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
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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