To evaluate the scientific evidence on guggul for hyperlipidemia including expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.
Electronic searches were conducted in nine databases, 20 additional journals (not indexed in common databases), and bibliographies from 50 selected secondary references. No restrictions were placed on language or quality of publications. All literature collected pertained to efficacy in humans, dosing, precautions, adverse effects, use in pregnancy/lactation, interactions, alteration of laboratory assays, and mechanism of action. Standardized inclusion/exclusion criteria were utilized for selection.
Before 2003, most scientific evidence suggested that guggulipid elicits significant reductions in serum total cholesterol, low-density lipoprotein (LDL), and triglycerides, as well as elevations in high-density lipoprotein (HDL) [Kotiyal JP, Bisht DB, Singh DS. Double blind cross-over trial of gum guggulu (Commiphora mukul) Fraction A in hypercholesterolemia. J Res Indian Med Yoga Hom 1979;14(2):11-6; Kotiyal JP, Singh DS, Bisht DB. Gum guggulu (Commiphora mukul) fraction 'A' in obesity-a double-blind clinical trial. J Res Ayur Siddha 1985;6(1, 3, 4):20-35; Gaur SP, Garg RK, Kar AM, et al. Gugulipid, a new hypolipidaemic agent, in patients of acute ischaemic stroke: effect on clinical outcome, platelet function and serum lipids. Asia Pacif J Pharm 1997;12:65-9; Urizar NL, Liverman AB, Dodds DT, et al. A natural product that lowers cholesterol as an antagonist ligand for the FXR. Science 3 May 2002 [Science Express Reports]; Nityanand S, Srivastava JS, Asthana OP. Clinical trials with gugulipid. A new hypolipidaemic agent. J Assoc Physicians India 1989;37(5):323-8; Kuppurajan K, Rajagopalan SS, Rao TK, et al. Effect of guggulu (Commiphora mukul-Engl.) on serum lipids in obese, hypercholesterolemic and hyperlipemic cases. J Assoc Physicians India 1978;26(5):367-73; Gopal K, Saran RK, Nityanand S, et al. Clinical trial of ethyl acetate extract of gum gugulu (gugulipid) in primary hyperlipidemia. J Assoc Physicians India 1986;34(4):249-51; Agarwal RC, Singh SP, Saran RK, et al. Clinical trial of gugulipid-a new hypolipidemic agent of plant origin in primary hyperlipidemia. Indian J Med Res 1986;84:626-34; Verma SK, Bordia A. Effect of Commiphora mukul (gum guggulu) in patients of hyperlipidemia with special reference to HDL-cholesterol. Indian J Med Res 1988;87:356-60; 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(4):659-64; Ghorai M, Mandal SC, Pal M, et al. A comparative study on hypocholesterolaemic effect of allicin, whole germinated seeds of bengal gram and guggulipid of gum gugglu. Phytother Res 2000;14(3):200-02]. However, most published studies were small and methodologically flawed. In August 2003, a well-designed trial reported small significant increases in serum LDL levels associated with the use of guggul compared to placebo [Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the treatment of hypercholesterolemia: a randomized controlled trial. JAMA 2003;290(6):765-72]. No significant changes in total cholesterol, high-density lipoprotein (HDL), or triglycerides were measured. These results are consistent with two prior published case reports [Das Gupta R. Gugulipid: pro-lipaemic effect. J Assoc Physicians India 1990;38(12):346].
The effects of guggulipid in patients with high cholesterol are not clear, with some studies finding cholesterol-lowering effects, and other research suggesting no benefits. At this time, there is not enough scientific evidence to support the use of guggul for any medical condition. Guggul may cause stomach discomfort or allergic rash as well as other serious side effects and interactions. It should be avoided in pregnant or breast-feeding women and in children. Safety of use beyond 4 months has not been well studied.
"Traditional (India) uses of C. mukul (CM) are for its anti-inflammatory, antispasmodic, carminative , emmenagogue, hypoglycemic, alternative , antiseptic, and astringent, a thyroid stimulant, anthelminitic, antihyperlipidemia , antidiabetic and antioxidant properties (Ramesh et al., 2011). It is an important herb used in the treatment of several degenerative disorders in modern medicine too and established as a hypolipidemic drugs (Ulbricht et al., 2005). Ayurvedic medicines containing gum guggul often contain guggul in their names, such as in Shunthiguggul , and Yogaraja guggul. "
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to investigate the effects of Commiphora mukul gum resin ethanolic
extract (CMEEt) administration against altered activities of key enzymes of carbohydrate
metabolism, lipid metabolism and changes in glycogen content (liver and muscle) and
lipids (liver and heart) in streptozotocin (STZ) induced insulin deficient diabetic Wistar albino
rats. Diabetes was induced by intraperitoneal injection of STZ (55 mg/kg body wt) to male
Wistar rats. The animals were divided into four groups: Control (C), control-treated (C+CM),
diabetic (D) and diabetic-treated group (D+CM). Diabetic-treated and control-treated rats
were treated with C. mukul gum resin ethanolic extract (CMEEt) in 2 ml distilled water, orally
(200 mg/kg body weight/day for 60 days). At the end of the experimental period, biochemical
parameters related to carbohydrate and lipid metabolism were assayed. The significant enhancement
in tissue lipids (heart and liver) total cholesterol, triglycerides, phospholipids and
free fatty acids of diabetic rats were nearer to normalized in diabetic treated rats (D+CM). Alterations
in the activities of enzymes of glucose metabolism (hexokinase, phosphofructokinase,
pyruvate kinase, and glucose-6-phosphatase, fructose-1,6-bisphosphatase and glucose-6-
phosphate dehydrogenase) and lipid metabolism (fatty acid synthase, malic enzyme and lipoprotein
lipase) as observed in diabetic (D) rats were prevented with CMEEt administration. In
conclusion, our findings indicate improvement of glucose and lipid metabolisms in STZ induced
diabetic rats by treatment with Commiphora mukul and suggest that the plant can be
used as an adjuvant for the prevention and/or management of insulin deficiency and disorder
related to it.
Keywords: C. mukul, diabetes, glycolysis, gluconeogenesis, lipogenesis, tissue lipids
"Traditional (India) uses of C. mukul are for its anti-inflammatory, antispasmodic, carminative, emmenagogue, hypoglycemic, alternative, antiseptic, and astringent, a thyroid stimulant, anthelminitic and antihyperlipidemia properties. It is an important herb used in the treatment of several degenerative disorders in modern medicine too and established as a hypolipidemic drug  . Ayurvedic medicines containing gum guggul often contain guggul in their names, such as Shunthi-guggul, and Yogaraja guggul. "
[Show abstract][Hide abstract] ABSTRACT: To study the antioxidant efficacy of Commiphora mukul (C. mukul) gum resin ethanolic extract in streptozotocin (STZ) induced diabetic rats.
THE MALE WISTAR ALBINO RATS WERE RANDOMLY DIVIDED INTO FOUR GROUPS OF EIGHT ANIMALS EACH: Control group (C), CM-treated control group (C+CMEE), Diabetic control group (D), CM- treated diabetic group (D+CMEE). Diabetes was induced by intraperitoneal injection of STZ (55 mg/kg/ bwt). After being confirmed the diabetic rats were treated with C. mukul gum resin ethanolic extract (CMEE) for 60 days. The biochemical estimations like antioxidant, oxidative stress marker enzymes and hepatic marker enzymes of tissues were performed.
The diabetic rats showed increased level of enzymatic activities aspartate aminotransaminase (AST), alanine aminotransaminase (ALT) in liver and kidney and oxidative markers like lipid peroxidation (LPO) and protein oxidation (PO) in pancreas and heart. Antioxidant enzyme activities were significantly decreased in the pancreas and heart compared to control group. Administration of CMEE (200 mg/kg bw) to diabetic rats for 60 days significantly reversed the above parameters towards normalcy.
In conclusion, our data indicate the preventive role of C. mukul against STZ-induced diabetic oxidative stress; hence this plant could be used as an adjuvant therapy for the prevention and/or management of diabetes and aggravated antioxidant status.
Asian Pacific Journal of Tropical Biomedicine 11/2012; 2(11):895-900. DOI:10.1016/S2221-1691(12)60249-4
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