Guggulu and Triphala for the Treatment of Hypercholesterolaemia: A Placebo-Controlled, Double-Blind, Randomised Trial

Abstract

<b><i>Background:</i></b> Several herbs are used for lowering high blood cholesterol levels in traditional medicines including Indian Medicine (Ayurveda). We aimed to assess the short-term effects of the combination of Guggulu (<i>Commiphora mukul</i>) and Triphala (<i>Terminalia chebula</i>, <i>Terminalia belerica</i>, and <i>Phyllanthus emblica</i>) on serum cholesterol in healthy subjects with hypercholesterolaemia. <b><i>Patients and Methods:</i></b> This was a parallel randomised double-blind controlled trial that included 90 individuals at low-moderate cardiovascular risk. The main outcome measures were serum levels of total and low- and high-density lipoprotein cholesterol (LDL-C, HDL-C). Secondary outcome measures included BMI, waist circumference, and adverse events. Subjects were administered either Guggulu and Triphala or placebo three times daily for 3 months, with 3 months of follow-up after the end of treatment. <b><i>Results:</i></b> At intention-to-treat analysis, from baseline to 3 months, total serum cholesterol decreased by 1.9% in the placebo (<i>n</i> = 44) and 3.3% (<i>p</i> = 0.01) in the intervention (<i>n</i> = 46) group. Serum LDL-C decreased by 4.9% (<i>p</i> = 0.03) and 4.8% (<i>p</i> = 0.02) in the placebo and intervention group, respectively, without differences between them. Two participants in the intervention group developed hypersensitivity rash (4.3%) as compared with none in the placebo group. <b><i>Conclusions:</i></b> Three months of treatment with Guggulu and Triphala did not show better effects than placebo on serum levels of total and LDL cholesterol, BMI, and waist circumference.

A meta-analysis and meta-regression study of the effects of Triphala on anthropometric parameters

“…The findings of all these tests were normal. However, Kamali et al (4) observed a substantial reduction in ALT levels in Triphala-treated patients; however, Donato et al (11) found no significant difference in ALT levels between Triphala-treated patients and controls at the end of the study.…”

“…The full-text review resulted in the exclusion of two articles: one was a non-RCT, and the other did not assess the outcomes of interest. Therefore, seven English and Thai articles (4,9,11,(21)(22)(23)(24) were considered in our research.…”

“…A PRISMA flowchart depicting the process of selecting articles for inclusion in the meta-analysis. (11) was performed on asymptomatic hypercholesterolemic patients. The treatment duration varied between 25 days and three months.…”

“…Previous preclinical trial studies have demonstrated that Triphala supplementation for 10 weeks reduced BW and body fat in mice (8). However, the results of the different clinical trials conducted to evaluate the anti-obesity effects of Triphala were inconsistent, and these clinical trials were conducted with a small number of participants (9)(10)(11). These inconsistencies may be due to variations in research design, small sample sizes, differences in population in individual trial and intervention periods, or differences in the dosages and forms of Triphala.…”

The Administration of Probiotics against Hypercholesterolemia: A Systematic Review

“…Ayurvedic formulations are prepared based on the patient's diet, behavioral changes, patient assessment, detoxification, and rejuvenation condition [16][17][18]. The most widely used herbs to reduce cholesterol are garlic, guggulu, and arjuna [19][20][21]. However, there is no clear evidence for the direct correlation between herbs and hypercholesterolemia [21].…”