Zeitschrift für Phytotherapie 2008; 29 - V37
DOI: 10.1055/s-2008-1047842

Cholesterol reduction using psyllium husks – Do gastrointestinal adverse effects limit compliance? Results of a specific observational study

B Uehleke 1, M Ortiz 1, R Stange 1
  • 1Department for Natural Medicine, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Immanuel Hospital, Berlin, Germany

Purpose

Despite known cholesterol lowering effects the use of psyllium husk (Plantaginis ovatae testa) in Germany for hypercholesterolemia is limited compared to their use as a laxative. To investigate whether use in hypercholesterolemia is limited due to adverse effects on the gastrointestinal system, a prospective observational study was conducted.

Methods

62 Outpatients with documented hypercholesterolemia and complaints of constipation were identified from an academic clinical center. Treatment with 3.5g psyllium husk preparation administered three times daily was initiated and patients were monitored at weekly intervals. Gastrointestinal symptoms were quantified using a validated Nepean Dyspepsia Index modified to identify both upper and lower abdominal symptoms. Diaries and study medication records were used to evaluate compliance.

Results

54 of 62 patients enrolled in the study completed the study protocol with 4 subjects discontinuing due to adverse reactions associated with psyllium husks. Total cholesterol was significantly decreased from 252±39mg/dL before treatment to 239±37mg/dL after 3 weeks of treatment. Similarly, low density lipoprotein (LDL)-cholesterol decreased from 174±34mg/dL to 162±31mg/dL during the study. Triglycerides and HDL (high density lipoprotein) were unchanged. Gastrointestinal symptoms were rated lower at the end than at begin of the study. In week 1 most of the patients reported gastrointestinal symptoms and also gastrointestinal adverse reactions, which however, showed a decrease from week 1 to weeks 2 and 3 in the diaries. Patient response to study medication was positive for patients completing the study.

Conclusions

Psyllium husk preparations may be a therapeutic option for patients with mild to moderately elevated cholesterol levels. Adverse gastrointestinal symptoms associated with the preparation appear to be transient in some of the patients. Compliance may be optimized with adequate patient counseling.