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Gum Guggul Extract and Cholesterol
Gum guggul is one of the oldest herbal remedies for lowering blood cholesterol. Experts believe that this cholesterol-lowering effect is due to the guggulsterones in the herb. However, many Western studies have failed to find any benefits for using cholesterol in the treatment of hypercholesterolemia. In contrast, Indian studies have consistently found such benefits. What is responsible for this sharp contrast between the results of Western and Indian studies? Read on to find out.
by Brad Chase
Gum guggul is the sap or gum resin from the Indian tree known as guggul or mukul myrrh tree (Commiphora wightii).
This tree grows in the semi-arid parts of Northern India. Because of its extensive use in Indian traditional medicine, the guggul tree is now listed as an endangered species.
Gum guggul is a yellow resinous sap used in Ayurveda medicine to treat constipation, rheumatism, arthritis, sciatica and obesity. This gum is also known as guggulipid and it is also used to make incense and perfumes because its fragrance is close to that of myrrh.
Interest in the cholesterol-lowering potential of gum guggul began in the 1960s when a group of Indian archeologists found an ancient Sanskrit text describing the use of the resin in the treatment of a disease characterized by the hardening of the arteries.
Since this discovery, there have been several studies investigating the effects of gum guggul on cholesterol especially in India where the herb was approved for treating hyperlipidemia and reducing the risks of cardiovascular diseases in 1986.
Besides lowering blood cholesterol levels, studies have also proven that gum guggul is useful in the treatment of acne and arthritis.
In addition, it can stimulate increased production of thyroid hormones, promote weight loss and also boost immunity.
These studies also show that gum guggul supplementation is safe and recommended for long-term use.
Common side effects of gum guggul are headache, nausea, vomiting, diarrhea, hiccups, allergic skin reactions and stomach upset. At high doses (higher than 500 mg per day), gum guggul can cause itching and rash not related to allergy.
A review of studies investigating the hypolipidemic benefits of gum guggul show that the herb can reduce cholesterol levels by 14 – 27% and lower triglycerides by 22- 30%.
In addition, gum guggul can increase HDL (high-density lipoprotein or “good”) cholesterol level by as much as 16%.
While the exact mechanism by which gum guggul lowers cholesterol is still up for debate, most experts believe that the herb increases the breakdown of cholesterol in the liver and its excretion from the body along with bile.
In addition, earlier studies suggested that guggulsterone, a steroid extracted from gum guggul, was responsible for the cholesterol-lowering properties of this herb.
However, a few recent studies showed that giving guggulsterone extracts to people with hyperlipidemia did not lower total cholesterol nor LDL (low-density lipoprotein or “bad”) cholesterol levels.
This may mean that there are other bioactive compounds in gum guggul responsible for its effects on cholesterol and lipoproteins. Alternatively, it could be that the guggulsterone extracts used in such studies are lacking some key guggulsterone fractions.
During the preparation of guggul extract, the herb is separated into gum and resin using solvent extraction. While the gum is mostly made up of insoluble carbohydrates, the resin has medicinal (chiefly anti-inflammatory and lipid-lowering) properties.
Upon further extraction, the gum guggul resin is separated into neutral, acidic and basic fractions.
The acidic fraction is responsible for the herb’s anti-inflammatory effect while the neutral fraction produces the lipid-lowering effects. The basic fraction has no therapeutic activity.
The lipid-lowering extract of gum guggul is also known as guggulipid. Guggulipid contains a mixture of guggulsterones, other steroids, diterpene, esters and alcohols.
Through these mechanisms, gum guggul significantly lowers serum triglycerides and total cholesterol levels especially the levels of LDL and VLDL (very low-density lipoprotein) cholesterol.
Not all studies agree that gum guggul can lower cholesterol levels. In fact, a few concluded that this herb can indeed raise the level of LDL cholesterol. One such study was published in the Journal of the American Medical Association in 2003.
In that study, the researchers investigated the lipid-lowering effects of 2 different doses of standardized guggul extract (containing 2.5% guggulsterones) on 103 healthy adults with high cholesterol levels.
These participants were divided into 3 groups. One group received 1000 mg of guggulipid while the second group got 2000 mg of the same guggul extract. The third group received placebo.
For 8 weeks, the participants received these doses of the extract or placebo 3 times daily.
At the end of the study, the results showed that while placebo slightly reduced the levels of LDL cholesterol, both doses of guggul extract slightly raised the level of that lipoprotein. In addition, the researchers found that the levels of total cholesterol, VLDL cholesterol, triglycerides and HDL cholesterol remained unchanged.
A 2009 study published in the journal, Complementary Therapies in Medicine, only provided partial support for the cholesterol-lowering activities of gum guggul.
In that study, 43 adults with moderately high cholesterol levels were given 2160 mg of guggul extract daily or placebo for 12 weeks. At the end of the study, the results showed that the participants receiving guggul extract had lower total cholesterol and HDL cholesterol than the placebo group.
In addition, the results showed that the levels of LDL cholesterol and triglycerides remained unchanged.
The researchers recognized that gum guggul affects cholesterol levels but recommended larger and longer studies to establish the efficacy and safety of gum guggul in the treatment of hypercholesterolemia.
A 2005 review of past studies published in the same journal had failed to find strong evidence to recommend gum guggul for lowering cholesterol levels. This review concluded that some studies confirmed the lipid-lowering benefits of gum guggul but others failed to find such benefits.
In fact, the best support for the cholesterol-lowering effects of gum guggul comes from Indian studies.
This curious fact has led many to believe that the difference between the outcomes of Indian and Western studies was due to diet.
One example of such Indian studies was published in the journal, Cardiovascular Drugs and Therapy, in 1994. In that study, 61 patients with hypercholesterolemia were given either 50 mg guggulipid or placebo twice daily for 24 weeks.
The results of the study showed that gum guggul
By continuing the guggulipid supplementation for another 12 weeks, the researchers determined that the lipid-lowering effect of gum guggul was similar to that of prescription cholesterol drugs after 36 weeks.
In addition, the benefits of gum guggul were lost after stopping supplementation for 12 weeks.
Such compelling results and the fact that the last 12-week washout period reversed the effects of gum guggul provide very strong support for recommending gum guggul in the treatment of hypercholesterolemia.
In a 2007 study published in the journal, Cardiovascular Therapeutics, the author provided an excellent summary of gum guggul research. The paper detailed the history of gum guggul in the treatment of hyperlipidemia from the first study in 1966 suggesting its lipid-lowering benefits.
The paper also explained that the varying results from past studies were due to differences in how these studies were designed, carried out and analyzed.
After removing bias and correcting for experimental errors, the author concluded that an analyses of these studies showed gum guggul can indeed lower cholesterol levels.
Besides the lipid-lowering effect of guggul extract, the review identified the herb’s anti-inflammatory and antioxidant properties as especially useful for improving cardiovascular health.
The review also provided the details of one study involving 200 patients suffering from chest pain and ischemic heart disease with abnormal electrocardiogram (ECG). After taking guggul extracts for 6 months, the levels of total cholesterol, triglycerides and lipid lipoproteins were reduced.
In addition, the ECG readings of 26% of the patients were normalized while the ECG readings of another 59% significantly improved.
This result showed that the anti-inflammatory and lipid-lowering effects of guggul extract can provide cardiovascular benefits for patients with heart disease.
The antioxidant guggulsterones in gum guggul stimulate the release of antioxidant enzymes such as superoxide dismutase while inhibiting oxidizing enzymes such as xanthine oxidase. As an anti-inflammatory agent, guggulsterone blocks necrosis factors such as NF-kappaB and TNF-alpha as well as interleukins such as IL-1beta.
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