Guggul (Commifora mukul)

safety

Allergies:

Avoid in individuals with a known allergy or hypersensitivity to guggul or any of its constituents. Hypersensitivity skin reactions have been noted, in most cases within 48 hours of starting therapy, and resolving spontaneously within one week of therapy discontinuation.

Side Effects and Warnings:

Standardized gugulipid is generally regarded as safe in healthy adults at recommended doses for up to six months. Gastrointestinal upset is the most common adverse effect, as well as diarrhea, nausea, vomiting, burping, and hiccough. Headache, restlessness, and anxiety have been noted in studies. Allergic skin rash (especially at higher doses) has been reported.
Gugulipid has been associated with inhibition of platelets and increased fibrinolysis (blood clot breakdown), and in theory the risk of bleeding may increase.
Although not well studied in humans, weight loss and stimulation of thyroid function may occur.

Pregnancy and Breastfeeding:

Guggul is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

dosing

There is no proven effective dose for guggul in adults. For hyperlipidemia, 500-1,000 milligrams of guggulipid (standardized to 2.5% guggulsterones) taken 2-3 times daily has been used. An equivalent dose of commercially prepared guggulsterone is 25 milligrams three times daily or 50 milligrams twice daily by mouth. A higher dose has been studied (2,000 milligrams three times daily, standardized to 2.5% guggulsterones), although this dose may be associated with a greater risk of hypersensitivity skin reactions. For nodulocystic acne, dose of guggulipid equivalent to 25 milligrams guggulsterone per day has been used.

There is no proven effective dose for guggul in children.

interactions

Interactions with Drugs

Co-administration of guggulipid to humans has been reported to decrease the bioavailability of the beta-blocker propranolol and the calcium channel blocker diltiazem.
Gugulipid has been associated with inhibition of platelets and increased blood clot breakdown. In theory, guggul may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
The effect of guggul on serum lipids remains controversial. Guggul may affect serum lipid levels (decreasing cholesterol, triglycerides, and low-density lipoproteins; increasing high-density lipoproteins), and may thus increase the effects of lipid-lowering drugs such as statins.
Animal studies suggest that the guggul constituent Z-guggulsterone may stimulate thyroid function. Therefore, additional effects may occur in patients taking thyroid drugs and guggul together.

Interactions with Herbs and Dietary Supplements:

The effect of guggul on serum lipids remains controversial. Guggul may affect serum lipid levels (decreasing cholesterol, triglycerides, and low-density lipoproteins; increasing high-density lipoproteins), and may thus increase the lipid-lowering effects of lipid-lowering agents such as niacin, garlic, or fish oil (omega-3 fatty acids).
Gugulipid has been associated with inhibition of platelets and increased blood clot breakdown. In theory, guggul may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic or saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.