Supplements · Metabolic & Cardiometabolic
psyllium decreases LDL cholesterol
In plain terms: Does psyllium fibre lower "bad" cholesterol?
Strong support Supplements 💰 Industry COI noted
Part of: 🧪 psyllium
RefutedContestedStrong support
consensus score 0.87
Yes — well-established across many trials, and gentle on sensitive guts.
📅 Last reviewed: 2026-07-15 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: All trials, pooled (Meta-analysis)
MechanismIn-vitroAnimalObservationalRCTMeta-analysis
How the studies fall
11 support 0 contradict 0 tested null 1 mixed · 12 sources, 10 independent groups · 1 superseded — pooled inside a review, counted once
What the evidence shows
Psyllium lowers LDL, non-HDL and ApoB (~10 g/d), with FDA-claim precedent in baked/cereal matrices — and it is low-FODMAP / IBS-friendly.
The evidence (15)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Neal, Balm 1990 · South Med J | RCT | supports | low | Controlled diet trial, n=59 (30 on diet + 20.4 g/day psyllium vs 29 diet only, 3 months after a 2-month AHA phase I lead-in): 'Psyllium supplementation resulted in an additional 5.5% reduction in the TC levels as compared to diet alone.' LDL-C fell 20.0% (men) and 11.6% (women) for diet + psyllium combined, so the isolated psyllium-vs-diet-alone increment is reported for total cholesterol, not LDL-C. Abstract-only; randomization and blinding not stated. ↩ SUPERSEDED — pooled in the review above, counted once |
| Jayaram S, Prasad HB, Sovani VB, Langade DG, Mane PR 2007 · J Indian Med Assoc. 2007 Mar;105(3):142-5, 150 | RCT | supports | low | Randomised 12-week add-on trial, n=100 (97 completers), LDL-C >130 mg/dl: isapgol (psyllium) 5.6 g twice daily + atorvastatin 10 mg vs atorvastatin 10 mg alone. 'At the end of the 12th week fall in LDL-C at 31.4% for isapgol + atorvastatin was significantly greater than 22.8% among the atorvastatin group (p < 0.05).' No between-group difference at 8 weeks (20.5% vs 16.0%, NS), and total cholesterol, HDL-C and triglyceride showed no between-group difference at either timepoint. No placebo arm; abstract-only, methods not readable. |
| Sirtori CR, Galli C, Anderson JW, Sirtori E, Arnoldi A 2009 · Nutr Res Rev 2009 Dec;22(2):244-61 | observational | supports | moderate | Narrative review of functional foods for dyslipidaemia (Nutr Res Rev 2009;22(2):244-61; PubMed pubType 'Review'). Psyllium is named as a source of cholesterol-lowering soluble fibre: 'They may contain, for example, soluble fibre (from oat and psyllium), useful both for lowering cholesterol and blood pressure, or fructans, effective in diabetes.' The readable text says 'cholesterol', not LDL specifically — the review reserves LDL-specific wording for other ingredients ('Phytosterols and stanols lower LDL-cholesterol in a dose-dependent manner'). No effect size, no dose, no pooled estimate, and no psyllium trial is quantified in the readable text; abstract-only, full text paywalled (Europe PMC isOpenAccess=N). Review-role second-hand summary of the same psyllium trial literature this claim already holds 14 primary appraisals of. Funding/COI: not seen. |
| Ribas 2015 · Br J Nutr | RCT | supports | moderate | Randomised, double-blind, placebo-controlled parallel trial in 51 dyslipidaemic Brazilian children and adolescents aged 6-19 y (psyllium 7.0 g/d, n 26, vs equivalent cellulose, n 25) for 8 weeks after a 6-week NCEP Step 2 diet run-in: 'Statistically significant changes between the control and intervention groups over time were observed for total cholesterol (7.7%; -0.39 mmol/l; P=0.003) and LDL-C (10.7%; -0.36 mmol/l; P=0.01).' Abstract-only read; small single-centre trial. |
| Zhu 2024 · Nutrition Research | meta-analysis | supports | high | Meta-analysis of 29 RCTs (2769 adults; random-effects WMD, 5 databases searched to Aug 2023): Plantago consumption significantly reduced LDL-C by 0.35 mmol/L and total cholesterol by 0.28 mmol/L. A subgroup isolating the claim's exposure found TC and LDL-C significantly lower in participants consuming Plantago husk or psyllium. No substantial effect on HDL-C or triglycerides. The stated 7% decrease in cardiovascular event risk is a modelled extrapolation from the LDL-C drop, not a measured endpoint. Abstract-only: no I2, risk-of-bias, publication-bias or registration detail available. |
| Jenkins 2005 · Am J Clin Nutr 81(2):380-7 | RCT | supports | high | Randomized 3-way crossover, n=34 hyperlipidemic outpatients, 1 mo per arm. The intervention is a composite: 'a diet high in plant sterols (1.0 g/1000 kcal), soy-protein foods (including soy milks and soy burgers, 21.4 g/1000 kcal), almonds (14 g/1000 kcal), and viscous fibers from oats, barley, psyllium, and the vegetables okra and eggplant (10 g/1000 kcal) (portfolio diets)'. Result: 'LDL-cholesterol concentrations decreased by 8.5+/-1.9%, 33.3+/-1.9%, and 29.6+/-1.3% after 4 wk of the control, statin, and portfolio diets, respectively.' Psyllium is never administered alone, its dose within the 10 g/1000 kcal fibre total is not reported, and no arm differs only in psyllium - so the LDL fall is attributable to the portfolio, not to psyllium. OFF-SCOPE for a psyllium claim; on-scope evidence for a portfolio claim, which the vault does not yet hold. |
| Pal 2017 · Nutrients | RCT | supports | low | 12-month double-blind placebo-controlled RCT (ACTRN12611000415909), 159 randomised / 127 analysed at 3 months (43 psyllium), 5 g psyllium vs 5 g rice flour three times daily before meals in overweight/obese non-diabetic Australian adults: 'LDL was significantly lower compared to control at 3 months in the PGX (-13.9%, p < 0.001) and PSY (-8.1%, p = 0.007) groups and at 6 months in the PGX (-11%, p = 0.006) group compared to control.' The psyllium effect was time-limited - the authors state 'LDL cholesterol was only significantly lower in the PSY group at 3 months compared to control' - with no significant LDL difference at 6 or 12 months, and apoB never moved in any arm. Energy, carbohydrate, fat and protein intakes were also significantly lower in psyllium than control at 3 months, so the LDL difference is not isolated to the fibre. Per-protocol analysis (32 of 159 excluded before the first timepoint, 58% reaching 12 months) and industry-funded: an author owns the company with a commercial interest in the comparator PGX product and the sponsor held randomisation and blinding. |
| Wei ZH, Wang H, Chen XY, Wang BS, Rong ZX, Wang BS, Su BH, Chen HZ 2009 · Eur J Clin Nutr | meta-analysis | supports | moderate | [FT-verified] Wei2009 21RCTs n=1717 LDL -0.278 mmol/L; significant dose-response 3-20g/d |
| Jovanovski E, et al. 2018 · Am J Clin Nutr | meta-analysis | supports | moderate | [FT-verified 2026-07 Tier-A; NOT re-verifiable 2026-08-18 - paywalled, no archive in _sources/] Jovanovski 2018 (Am J Clin Nutr 108(5):922-932), 28 RCTs, n=1924, median ~10.2 g/d psyllium: LDL-C MD -0.33 mmol/L (95% CI -0.38, -0.27; P<0.00001); non-HDL -0.39 mmol/L; apoB -0.05 g/L. Authors' GRADE certainty for the LDL estimate is MODERATE, 'downgraded for inconsistency'; high certainty applied only to apoB. No CV events measured. |
| Moreyra AE, Wilson AC, Koraym A 2005 · Arch Intern Med | RCT | supports | moderate | Blinded placebo-controlled RCT, n=68, 12 weeks: on an identical 10 mg simvastatin background, LDL-C fell 55 mg/dL (1.42 mmol/L) with placebo vs 63 mg/dL (1.63 mmol/L) with 15 g/day psyllium (P = .03); ApoB and total cholesterol moved similarly, triglycerides and HDL did not. ~23 per arm, single centre, abstract-only reading. |
| Pal, Khossousi, Binns, Dhaliwal, Ellis 2011 · Br J Nutr. 2011 Jan;105(1):90-100 | RCT | supports | moderate | Overweight/obese adults were randomised to control (with placebo), psyllium fibre supplement (FIB), healthy eating plus placebo (HLT) or healthy eating plus fibre supplement (HLT-FIB) for 12 weeks: 'The HLT-FIB, HLT and FIB groups all had significant reductions in total cholesterol and LDL-cholesterol compared with control after 6 and 12 weeks.' The supplement-alone arm therefore lowered LDL against placebo; the abstract gives no effect size, n or blinding detail. |
| Gholami Z, Paknahad Z 2025 · Genes Nutr | meta-analysis | supports | moderate | Dose-response MA (PROSPERO CRD42023402987), 41 RCT records/arms, n=2049; LDL-C pooled from 26 comparisons: WMD -8.55 mg/dL (95% CI -12.92, -4.19), p<0.0001, I2=88.46%. Effect is dose-confined: >10 g/d -11.06 (-15.52, -6.60) p=0.001 vs <10 g/d +1.99 (-1.29, 5.28) p=0.23; continuous meta-regression on dose null (slope -0.34, p=0.41). Leave-one-out robust (-9.44 to -7.28). Total-C -9.05 (-13.71, -4.40); HDL-C +0.57 (-0.88, 2.04) and TG -5.29 (-12.14, 1.54) both null. Quality moderate not high: 'a publication bias was observed in LDL-C (p=0.04)' (trim-and-fill moves it further from null, -14.58), multiple arms of one trial entered as independent comparisons, active comparators (wheat bran, plant sterol, niacin, guar gum) pooled with placebo and the promised comparator subgroup never reported, and the authors' own close is 'psyllium's impact on lipid profile remains inconclusive'. |
| Schoeneck 2021 2021 · Nutr Metab Cardiovasc Dis | meta-analysis | supports | high | Umbrella SR of 37 guidelines + 108 SRs/MAs, GRADE-rated: 'With high evidence, foods ... high in soluble fiber (e.g. oats, barley, and psyllium) caused at least moderate (i.e. 0.20-0.40 mmol/L) reductions in LDL cholesterol.' Psyllium named explicitly in the top evidence tier. Note this synthesis subsumes pre-2019 psyllium MAs already voting on this claim (jovanovski-2018 and others) - not an independent vote. |
| Juhasz 2023 · Am J Clin Nutr | meta-analysis | mixed | moderate | LDL was analysed and psyllium was in the network, but the paper's LDL result names a different fibre: 'Galactomannans were ranked first in reducing the levels of triglycerides (SUCRA: 82.77%) and LDL cholesterol (SUCRA: 86.56%).' Psyllium is named top only for HOMA-IR (SUCRA: 96.67%); no psyllium LDL rank or estimate appears in the available text, so this source cannot be read as showing psyllium lowers LDL. 'Most comparisons had a low or moderate certainty of evidence.' Abstract-only read - full text is subscription-gated. |
| Ganji 1996 · Int J Food Sci Nutr | RCT | supports | low | 20 g/day psyllium in a 10-subject randomized crossover feeding trial: 'SO + PF diet significantly reduced serum cholesterol compared with SO diet (P < 0.001). CO + PF diet significantly reduced serum cholesterol compared with CO diet (P < 0.014)'; 'Reduction of serum cholesterol was due to reduction of LDL cholesterol', with LDL and apoB reductions parallel to total cholesterol (no LDL point estimate reported). |
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