Guggul

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Guggul

Common Names

  • Gum guggal
  • Gum guggulu
  • Guggal

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.


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 to treat various conditions, but studies are limited.

In lab experiments, a chemical in guggul called guggulsterone affects cholesterol production by the liver. Mice fed guggul had reduced cholesterol levels compared with mice on 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
  • 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 CYP3A4 substrate drugs: Guggul may make these medications 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.
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For Healthcare Professionals

Scientific Name
Commiphora mukul
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 or in combination with other botanicals to treat various disorders including rheumatism, arthritis, neurological diseases, hemorrhoids, urinary disorders, and skin diseases.

Preclinical studies suggest that the compound guggulsterone has antiangiogenic and antitumor properties (4) (5) (6) (7). In an animal study, guggul had cardioprotective effects (16).

Studies in humans are limited, but suggest guggul may be effective for hypercholesterolemia (1) (2) (11). However, other trials indicate uncertain benefit (20) or that guggul may actually raise cholesterol levels (3). It also showed no benefit when taken with Triphala, an Ayurvedic formulation (21). Additional research is needed to determine safety and efficacy.

Purported Uses
  • Acne
  • Arthritis
  • Hemorrhoids
  • High cholesterol
  • Urinary tract disorders
  • Weight loss
Mechanism of Action

In vitro, guggulsterone affected biosynthesis of cholesterol in the liver (2). Cholesterol-lowering activity in mice was attributed to inhibition of FXR, a nuclear hormone receptor that is activated by bile acids. FXR mediates a negative feedback loop to decrease bile acid production by the liver. This loop is an important component of cholesterol metabolism regulation (10). In humans, hypolipidemic outcomes may be better for those with a higher capacity to metabolize Z-guggulsterone with moderate carboxylesterase induction (19).

In tumor cells, guggulsterone induced apoptosis by activating JNK (5) and repressing Akt signaling (6).

Guggulsterone activates nuclear receptors such as estrogen receptor alpha, pregnane X receptor, and progesterone receptor and may induce CYP3A genes (8).

Adverse Reactions

Headache, mild nausea, eructation, hiccups, and loose stools; hypersensitivity rash (2) (3) (20) (21)

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. Symptoms resolved after product discontinuation (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

CYP3A4 substrates: Lab studies suggest that guggul induces CYP3A4 and may affect the intracellular concentration of drugs metabolized by this enzyme (8).

Herb Lab Interactions

Reduced serum triglycerides (2)
Elevated TSH, T3, and T4 (9)

Dosage (OneMSK Only)
References
  1. Kuppurajan K, et al. Effect of guggulu (Commiphora mukul—Engl.) on serum lipids in obese, hypercholesterolemic and hyperlipemic cases. J Assoc Physicians India 1978;26:367-73.
  2. Singh RB, Niaz MA, Ghosh S. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc Drugs Ther 1994;8:659-64.
  3. Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the treatment of hypercholesterolemia: a randomized controlled trial. JAMA 2003;290:765-72.
  4. Sarfaraz S, Siddiqui IA, Syed DN, Afaq F, Mukhtar H. Guggulsterone Modulates MAPK and NF-kappaB Pathways and Inhibits Skin Tumorigenesis in Sencar Mice. Carcinogenesis. 2008 Oct;29(10):2011-8.
  5. Singh SV, Choi S, Zeng Y, Hahm ER, Xiao D. Guggulsterone-induced apoptosis in human prostate cancer cells is caused by reactive oxygen intermediate dependent activation of c-Jun NH2-terminal kinase. Cancer Res. Aug 1 2007;67(15):7439-7449.
  6. Shishodia S, Sethi G, Ahn KS, Aggarwal BB. Guggulsterone inhibits tumor cell proliferation, induces S-phase arrest, and promotes apoptosis through activation of c-Jun N-terminal kinase, suppression of Akt pathway, and downregulation of antiapoptotic gene products. Biochem Pharmacol. Jun 30 2007;74(1):118-130.
  7. Xiao D, Singh SV. z-Guggulsterone, a constituent of Ayurvedic medicinal plant Commiphora mukul, inhibits angiogenesis in vitro and in vivo. Mol Cancer Ther. Jan 2008;7(1):171-180.
  8. Brobst DE, Ding X, Creech KL, Goodwin B, Kelley B, Staudinger JL. Guggulsterone activates multiple nuclear receptors and induces CYP3A gene expression through the pregnane X receptor. J Pharmacol Exp Ther. Aug 2004;310(2):528-535.
  9. DerMarderosian A, editor. The Review of Natural Products. St. Louis: Facts and Comparisons; 1999.
  10. Urizar NL, et. al. A natural product that lowers cholesterol as an antagonist ligand for FXR. Science. 2002 May 31;296(5573):1703-6.
  11. Singh BB, Vinjamury SP, Der-Martirosian C, et al. Ayurvedic and collateral herbal treatments for hyperlipidemia: a systematic review of randomized controlled trials and quasi-experimental designs. Altern Ther Health Med. 2007 Jul-Aug;13(4):22-8.
  12. Grieco A, Miele L, Pompili M, et al. Acute hepatitis caused by a natural lipid-lowering product: when “alternative” medicine is no “alternative” at all. J Hepatol. 2009 Jun;50(6):1273-7.
  13. Salavert M, Amarger S, Le Bouedec MC, et al. Allergic contact dermatitis to guggul in a slimming cream. Contact Dermatitis. 2007 May;56(5):286-7.
  14. Kölönte A, Guillot B, Raison-Peyron N. Allergic contact dermatitis to guggul extract contained in an anticellulite gel-cream. Contact Dermatitis. 2006 Apr;54(4):226-7.
  15. Yellapu RK, Mittal V, Grewal P, Fiel M, Schiano T. Acute liver failure caused by ’fat burners’ and dietary supplements: a case report and literature review. Can J Gastroenterol. 2011 Mar;25(3):157-60.
  16. Ojha S, Bhatia J, Arora S, Golechha M, Kumari S, Arya DS. Cardioprotective effects of Commiphora mukul against isoprenaline-induced cardiotoxicity: a biochemical and histopathological evaluation. J Environ Biol. 2011 Nov;32(6):731-8.
  17. Urizar NL, Moore DD. GUGULIPID: a natural cholesterol-lowering agent. Annu Rev Nutr. 2003;23:303-13.
  18. Bai S, Jain M. 1H and 13C assignments of five cembrenes from guggul. Magn Reson Chem. 2008 Aug;46(8):791-3.
  19. Yang D, Yang J, Shi D, et al.Hypolipidemic agent Z-guggulsterone: metabolism interplays with induction of carboxylesterase and bile salt export pump. J Lipid Res. 2012 Mar;53(3):529-39.
  20. Nohr LA, Rasmussen LB, Straand J. Resin from the mukul myrrh tree, guggul, can it be used for treating hypercholesterolemia? A randomized, controlled study. Complement Ther Med. Jan 2009;17(1):16-22.
  21. Donato F, Raffetti E, Toninelli G, et al. Guggulu and Triphala for the Treatment of Hypercholesterolaemia: A Placebo-Controlled, Double-Blind, Randomised Trial. Complement Med Res. 2021;28(3):216-225.
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