Guggulipid
Scientific Names: Commiphora mukul Other Common Names: Gum guggul, gugguulu Overall Safety: 🙂
Therapeutic Efficacy and Considerations:
Hyperlipidemia: 😐 Evidence for treatment of hyperlipidemia is conflicting; although a multitude of small-to-medium size studies conducted in India demonstrated consistent reduction of lipid levels, a high-quality study in American patients did not demonstrate benefit. At this point, the evidence does not support efficacy in patients on standard American diets. However, as guggulipid has a favorable side effect profile, patients who wish to try it in combination with lifestyle modifications do not need to be discouraged. They should be counseled to use a standardized extract product rather than gum guggul. Dose: 75-100 mg guggulsterone daily in 2-3 divided doses.
Osteoarthritis: 😐 Preliminary evidence from case studies with a specialized extract of guggul indicates that guggulipid may have benefit to reduce osteoarthritis symptoms. Currently, the evidence does not support use in this indication. Dose: 17.5 mg guggulsterones TID.
Obesity: 🙁 One moderately sized trial demonstrated no benefit for guggulipid and a diet and exercise program over placebo and the same diet and exercise program. Use for this indication is not recommended. daily in 2-3 divided doses.
Osteoarthritis: 😐 Preliminary evidence from case studies with a specialized extract of guggul indicates that guggulipid may have benefit to reduce osteoarthritis symptoms. Currently, the evidence does not support use in this indication. Dose: 17.5 mg guggulsterones TID.
Obesity: 🙁 One moderately sized trial demonstrated no benefit for guggulipid and a diet and exercise program over placebo and the same diet and exercise program. Use for this indication is not recommended.
Chemistry/Pharmacology: “Guggul” refers to an extract of resin from the Commiphora mukul tree, while “guggulipid” refers to an ethyl acetate extract of the resin. Guggulsterones are ketonic steroids and the primary active ingredients. They decrease hepatic lipid synthesis, perhaps by antagonizing the Farnesoid X receptor. Guggulipid may increase T3 by increasing conversion from T4 and may or may not affect coagulation.
Drug Interactions: Thyroid supplements. Guggul may decrease/slow absorption of many drugs including beta-blockers and calcium channel blockers, therefore, separation of doses is recommended.
Contraindications/Precautions: Pregnancy (due to emmenagogic and abortifacient effects), thyroid supplements (may interfere with TSH monitoring). Use caution with anticoagulant therapies.
Adverse Effects: Generally, well tolerated. For gum guggul: hiccups, menstrual irregularities, rash, diarrhea, restlessness, headache, GI distress, belching, bloating. One case report of rhabdomyolysis after guggul gum resin for 2 weeks. Guggulipid extract may cause epigastric fullness. Hypersensitivity skin reactions at doses of >3 grams/day of guggulipid.
