Health Canada and the FDA DO NOT ALLOW Cholesterol-Lowering Claims about Gum Guggul. Perplexing!
Source: Cardiovascular Drug Reviews (2007)
Lifestyle Medicine Update (May 29, 2024)
As reported in the journal Cardiovascular Drug Reviews, as far back as 1998, in India, gum guggul was approved as a drug to lower cholesterol and triglyceride levels in humans (hypolipidemic), based on its proven efficacy and safety profile. In Canada and the United States Gum Guggul is sold over the counter as a supplement or a natural health product, where it does not require a prescription from a medical practitioner. As summarized in the journal Cardiovascular Drug Reviews in 2007, overall, most clinical studies show that 70-80% of patients with high cholesterol will show a lowering of their blood cholesterol level by 20-30% within several months of taking the prescribed dosage of gum guggul orally. Many patients also see a drop in triglyceride levels as well as a drop in a key inflammatory marker (CRP – C-Reactive Protein) that is strongly tied to heart attack risk. In some cases, it also raises the good cholesterol that reverses plaque build-up in the artery wall – HDL-cholesterol. So, gum guggul has been shown in human studies to reduce four key risk factors for heart and cardiovascular disease:
Lowers total cholesterol and LDL-cholesterol (the bad cholesterol)
In some cases, it raises the good cholesterol- HDL
Lowers CRP – an important inflammatory marker tied to cardiovascular disease risk.
Lowers triglyceride levels – the amount of fat in the bloodstream.
What is Gum Guggul and How Does it Work?
Gum guggul is the resin from the mukul myrrh tree, which is native to India. It contains sterol compounds called guggulsterones, which are shown to help excrete cholesterol from the body by converting it into bile acids in the liver and flushing it through the liver’s bile ducts into the intestinal tract. As such, more cholesterol leaves your body with each bowel movement, in the form of bile acids. Guggulsterones also have antioxidant and anti-inflammatory effects (lowering NF-kb), which appear to lower the CRP and has been used successfully in a North American clinical trial to help manage knee osteoarthritis. This all sounds quite impressive, don’t you think? So, it’s quite bewildering that Health Canada does not allow companies that use the proven dosage and standardized grade of gum guggul in their supplements to tell the public or state on the label or on their website that gum guggul may help to lower cholesterol and triglycerides and/or that it has been shown to have other cardiovascular health benefits.
I think it’s a case of bad political science taking precent over good human health science. I’m not against the use of cholesterol-lowering statin drugs like Crestor or Lipitor (or some of the new cholesterol-lowering drugs in the marketplace) in high-risk patients and in patients who are unresponsive to other cholesterol-lowering measures (including the use of gum guggul and artichoke leaf extract). But, to prevent companies, who manufacture an evidence-based guggul supplement, from telling the public or health practitioners that gum guggul can help to lower cholesterol and triglycerides and provide them with links to peer-reviewed research papers that validate its cholesterol and triglyceride lowering effects (like the research I have provided below), certainly does not serve the public’s interest. I say this because gum guggul has been shown to be safe to use in patients with certain liver problems and those who are pre-diabetic or type 2 diabetics, where the use of statin drugs may worsen their liver condition, trigger, or worsen type 2 diabetes blood sugar problems, and can lead to memory loss and/or severe muscle pain in some users. Gum guggul does not have any these side effects and is a good choice to help lower mild to moderately high cholesterol problems in patients who are otherwise at low risk for heart attack or stroke. And it doesn’t cause liver damage. In these cases, gum guggul supplementation, along with appropriate dietary and lifestyle change, can be the first treatment choice. If it doesn’t work within a three-to-six-month trial period, statin drugs can always be introduced later.
But I suspect that the lobbying power of the big drug companies has likely persuaded Health Canada and the US FDA to keep the science and benefits of gum guggul hidden from the public and health practitioners who might otherwise recommend it in select cases. Statin drug sales globally were over $15 billion in 2023, and are expected to reach almost $19 billion by 2030. (https://www.maximizemarketresearch.com/market-report/global-statin-market/77560/#:~:text=Statin%20Market%3A%20Global%20Industry%20Analysis%20and%20Forecast%20(2024%2D2030)&text=Statin%20Market%20was%20valued%20US,3%25%20during%20a%20forecast%20period )
I would encourage you to read the 2007 review paper in the journal, Cardiovascular Drug Reviews, which I have provided in the reference section below. This article reviews all the clinical studies where gum guggul has been applied and explains its mechanism of action and safety profile. In my view it’s a shame that many of the supplements found on the Amazon page that features many different gum guggul supplements (https://www.amazon.com/gum-guggul/s?k=gum+guggul) cannot promoted for their cholesterol or triglyceride lowering effects. The same is true for the Adeeva Chole Forte, which also contains artichoke leaf extract to enhance its efficacy. I have provided a link to the 2007 gum guggul review found in the journal Cardiovascular Drug Reviews in the text below, so you can examine the evidence for yourself.
Reference:
Deng R. Therapeutic effects of guggul and its constituent guggulsterone: Cardiovascular benefits. Cardiovascular Drug Reviews. 2007, 25(4)3. https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1527-3466.2007.00023.x
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Dr. Meschino
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Dr. James Meschino
ABOUT THE AUTHOR
Dr. James Meschino, DC, MS, ROHP, is an educator, author, and researcher having lectured to thousands of healthcare professionals across North America. He holds a Master’s Degree in Science with specialties in human nutrition and biology and is recognized as an expert in the field of nutrition, anti-aging, fitness, and wellness as well as the author of numerous books.