Guggul
Commiphora mukulGuggul, the sticky gum resin from the mukul myrrh tree, plays a major role in Ayurveda , the traditional herbal medicine of India. It was traditionally combined with other herbs for the treatment of arthritis, skin diseases, pains in the nervous system, obesity, digestive problems, infections in the mouth, and menstrual problems.
What Is Guggul Used for Today?
Based on preliminary studies, guggul has become a popular herbal treatment for high cholesterol . 2-5 However, the best-designed trial failed to find benefit.
Other potential uses of guggul have no more than minimal supporting evidence. One small study hints that guggul might be helpful for acne . 6 In addition, a study in mice found potential anti-diabetic effects. 7
Recently, guggul has been promoted as a weight-loss agent. Supposedly, it works by enhancing thyroid function. However, there is little evidence that guggul actually affects the thyroid, and one small double-blind, placebo-controlled trial failed to find it effective for weight loss. 8
What Is the Scientific Evidence for Guggul?
High Cholesterol
Three double-blind studies performed in India found evidence that guggul can reduce cholesterol levels. However, the largest placebo-controlled study failed to find benefit.
One of the positive placebo-controlled studies enrolled 61 individuals and followed them for 24 weeks. 9 After 12 weeks of following a healthy diet, half the participants received placebo and the other half received guggul at a dose providing 100 mg of guggulsterones daily. The results after 24 weeks of treatment showed that the treated group experienced an 11.7% decrease in total cholesterol, along with a 12.7% decrease in LDL ("bad" cholesterol), a 12% decrease in triglycerides, and an 11.1% decrease in the total cholesterol/HDL ("good" cholesterol) ratio. These improvements were significantly greater than what was seen in the placebo group.
Similar results were seen in a double-blind, placebo-controlled trial of 40 individuals. 10
A double-blind study of 228 individuals given either guggul or the standard drug clofibrate found approximately equal efficacy between the two treatments. 11 However, the absence of a placebo group makes these results less than reliable.
In contrast to these results, a double-blind, placebo-controlled study of 103 people failed to find guggul effective at a dose of 75 mg or 150 mg of guggulsterones daily. 15 In fact, the herb seemed to worsen levels of LDL ("bad") cholesterol. The reason for this discrepancy is not clear.
Acne
A small controlled trial compared oral gugulipid (50 mg of guggulsterones twice daily) against tetracycline for the treatment of acne and reported equivalent results. 6 Unfortunately, the study report does not state whether this trial was double-blind, and it also lacked a placebo group. (For information on why this matters, see Why Does This Database Rely on Double-blind Studies? )
Dosage
Guggul is manufactured in a standardized form that provides a fixed amount of guggulsterones, the presumed active ingredients in guggul. The typical daily dose should provide 100 mg of guggulsterones.
Safety Issues
In clinical trials of standardized guggul extract, no significant side effects other than occasional mild gastrointestinal distress or allergic skin rashes have been seen. 12,13-15 Lab tests done in the course of these trials did not reveal any alterations in liver or kidney function, blood cell numbers and appearance, heart function, or blood chemistry.
Drugs in the statin family used to reduce cholesterol can cause a potentially serious condition called rhabdomyolysis, in which muscle fibers break down. One case report hints that this could occur with guggul, as well. 16
Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established.
References
1. Satyavati GV. Gum guggul ( Commiphora mukul )—the success story of an ancient insight leading to a modern discovery. Indian J Med Res . 1988;87:327-335.
2. Nityanand S, Srivastava JS, Asthana OP. Clinical trials with gugulipid. A new hypolipidaemic agent. J Assoc Physicians India . 1989;37:323-328.
3. Agarwal RC, Singh SP, Saran RK, et al. Clinical trial of gugulipid—a new hyperlipidemic agent of plant origin in primary hyperlipidemia. Indian J Med Res . 1986;84:626-634.
4. Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther . 1994;8:659-664.
5. Verma SK, Bordia A. Effect of Commiphora mukul (gum guggulu) in patients of hyperlipidemia with special reference to HDL-cholesterol. Indian J Med Res . 1988;87:356-360.
6. Thappa DM, Dogra J. Nodulocystic acne: oral gugulipid versus tetracycline. J Dermatol . 1994;21:729-731.
7. Subramaniam A, Stocker C, Sennitt MV, et al. Guggul lipid reduces insulin resistance and body weight gain in C57B1/6 lep/lep mice [abstract]. Int J Obes Relat Metab Disord . 2001;25(suppl 2):S24.
8. Antonio J, Colker CM, Torina GC, et al. Effects of a standardized guggulsterone phosphate supplement on body composition in overweight adults: a pilot study. Curr Ther Res . 1999;60:220-227.
9. Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther . 1994;8:659-664.
10. Verma SK, Bordia A. Effect of Commiphora mukul (gum guggulu) in patients of hyperlipidemia with special reference to HDL-cholesterol. Indian J Med Res . 1988;87:356-360.
11. Nityanand S, Srivastava JS, Asthana OP. Clinical trials with gugulipid. A new hypolipidaemic agent. J Assoc Physicians India . 1989;37:323-328.
12. Nityanand S, Srivastava JS, Asthana OP. Clinical trials with gugulipid. A new hypolipidaemic agent. J Assoc Physicians India . 1989;37:323-328.
13. Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther . 1994;8:659-664.
14. Agarwal RC, Singh SP, Saran RK, et al. Clinical trial of gugulipid—a new hyperlipidemic agent of plant origin in primary hyperlipidemia. Indian J Med Res . 1986;84:626-634.
15. Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the treatment of hypercholesterolemia: a randomized controlled trial. JAMA . 2003;290:765-72.
16. Bianchi A, Cantu P, Firenzuoli F, et al. Rhabdomyolysis caused by Commiphora mukul, a natural lipid-lowering agent. Ann Pharmacother . 2004;38:1222-5.
Last reviewed April 2009 by EBSCO CAM Review Board
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