Background

Blond psyllium (Plantago ovata) is an herb. Its seed husk is used as a laxative and stool softener and to help reduce cholesterol.

Psyllium seed husks absorb water in the stomach and form a large mass. This mass stimulates the bowel in people with constipation. In people with diarrhea, it can slow down the bowel and reduce bowel movements. This mass can also reduce the amount of cholesterol that is absorbed into the body.

Blond psyllium is commonly used as a stool softener in people with constipation and hemorrhoids. It is also used for diarrhea, irritable bowel syndrome (IBS), high cholesterol, heart disease, and diabetes. It's used for many other conditions, but there is no good scientific evidence to support most of these other uses.

Safety Safety definitions

When taken by mouth: Blond psyllium is likely safe for most people when taken with plenty of fluids. Drink at least 8 ounces of fluids for every 3-5 grams of husk or 7 grams of seed. It might cause gas, stomach pain, diarrhea, constipation, and nausea. Start with a lower dose and increase the dose slowly to reduce the risk for side effects.

Blond psyllium is likely unsafe when taken without enough fluids. It might cause choking or block the gastrointestinal (GI) tract.

When applied into the eye: Blond psyllium mucilage in eyedrops is possibly safe for most people.

When applied to the skin: There isn't enough reliable information to know if blond psyllium is safe or what the side effects might be.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Blond psyllium is likely safe when taken by mouth appropriately when pregnant or breast-feeding.

Growths in the large intestine and rectum (colorectal adenoma): Blond psyllium might increase the risk of new growths in people with a history of colorectal adenoma. People who have had this condition should avoid blond psyllium.

Gastrointestinal (GI) disorders: Don't use blond psyllium if you tend to develop hard stools in the rectum due to GI tract narrowing, obstruction, or conditions that can lead to obstruction, such as spastic bowel.

Allergy: Some people can have severe allergic reactions to blond psyllium. This is more likely in people who have been exposed to blond psyllium at work. Don't use blond psyllium if you are sensitive to it.

Phenylketonuria: Some blond psyllium preparations are sweetened with aspartame and should be avoided in patients with phenylketonuria.

Swallowing disorders: Do not use blond psyllium if you have problems swallowing. Blond psyllium might increase your risk of choking.

Effectiveness

Dosing & administration

Blond psyllium has most often been used by adults in doses of 3-24 grams by mouth daily for up to 20 weeks. Always drink at least 8 ounces of fluids for every 3-5 grams of husk or 7 grams of seed.

Blond psyllium is available in many different types of products, including cereals, breads, and snack bars. Metamucil is a well-studied, commonly used brand of blond psyllium. Speak with a healthcare provider to find out what type of product and dose might be best for a specific condition.

Interactions with pharmaceuticals

Carbamazepine (Tegretol)

Interaction Rating=Moderate Be cautious with this combination.

Blond psyllium contains large amounts of fiber. Fiber can decrease how much carbamazepine the body absorbs. This might decrease the effects of carbamazepine.

Digoxin (Lanoxin)

Interaction Rating=Minor Be watchful with this combination.

Blond psyllium is high in fiber. Fiber can decrease the absorption and decrease the effects of digoxin. To avoid this interaction, take digoxin one hour before or four hours after blond psyllium.

Ethinyl estradiol

Interaction Rating=Minor Be watchful with this combination.

Ethinyl estradiol is a form of estrogen that's in some estrogen products and birth control pills. Psyllium might decrease how much ethinyl estradiol the body absorbs. But this is unlikely to be a big concern.

Lithium

Interaction Rating=Moderate Be cautious with this combination.

Blond psyllium contains large amounts of fiber. Fiber can decrease how much lithium the body absorbs. To avoid this interaction, take blond psyllium at least one hour after lithium.

Medications taken by mouth (Oral drugs)

Interaction Rating=Minor Be watchful with this combination.

Psyllium contains large amounts of fiber. Fiber can decrease, increase, or have no effect on how much medicine the body absorbs. Taking psyllium along with medicine you take by mouth may impact the effects of your medicine. To avoid this interaction, take psyllium 30-60 minutes after medications you take by mouth.

Metformin (Glucophage)

Interaction Rating=Moderate Be cautious with this combination.

Blond psyllium might change how much metformin the body absorbs. This might increase or decrease the effects of metformin. To avoid this interaction, take blond psyllium 30-60 minutes after taking metformin.

Olanzapine (Zyprexa)

Interaction Rating=Moderate Be cautious with this combination.

Blond psyllium contains large amounts of fiber. Fiber can decrease how much olanzapine the body absorbs. This might decrease the effects of olanzapine.

Interactions with herbs & supplements

Iron: Taking blond psyllium with iron supplements can reduce the amount of iron that the body absorbs. To avoid this interaction, take iron supplements one hour before or four hours after psyllium.
Riboflavin: Psyllium seems to slightly reduce the amount of riboflavin that the body absorbs. But this probably isn't a big concern.

Interactions with foods

Taking psyllium can make it difficult to digest fat from the diet. This can increase the amount of fat lost in the stool. Taking psyllium with meals over a long period of time might also affect nutrient absorption. In some cases, it might be necessary to take vitamin or mineral supplements.