Elevated Cholesterol and its treatment is at epidemic proportions in western society. Many of the medications have fairly significant side effects and require liver function monitoring. Gugulipid is an extract from the resin of the mukul myrrh tree. The resin is called gum guggul, hence the name of the active ingredient. Its use dates back to 600 B.C., but clinical studies were only begun in the 1970's. Gugulipid is widely used for treatment of elevated cholesterol in India since the studies to date have been performed in the land where the tree is indigenous flora. The active extracts are E and Z-Guggulsterones, and products sold in India contain a standardized minimum of 50 mg of guggulsterones per gram of gugulipid. The mechanism of action is still uncertain, but it is thought to bind bile acids in the intestine, to stimulate fat busting enzymes, and by inhibiting HMG-CoA reductase enzymes in the liver.
Studies: Four Indian studies totaling about 200 patients from the 80's and 90's showed that on average 70% of the patients lowered their total cholesterol and triglycerides - this compares very well with the results seen in U.S. phamaceutical company studies with prescription medications! The studies were short term and did not all break down the cholesterol into HDL and LDL, only measuring Total Cholesterol. Several other studies have shown increases in HDL from 20-37%!! Recent U.S. Studies HAVE NOT shown similar beneficial results with Guggul, and actually hinted that some takers had worsened lipid profiles! I have been personally disappointed with the lipid lowering benefits in my medical practice and no longer recommend Guggul to my patients!6 Further, this study also reported an incidence of skin rash in study participants that bears keeping in mind.
Side effects: Minimal in most foreign studies - some had bloating, hiccups and upset stomach, but this was no more prominent than in those taking dummy pills (placebo). Skin hypersensitivity and rash was reported in the most recent U.S. study6
Common Doses: In the Indian studies, 25 mg of guggulsterones taken three times daily. Start 1-2 caps three times daily of the most common supplements found in the U.S..
Summary: What was once thought to be a promising treatment for elevated cholesterol has unfortunately not panned out in a recent U.S. study6! More studies are underway, and a synthetic form which is more potent is also under development. On the positive side, Gugulipid is generally less expensive than traditional pharmaceuticals, so that may keep it in the "to consider" category prior to use of prescription medications. Talk with your physician and develop a health improvement plan centered around diet and exercise first.
References:
- Singh RB, et al. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther 1994; 8:659-664.
- Nityanand S, et al. Clinical trials with gugulipid. J Assoc Physicians India 1989; 37(5):323-328.
- Verma SK, Bordi A. Effect of Commiphora mukul (gum gugulu) in patients with hyperlipidemia with special reference to HDL cholesterol. Indian J Med Res 1988;87:356-360.
- Agarwal RC, et al. Clinical trial of gugulipid - a new hypolipidemic agent of plant origin in primary hyperlipidemia. Indian J Med Res 1986;84:626-634.
- Gopal K, et al. Clinical trial of ethyl acetate extract of gum guggulu (gugulipid) in primary hyperlipidemia. J Assoc Physicians India 1986;34(4):249-251.
- Szaparay PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the treatment of hypercholesterolemia. A randomized controlled trial. JAMA 2003; 290:765-72.
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Last revised: June 07, 2004
