Psyllium

Latest Edit: Hector 2014-03-17 (EDT)

See Also	Food Supplements

Psyllium is a viscous, water-soluble fiber that is prepared from the mechanical removal of the husk from blonde psyllium seed. Among the soluble fibers, psyllium is one of the most palatable, and is used as the active ingredient in several bulk fiber products.

Food Sources

Psyllium belongs to a class of gel-forming, soluble fibers that include gums, pectins, mucillages, and certain hemicelluloses that can be extracted with water from plants and their seeds.

Uses

Psyllium has primarily been used for the following:

• Constipation
• Irritable Bowel Syndrome
• Ulcerative Colitis
• Diabetes prevention and management
• High cholesterol prevention and management.
• Coronary heart disease

Prescribing Considerations

The recommended dosages have not yet been established. To determine what your specific requirements are talk to your naturopathic doctor or other trained medical professional.

• As a general rule, any medications taken by mouth should be taken one hour before or four hours after psyllium to prevent interactions.

Safety

The safety precautions of psyillum include:

• Psyllium must be taken with plenty of water so it doesn't bulk up and block your esophagus, throat, or intestines. Drink at least 8 ounces of fluids for every 3-5 grams of husk or 7 grams of seed.
• Side-effects of psyllium, which typically occur with higher dosages include excessive bloating, gas, or diarrhea. They may also include stomach pain, constipation, and nausea
• Psyllium has been linked to reports of headache, backache, runny nose, cough, and sinus problems in some individuals.
• Allergies to psyllium can exist resulting in symptoms such as swollen nasal passages, sneezing, swollen eyelids, hives, and asthma. If you have an allergic reaction stop using psyllium immediately and seek medical attention.
• Psyllium may be effective when used for acute constipation or for short-term treatments for other conditions. It is not advised to use psyllium long-term.

• Pregnancy and Breast-feeding:

• Psyllium is best used with caution.

• Precautions:

• Diabetes: Psyllium can lower blood sugar levels in people with type 2 diabetes. Monitor blood sugar levels closely. Some preparations of psyillum contain sugar that might increase blood sugar levels.
• Gastrointestinal (GI) disorders: Don’t use blond psyllium if you tend to develop hard stools in the rectum due to ongoing constipation (fecal impaction), GI tract narrowing, obstruction, or conditions that can lead to obstruction, such as spastic bowel.
• Known allergies to psyllium.
• Phenylketonuria: Some blond psyllium preparations are sweetened with aspartame (Nutrasweet) and should be avoided in patients with phenylketonuria.
• Surgery: Blond psyllium might affect blood sugar levels, making blood sugar control more difficult during and after surgery. Stop taking blond psyllium at least 2 weeks before a scheduled surgery.
• Swallowing disorders: Don’t use blond psyllium if you have problems swallowing. Blond psyllium might increase your risk of choking.

• Drug Interactions:

• Carbamazepine (Tegretol): Psyllium can decrease how much carbamazepine (Tegretol) the body absorbs.
• Lithium: Psyllium can decrease how much lithium the body absorbs. To avoid his interaction take blond psyllium at least one hour after lithium.
• Medications for diabetes (Antidiabetes drugs): Taking psyllium with diabetes medications might cause your blood sugar to be too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

• Warfarin (Coumadin) Warfarin (Coumadin) is used to slow blood clotting. Some people worry that blond psyllium may decrease warfarin (Coumadin) absorption and its effectiveness, which could increase the risk of clotting. Psyllium does NOT seem to affect warfarin (Coumadin) absorption or effectiveness.
• Digoxin (Lanoxin): Psyllium can decrease the absorption and decrease the effectiveness of digoxin (Lanoxin).
• Ethinyl estradiol: Ethinyl estradiol is a form of estrogen that's in some estrogen products and birth control pills. Some people worry that psyllium can decrease how much ethinyl estradiol the body absorbs. But it is unlikely that psyllium will significantly affect ethinyl estradiol absorption.

• Nutrient Interactions:

• Iron: Psyllium decreases the absorption of iron. Take iron supplements one hour before or four hours after psyllium to avoid this interaction.
• Riboflavin: Psyllium may have a slight, yet likely insignificant, reduction in the amount of riboflavin that the body absorbs.
• Fat Psyllium can make dietary fat more difficult to digest and can increase the amount of fat lost is the stool when taken in combination with dietary fats such as soybean oil or coconut oil.