This fiber supplement can ease constipation and lower cholesterol
Psyllium is a form of soluble fiber sourced from the husks of the psyllium (Plantago ovata) seed. This plant grows most predominantly in India as it is native to Asia, but it can be found worldwide, including growing wildly in the southwest U.S. Psyllium is sold under a wide variety of names but is probably best known as Metamucil®.
Some people may need a fiber supplement, such as psyllium, to increase their intake. Fiber is said to help with a wide range of health issues, including:
• Diarrhea and loose stools
• Heart disease
• High blood pressure
• High cholesterol
• Irritable bowel syndrome (IBS)
• Metabolic syndrome
There are two types of fiber: Soluble fiber attracts water and turns to gel during digestion to help slow the process. Insoluble fiber adds bulk to the stool and seems to help food pass more quickly through the stomach and intestines.
Here’s a look at several findings from the available research on the potential health benefits of psyllium:
Increasing your intake of soluble fiber may promote bowel regularity. As psyllium makes its way down your digestive tract, it absorbs water in the intestines, swells, and contributes to a gel-like stool that’s softer and easier to pass.
In a review published in Alimentary Pharmacology and Therapeutics in 2014, however, researchers reviewed clinical trials on the effect of prunes on gastrointestinal function and found that prunes were superior to psyllium for improving stool frequency and consistency. Another study found that psyllium and prune fiber were equally effective in improving constipationand quality of life, however, prune fiber was more effective at relieving flatulence and bloating.
Adding soluble fiber to your diet may help to lower your cholesterol. In fact, the Food and Drug Administration allows psyllium products to make the health claim that they reduce the risk of cardiovascular disease by lowering cholesterol.
Soluble fiber interferes with the uptake of bile acids in the intestines, leading to their excretion in the stool. As the liver converts cholesterol to replace the bile acids, levels of LDL “bad” cholesterol are lowered. Increasing your soluble fiber intake by five to 10 grams a day typically results in a five-percent reduction in LDL cholesterol.
In a study published in PLoS One in 2012, participants took a psyllium supplement or a placebo. Psyllium supplementation resulted in a six-percent reduction in LDL cholesterol.
Psyllium has also been shown to be an effective co-therapy for statin drugs and bile acid sequestrants. A three‐month study with 68 patients with high cholesterol showed that low‐dose simvastatin (10 milligrams a day) combined with psyllium (five grams three times a day before meals) was superior to low‐dose simvastatin alone and equivalent to a higher dose of simvastatin (20 milligrams a day) alone. When combined with a bile acid sequestrant like colestipol or cholestyramine, psyllium increased the cholesterol‐lowering efficacy and decreased the symptoms associated with sequestrant therapy.
Irritable Bowel Syndrome (IBS)
A meta-analysis from 2014 that evaluated dietary fiber supplementation in 14 randomized controlled trials involving 906 patients with IBS found that fiber supplementation (especially with psyllium) was effective in improving IBS symptoms compared to placebo. IBS is a common chronic gastrointestinal disorder that’s widely believed to be caused by too little dietary fiber. In people with IBS, soluble fiber is believed to cause less abdominal pain/discomfort, abdominal bloating/distension, and flatulence than insoluble fiber.
Some research suggests that soluble fiber such as psyllium may help improve glucose control in people with type 2 diabetes. In a report published in the American Journal of Clinical Nutrition in 2015, for instance, researchers analyzed previously published studies and found that taking psyllium before meals resulted in a significant improvement in fasting blood glucose and glycated hemoglobin (HbA1c) in people with type 2 diabetes.
Soluble fiber is also said to promote a feeling of fullness, or satiety, which may result in better weight control. In a study published in the journal Appetite in 2016, for instance, psyllium supplementation resulted in greater fullness and less hunger between meals compared to a placebo.
Possible Side Effects
Side effects can include gas, bloating, diarrhea, and constipation. Allergic reactions have also been reported. To prevent constipation, drink plenty of fluids, exercise regularly, and eat a high-fiber diet, including whole-grain (bran) cereals, fruits, and vegetables.
Psyllium shouldn’t be taken by people with bowel obstructions or spasms, difficulty swallowing, or a narrowing or obstruction anywhere in the digestive tract. People with kidney disease and those who are taking certain medications may not be able to take psyllium supplements. Psyllium is not recommended for use in children unless recommended by the child’s doctor.
If you have a new or persistent change in your bowel habits, be sure to consult your doctor. If you have a health condition that requires treatment (such as diabetes or heart disease), talk with your doctor if you’re interested in psyllium rather than in forgoing or delaying standard care. Also, if you’ve been prescribed medication, never discontinue taking it without consulting your physician first.
Dosage and Preparation
Psyllium comes in many forms—as a powder, granules, capsule, liquid, and wafer, all of which are taken by mouth. It’s usually taken one to three times daily. Psyllium must be taken in the recommended amount and mixed with an adequate amount of water or other liquid (at least eight ounces or 240 milliliters) or it may lead to constipation and possibly even cause a small bowel obstruction. Starting slowly with a small dose—specifically, no more than a five-gram increase a day each week—is recommended to give the digestive system time to adjust to the increased fiber.
The Institute of Medicine recommends a fiber intake of about 25 grams a day for women and 38 grams a day for men (adults ages 21 to 50). Older adults tend to consume fewer calories, so the recommendation for women and men over 50 is 21 grams and 30 grams a day, respectively.
If using as a laxative, psyllium should only be used for one week. Psyllium can be used for longer periods of time as a fiber supplement, but only with your doctor’s permission.
The absorption of many drugs can be affected by psyllium, so talk to your doctor before using psyllium if you’re taking any medicine. Don’t take psyllium at the same time you take your medicines. Psyllium should be taken at least two hours before taking your medicines or two to four hours afterward.
What to Look For
Before incorporating a fiber supplement like psyllium consider whether you can increase your fiber consumption by changing your diet. To get more soluble fiber every day, look to oats, barley, nuts, seeds, legumes (such as beans, lentils, and peas), fruits like apples, oranges, and grapefruit, and vegetables. Insoluble fiber is found in fruits with edible peel or seeds, vegetables, whole-grain products (such as whole-wheat bread, pasta, and crackers), bulgur wheat, stone ground cornmeal, cereals, bran, rolled oats, buckwheat, and brown rice. While there’s no dietary reference intake for soluble or insoluble fiber, many experts recommend that about one-quarter of your total daily dietary fiber intake—about six to eight grams—come from soluble fiber.
A Word From Verywell
Although psyllium may be helpful in treating certain types of occasional constipation and may have benefits when taken for other conditions, it’s best used in combination with other treatments and preventative strategies that may include diet, lifestyle changes, and medication.