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.
5 to 15 grams daily
What Research Shows
May Be Effective
Not Enough Data to Assess
Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.
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.
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:
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.
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.
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).
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.
Last reviewed July 2019 by EBSCO NAT Review Board Eric Hurwitz, DC
Last Updated: 4/10/2020
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