Guggul

Generic name: Commiphora Mukul Hook. Ex Stocks., Commiphora Wightii (Arn.) Bhandari
Brand names: Guggal, Guggul, Guggulu, Gugulipid, Gum Guggal, Gum Guggulu, Indian Bdellium, Indian Myrrh

Usage of Guggul

Acne

One small study has shown guggulsterone to be as effective as tetracycline in the treatment of nodulocystic acne.(55) In vitro antibacterial effects have been described.(16)

Anti-inflammatory effects

Down-regulation of the expression of inflammatory mediators, including interleukins, transcription factors and cytokines, and hyaluronidase and collagenase enzymes have been demonstrated for extracts of C. mukul.(4, 14, 15, 16, 17, 18)

Animal data

Extracts of the plant have anti-inflammatory action and inhibit carrageenan-induced rat paw edema in animal models. Guggul was as effective as phenylbutazone and ibuprofen in an animal model of acute and chronic inflammation.(11, 19, 20, 21)

In mice with induced colitis, guggulsterone decreased the severity of the inflammatory disease.(16, 22) In rats with induced uveitis, guggulsterone demonstrated a protective effect against inflammatory mediators.(23)

Clinical data

A clinical study conducted in 30 elderly patients with osteoarthritis of the knee showed significant improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scores after taking 500 mg of C. mukul (guggulsterone 3.5%) 3 times daily with food. However, not all outcome measures showed improvement at the 2-month point.(24) Clinical studies in GI inflammatory disease are lacking.

Cancer

Animal data

In vitro studies have evaluated the effect of C. mukul extracts in a wide variety of cancer cell lines, including leukemia, myeloma, and head and neck, lung, breast, ovarian, prostate, skin, and bone cancers.(2, 25, 26, 27, 28, 29, 30, 31, 32, 33) Induction of apoptosis and inhibition of angiogenesis and cell signaling, as well as the down-regulation of transcription factors, have all been demonstrated.

Cardiac effects

Animal data

In rats with isoproterenol-induced ischemia, a hydroalcoholic extract of C. mukul improved cardiac function and prevented myocardial ischemic impairment.(34) Guggulsterone also exerts a protective effect on cardiac enzymes against drug-induced myocardial necrosis.(35)

Clinical data

In an older trial, C. mukul in combination with Inula racemosa (another Ayurvedic botanical) was studied in 200 patients with ischemic heart disease and found to improve electrocardiogram readings and decrease episodes of dyspnea and chest pain.(36) Gum guggul fraction increased fibrinolytic activity and decreased platelet adhesiveness.(37) However, there were no adverse effects on hemodynamic parameters in a safety study.(2)

Dementia

Animal data

Positive effects on neuroinflammation, memory impairment, and dementia-related memory deficit in animal models suggest potential benefits in Alzheimer disease dementia. Effects appear to result from disruption in amyloid protein processing via cholesterol synthesis pathways.(69)

Diabetes

Animal data

In mice with induced diabetes, administration of C. mukul extracts improved glucose tolerance, decreased plasma insulin levels, reduced weight gain, and improved the lipid profile.(38, 39)

Clinical data

Research reveals no clinical trials regarding the use of guggul for diabetes. However, a small trial with 58 adult obese patients demonstrated that diet and guggulu taken over 30 days increased weight loss in patients who weighed more than 90 kg.(40)

Endocrine effects

Animal data

In mice with induced hypothyroidism, coadministration of C. mukul extracts reversed the hypothyroid state and increased triiodothyronine levels in euthyroid animals.(41, 42) In vitro laboratory experiments have shown that guggulsterone is able to bind to mineralocorticoid, glucocorticoid, androgen, and progesterone receptors with either antagonist or agonist action.(43, 44)

Hemorrhoids

A guggul-based kshar sutra ligation was more effective in healing but was less favored than rubber band ligation of hemorrhoids.(56)

Hyperlipidemia

Animal data

Rabbits with induced hyperlipidemia showed decreases of high-density lipoprotein (HDL) and triglycerides after 14 weeks of receiving C. mukul extracts.(45) Studies have shown that the guggulsterones are antagonist ligands for the bile acid receptor farnesoid X receptor, which is activated by bile salts, thus reducing cholesterol.(2, 46)

Clinical data

Limited quality clinical trials have been conducted, with the majority of studies in eastern Indian populations. Reviews of these studies have been published. In most studies, total cholesterol and HDL were reduced. However, in a study conducted in a US population, increases in low-density lipoprotein (LDL) were observed, and case reports of increased LDL with guggul consumption exist. Systematic reviews conducted on herbal medicines used for treatment of cardiovascular conditions, including hyperlipidemia reported the same data for guggul noting reductions as well as increases observed in total and LDL cholesterol, significant decreases in triglycerides, and minor adverse effects.(67, 68) Until larger, long-term quality trials have been conducted and the incidence of adverse events clarified, C. mukul extracts cannot be routinely recommended for the management of hyperlipidemia.(4, 47, 48, 49, 50, 51, 52, 53, 54)

Urinary stones

Studies have demonstrated the ability of C. wightii extracts (synonymous with C. mukul) to inhibit the growth of struvite crystals associated with the development of urinary stone/calculi.(57, 58)

Guggul side effects

While the human safety profile of the extract has not been well described for children, pregnant or breast-feeding women, or patients with severe hepatic or renal disease, little to no adverse events have been reported in clinical studies; the adverse effects were primarily GI-related (diarrhea, nausea) as well as cases of hypersensitivity, possible thyroid problems, headache, hiccough, and rash.2, 4, 48, 52, 61, 67

In a study evaluating the effect of oral guggulipid on hyperlipidemia, moderate to severe generalized cutaneous reactions were noted in 9% of participants, leading to dropouts from the study.62 Case reports exist of acute eczematous reactions to guggul-containing creams.63, 64

A case report exists of rhabdomyolysis in a patient taking an extract of C. mukul 300 mg 3 times daily who was previously sensitized (increased creatine kinase) to lipid-lowering statins.59 A similar case report of increased transaminases exists for a combination preparation containing guggulsterol and red yeast rice extract; however, fungal metabolites found in the red yeast rice extract were suspected to be responsible for the adverse effect because the metabolites are structurally similar to lovastatin. The patient had previously experienced hepatotoxicity while taking lovastatin.65 A case report of hepatotoxicity exists for a combination product (fat burner) that included guggul.66

Before taking Guggul

Information regarding safety and efficacy in pregnancy and lactation is lacking.

How to use Guggul

Clinical trials are lacking to provide dosage guidelines; however, in a US clinical trial in hyperlipidemia, 75 mg to 150 mg of standardized guggulsterones were administered daily.51 1,000 mg capsules containing 21 mg of guggulsterones were used in this study. In a study evaluating the anti-inflammatory effect of guggul, 500 mg of gum guggul was used 3 times daily.24

Various formulations (eg, tablets, capsules, powders) of guggul are available. Guggul and gugulipid are typically standardized to provide a fixed amount, normally 2.5% or 3.5%, of guggulsterones. However, liquid chromatography has shown commercial over-the-counter products contain less or none of claimed guggulsterone content.6, 7, 13 Standardization of herbal products is warranted.

Warnings

Research reveals little information regarding toxicology with the use of guggul. In rats, dogs, and monkeys, no acute, subacute, or chronic toxicity has been reported. No mutagenesis or teratogenicity has been described for gum guggul.2

What other drugs will affect Guggul

Diltiazem: Guggul may decrease the serum concentration of diltiazem. Monitor therapy.(60)

Propranolol: Guggul may decrease the serum concentration of propranolol. Monitor therapy.(60)

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Popular Keywords