Health Benefits of Psyllium: Advice from a dietitian

Have you heard that psyllium is good for gut health? Learn more about the health benefits of psyllium fiber, along with how to take it safely, from Desiree Nielsen RD, author of Good For Your Gut, and a gut health dietitian with over a decade of experience.

As a gut health dietitian, I’m all about the magic of eating more high fiber foods. And one of my absolute favourites is psyllium, a fiber supplement that I lovingly refer to as grandma’s magic fairy dust.

Why? Because along with being a digestive remedy for pretty much everyone’s grandma, this incredible plant food provides natural constipation relief while also boosting the gut microbiome. Because it’s a soluble fibre that isn’t overly fermentable, it’s gentle enough for those with compromised digestion, making it one of the only supplements for IBS I recommend. 

I’ve got over a decade of experience supporting people in the digestive health issues, so let me share everything I’ve learned about about psyllium, including dosage, how to use it for constipation and high cholesterol as well as how it stacks up to metamucil and colon broom.

And if you’re looking for more digestive health nutrition, pick up a copy of my book, Good For Your Gut, which contains 100 pages of easy to understand guidance along with over 90 delicious recipes to help you protect, heal and soothe your gut.

Want to skip to the good part? Use this table of contents to get to exactly the information you need.

• What is psyllium?
• Health benefits of psyllium
• How to take psyllium
• Psyllium for constipation and diarrhea
• Side effects and precautions
• Whole psyllium husk vs ground psyllium
• Metamucil vs psyllium
• Colon broom vs psyllium
• Psyllium for lowering cholesterol

What is psyllium?

Psyllium is a natural fiber supplement derived from the plantago ovata plant, a shrub-like herb that originated in Iran and India and is commonly grown across the Mediterranean region. 

Also known as isphaghula, plantago ovata can produce thousands of gel-like seeds on a single plant. It is the husk of these seeds that provide the fiber supplement we call psyllium.

Why psyllium is so dang good for you

Psyllium is used as fiber supplement or natural bulk forming laxative. Psyllium is unique because contains viscous soluble fibre, a type of fibre that most of us don’t get enough of in our diet. Viscous fibers form a gel in the digestive tract that helps to add bulk to the stool, making it easier to pass while also being less irritating to damaged guts like the insoluble fibre from some vegetables or whole grains. 

What’s more, psyllium is a low fermentation fibre, meaning that it’s less likely to cause painful gas and bloating than other types of fibre, making it a great choice for increasing fibre in an irritated gut, like for those with celiac disease or ulcerative colitis.

Even though it is less fermentable, psyllium contains a type of fiber called arabinoxylan, which is a prebiotic associated with boosting the gut microbiome and specifically, improving levels of bacteria that produce a short chain fatty acid called butyrate, which is supports gut and immune health. But there are a couple of different forms of psyllium on the market with very different fiber contents!

• 1 tablespoon (15 ml) of whole psyllium husk (5 grams) contains 3.5 grams of fiber.
• 1 tablespoon (15 ml) of ground psyllium (9 grams) contains about 7 grams of fiber. 

If that doesn’t seem like enough fibre to be effective, remember that it’s a very special fibre so it’s effective even at a smaller dose.

(I took the nutrient data from a common manufacturer (NOW foods) as the Canadian nutrient file does not have a standardized listing for psyllium)

How to take psyllium

When it comes to adding fibre to your diet, you want to start low and build up slowly. Ignore at your own peril! Your gut needs time to adapt to the fibre to avoid side effects such as gas and bloating. The lower in fiber your current diet is, or the more issues you have with your gut, the more you need to heed this advice.

As your fiber intake goes up, you need to drink more water because fibre – especially psyllium fiber – needs water to do its job. Skip the water and it could make you super constipated and miserable.

Because I have always worked with people with very compromised guts, such as those with IBS, celiac disease and Crohn’s disease, I take a conservative approach to psyllium dosage.

Here is exactly what we recommend in practice to our clients:

• Start with 1 teaspoon of psyllium husk (5 mL) a day, in one large glass of water. Stir and drink immediately. 
• After 5 days, if you are tolerating it well, add another 1 teaspoon (5 mL) in water per day. You can do this in one shot, or spread it over two doses if you wish. 
• After 5 days, if you’re tolerating it well, you can add another 1 teaspoon (5 mL) in water per day, to the same dose or as a separate dose, for a total of 1 tablespoon a day.

If you are tolerating psyllium and feeling a bit impatient, you can speed up the increases but I highly recommend that you drink plenty of water. The most important thing is that you are listening to your body.

FYI: I don’t recommend using psyllium capsules, unless you’re traveling, as you have to take A LOT of capsules to get the right dosage.

Don’t loving drinking psyllium in water? You can try it in juice, or just add it to food. Which will not alter its effectiveness. Try adding psyllium to oatmeal, yogurt, overnight oats and even smoothies but remember it gels quickly! Add an extra ½ cup of liquid to your smoothies to accommodate the thickening. If you’re worried about getting the ratio right and solidifying your meal (!), you can also mix your psyllium with 1/4 cup of water first to form a gel, then add the gel to your dish.

Psyllium for constipation and diarrhea

Psyllium is one of my favourite, affordable, options for managing constipation. Because psyllium is a bulk-forming laxative, and NOT a stimulant, it can provide gentle, gradual relief of constipation as well as constipation prevention when taken regularly. 

A 2021 systematic review in the American Journal of Gastroenterology confirms that psyllium can improve symptoms of constipation; however, the research varied widely in dosage and comparison to other laxatives and as a result, it was given a grade B recommendation alongside kiwis and prunes.

If you are SUPER constipated (you go less than 1 a week) take note that adding too much fibre can make you feel worse, not better, if your gut is moving too slowly to clear it. Which is why my slow dosage protocol is important. And you probably want to empty the bowel BEFORE starting fiber therapy.

Psyllium may also help if you have diarrhea, because of its gel-like thickening. It’s a common recommendation for our clients with inflammatory bowel disease like diarrhea-predominant IBS, Crohn’s and Ulcerative colitis who have multiple bowel movements a day to try and bind the stool to provide some relief.

The Canadian Association of Gastroenterology IBS Practice Guidelines recommend psyllium for symptom improvement in IBS, including constipation and diarrhea.

Psyllium may also be beneficial in diverticulitis but must never be used if there is a blockage or narrowing in the intestines. Because psyllium has plenty of health benefits, it’s a great option for those looking to get more fiber into their lives.

FAQ: is it safe to use psyllium everyday?

Yes! Because psyllium is a natural fibre – essentially a food – it is very safe for daily use. However, it is important to keep psyllium separate from any medications you might be on, as it can bind them and lower their effectiveness. Take psyllium 2 hours before medications or 4 hours after medications.

Side effects and precautions

Although psyllium is a low fermentation fibre, it can increase gas and bloating as it relates to bowel movements (mostly constipation) as it adds bulk to the stool. Slowly increasing the dose as tolerated helps minimize this effect.

And be sure to take 2 hours away from medications and supplements as it can bind them and lower their effectiveness. Also, do not take psyllium if you have swallowing problems as it may be a choking risk.

FAQ: what’s the difference between whole psyllium husk and ground psyllium?

Whole psyllium husk is just that: the whole seed husk. Ground psyllium is psyllium husk that has been ground. And the two do behave differently: ground psyllium gels faster and firmer than psyllium husk. So for palatability and ease of use, I typically recommend husk over ground but if you have diarrhea, you might want a stronger gel. Add it to food instead, maybe use it in place of chia seeds to make a quick fruit jam?

Metamucil vs psyllium

Metamucil is simply ground psyllium, with additions (maltodextrin) that make it mix smoothly in water, and some varieties contain colours and sweetener for palatability. 

If it’s easier for you to find metamucil than plain psyllium husk, go for it as it will have the same health benefits of psyllium. I recommend the unsweetened variety.

Colon broom vs psyllium

Colon broom is essentially expensive metamucil. Its main ingredient is ground psyllium, along with naturally-derived colours, flavours and sweeteners. 

As a dietitian, I really hate the way colon broom markets itself as some kind of miracle product. It’s also way too pricey. Just buy plain metamucil or psyllium husk and save your money!

Health benefits of psyllium: cholesterol lowering

Because psyllium is a viscous, soluble fibre, it forms a gel that can bind things in the gut. Once bound, these substances will be carried out of the body in your stool.

One of the substances soluble fiber can bind is bile salts, which your liver makes from cholesterol, to help you absorb dietary fats. When we eat soluble fibre, it helps us eliminate these bile salts in our stool, meaning that our liver then takes more cholesterol from our bloodstream…which is why you may have heard that psyllium is good for lowering cholesterol!

And, the clinical research supports this theory: a 2018 systematic review on the effectiveness of psyllium in reducing cholesterol levels found that psyllium is effective in reducing LDL cholesterol, non-HDL cholesterol and apoB with a median dose of 10 grams daily of psyllium husk daily. And a 2021 umbrella review on the effects of different foods on cholesterol confirms that viscous fibres like psyllium and beta-glucan from oats have a beneficial effect.

Phew! There you have it: everything you could ever possibly need to know about psyllium. Have a question? Drop it in the comments below…and consider sharing this article with someone you think might find it useful!