Psyllium husk has therapeutic effects in hyperlipidemia

+HDL-Cholesterol) described by Delong et al (1986) and Beamount et al (1970)11.Data were expressed as the mean ± SD and “t” test was applied to determine statistical significance as the difference. A probability value of <0.05 was the limit of significance.

RESULTS

Out of 40 patients, 38 completed the over all study period. Two patients withdrew from one group (Psyllium husk group) due to non-compliance of psyllium.They did  complaint about metallic test after taking Psyllium husk. Tables 1, 2, and 3 are showing the results. When results were summed up and test parameters were compared, it was seen that, after 90 days of treatment with Psyllium husk, LDL-Cholesterol decreased from 159.72±5.70 mg/dl to 129.55±2.81 mg/dl, which is highly significant (P<0.001). The overall percentage change from day-0 to day-90 was -18.88, as shown in table no 1. In placebo group at day-0, LDL-Cholesterol level was 150.75±2.67 mg/dl, which decreased to 148.80±2.28 mg/dl, which is non-significant (P>0.05).The overall percentage decrease in the parameter was -1.29.The difference between mean values among placebo group and Niacin group is 17.59, which is highly significant (<0.001)

DISCUSSION

This study proves that significant changes occurred in serum LDL-Cholesterol as a result of administration of Psyllium husk for the period of three months.

LDL- Cholesterol is reduced  18.8% in this period, which is highly significant (<0.001). Our study matches with the study of Anderson et al (1988) who observed almost same changes in LDL- Cholesterol of 26 male patients, treated with 3.4 gm of Psyllium thrice daily for eight weeks. Our study results are in contrast with the study results of Kris-Etherton et al (1999) who observed less percentile changes in lipid profile of hyperlipidemic patients. They observed that Psyllium decreased LDL- Cholesterol 10.2% in 70 male patients when treatment period was 4 weeks. This contrast may be due to increased sample size and lesser duration of treatment in their study. They even saw 1% increase in HDL-Cholesterol in placebo group but by Psyllium treatment HDL-Cholesterol  was decreased upto 0.3%.They did not mention the mechanism by which placebo increased the HDL-Cholesterol and Psyllium has reduced it. They discussed various mechanisms by which Psyllium decreased cholesterol. One of the mechanisms was that Psyllium stimulated bile acid synthesis (7- ?-hydroxylase activity). Second mechanism was diversion of hepatic cholesterol for bile acid production. Effects of Psyllium on absorption of  cholesterol and fat appeared minimal but may  make a small contribution to cholesterol lowering. Additional mechanisms such as inhibition of hepatic cholesterol synthesis by propionate and secondary effects of slowing glucose absorption may also play a role.   

REFERENCES

1. Anderson JW, Davidson MH, Blonde L, et al (2000).Long term cholesterol-lowering effects of Psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia.Am. J. Clin; 71: 1433-8.

2. Beamount JL, Carlson LA, Cooper GR (1970). Classification of hyperlipidemia. Bull. WHO; 43: 891-908.

3. Bell LP, Hectorne K, Reynolds H, Balm TK, Hunninghake DB (1989). Cholesterol lowering effects of Psyllium hydrophilic mucilloid. JAMA; 261; 3419-3423.

4. Delong DM, Delong ER, Wood PD, Lippel K, Rifkind BM (1986). A comparison of methods for the estimation of plasma low and very

5. Edington L, Geekie M, Carter R et al (1987). Effects of dietary cholesterol on plasma cholesterol concentration in subjects following reduced fat, high fiber diet. BMJ; 294: 333-336.

6. Karira KA, Shah SMA, Salahuddin et al (2000). Incidence of lipid disorders in offspring of patients with premature myocardial infarction. Medical Channel; 6: 9-12

7. Kostner GM, Gavish D, Leopold B, Bolzano K, Weintraub MS, Breslow JL (1989). HMG-CO A reductase inhibitors lower LDL cholesterol without reducing LP (a) levels.

8. Kris-Etherton PM, Pearson TA, Wan Y et al (1999). High mono-unsaturated fatty acids diet lower both plasma cholesterol and triglycerol concentration. Am. J. Clin. Nutr; 70: 1009-1015.

9. Mayes PA, (1993). Cholesterol synthesis, transport and excretion. In: Harper’s Biochemistry. Murray RK, Granner DK, Mayes PA, Rodwell VW. Eds. (23rd edition) Appleton and Lange, Connecticut,pp. 266-278.

10. Memon MA (2001). Efficacy, safety and tolerability of Psyllium hydrophilic mucilloid in mild to moderate hypercholesterolemia. Medical Channel; 7: 37-40.

11. Spence JD, Huff MW, Heidenheim P, et al (1995). Combination therapy with colestipol and Psyllium mucilloid in patients with hyperlipidemia. Ann. Intern. Med: 123; 493-499.

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