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8 Proven Benefits and Side Effects of Psyllium Hust (Metamucil) [Updated Dec/2022]

Psyllium husk fiber powder is the most widely used edible colloidal fiber at present, similar to chia seeds , it has the properties of swelling after absorbing water and prebiotic properties (can absorb more than 3 times the volume of water).

Clinically, psyllium husk fiber is regarded as a kind of bulk-forming laxatives, which can increase the volume and water content of feces and achieve the effect of promoting defecation (characterized by non-irritating and addictive).

In addition to promoting bowel movements, current research has also found that psyllium may also have potential benefits in improving diarrhea, irritable bowel syndrome, inflammatory bowel disease, ulcerative colitis, diabetes and hypercholesterolemia.


What is Psyllium Husk (Metamucil)?

Psyllium husk comes from the Plantago family (Plantaginaceae), originated in India and Iran, and is now widely planted all over the world

At present, the psyllium health products on the market are made by processing and grinding the seed husk, which are usually in the form of silk, powder and liquid.

Benefits and side effects of psyllium


What Are The Recommended Empirical Effects (Benefits) of Psyllium Husk (Metamucil)?

  1. Psyllium Husk (Metamucil) Is Beneficial For Blood Pressure Regulation

Blood pressure is defined as the product of cardiac output and peripheral resistance. Hypertension is caused by increased cardiac output or increased peripheral resistance, and is a potential risk factor for cardiovascular disease.

A large number of epidemiological data indicate that systolic blood pressure is a far more important determinant of cardiovascular risk than diastolic blood pressure. Systolic hypertension is the most common type of hypertension, which increases coronary artery disease and congestion. Risk of heart failure, stroke (ischemic and hemorrhagic), renal failure, and peripheral arterial disease.

A systematic literature review and meta-analysis (meta-analysis, including 11 randomized controlled trials, a total of 592 participants) pointed out that intake of psyllium husk can help reduce systolic blood pressure (-2.04 mmHg) . Note 1

In addition, meta-regression analysis (meta-regression) highlighted that the blood pressure-lowering effect of psyllium was greater in subjects with higher baseline blood pressure (systolic and diastolic blood pressure).

*Conclusion: For people with hypertension, supplementation of Psyllium may have a positive effect on blood pressure regulation, but it is limited by the small number of samples, and more research is needed to support it

  1. Psyllium Husk (Metamucil) Benefits People From Losing Weight

Obesity is one of the most common and expensive chronic diseases in the world.

It is estimated that in the United States alone, obesity affects one-third of adults and accounts for one-third of the total death rate. It is caused by pathological processes such as diabetes, insulin resistance, dyslipidemia, hypertension, and atherosclerosis.

At the most basic level, the pathogenesis of obesity seems to be very simple. Calorie intake exceeds continuous energy expenditure.

However, more and more evidence shows that the pathogenesis of obesity is much more complicated than passively accumulating excessive calories. This complexity is the core reason why obesity is difficult to treat.

A systematic literature review and meta-analysis (Meta-analysis, including 22 randomized controlled trials, with a total of 1458 adult participants) pointed out that compared with the control group, oral psyllium husk fiber had an effect on body weight, There were no significant effects on body mass index or waist circumference . Note 1

Additionally, the duration of psyllium husk fiber consumption has a non-linear relationship to BMI and waist circumference

*Conclusion: Oral psyllium husk fiber is not significantly helpful for weight loss, but due to the heterogeneity and bias of the included studies, more long-term large-scale trials are still needed for further verification

  1. Psyllium Husk (Metamucil) Is Good For Blood Sugar Control

Type 2 diabetes is mainly related to abnormal insulin secretion and insulin sensitivity. The triggering factors can be divided into controllable (body mass index, central obesity and sedentary lifestyle) and uncontrollable (age, race and genetics).

The study found that for every 1% increase in glycosylated hemoglobin (HbA1c), all-cause mortality and cardiovascular disease mortality will increase by 30% and 40%, respectively. Note 1

A literature meta-analysis (meta-analysis, including 35 randomized controlled clinical trials) pointed out that consuming psyllium husk before meals can significantly improve fasting blood sugar and glycated hemoglobin, especially in subjects who are undergoing diabetes treatment (the period of use is between 2–52 weeks, the daily dose is about 10.2 g) . Note 2

*Conclusion: Oral psyllium husk fiber is beneficial to the blood sugar control of diabetic patients, and may be used in clinical practice to become an effective lifestyle adjustment option

  1. Psyllium Husk (Metamucil) Increases Satiety and Reduces hunger

Overweight and obesity are currently the biggest problems in human health. Therefore, effective weight loss methods are often sought after. Common weight loss principles include: regulating energy consumption, suppressing appetite, and blocking fat/sugar absorption

In terms of ease of implementation, it is the most difficult to control appetite, because the level of appetite is affected by a variety of physiological, behavioral and environmental factors.

According to two randomized, double-blind, placebo-controlled studies, supplementing psyllium husk before meals can reduce hunger, increase satiety, and reduce the desire to snack between meals . Note 1

The underlying mechanism is related to the delay of gastric emptying and slowing down of the small intestine transit time brought by psyllium seed colloidal fibers.

*Conclusion: Taking psyllium (shell) before meals can regulate appetite, increase satiety, and help reduce calorie intake

  1. Psyllium Husk (Metamucil) Regulates Cholesterol

Cholesterol has multiple roles in the human body. In addition to forming hormones (gonadal and adrenal glands), vitamin D and bile acid precursors, it is also an important component of cell membranes.

The total amount of cholesterol is mainly related to dietary intake, absorption efficiency, metabolism, intestinal hepatic circulation and excretion rate. If it is too high, it may cause atherosclerosis and cardiovascular disease.

A meta-analysis of the literature (meta-analysis, including 21 controlled clinical trials, with 1717 patients with mild to moderate hypercholesterolemia) pointed out that compared with placebo, the intake of psyllium husk has lower serum total cholesterol and lower blood cholesterol levels. The effect of high-density lipoprotein cholesterol (and the effect is most significant when the daily dose is between 3 and 20.4 g during the use period of more than 2 weeks). Note 1

*Conclusion: Eating Psyllium has a positive effect on regulating cholesterol, but the results still need more large-scale studies to further verify

  1. Psyllium Husk (Metamucil) Benefits People Suffering Irritable Bowel Syndrome

The term constipation generally refers to the disturbance of intestinal peristalsis, which is defined as the number of bowel movements less than 3 times a week, but sometimes any form of dysfunction can also be called constipation, including hard stools, feeling unclean, and intention to defecate but unable to come out.

It is estimated that the global prevalence rate of constipation is between 2% and 27%, and the ratio of women to men is about 2:1, and the incidence rate increases with age, with a prevalence rate of nearly 50% above 65.

A placebo-controlled study (for 4 weeks in 22 patients with idiopathic constipation) pointed out that oral administration of psyllium husk not only helped to increase the frequency and weight of defecation, but also improved the hardness and pain of defecation. Note 3

An article published in clinical gastroenterology and hepatology looked at the effects of psyllium fiber in a randomized double-blinded trial in 103 children with irritable bowel syndrome. In addition, psychological characteristics were measured at baseline. In this study, children that received psyllium had a significant reduction in mean number of abdominal pain episodes compared with placebo, and the reduction could not be attributed to psychological factors. (Note 4) So the study offers a potential approach to reduce episodes of abdominal pain and children with irritable bowel syndrome.

Another randomized controlled double-blind trial (for 4 weeks, with 72 constipation patients meeting Rome III criteria) pointed out that both psyllium husk and mixed fiber can help improve constipation symptoms and quality of life. Note 5

*Conclusion: Oral Psyllium can positively improve constipation symptoms in the short term, but more research is needed to confirm the long-term effect.

  1. Psyllium Husk (Metamucil) Improves Fecal Incontinence

Fecal incontinence is mainly defined as uncontrollable excretion of feces or mucus, and the duration is more than 1 month, the population prevalence rate can reach 0.4% to 18%, and often seriously affect the quality of life of patients (sleep, work and social activities) ). Note 6

There are many main causes of fecal incontinence, including: anal sphincter abnormalities (such as birth trauma, hemorrhoidectomy, stretching injuries), structural abnormalities (fistula, rectal prolapse, perineal descent syndrome), inflammatory diseases (Crohn’s disease, Ulcerative colitis, radiation proctitis), diarrhea (after cholecystectomy, irritable bowel syndrome), etc.

A randomized, double-blind, placebo-controlled crossover trial (4 weeks in 80 patients with fecal incontinence) showed that either oral psyllium husk or treatment medicine like loperamide has reduced seizure frequency, The severity of symptoms and the effect of improving the quality of life, but the side effects of drugs are relatively large (such as headache, constipation) . Note 7

*Conclusion: Oral psyllium may improve some patients with fecal incontinence, but due to implementation errors and high bounce rate, more large studies are needed to confirm

  1. Psyllium Husk (Metamucil) Reduces Inflammation Indicators: C-Reactive Protein

C-Reactive Protein is an acute phase protein produced by the human body when it has an inflammatory response, and is mainly synthesized by the liver.

Numerous evidences point out that excessive C-reactive protein levels are often associated with coronary heart disease events, hypertension, type 2 diabetes, malignant tumors, metabolic syndrome, depression, and cognitive decline. Note 8

A 3-month randomized controlled trial of 162 overweight or obese adults found that supplementation with psyllium fiber powder did not significantly improve C-reactive protein and related markers of inflammation compared to no supplementation controls (eg: interleukin-6 concentration, fibrinogen level, white blood cell count) . Note 9

*Conclusion: Supplementing psyllium fiber alone does not have the effect of reducing C-reactive protein


What Are The Psyllium Husk (Metamucil) Side Effects?

For most people, psyllium is a well-tolerated food, but possible side effects or adverse reactions that have been reported include: bloating, stomach pain, diarrhea, constipation, nausea and gas.

In addition, although allergy to psyllium husk is extremely rare, it can still occur. If you experience chest and throat tightness, flushing, loss of consciousness, rash, itching, swelling (face/tongue/throat), dizziness, difficulty breathing, sneezing and other abnormal phenomena, please seek medical treatment immediately.

Safety precautions (12 Points of Use Contraindications)

  1. When eating, please drink enough water (with at least 250 ml of water per 3 to 5 g) to avoid excessive fiber causing blockage or suffocation of the throat.
  1. Do not use with drugs, because it may affect or delay the absorption of certain drugs (the two are at least 2 to 4 hours apart). Common susceptible drugs such as tricyclic antidepressants (Amitriptyline) and epilepsy drugs (Tegretol) , Bile acid binder (Questram), cardiovascular drugs (digoxin), lithium, etc.
  1. Ingestion of psyllium husk may increase the risk of adenoma recurrence in people with a history of colorectal adenoma, especially for subjects with a high calcium diet. Note 1
  1. Diabetics or those taking blood sugar lowering drugs should use caution, because psyllium husk may lower blood sugar. For safety, please monitor blood sugar regularly. Related drugs are not named: glimepiride, glyburide libenclamide, insulin, pioglitazone, rosiglitazone, chlorpropamide, glipizide, tolbutamide.
  1. Some products may add sweeteners, such as saccharin or aspartame, such as diabetes, phenylketonuria (phenylketonuria) or those who have to restrict sugar diet, please avoid using it.
  1. Do not use for patients with dysphagia, fecal impaction, or any gastrointestinal tract narrowing, obstruction, or bowel spasm.
  1. Patients with low blood pressure or taking blood pressure lowering drugs should use caution, because psyllium husk may lower blood pressure. For safety, please monitor blood pressure regularly.
  1. Please stop using it 2 weeks before the operation, because psyllium husk may affect blood sugar, making it more difficult to control blood sugar during and after the operation.
  1. Do not use with carbamazepine (the drug for the treatment of epilepsy, mania, alcohol abstinence syndrome, diabetes insipidus), as it may reduce the efficacy of the drug (because too much fiber will hinder drug absorption).
  1. Do not use together with lithium salts (bipolar disorder drugs), which may reduce the efficacy of the drug.
  1. Do not use digoxin (a drug for the treatment of atrial fibrillation, heart failure, atrial flutter, arrhythmia, paroxysmal upper ventricular tachycardia), which may reduce the efficacy of the drug.
  1. Do not use together with ethinyl estradiol (a drug for the treatment of acne, hirsutism, contraception, and seborrheic dermatitis), which may reduce the effectiveness of the drug.
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