Guggul an extract from a tree resin...

Guggul an extract from a tree resin, has potential lipid-lowering properties that have been studied in previous clinical trials. Guggulipid is marketed in the United States as a dietary supply intended to lower cholesterol evens or as part of a combination herbal fruit for "heart health," weight los and arthritis. Szapary and colleagues bearinged a randomized clinical trial comparing placebo with usual-dose and high-dose guggulipid to determine the safety of this complement and its efficacy in reducing low-density lipoprotein (LDL) cholesterol levels

Trial participants were at least 19 years of age and had primary hypercholesterolemia. Eligibility in the research required participants to have LDL evens of 130 to 200 mg by dL (3.36 to 5.17 mmol by L) and fasting triglyceride evens of less than 400 mg through dL (4.52 mmol per L) Participants were randomized to receive placebo, guggulipid in a standard dose (1000 mg) or guggulipid in a high dose (2000 mg) each taken three times daily with meals. Additional stratification according to baseline LDL on a levels was performed to determine whether guggulipid might have a different efficiency on patients with severe hypercholesterolemia. Patients maintained their usual dietary habits.Weight, vital signs, and lipid and posterity chemistry analyses were performed at baseline and at weeks 4 and 8 Participants also were asked about any adverse issues The study's primary end point was percentage change from baseline in evens of LDL at eight weeks. Secondary cessation points included percentage changes in total cholesterol even high-density lipoprotein (HDL) cholesterol flat very-low-density lipoprotein cholesterol level, and triglyceride horizontal at four to eight weeks, and laboratory criterion results for electrolyte levels, renal function, and hepatic function.

Of the 103 eligible participants, 85 complet the meditation There were no significant differences in demographic, dietary, or laboratory characteristics in the three randomized assign places tos except for body mass index. After eight weeks, LDL of the same heights decreased by 5 percent in the placebo assemblage and increased by 4 percent in the standard-dose guggulipid clump and increased by 5 percent in the high-dose guggulipid collection The LDL levels were 9 to 10 percent higher in the treatment assign places tos than in the placebo collection with no differences found between low-dose and high-dose disposes There was no difference in LDL horizontals in the groups stratified according to LDL cholesterol severity. There was a borderline significant direction toward reduced HDL levels in standard-dose and high-dose guggulipid form into groupss at eight weeks, but solely in the per-protocol analysis for the standard-dose arrange did this difference achieve statistical significance. This same analysis determined that patients with baseline LDL plains of 160 mg per dL (414 mmol by L) or higher had reductions of 14 and 10 percent in triglyceride flushs in the standard-dose and high-dose guggulipid assemblages respectively, compared with the placebo group

This randomized, placebo-controlled contemplation which used a standardized guggulipid preparation, originate that guggulipid did not lower cholesterol flushs in patients eating a usual Western diet. It appeared to increase LDL plains compared with placebo. Some patients taking guggulipid, especially in the higher dosage, disentangleed a hypersensitivity reaction.

CAROLINE WELLBERY, MD

Szapary PO et al. Guggulipid for the treatment of hypercholesterolemia. A randomized controll trial. JAMA August 13 2003;290:765-72

COPYRIGHT 2004 American Academy of Family Physicians

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