Know the Isabgol Benefits, Side effects and Dosage

Psyllium husk is known as Ashvagola or Ashwakarna in Ayurveda which literally means one which have ears like horse (Ashva=horse;Gola=Round and Karna=Ears). It named so perhaps due to appearance of seeds which are concave and elongated like horse ear. Isabgol is its Persian name (asp=Horse, and Ghol=Round). It is known as Aspaghol in Unani, and Isapppa in Siddha.

Other common names

1. Hindi: Isabgol, Isabgol Bhusi, Isapagula husk, Ispaghula
2. English: Spogel Seed husk, Psyllium, Ispagol Psyllium, Plantago ispagol, Blond psyllium
3. Arabic: Bazre-Qutuna
4. Persian and Urdu: Aspiyoos, Shikamdarida, Aspghol Aspaghol Musallam, Suboos-e-Aspaghol
5. Siddha: Isapppa

In Ayurveda, Psyllium is considered cooling, pungent and astringent. It balances all three humors Vata, Pitta, and Kapha. It decreases the swelling of digestive tract and gives relief in constipation and piles. But as it high on fiber, initially may cause gas.

About The Plant Plantago ovata

It is a stemless or sub-caulescent soft hairy or woolly annual herb which attains a height of 30-45 cm. Leaves narrowly linear or filiform appearing whorled due to the short terete stem. The spikes are 1.2-4 cm long and about 0.5 cm broad, cylindrical to ovoid in shape and bear between 45-70 flowers.

Flowers are bisexual, tetramerous, anemophilous and protogynous and as such favoring out crossing. The fruits are ellipsoid capsules, about 8 mm long, obtuse, membranous, glabrous, upper half coming off as a blunt conical lid.

Seeds are ovoid-oblong, boat-shaped, smooth, rosy-white being concave on one side and convex on the other. The concave side of the seed is covered with a thin white membrane produced by fusing of outer layer of ovule together with the inner epidermis, forming the seed coat. The seed epidermis is made of polyhedral cells whose walls are thickened by a secondary deposit which is the source of mucilage.

On mechanical milling, the coating of seed provides the husk, a membranous covering of the seed, white to light pink in color, translucent and odorless.

Parts used:Whole Seeds or Husk of the Seeds.

SCIENTIFIC CLASSIFICATION

Psyllium plant is small, stemless, and grows annually. The plant belong to Genus Plantago and family Plantaginaceae. There are about 200 species in this genus and ovata and psyllium are commercially cultivated for obtaining the psyllium husk.

1. KINGDOM: Plantae – Plants
2. SUBKINGDOM: Tracheobionta – Vascular plants
3. SUPERDIVISION: Spermatophyta – Seed plants
4. DIVISION: Magnoliophyta – Flowering plants
5. CLASS: Magnoliopsida – Dicotyledons
6. SUBCLASS: Asteridae
7. ORDER: Plantaginaceae
8. FAMILY: Plantaginaceae – Plantain family
9. GENUS: Plantago L. – plantain P
10. SPECIES: Plantago ovata Forssk. – Desert Indian wheat

What is Isabgol or psyllium husk

Psyllium/Ispaghula/Isabgol is obtained from a plant called Plantago ovata (Synonym: P. ispaghula). This plant is indigenous to the Mediterranean region especially Southern Europe, North Africa and West Asia.

It is now cultivated in many other countries e.g. West Asia, America, Mediterranean countries and Russia. In India it is mainly cultivated in north Gujarat, south-western Rajasthan, Punjab and Haryana states.

The psyllium husk is derived from the seeds of the plant. The outer coat of the seeds are separated by crushing and winnowing.

Composition of Isabgol or psyllium husk

Psyllium husk contains a high proportion of hemicelluloses, composed of a xylan backbone linked with arabinose rhamnose and galacturonic acid units (arabinoxylans). It also contains Carbohydrates, Protein, Tannin, Glycosides, Fixed oil, Linoleic acid, Palmetic acids, Iron, Zinc, Potassium and Sodium.

How Psyllium Husk Works

Psyllium has been found to be practically unaffected by the digestive enzymes of stomach and bacteria and passes unchanged through the intestine.

It pass through the small intestine to large intestine. There the husk absorbs water and swells approximately ten times. This causes formation of soft stool bulk and since it is jelly-like so it moves easily. This further causes normal stimulation for bowel.

It takes about half day to cause motion after consuming husk.

Medicinal Properties of Isabgol or psyllium husk

• Non-habit forming laxative, diuretic
• Nourishing, cooling
• Anti-inflammatory, expectorant, antitussive
• Antihyperglycaemic, Lowers blood sugar absorption
• Anti-peptic ulcer, Antidysentric, Anti-oxidant
• Bad cholesterol lowering
• Blood pressure lowering
• Lipid lowering
• Restores and maintains bowel regularity
• Cleanses the colon

In a study by Anderson (2000), a meta-analysis of 8 clinical studies was done, which included 384 and 272 mild to moderate hypercholesterolemic people receiving either 10.2 grams/day psyllium or cellulose placebo, respectively, over a period of 8 weeks or more, along with a low fat diet. They found that psyllium intake adjunctive to a low-fat diet lowered total serum cholesterol by 4% and LDL cholesterol by 7%.

In another meta-analysis of 12 studies, which included a total of 404 mild to moderate hypercholesterolemic people taking 3 g or less of psyllium per day, psyllium intake was found to lower total cholesterol and LDL by 5% and 9% respectively.

The majority of recent clinical studies show psyllium appears to modestly lower total cholesterol levels by anywhere from 3-8% and LDL levels by about 5-13% in mild to moderately hypercholesterolemic patients, with the actual effects depending on the various factors involved in each study.

Health Benefits of Isabgol (psyllium husk)

Laxative, useful in Constipation

It is a gentle natural bulk-forming laxative that promote the regulation of large bowel function and gives relief in constipation. It is high in both fiber and mucilage (10–30%). Mucilage is clear, colorless, gelling agent that absorbs the water and increases in volume. So Isabgol softens the stool and at the same time lubricates the passage for easy removal of feces.

Useful in Diarrhea

It is also beneficial in diarrhea as it slows down the gastric emptying time and colon transit time. In the case of diarrhea 2 teaspoonful of husk should be given with cold water mixed with lemon juice.

Blood pressure lowering properties

It shows blood pressure lowering properties and is useful in hypertension.

Study has shown its blood pressure lowering effect in a 6 months trial on hypertensive and obese patients (Cicero et al., 2007). But some other studies have not shown any changes in blood pressure (Bell et al., 1990). More studies are needed.

But such studies do prove that its use is completely safe and poses no health risk if taken while suffering from high blood pressure and diabetes.

Useful in Bowel Diseases

It is useful in the treatment and prevention of following bowel diseases:

Diverticulosis (condition in which very small (5 to 10 millimeters) in diameter pouches/diverticula form in the wall of the colon or large intestine)

Irritable bowel syndrome (condition involving recurrent abdominal pain and diarrhea or constipation, often associated with stress, depression, anxiety, or previous intestinal infection.)

Inflammatory bowel disease (group of inflammatory conditions of the colon and small intestine. Crohn’s disease and ulcerative colitis are the principal types of inflammatory bowel disease)

In chronic colitis psyllium should be given in a dose of 2 teaspoonful, 3-4 times a day, with buttermilk or curd.

Useful in Piles

It is very useful for dry and bleeding piles. It prevents and cures constipation. It also cures congestion in the liver and have cooling effect on the body. In piles you may take about 2 teaspoonful of this husk with water or buttermilk three times a day for four-five months.

Blood Sugar Lowering, Useful in Diabetes

It regulates blood glucose equilibrium and Lowers blood glucose by allowing slow sugar absorption. Intake of psyllium husk in a dose of 5 grams twice a day, half an hour before breakfast and dinner is effective in significantly reducing Fasting plasma glucose FBS, and HbA1c (Glycosylated hemoglobin). A person with diabetes can daily take this husk for lowering the sugar level. It is safe, effective and natural.

Lowers Blood Cholesterol Level

It lowers blood cholesterol level (especially LDL cholesterol). It significantly increases high-density lipoprotein/HDL/HDL-cholesterol. HDL cholesterol, is the good cholesterol. It should be more for good health and lowering the risk of heart disease. LDL cholesterol/ low-density lipoprotein is the bad cholesterol. It is important to decrease the bad cholesterol and increase the good cholesterol. Also the consumption of husk significantly decreased the LDL/HDL ratio.

Lipid Lowering

It has blood lipid lowering property. A study (Garvin et al., 1965) show supplementation with 9.6 g psyllium/day for 5 week reduced serum triglycerides by 9%. It has favorable effect on the lipoprotein profile.

Reduces plasma triacylglycerol

In a study, in men with coronary heart disease after a low-saturated-fat, low-cholesterol diet, the incorporation of psyllium husk significantly reduced plasma triacylglycerol concentrations by 6.7%.

Probiotic, Antioxidant

It has probiotic effect. It promotes the growth of good bacteria in human gut.

The Dosage of Isabgol or Psyllium husk

For constipation:

Adult 1-2 teaspoonful 2-3 times a day with a glass of water, milk or curd.

Children Half teaspoonful 2-3 times a day with a glass of water, milk or curd.

The powdered seed husk must be stirred in 150 ml water and be drunk immediately, after consumption, a large amount of water should be consumed.

FDA has recently approved the use of the following statement on psyllium products:“3g to 12g of soluble fiber from psyllium seed husk when included as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease”.

Few Important points about Isabgol

It is over-the-counter OTC completely natural bulk laxative.

It can even be taken in pregnancy and breastfeeding.

It is safe, well tolersated, in persons with type II diabetes. It improves glycemic control.

It should always be taken in recommended dose and with milk or water . Cholesterol reduction needs higher doses for optimal effects. For constipation a lower dose will do.

It is high in fiber and absorbs water so it is important to increase the fluid intake.

Use of Blond Psyllium husk up to six months did not clinically alter vitamin or mineral status in a review of eight human trials. It did not reduce absorption of calcium. (J AmGeriatr Soc, 43, 1995;Am J Clin Nutr, 71, 2000;Natural Medicines Comprehensive Database, 2007.)

Sudden increases in dietary fiber may cause temporary gas and bloating. Start with a low dose and one dose per day and increase gradually to allow the gastrointestinal tract to adapt. This also reduces the occurrence of its side-effects.

Possible Side-Effect of Psyllium Supplementation

• It may alter nutrient and drug absorption. To avoid drug interaction it should be taken at least 2 hours before or after other medications.
• It interacts and decreases absorption of Carbamazepine, lithium, warfarin and Iron.
• It may reduce the appetite.
• It reduces the blood glucose level and blood pressure.

It is high in fiber so the its fermentation by anaerobic bacteria in the large intestine and may cause increase bloating and flatulence, abdominal pain, cramping and diarrhea.

Person suffering from severe abdominal pain, infections, vomiting, difficulty swallowing, esophageal stricturing or obstruction, chronic bowel narrowing or obstruction, and bowel surgery should not take psyllium.

Allergic reactions to ingestion or inhalation of Plantago products have been reported, especially after previous occupational exposure to these products.

It should always be taken with a sufficient amounts of liquid, e.g. Take 150 ml water/5 g psyllium. Failure to do so may result in swelling of the seed coats and blockage of the esophagus, which may cause choking. Intestinal obstruction may occur if an adequate fluid intake is not maintained.

• It should never be taken in dried powder form as that may cause bowel or oesophageal obstruction.
• If bleeding, or no response and abdominal pain occur 48 h after ingesting the seed coats, treatment should be discontinued and medical advice sought.
• Do not take bulking agents when laying down.
• Do not use with anti-peristaltics.

REFERENCES

1. Anderson JW., et al. Cholesterol-lowering effects of psyllium intake adjunctive to diet therapy in men and women with hypercholesterolemia: meta-analysis of 8 controlled trials. Am J Clin Nutr. 2000;71:472-9.

2. Anderson JW., et al. Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia. Am J Clin Nutr. 2000;71:1433-1438.

3. Olson BH., et al. Psyllium-enriched cereals lower blood total cholesterol and LDLcholesterol, but not HDL cholesterol, in hypercholesterolemic adults: results of a meta-analysis. J Nutr. 1997;127:1973-80.

4. Tai ES., et al. A study to assess the effect of dietary supplementation with soluble fiber (Minolest) on lipid levels in normal subjects with hypercholesterolemia. Ann Acad Med Singapore. 1999;28:209-13.

5. Davidson MH, et al. Long-term effects of consuming foods containing psyllium seed husk on serum lipids in subjects with hypercholesterolemia. Am J Clin Nutr. 1998;67:367-

6. MacMahon, et al. Ispaghula husk in the treatment of hypercholesterolaemia: a double-blindcontrolled study. J Cardiovasc Risk. 1998;5:167-72.

7. Van Rosendaal GM., et al. Effect of time of administration on cholesterol-lowering bypsyllium: a randomized cross-over study in normocholesterolemic or slightly hypercholesterolemic subjects. Nutr J. 2004;3:17.

8. FDA Talk Paper. 1998.

9. Jenkins DJ, et al. Soluble fiber intake at a dose approved by the US Food and Drug Administration for a claim of health benefits: serum lipid risk factors for cardiovascular disease assessed in a randomized controlled crossover trial. Am J Clin Nutr. 2002;75:834-9.

10. American Diabetes Association (2005) Clinical Practice Recommendations 2005. Diabetes Care 28, S1–S79.

11. Gelissen IC, Brodie B and Eastwood MA (1994) Effect of Plantago ovata (psyllium) husk and seeds on sterol metabolism: studies in normal and ileostomy subjects. American Journal of Clinical Nutrition 59, 395-400.

12. Central Council for Research in Unani Medicine. Standardization of single drugs of Unani medicine – part I. New Delhi, Ministry of Health and Family Welfare, 1987.

13. European pharmacopoeia, 3rd ed. Suppl. 2001. Strasbourg, Council of Europe, 2000.

14. Kritchevsky D et al. Infl uence of psyllium preparations on plasma and the liver lipids of cholesterol-fed rats. Artery, 1995, 21:303–311.

15. Heaney RP, Weaver CM. Effect of psyllium on absorption of co-ingested calcium. Journal of the American Geriatrics Society, 1995, 43:261–263.

16. WHO monographs on selected medicinal plants, World Health Organization, Geneva, Vol. 1, 1999, 202-206.

17. WHO monographs on selected medicinal plants, World Health Organization, Geneva, Vol. 3, 2007, 268-282.