholesterol-lowering effects of psyllium hydrophilic mucilloid for hypercholesterolemic men Arch Intern Med. 1988 Feb;148(2):292-6. PMID: 3277558.
  20. Wolever TM, Jenkins DJ, Mueller S, Boctor DL, Ransom TP, Patten R, Chao ES, McMillan K, Fulgoni V 3rd. Method of administration influences the serum cholesterol-lowering effect of psyllium m J Clin Nutr. 1994 May;59(5):1055-9. doi: 10.1093/ajcn/59.5.1055. PMID: 8172091.
  21. Brum JM, Gibb RD, Peters JC, Mattes RD. Satiety effects of psyllium in healthy volunteers Appetite. 2016 Oct 1;105:27-36. doi: 10.1016/j.appet.2016.04.041. Epub 2016 May 7. PMID: 27166077.
  22. Rigaud D, Paycha F, Meulemans A, Merrouche M, Mignon M. Effect of psyllium on gastric emptying, hunger feeling and food intake in normal volunteers: a double blind study Eur J Clin Nutr. 1998 Apr;52(4):239-45. doi: 10.1038/sj.ejcn.1600518. PMID: 9578335.
  23. Pal S, Radavelli-Bagatini S. Effects of psyllium on metabolic syndrome risk factors Obes Rev. 2012 Nov;13(11):1034-47. doi: 10.1111/j.1467-789X.2012.01020.x. Epub 2012 Aug 5. PMID: 22863407.
  24. Pastors JG, Blaisdell PW, Balm TK, Asplin CM, Pohl SL. Psyllium fiber reduces rise in postprandial glucose and insulin concentrations in patients with non-insulin-dependent diabetes Am J Clin Nutr. 1991 Jun;53(6):1431-5. doi: 10.1093/ajcn/53.6.1431. PMID: 1852093.
  25. Ziai SA, Larijani B, Akhoondzadeh S, Fakhrzadeh H, Dastpak A, Bandarian F, Rezai A, Badi HN, Emami T. Psyllium decreased serum glucose and glycosylated hemoglobin significantly in diabetic outpatients J Ethnopharmacol. 2005 Nov 14;102(2):202-7. doi: 10.1016/j.jep.2005.06.042. Epub 2005 Sep 8. PMID: 16154305.
  26. Cicero AF, Derosa G, Manca M, Bove M, Borghi C, Gaddi AV. Different effect of psyllium and guar dietary supplementation on blood pressure control in hypertensive overweight patients: a six-month, randomized clinical trial Clin Exp Hypertens. 2007 Aug;29(6):383-94. doi: 10.1080/10641960701578378. PMID: 17729055.
  27. Kecmanović D, Pavlov M, Ceranić M, Sepetkovski A, Kovacević P, Stamenković A, Masirević V, Ranković V. [Plantago ovata (Laxomucil) after hemorrhoidectomy]  Acta Chir Iugosl. 2004;51(3):121-3. Serbian. doi: 10.2298/aci0403121k. PMID: 16018379.
  28. Juarranz M, Calle-Purón ME, González-Navarro A, Regidor-Poyatos E, Soriano T, Martínez-Hernandez D, Rojas VD, Guinee VF. Physical exercise, use of Plantago ovata and aspirin, and reduced risk of colon cancer Eur J Cancer Prev. 2002 Oct;11(5):465-72. doi: 10.1097/00008469-200210000-00009. PMID: 12394244.

 

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