a review of the medicinal evidence for its therapeutic properties

Om Prakash Rout et al / IJRAP 3(1), Jan – Feb 2012
Review Article
www.ijrap.net
OLEOGUM RESIN GUGGULU: A REVIEW OF THE MEDICINAL EVIDENCE FOR ITS
THERAPEUTIC PROPERTIES
Om Prakash Rout1*, Rabinarayan Acharya2, Sagar Kumar Mishra3
1
Dept of Dravyaguna, Rajiv Lochan Ayurvedic Medical College, Chandkhuri, Durg, Chhatisgarh, India
Dept. of Dravyaguna, I.P.G.T & R.A., Gujarat Ayurved University, Jamnagar, Gujarat, India
3
Pharmacognosy & Phytochemistry Division, University Dept. of Pharmaceutical Sciences, Utkal University, Vani
Vihar, Bhubaneswar, Odisha, India
2
Received on: 14/10/2011 Revised on: 22/12/2011 Accepted on: 09/01/2012
*Corresponding author
Dr. Om Prakash Rout, Lecturer, Dept of Dravyaguna, Rajiv Lochan Ayurvedic Medical College & Hospital, Chandkhuri, Gundardehi Road, Durg,
Chhatisgarh, India Email: [email protected]
ABSTRACT
Guggulu is an oleogum resin that exudes spontaneously as a result of injury from the bark of Commiphora wightii Bhandari (Syn : Commiphora
mukul Hook. ex Stocks or Balsamodendron mukul Hook. ex Stocks). In Ayurveda guggulu enters into the preparation of several compound medicines
most of which are named with suffix ‘guggulu’. It is a complex mixture of steroids, diterpenoids, aliphatic esters, carbohydrates, amino acids and
variety of inorganic compounds. Traditionally it is used to treat arthritis, obesity, and other disorders. Guggul has been shown to lower cholesterol and
triglycerides. This review is an effort to compile all the available information reported on its macroscopic features, chemical constituents,
pharmacological activities, toxicity and adverse reactions,
Keywords: Guggulu, Commiphora wightii, macroscopic features, chemical constituents, pharmacological activities, toxicity, adverse reactions.
INTRODUCTION
Guggulu is an oleogum resin that exudes spontaneously
as a result of injury from the bark of Commiphora wightii
Bhandari (Syn : Commiphora mukul Hook. ex Stocks or
Balsamodendron mukul Hook. ex Stocks). Guggul, more
popularly known as Bdellium, is derived from the gummy
resinous exudate of a plant closely related to myrrh that is
found in arid to semi-arid areas of Northern India,
Bangladesh and Pakistan1. The Sanskrit definition of the
term "guggul" is "one that protects against diseases." This
attests to the wide respect and therapeutic Ayurvedic
applications for this botanical, considered the most
important for the removal of "ama," toxic substances
which accumulate as a result of sluggish digestion and
circulation associated with a slowing of metabolism2,3.
Guggul is a resin, the major ingredient in joint care and
immuno care that has been regarded as a remedy in
Ayurvedic medicine, known to increase white blood cell
count and to possess strong immuno-modulating
properties. Guggul is one of the "broad spectrum" health
products with a wide range of benefits. Mode of action
makes this product very helpful not only in protecting
against the common cold but also in various other
conditions. It has been shown to have remarkable
properties as an adjuvant of other types of therapies. In
addition, lower cholesterol and triglycerides, while
maintaining the HDL to LDL ratio has long known
Guggul. It has been subjected to hundreds of clinical
studies4.
HISTORY
Veda
Guggul is described as “Agni Sthana” and used for
‘Dhupa’. In Atharva Veda, it is mentioned that Yaksma
and other diseases will not spread to the areas fumigated
by Guggulu. ‘Sayana also introduced it as a well known
‘Dhupana dravya’. It was used for the treatement of
diseases of cattle2,3,5,6.
Samhita
It is observed that the internal usage of Guggul increased
during Samhita period only. Acharya Charaka included
Guggul in “Sangya Sthapana Maha Kashaya” (Su. 4/48)
and in “Kashaya Skandha” (Vi.8/144)7. Maharishi
Sushruta has described Guggul in the list of seven most
important drugs for the treatment of Sthaulya (Su. 15/32).
He has prescribed Guggul with Go-mutra in condition of
vitiated Vata with Medodhatu dominated Kapha dosha
(Chi. 5/35). The drug is also mentioned as highly
effective in the treatment of Vrana as a fumigating agent
(Su. 5/10-12), Kushtha (Chi. 9/6), Vidradhi (Chi. 17/32),
Pratisaranartha (Chi. 22/5), Shotha (Chi. 23/12), Gulma
(Utt. 42/63)8,9 etc. Acharya Kashyapa has quoted Guggul
in different formulations to treat various diseases. Ghrita,
Taila, Avaleha, Dhoopana etc. many formulations of it are
also described for the treatment of many ‘Bala Rogas’10.
Maharishi Bhela has prescribed that Dhoomrapana of
Guggulu should be taken after bath and after taking meal.
He also described the Vrana ropana property of
Guggulu11. Maharishi Harita has elaborated Guggulu in a
separate chapter titled “Guggulu Kalpa” (5th Chap.6-8).
Here, he has opined that Guggulu from Marudesha must
be collected in Ushna Ritu and Guggulu from hilly areas
must be collected in Sheeta Ritu12. Many formulations of
Guggulu have been mentioned in Sharangadhara Samhita.
However, in Vati kalpadhyaya (Sha. Sam. M. Kha. 7),
Guggulu has been suggested specifically for the Vati
preparation, because it facilitates the binding capacity.
Sarangadhara quoted it among the drugs to be used when
they are older (Purana)13.
Vagbhata has described that it is a drug of choice for
Medoroga and Vatavikaras.He has also quoted its
Medohara action along with other drugs like Shilajatu,
Rasanjana and Brihat panchmula (A. H. Su. 14/23). He
has also used Guggul in Sneha vyapada chikitsa (A. H.
Su. 16/34) and prescribed Guggulu in diseases produced
due to vitiated Vata, Kapha, Medodhatu and in Amavata
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Om Prakash Rout et al / IJRAP 3(1), Jan – Feb 2012
(A. H. Chi. 21/50). Vagbhata has also mentioned Guggul
in the list of selected drugs for the treatment of certain
important diseases like Kushtha, Prameha, Shopha14 etc.
Nighantu
An elaborative description can be traced about Guggul as
regards its synonyms, types, properties and uses in
Dhanvantari nighantu, Madanpal nighantu, Raj nighantu,
Bhavaprakasha nighantu, etc15-21.
Rasa Granthas
Guggul is not included anywhere in Maharasa, Uparasa,
Sadharanarasa etc. groups in Rasa shastra. But it is quoted
in Dravaka Gana and Mitra Panchaka gana as a reducing
agent for different metals and minerals22-24.
Mythological origin of Guggul by God Vishnu has been
described in Prathmollas of Anand Kanda. It has also
quoted five types of Guggulu2-3.
Rasa Ratna Samuchchaya, Rasendra Sar Sangraha, Rasa
Ratnakar, Chakradatta, Yoga Ratnakar etc. have
prescribed many Yogas of Guggul for various ailments2229
.
Gana( Classification)
Different Acharya have described Guggulu under
different Ganas, which are described as follows –
Grantha: Gana/Varga
Charaka Samhita7: Sangyasthapana, Kashaya Skandha
Sushruta Samhita8-9: Eladi, Kaphasmari bhedana
Ashtanga Sangraha28: Eladi
Ashtanga Hridaya14: Eladi, Rasayana
Harita Samhita12: Rasayana
Dhanvantari Nighantu17: Chandanadi
Madanpala Nighantu19: Karpooradi
Kaiyadeva Nighantu20: Aushadhi
Bhavaprakasha Nighantu16: Karpooradi
Rajavallabha Nighantu30: Nanoushadhi
Saligrama Nughantu21: Karpuradi
Madhava Dravyaguna15: Vividhaousadhi
Nighantu Adarsha31: Guduchyadi
Dravya Guna Vigyana32: Vedana Sthapana (P. V.
Sharma)
Again Vagbhata has quoted that Guggulu was evolved as
“Amrita” by Lord Vishnu during Devasur Sangrama for
replenishing lost Bala, Shourya and Teja of Devas. (As.
San. Utt. 49)33.
Types of Guggulu
In Atharva veda, it is reported that Guggulu has two types
i.e.3.
1. Nadi Sameepottha, Which is found near the Sindhu
River.
2. Samudra Sameepottha, This is found near the ocean.
Bhavaprakasha has reported five types of Guggulu on the
basis of color16 –
These are:
A. Mahishaksha
B. Mahanela
C. Kumuda
D. Padma
E. Hiranya
Each type has its specific color, as Mahishaksha has the
color either of Bhringa or Anjana. Mahaneel is extremely
blue in color, Kumuda type has the color of Kumuda
flower i.e. white, Padma looks dark red like ruby color,
while Hiranya looks like gold. However, each type of
variety has been prescribed for specifically in human and
animals.
The Kanaka type has been told as best among all and
prescribed to use as medicine in human beings.
Mahishaksha can be used as medicine in humans,
Mahaneel and Mahishaksha have been told to be useful in
elephants and Kumuda and Padma has been said to be
useful in horse.
Synonyms (Paryaya)
Unfolding the hidden meanings of the paryayas or
synonyms of the drugs, mentioned in Ayurvedic texts
becomes more relevant as these define various
characteristics of the drugs and hence help in identifying
them15-21.
Rasapanchaka
Rasa: Tikta, Katu
Guna: Laghu, Ruksha, Tikshna, Visada, Sukshma, Sara,
Sugandhi (Purana Guggulu) & Snigdha, Picchila (Navina
guggulu)
Virya: Ushna
Vipaka: Katu
Dosakarma: Tridosahara
Dhatu karma: Rasayana, vrisya (old Guggulu), lekhana
(new Guggulu)
Rogaghnata: Sthoulya/ medoroga, amavata, vata vyadhi,
prameha, apaci, gandamala, sotha, pitaka, ashmari, arsha
and kustha32,34
Apathya
During the administration of Guggulu the patients should
be advised not to take Amla rasa, Tikshna guna
predominant drug and diet. Should also not drink Madya
and to avoid Ajirna bhojana, Maithuna, Vyayama, Atapa
sevana and Krodha32.
Side effects
On improper use, it gives bad effect to livers and lungs.
Long term and higher dose administration of Guggulu
may lead to Timira, Mukhasosa, Klaibya, Krisata,
Murcha, Sauthilya and Roukshata32.
Sodhana (Purification process) of Guggulu
Different shodhana processes are described for the
various drugs in our classics. For the Shodhana of
Guggulu, Gomutra, Godugdha, Triphala kasaya, vasa
kasaya/svarasa and Nirgundi svarasa with Haridra curna
are used as media reported in Ayurvedic Pharmacopoeia
of India, Part II, Volume, II; 2008:277.
Scientific Clasification
Kingdom: Plantae - Plants
Subkingdom: Tracheobionta – Vascular plants
Superdivision: Spermatophyta – Seed plants
Division: Magnoliophyta – Flowering plants
Class: Magnoliopsida – Dicotyledons
Subclass : Rosidae
Order: Sapindales
Family: Burseraceae – Frankincense family
Genus: Commiphora Species
Commiphora wightii (Arnott.) Brand33
Vernacular Names
Bengali: Guggulu, Guggul, Guggal, ranghan turb, Makal,
Guggal; Canarese: Guggulu; Dukshini: Gugul, Guggul,
Mukul, Ranghan turb; Gujarati: Gugul, Gugal,
Bhesaghgala, Guggul, Gugara, Mukul, Ranghanturb,
Bhaisoguggul; Hindi: Gugala, Guggal, Guggul, guggulu,
Gugava, gugavik, Kukul, Rranghanturb, Gogil,
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Om Prakash Rout et al / IJRAP 3(1), Jan – Feb 2012
Bhasagugul; Kannad: Kanthgal, Kangah, Guggul, Ivadolguggala, Idbol; Marathi: Gugal, Guggal, Guggul,
hansaguggul, kantguggul, Mahaishsguggul; Sindhi:
Gugaru; Tamil: Kukkil, Gukkal, Guggal, Gugal, Gukkula,
Maishskshi, maisachhi, Kungiliyam; Telugu: Meshakshi,
Gukkal, Guggal, Guggal, Gugal, Gukkula, maishakshim,
Mahishaksh-Gugilamu, Cheetu mahishashi; Arabic:
Mukulyahuda, Mulkarjak, Mushkilerarjak, Mogla, Mogal,
Mokhit,
Aphalatana,
Mukal,
Ahlatan,
Mogal,
Arzagiaglatam; English: Gum giggulu, Indian bdellium,
Indian bdellium, salativee, Bdellium, Guggulu, Borassus,
Flabelliformis; Persian: Baijahundanas, Boejahudan;
Pharsi: Boejahudon, Buejahudan, Boe, jhoodan,
Vorojahudan; Sinhali: Rata dummula, Guggulu, tatayy,
Jauya; Unani: Afaletana, Mikal32,35
Macroscopic Features
Translucent, vernacular or stalactic, tears of varying sizes,
reddish yellow or brown in colour, more often occurring
in resinous lumps which turn darker in colour on long
storage. Fracture-brittle, exposing a rough or waxy
surface having a moist unctuous appearance; balsamic
odour, acrid, bitter and aromatic taste. 36
Traditional Uses
In Ayurvedic, Indian traditional system of medicine,
herbs are usually used in combinations37. Yogaraj
guggulu is traditionally for detoxifying, treating obesity,
joint pain, arthritic conditions, muscle aches, rheumatism,
and gout. Punavadi guggulu is for detoxifying the
kidneys, eliminating fluid, helping heart conditions, and
inflammations. Triphala guggulu is for joint pain, arthritic
conditions, muscle aches, rheumatism, and weight loss38.
Gum guggul is used as incense, to make lacquers,
varnishes, and ointments, as a fixative in perfumes, and in
medicine39. Gum guggul is used to treat dysmenorrhea,
dyspepsia,
endometritis,
hypercholesteremia,
hypertension, impotence40, bronchitis, caries, catarrh,
gingivitis, hay fever, hysteria, inflammation, laryngitis,
lochia,
mania,
pharyngitis,
phthisis,
pyorrhea,
rheumatism, sores, sore throat, stimulant, tonsillitis,
tumors, wounds41, bone fractures42, gout, scrofula,
sciatica, facial paralysis, diplegia, leprosy, leucoderma,
pectoral disorders, otorrhea, epilepsy, fever, strangury,
hemorrhoids, dysmenorrheal, amenorrhea, ulcers, anemia,
coronary, thrombosis, stomatopathy, pharyngopathy,
spermatorrhea, urinary calculus, diabetes, trichosis, to
enhance phagocytosis, to increase leukocytes37, to induce
abortion43, and as a tonic for the uterus41. Traditional uses
of C. mukul include as an anti-inflammatory,
antispasmodic,
carminative,
emmenagogue,
hypoglycemic40, alterative, antiseptic, astringent, sedative,
stomachic,
carminative,
diaphoretic,
diuretic,
expectorant41, antispasmodic, antisuppurative, aperient,
expectorant, a thyroid stimulant37, anthelmintic,
depurative, vulnerary, antiseptic, demulcent, aphrodisiac,
stimulant, liver tonic, detergent, anti-spasmodic,
hematinic, diuretic, and lithonotriptic44.
Modern Uses
Modern therapeutic uses of guggul include nervous
diseases, hemiplegia, leprosy, marasmus, muscle spasms,
neuralgia, ophthalmia, pyelitis, pyorrhea, scrofula, skin
diseases, spongy gums, ulcerative pharyngitis,
hypertension, ischaemia, hypertension, hemorrhoids, and
urinary tract disorders45,46. More recently, C. mukul was
found to be a relatively safe and effective supplement for
osteoarthrtiis of the knee47. Research studies showed that
guggul is effective against aspects of cardiovascular
disease. Guggul reduced the stickiness of platelets48. The
crude gum guggul and each of the fractions containing the
E- and Z-guggulsterones have hypocholesteremic activity:
the ethyl acetate extract, the neutral compounds from the
extract, the ketonic compounds in the neutral fractions,
and that containing the purified E- and Zguggulsterones49.
Chemical Constituents
A detailed chemical study of guggulu revealed that it is a
complex mixture of steroids, diterpenoids, aliphatic
esters, carbohydrates, amino acids and variety of
inorganic compounds. Besides known sesamin and
cholesterol, Sukh Dev et al have isolated Zguggulsterone,
E-guggulusterone,
16
βhydroxyprogesterone and three new sterols viz.
guggulsterols I, II & III50. Later workers have isolated
two more new sterols guggulsterol- IV and guggulsterolV51,52. Besides a new alcohol viz. mukulol52, four steroids
too have been isolated from guggulu53.
Extracts of the oleoresin include compounds known for
their hypolipidemic properties, on which this report
focuses the Z- and E-isomers of guggulsterone and its
related guggulsterols54. Other types of chemicals that
were named as gum guggul constituents were a tetrol,
nonadecan-1,2,3,4-tetrol, lignans and terpenes. The
lignans included guggullignan I; guggullignan II;
octadecane-1,2,3,4-tetraol-1-yl
3-(4-hydroxy-3methoxyphenyl) propanoate, ferulic acid [1135-24-6], and
sesamin [607-80-7]56-58. The terpenes included mukulol
[41943-03-7]; allylcembrol I [39012-00-5]; cembrene A
[31570-39-5] (Dev, 1983); cembrene [20016-72-2]; αcamphorene I [532-87-6] (Rücker, 1972); myrcene [12335-3], and dimyrcene45. Bajaj, A.G et. al. 1982 lists the
components of the essential oil of C. mukul and their
percentages by weight:57: α-pinene, 4.75%; myrcene,
3.50%; eugenol, 14.70%, cadinene, 5.50%; geraniol,
6.20%; methyl heptanoate, 17.50%; (+)-α-phellandrene,
5.50%; (+)-limonene, 6.50; (±)-bornyl acetate, 7.30%;
(±)-linalool, 8.70%; methyl chavicol, 5.40%; α-pineol,
4%; 1,8-cineole (eucalyptol), 3.5%; and unidentified
compounds. The crude gum guggul was found to contain
2% guggulsterones. Its ethyl acetate extract contains 4%
to 4.5% guggulsterones. The neutral subfraction contains
4.2% to 4.7% guggulsterones. The ketonic subfraction of
the neutral subfraction contains 35% to 40%
guggulsterones, from which the 10% E- and Zguggulsterones are derived49.E- and Z-Guggulsterones in
gum guggul were profiled using ultraviolet (UV)
monitoring27. Guggulsterols in gum guggul were
identified by 1 HNMR, and spectrometers and
spectrophotometers were used to gather spectral and
analytical data53.
Pharmacology
Lipid-lowering effects
Typical guggulipid preparations contain 2.5-5% of the
plant sterols guggulsterones E and Z. These two
components have been reported to exert effects on
lipids.55-56
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Om Prakash Rout et al / IJRAP 3(1), Jan – Feb 2012
Hypochloesterolemic Activity
Crude guggulu was found to possess highly encouraging
hypolipaemic activity in rabbits57. Crude guggulu and its
alcohol soluble fractions caused significant fall in serum
cholesterol and serum turbidity with a concomitant
increase in the coagulation time and prothrombin time5859
. Fraction A and a steroidal fraction present in guggulu
also showed significant hypolipaemic activity in
cholesterol fed chicks60-61. Alcoholic extract and a pure
steroid isolated from it reduced serum cholesterol level in
normal and triton induced hyperlipidemic rats and
cholesterol fed hyperlipidemic rabbits58. Clinical studies
on patients of hypercholesterolemia associated with
obesity, ischaemic heart diseases, hypertension, diabetes,
etc. showed a fall in total serum cholesterol and serum
lipiphosphorous when treated with guggulu. The body
weight of the obese ones declined significantly62. Other
clinical studies showed that the lowering of serum
triglucerides was found most encouraging in case of gum
guggulu in comparison to all the drugs known so far63. In
a long term clinical study it was found that fraction A of
guggulu in cases of hyperlipoproteinaemia reduced
triglycerides by 36.5% whereas the drug clofibrate
brought a reduction of 33.3%. Serum cholesterol was
reduced by 26.2% with fraction- A treatment when 31.5%
was the result with clofibrate. Fraction- A enhanced the
rate of excretion of cholesterol and also reduced its
synthesis64.
Anti – fertility activity
Guggulu caused a reduction in the weight of rat uterus,
ovaries and cervix with a concomitant increase in their
glycogen and sialic acid levels thereby showing that it
might be useful as an antifertility agent65.
Antioxidant effects
Guggul extracts have been reported to possess antioxidant
properties66 possibly mediating protection against
myocardial necrosis.67-68.
Platelet effects
Guggulipid has been found to inhibit platelet aggregation
and increase .brinolysis.69-71, 66
Anti-inflammatory
Pharmacological studies have shown that the oleoresin is
a highly potent antiinflammatory agent as compared to
hydrocortisone and butazolidin against Brownlee’s
formaldehyde induced arthritis in albino rats72. The acidic
fraction of the oleo resin was active one whereas the non
– acidic and the solid fractions were inactive.The activity
of the acidic portion was present even in the
adrenalectomised animals73. The results of several studies
suggest possible anti-inflammatory and antiarthritic
activities of guggul74-82.
Thyroid effects
Data from animal models suggest that the guggul
constituent guggulsterone Z may stimulate thyroid
function.83 However, results from a recent randomized
controlled trial in 103 patients’ reports no difference in
thyroid stimulating hormone (TSH) with the use of
guggul84.
Anti – arthritic Activity
Suddha guggulu administered to 30 patients of
rheumatoid arthritis showed complete remission (66.66%)
major to minor (23.33% - 10%) improvement besides anti
–inflammatory and analgesic properties85.
In the treatment of heart diseases
The fraction A and the steroidal component derived from
it were studied in experimental myocardial infarction in
rats produced by isoprenaline. The results show that
guggulu is one of a few drugs which is effective in both
hyperlipidemia and myocardialnecrosis86.
In infective hepatitis
The antagonizing property of guggulu on the liver
hypertrophy has been established87.
Adverse Effects
Gastrointestinal: In clinical studies and historically,
guggul and guggulipid have been associated with
diarrhea, loose stools, nausea, vomiting, eructation
(belching), and hiccough. Frequency has varied between
10—30%; these symptoms have been observed both with
guggul63,88-89 and with guggulipid90-92. Most symptoms
have been well controlled with supportive care or
treatments such as antacids, although discontinuation is
occasionally necessary.
Neurologic/CNS: Headache was reported in 22 of 31
patients (71%) in one study74.Restlessness and
apprehension were noted in one of 44 patients in a
different study93.
Endocrine: Stimulation of thyroid function has been
noted in animal studies93,83,94,63, although a recent human
trial reports no effects of guggulipid in thyroid stimulating
hormone (TSH) levels after 8 weeks of therapy96.
Hematologic: Guggulipid administration has been
associated with inhibition of platelet aggregation and
increased brinolysis69, 70,95, 66.
Genitourinary: Weight reduction and chemical changes
in reproductive organs have been observed in female
rats65.
Dermatologic: Hypersensitivity skin reactions were noted
in a clinical trial, occurring in 5 of 34 patients (15%)
receiving 50 mg of guggulsterones three times daily, and
in 1 of 33 (3%) of patients receiving 25 mg of
guggulsterones three times daily. In most cases, reactions
occurred within 48 hours of starting therapy, and resolved
spontaneously within 1 week of therapy discontinuation,
although one patient required oral steroids92.
Renal: A case of rhabdomyolyis has been reported97.
Rhabdomyolis may lead to renal failure.
Toxicological Data
Traditional Ayurvedic treatments for obesity were
administered in a clinical trial to determine their
effectiveness for weight loss. All of the formulations
contained gum guggul among its herbal ingredients. Each
group except controls were administered triphala guggul
(138 mg gum guggul). Group I was administered
gokshuradi guggul (35 mg gum guggul); Group II,
sinhanad guggul (15 mg gum guggul); Group IV,
chandraprabha vati (57.6 gum guggul); and Group III,
placebo tablets as a control. The 70 participants
experienced a few minor side effects such as nausea and
mild diarrhea (eight in treatment groups, two in control
group)98. In a phase I tolerability study of Yogarajguggulu (containing 39.87% guggulu) with male
volunteers (22-28 years old), general tolerability was
“good” at doses up to 9 g/day. Three volunteers reported
diarrhea; whether intestinal parasites were irritated by
Yogaraj-guggulu were not determined. One subject
developed rash and pruritus,which was probably not drug18
Om Prakash Rout et al / IJRAP 3(1), Jan – Feb 2012
related since a rechallenge dose failed to reproduce the
symptoms and the patient had a past history of urticaria.
Another subject had stomatitis; he, however, also had a
history of recurrent stomatitis99. In other studies reporting
no significant side effects, adult obese patients were
administered medohar, a guggulu formulation, for 30 days
for weight loss100, and patients with primary
hyperlipidemia received gugulipid three times a day for
six weeks103. A standardized gugulipid extract had a few
side effects, including minor gastrointestinal disturbances,
such as dyspepsia, fullness102. Caution is recommended
when using guggul in people with liver disease,
inflammatory bowel disease, or diarrhea103. It should not
be used during pregnancy and it can cause diarrhea,
hiccups, apprehension, and restlessness. Gum guggul
possibly interacts with several drugs104. More side effects
are associated with the crude gum guggul. These include
skin rashes, irregular menstruation, diarrhea, headache,
mild nausea, eructation, hiccough, and with very high
doses, liver toxicity1,42.
CONCLUSION
Although the results from this review are quite promising
for the use of guggulu as a multi-purpose medicinal agent,
several limitations currently exist in the current literature.
While recent researchers have focused attention on the
anti-inflammatory activity and hypolipaemic activity of
guggulu comparatively less work has been done relating
to other properties of the drug enumerated in Ayurveda.
While guggulu has been used successfully in Ayurvedic
medicine for centuries, more clinical trials should be
conducted to support its therapeutic use. It is also
important to recognize that guggulu may be effective not
only in isolation, but may actually have a potentiating
effect when given in combination with other herbs or
drugs.
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