Common Names
- Gum guggal
- Gum guggulu
- Guggal
For Patients & Caregivers
How It Works
Studies on whether guggul can lower cholesterol levels are mixed.
Guggul is a resin extract that has been used in Ayurvedic medicine for centuries. Scientists do not know exactly how guggul works. In laboratory experiments, a chemical in guggul called guggulsterone affects the production of cholesterol by the liver. Mice that are fed guggul have reduced cholesterol levels compared with mice that have normal diets.
In humans however, studies on whether guggul can lower cholesterol levels are mixed. One study suggests it may actually raise cholesterol levels. Therefore, additional study is needed to determine whether guggul is safe and effective.
Purported Uses
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To treat acne
Evidence is lacking to support this claim for guggul alone. See the Ayurveda monograph for more information on the treatment of acne. -
To treat arthritis
Evidence is lacking to support this claim. -
To treat hemorrhoids
Evidence is lacking to support this claim. -
To reduce high cholesterol
Studies on whether guggul can lower cholesterol levels are mixed. -
To treat urinary tract disorders
Evidence is lacking to support this claim. -
To lose weight
Evidence is lacking to support this claim.
Do Not Take If
- You are taking warfarin, aspirin, NSAIDs or other blood thinners: In theory, guggul may increase the risk of bleeding. Take with caution and ask your doctor.
- You are taking thyroid supplements, or have hyperthyroidism or hypothyroidism: Guggul may stimulate the thyroid gland.
- You are taking drugs that are substrates of Cytochrome P450 3A4: Guggul may make these drugs less effective.
Side Effects
- Headache
- Mild nausea
- Belching
- Hiccups
- Loose stools
- Rash
Case reports
- Allergic reactions: Contact dermatitis related to guggul in slimming and anticellulite creams
- Elevated liver enzymes: In a 63-year old woman after using an over-the-counter lipid-lowering product for 6 months that contained guggulsterol and red yeast rice extract. Her symptoms normalized after the product was discontinued.
- Liver failure requiring transplant: In a healthy woman who took a dietary supplement containing usnic acid, green tea, and guggul tree extract. Although usnic acid was considered the main cause, its effects could have been amplified by the other ingredients.
For Healthcare Professionals
Clinical Summary
Guggul is derived from the resin of a medicinal plant that has been used for thousands of years in Ayurveda. Extracts of the plant are traditionally used alone and in combination with other botanicals to treat various clinical disorders including rheumatism, arthritis, neurological diseases, hemorrhoids, urinary disorders, and skin diseases.
Studies on the safety and efficacy of guggul are limited. In an animal study, guggul had protective effects against cardiotoxicity (16).
A few human studies suggest guggul may be effective for hypercholesterolemia (1) (2) (11). However, other trials showed that guggul may have uncertain benefit (20), or actually raise cholesterol levels (3). Additional research is needed to determine safety and efficacy.
In vitro and in vivo (4) studies suggest that guggulsterone, a sterol from guggul, has antiangiogenic (7) and antitumor properties, inducing cell-cycle arrest and apoptosis in a variety of tumor cells (5) including those resistant to chemotherapy (6).
Mechanism of Action
In vitro studies point to the effect of guggulsterone on the biosynthesis of cholesterol in the liver (2). Another study proposes that the cholesterol-lowering activity of guggulsterone in mice comes from its inhibition of FXR, a nuclear hormone receptor that is activated by bile acids. FXR mediates a negative feedback loop that decreases the rate of bile acid production by the liver. This loop is an important component in the regulation of cholesterol metabolism (10).
Hypolipidemic outcomes may be better in individuals with a relatively higher capacity of metabolizing Z-guggulsterone with moderate carboxylesterase (CES1) induction (19).
Guggulsterone activates nuclear receptors such as estrogen receptor alpha, pregnane X receptor, and progesterone receptor and may induce CYP3A genes (8).
In tumor cells, guggulsterone induces apoptosis by activating JNK (5) and repressing Akt signaling (6).
Adverse Reactions
Headache, mild nausea, eructation, hiccups, and loose stools; hypersensitivity rash (2) (3) (20)
Case reports
- Allergic reactions: Contact dermatitis attributed to guggul in slimming and anticellulite creams (13) (14).
- Severe hypertransaminasemia: In a 63-year old woman after using an over-the-counter lipid-lowering product for 6 months that contained guggulsterol and red yeast rice extract. Her symptoms normalized after the product was discontinued (12).
- Acute hepatic failure requiring transplant: In a healthy woman who took a dietary supplement containing usnic acid, green tea, and guggul tree extract (15). Although usnic acid was considered the predominating factor, its effects could have been amplified by the other ingredients.
Herb-Drug Interactions
Anticoagulants/Antiplatelets: Due to potential anticoagulant and antiplatelet effects, guggul theoretically may potentiate the effects of aspirin, NSAIDs, and warfarin.
Thyroid supplements: Guggul may have thyroid-stimulating activities.
Cytochrome P450 enzymes: Laboratory studies indicate that guggul induces CYP3A4 and can affect the intracellular concentration of drugs metabolized by this enzyme (8).