What is it?
Black psyllium is a weed that grows aggressively throughout the world. The plant was spread with the colonization of the New World and was nicknamed "Englishman's foot" by the North American Indians. People use the seed to make medicine. Be careful not to confuse black psyllium with other forms of psyllium including blond psyllium.
Black psyllium is used for chronic constipation and for softening stools in conditions such as hemorrhoids, cracks in the skin around the anus (anal fissures), surgery on the rectum, and pregnancy. It is also used for diarrhea, dysentery, irritable bowel syndrome (IBS), reducing high cholesterol, and treating cancer.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for BLACK PSYLLIUM are as follows:
- Constipation. Black psyllium works as a bulk laxative and reduces constipation.
Possibly effective for...
- Improving high cholesterol.
Insufficient evidence to rate effectiveness for...
- Irritable bowel syndrome (IBS).
- Other conditions.
More evidence is needed to rate the effectiveness of black psyllium for these uses.
Black psyllium adds bulk to the stool which might help with constipation, diarrhea, and irritable bowel syndrome. It also increases the elimination of cholesterol from the body before it can be absorbed and enter the bloodstream.
Black psyllium, when taken with enough water, is safe for most people. Mild side effects include bloating and gas. In some people, black psyllium can cause allergic reactions such as runny nose, red eyes, rash, and asthma. Black psyllium might lower blood sugar. If you have diabetes, check your blood sugar carefully.
Be sure to take black psyllium with plenty of water. Otherwise, you might choke. The concern is so important that the U.S. Food and Drug Administration (FDA) requires that psyllium be labeled: "WARNING: Taking this product without adequate fluid may cause it to swell and block your throat or esophagus and may cause choking. Do not take this product if you have difficulty in swallowing. If you experience chest pain, vomiting, or difficulty in swallowing or breathing after taking this product, seek immediate medical attention.”
Black psyllium seeds contain a substance that can cause kidney damage. Commercial preparations of black psyllium usually have this substance removed. Do not use black psyllium seeds unless they have had special processing to make them less toxic.
Special precautions & warnings:
Pregnancy and breast-feeding: Taking black psyllium during pregnancy or breast-feeding seems to be safe, as long as enough water is taken with the dose.
Diabetes: Black psyllium can lower blood sugar levels in people with type 2 diabetes by slowing down absorption of carbohydrates. Monitor blood glucose levels closely if you have diabetes and use black psyllium. Doses of your medications for diabetes may need to be adjusted. On the other hand, some black psyllium products can contain added sugars and other carbohydrates that might increase blood sugar levels. Check labels for added sugar, and again, be sure to monitor your blood sugar levels.
Intestinal problems: Don’t use black psyllium if you have impacted stools, a complication of constipation in which the stool hardens in the rectum and can’t be moved by usual movement of the bowel. Don’t use black psyllium if you have a condition called gastrointestinal (GI) atony, narrowing of the GI tract, bowel blockage or conditions that can lead to bowel blockage such as spastic bowel. The concern is that when black psyllium absorbs water and swells up, it might block the GI tract in people with these types of conditions.
Allergies: Some people are severely allergic to black psyllium. This is more likely to happen to people who have been exposed black psyllium on the job. These people shouldn’t use black psyllium.
Phenylketonuria: Some black psyllium products might be sweetened with aspartame (Nutrasweet). If you have phenylketonuria, avoid these products.
Surgery: Because black psyllium might affect blood sugar levels, there is a concern that it might interfere with blood sugar control during and after surgery. Stop using black psyllium at least 2 weeks before a scheduled surgery.
Swallowing disorders: People who have trouble swallowing might be more likely to choke on black psyllium. If you have a swallowing problem, don’t use black psyllium.
Be cautious with this combination.
Black psyllium contains large amounts of fiber. Fiber can decrease how much carbamazepine (Tegretol) the body absorbs. By decreasing how much carbamazepine (Tegretol) the body absorbs, black psyllium might decrease the effectiveness of carbamazepine (Tegretol).
Black psyllium is high in fiber. Fiber can decrease the absorption and decrease the effectiveness of digoxin (Lanoxin). As a general rule, any medications taken by mouth should be taken one hour before or four hours after black psyllium to prevent this interaction.
Black psyllium contains large amounts of fiber. Fiber can decrease how much lithium the body absorbs. Taking lithium along with black psyllium might decrease the effectiveness of lithium. To avoid this interaction, take black psyllium at least 1 hour after lithium.
Medications for diabetes (Antidiabetes drugs)
Black psyllium might decrease blood sugar by decreasing how much sugar your body absorbs from foods. Diabetes medications are also used to lower blood sugar. Taking black 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.
There are no known interactions with herbs and supplements.
Taking black psyllium with meals over a long period of time might interfere with nutrient absorption. In some cases, taking vitamins or mineral supplements might be necessary.
The following doses have been studied in scientific research:
- As a laxative for constipation: The typical dose of black psyllium seed is 10-30 grams per day in divided amounts. Mix 10 grams of seed in 100 mL water, and then drink at least another 200 mL of water. It's important to take enough water. Otherwise, black psyllium might cause choking. Take at least 150 mL water for each 5 grams of black psyllium. The FDA labeling recommends at least 8 ounces (a full glass) of water or other fluid with each dose.
Avoid chewing or crushing the seeds. This can release a chemical that builds up in the kidneys.
Black psyllium should be taken 30-60 minutes after eating a meal or taking other drugs.
Brown Psyllium, Dietary Fiber, Fibre Alimentaire, Fleaseed, Fleawort, French Psyllium, Graine de Psyllium, Herbe aux Puces, Œil-de-Chien, Plantain, Plantago psyllium, Plantain, Plantain Pucier, Psyllion, Psyllios, Psyllium, Psyllium afra, Psyllium arenaria, Psyllium Brun, Psyllium d’Espagne, Psyllium indica, Psyllium Noir, Psyllium Seed, Pucière, Pucilaire, Spanish Psyllium, Zaragatona.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).
To see all references for the Black psyllium page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/97.html.
- Frati Munari AC, Benitez Pinto W, Raul Ariza Andraca C, Casarrubias M. Lowering glycemic index of food by acarbose and Plantago psyllium mucilage. Arch Med Res 1998;29:137-41.
- Kaplan MJ. Anaphylactic reaction to "Heartwise." N Engl J Med 1990;323:1072-3.
- Shulman LM, Minagar A, Weiner WJ. Perdiem causing esophageal obstruction in Parkinson's disease. Neurology 1999;52:670-1.
- Schneider RP. Perdiem causes esophageal impaction and bezoars. South Med J 1989;82:1449-50.
- Lantner RR, Espiritu BR, Zumerchik P, Tobin MC. Anaphylaxis following ingestion of a psyllium-containing cereal. JAMA 1990;264:2534-6.
- Wolever TM, Vuksan V, Eshuis H, et al. Effect of method of administration of psyllium on glycemic response and carbohydrate digestibility. J Am Coll Nutr 1991;10:364-71.
- Freeman GL. Psyllium hypersensitivity. Ann Allergy 1994;73:490-2.
- Vaswani SK, Hamilton RG, Valentine MD, Adkinson NF. Psyllium laxative-induced anaphylaxis, asthma, and rhinitis. Allergy 1996;51:266-8.
- Suhonen R, Kantola I, Bjorksten F. Anaphylactic shock due to ingestion of psyllium laxative. Allergy 1983;38:363-5.
- Anderson JW, Allgood LD, Turner J, et al. Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr 1999;70:466-73.
Agha FP, Nostrant TT, Fiddian-Green RG. Giant colonic bezoar: a medication bezoar due to psyllium seed husks. Am J Gastroenterol 1984;79:319-21.
- Perlman BB. Interaction between lithium salts and ispaghula husk. Lancet 1990;335:416.
- Etman M. Effect of a bulk forming laxative on the bioavailablility of carbamazepine in man. Drug Dev Ind Pharm 1995;21:1901-6.
- Cook IJ, Irvine EJ, Campbell D, et al. Effect of dietary fiber on rectosigmoid motility in patients with irritable bowel syndrome: A controlled, crossover study. Gastroenterology 1990;98:66-72.
- Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. 2nd ed. New York, NY: John Wiley & Sons, 1996.
- The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
- Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
- Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
- Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.
- Show more references
- Show fewer references
Last reviewed - 09/14/2012
This copyrighted, evidence-based medicine resource is provided by Natural Medicines Comprehensive Database Consumer Version. Natural Medicines Comprehensive Database disclaims any responsibility related to consequences of using any product. This monograph should not replace advice from a healthcare professional and should not be used for the diagnosis or treatment of any medical condition.
Copyright © 1995 - 2013 Therapeutic Research Faculty
, publishers of Natural Medicines Comprehensive Database
, Prescriber’s Letter
, Pharmacist’s Letter
. All rights reserved. For scientific data on natural medicines, professionals may consult the Professional Version of Natural Medicines Comprehensive DatabaseNatural Medicines Comprehensive Database (http://www.naturaldatabase.com/)