Psyllium husk — or psyllium powder, which is simply the ground-up husks — comes from the seeds of the herb _Plantago ovata_, and is usually sold as a fiber supplement, but it also acts as a bulk-forming laxative. If you're going to take a laxative, psyllium is one of the simplest and shows promise for providing a few other health benefits too. But if you find yourself taking psyllium daily over the long term, you should probably have a chat with your doctor.
You should consult with your doctor if you find yourself needing psyllium husk every day. It's recommended that you limit your use of the fiber supplement to no longer than one week.
Where to Find Psyllium Husk
Psyllium husk comes in several forms, including powder, capsules and chewable wafers; you'll find it in the pharmacy or over-the-counter medicine sections of most supermarkets and almost every health food or supplement store. With that said, it isn't always labeled as psyllium. For example, the popular fiber/laxative supplement Metamucil is actually psyllium husk. You may also see psyllium sold under such brand names as Cilium, Alramucil, Genfiber, Maalox Daily Fiber Therapy and Hydrocil.
Did you know? Psyllium may also be sold as ispaghula husk or labeled as blond psyllium.
How Psyllium Husk Works
When you take psyllium, you must drink at least 8 ounces of liquid along with the supplement. All that liquid does two things: First, it allows the psyllium husk to absorb water and "plump" in your intestines, forming a bulky stool that's easy to pass. That's what differentiates a bulk-forming laxative like psyllium from a stimulant laxative such as _cascara sagrada_, which triggers muscular contractions to move stool through your intestines.
Second, the liquid helps prevent the psyllium husk from forming a blockage in your intestines or simply increasing constipation instead of helping it — two of the biggest potential side effects of a bulk-forming laxative such as psyllium.
Speaking of blockages: If you have a history of intestinal blockage, rectal bleeding or trouble swallowing, you should talk to your doctor before taking psyllium husk supplements.
The Long-Term Side Effects of Laxatives
Although fiber supplements like psyllium are some of the gentlest laxatives you can take, Medline Plus still recommends that you don't take psyllium for more than a week unless your doctor tells you to.
Why the limited duration? There are two reasons. First, if you need to take a laxative for extended periods of time, it may signal a less-obvious problem that would benefit from a doctor's attention. Second, as gentle as psyllium husk fiber is, all laxatives bring with them some risk of side effects, such as interacting with medications or complicating medical conditions such as appendicitis or bowel obstructions.
Your doctor can help you anticipate or deal with such side effects — but only if you talk to him about what you're taking.
Potential Hazards of Psyllium Husk
Aside from the risk of intestinal blockage, psyllium husk can also interact with some medications. Medline Plus warns that you shouldn't take digoxin, salicylates or nitrofurantoin within three hours of taking psyllium, while the Linus Pauling Institute also warns that psyllium can reduce absorption of several medications, including lithium, warfarin and carbamazepine, if you take the medications and psyllium at the same time.
Both of these warnings are excellent examples of why you should always check in with your doctor before adding any new supplements to your regimen, even something as innocuous as psyllium.
Fiber supplements, such as psyllium husk, can also affect blood sugar levels, so make sure you speak with your doctor if you have diabetes. Although psyllium has been shown to have some benefit in lowering cholesterol, if you have a history of heart disease, high blood pressure or kidney disease, you should speak to your doctor before taking psyllium.
Although psyllium is considered very safe, Medline Plus warns of several possible side effects that would require you to call your doctor immediately. These include difficulty breathing, stomach pain, difficulty swallowing, skin rash, and nausea and vomiting.
Before You Take Psyllium Daily
Before you start taking a fiber powder like psyllium every day, take a moment and consider what's prompting you to do so. If you routinely struggle with constipation, the Mayo Clinic notes that sometimes simple lifestyle changes, such as adjusting your diet to include fiber-rich foods, drinking plenty of water and exercising regularly, may be all it takes to eliminate constipation.
How do you know if you're constipated? Normal bathroom habits can range anywhere from three bowel movements a day to three bowel movements a week, so what qualifies as "constipation" for one person might just be normal for another person. The best definition of constipation is if you're having notably fewer bowel movements than is typical for you.
Psyllium Husk for Cholesterol
Constipation isn't the only reason you might be looking into taking a supplement like psyllium daily. There's a growing body of evidence to show that taking psyllium husk regularly can improve your cholesterol profile too.
In a 2018 meta-analysis published in the American Journal of Clinical Nutrition, researchers performed a systematic review of 28 clinical trials and found that taking psyllium fiber significantly reduced LDL cholesterol levels.
In light of such results, it may be tempting to take psyllium husk long term for its cholesterol benefits. But remember that if you have a cholesterol condition that requires this sort of treatment, you should consult your physician. That goes doubly if you're on any medication, which, as innocuous as it is, psyllium can still interact with.
Other Benefits of Psyllium Husk
In a 2019 trial published in the journal Clinical Nutrition ESPEN, researchers found that psyllium not only decreased constipation symptoms, it also helped with weight loss and improved the patients' cholesterol levels. However, the same study also found that flaxseed appeared to be even more effective in every measure.
Increased fiber intake — whether through diet or through viscous fiber supplements like psyllium — is also widely recognized to improve blood sugar control in individuals with Type 1 or Type 2 diabetes. Along somewhat similar lines, a 2016 study published in the journal Appetite noted that psyllium fiber was effective at reducing feelings of hunger and the desire to eat between meals, which in turn may help with weight control.
Also interesting is the revelation, published in a 2019 issue of the International Journal of Molecular Sciences, that using psyllium husk creates significant changes in intestinal microbes, more so if you're constipated when you take the psyllium — although it's not entirely clear what the ultimate effects of those changes may be.
And finally, a 2017 randomized, double-blind trial published in the journal Clinical Gastroenterology and Hepatology showed that taking psyllium fiber produced a notable decrease in pain for children with irritable bowel syndrome.
- Linus Pauling Institute: Fiber
- MedlinePlus: Psyllium
- Harvard Heart Letter: Psyllium Fiber: Regularity and Healthier Lipid Levels?
- American Journal of Clinical Nutrition: Effect of Psyllium Fiber on LDL Cholesterol and Alternative Lipid Targets
- Mayo Clinic: Over-the-Counter Laxatives for Constipation: Use With Caution
- Clinical Nutrition ESPEN: Effect of Flaxseed or Psyllium vs. Placebo
- International Journal of Molecular Sciences: The Effect of Psyllium Husk on Intestinal Microbiota in Constipated Patients and Healthy Controls
- Clinical Gastroenterology and Hepatology: Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome
- Metamucil: Original Coarse Powder
- Appetite: Satiety Effects of Psyllium in Healthy Volunteers