other · for high cholesterol
Psyllium
Forms a gel in your gut that traps cholesterol before it is reabsorbed.
Say that in clinical terms
Soluble fiber from psyllium forms a viscous gel in the gut that binds bile acids and dietary cholesterol, increasing their excretion in stool and prompting the liver to pull more LDL cholesterol out of the blood to replace the lost bile acids.
How strong is the research?
Strong evidence
2 papers read, 2 supporting.
Tested as: psyllium husk (Plantago ovata) soluble fiber, 7-15 g/day (FDA-qualifying dose is 7 g/day soluble fiber from husk of >=95% purity; trial median dose ~10.2 g whole husk/day), taken with adequate fluid, as an adjunct to a diet low in saturated fat and cholesterol
How much to take
7–15 g
Before you take it
- No Tolerable Upper Intake Level (UL) has been established for psyllium husk by the FDA, NIH IOM, or NIH ODS; studied supplemental doses in clinical trials typically range from 3.4 to 10 g/day
- Must be taken with at least 240 mL (8 oz) water — swallowing without adequate fluid can cause esophageal or intestinal obstruction
- Reduces absorption of multiple oral medications — oral drugs should be taken at least 2 hours before or 4–6 hours after psyllium; documented interactions include digoxin, warfarin, lithium, carbamazepine, and tricyclic antidepressants
- Antibiotic interaction is asymmetric — tetracyclines and quinolones should be taken at least 2 hours before or 4–6 hours after psyllium to avoid reduced antibacterial efficacy
- May potentiate the glucose-lowering effect of insulin and oral hypoglycemic agents; patients on diabetes medications should monitor blood glucose and consult their prescriber before starting psyllium
- Rare anaphylactic hypersensitivity reactions have been reported, most commonly in individuals with occupational psyllium powder exposure (healthcare workers, food manufacturing); individuals with latex sensitivity may be at elevated risk
- Contraindicated in individuals with esophageal narrowing, GI obstruction, difficulty swallowing, or fecal impaction
- Bloating, gas, and flatulence are common side effects, especially during the first 3–10 days of use as the gut microbiome adjusts; initiating at a lower dose and gradually titrating upward can improve tolerance