# Psyllium (Plantago ovata) *Ispaghula, ispaghul, spogel seed, flea seed; *Plantago ovata* Forssk. (*Plantago ispaghula*); the true psyllium of pharmacy is *Plantago afra* L. (*Plantago psyllium* L.) or *Plantago indica* L. (*Plantago arenaria* Waldst. & Kit.), the sand plantain; the *psullion* of Dioscorides; in pharmacy *Plantaginis ovatae semen* and *seminis tegumentum*, ispaghula seed and husk, and *Psyllii semen*, psyllium seed* **Known today as.** Seeds of plantains, of the family Plantaginaceae. Ispaghula, *Plantago ovata*, Grieve gives as a plant of India, Persia, Spain, and the Canary Islands, its seed boat-shaped, pale greenish brown, up to an eighth of an inch long, with no odour or taste; the mucilage is held in the seed coat, which was “sometimes used to stiffen linen.” The European Medicines Agency’s assessment report finds the husk 85 per cent water-soluble fibre. Psyllium seed proper comes from *Plantago afra* or *P. indica*, the latter the sand plantain whose smaller, black seeds Grieve says were “used similarly.” Kind: Plant > **Caution.** It must always be taken with enough liquid; swallowed with too little, bulk-forming agents can obstruct the throat and oesophagus, with choking, and the intestine. The European agency rules it out for anyone with a sudden change in bowel habit lasting more than two weeks, undiagnosed rectal bleeding, narrowing or blockage of the gut, diseases of the oesophagus, or difficulty in swallowing, and not recommended under six for constipation. It may delay the absorption of other medicines taken with it, such as minerals, vitamin B12, cardiac glycosides, coumarins, carbamazepine, and lithium; diabetics and people on thyroid hormone should take it under medical supervision. Ispaghula and psyllium contain potent allergens: people handling the powder at work, such as healthcare workers and caregivers, can become sensitised by inhaling it, and reactions up to anaphylaxis have been reported. Flatulence, which generally passes in the course of treatment, and abdominal distension may occur. ## What was it used for? A mild laxative and a remedy for the bowel. Grieve finds the seeds useful in place of linseed or barley and for diarrhoea and dysentery, the decoction a good demulcent drink, and the seeds mixed with sugar and taken dry “invaluable in this form for reducing inflamed mucous membranes of the intestinal canal,” roasted seeds turning astringent for children’s diarrhoea. ## What does modern science say? The European Medicines Agency’s herbal committee accepts all three on clinical evidence, as ‘well-established use,’ for habitual constipation and for conditions in which easy defaecation with soft stool is desirable, such as painful defaecation after rectal or anal surgery, anal fissures, and haemorrhoids; the husk also where more daily fibre may be advisable, as an adjuvant in constipation-predominant irritable bowel syndrome and to diet in high cholesterol (monographs of 2013). Its assessment reports find the husk’s active fraction a highly branched acidic arabinoxylan; the ispaghula seed holds 20 to 30 per cent of mucilage, the psyllium seed only about 10 to 12. Reviews of trials report that psyllium lowered fasting blood sugar, HbA1c, and insulin resistance against placebo (nineteen trials, 2024) and lowered systolic blood pressure by about 2 mmHg (eleven trials, 2020). On body weight they disagree: a 2023 meta-analysis of six trials in overweight and obese people found it reduced weight when taken before meals, while a 2025 meta-analysis of twenty-seven trials of psyllium husk found that it significantly increased body weight. ## Pharmacognosy and toxicology - **arabinoxylan**: highly branched and acidic, the active fraction of the husk - **mucilage**: 20 to 30 per cent of the ispaghula seed, 10 to 12 per cent of the psyllium seed **Mechanism.** A bulk-forming agent: taken with too little liquid it can obstruct the throat, oesophagus, or intestine, and it may delay the absorption of other medicines taken with it. **Standing.** European Union herbal monographs (2013): well-established use of the husk and of both seeds for habitual constipation and where soft stool is desirable. Meta-analyses (2023, 2025) disagree on body weight. ## What lore surrounds it? Dioscorides records the saying that the fresh plant brought into a house “does not allow fleas to breed,” and lists *herba pulicaria* among its other names. ## What did the older authorities say? **Dioscorides, *De materia medica* 4.70.** His *psullion*, which the modern translators suggest is *Plantago psyllium*, the flea seed, has a rough leaf and little pods at the top holding a seed like fleas, black and hard; it grows in fields and untilled places. Applied with oil of roses, vinegar, or water it cools, and he recommends it for the arthritic, tumours and oedema, inflammation of the parotid gland, and dislocations, and smeared on with vinegar for the hernias of children and protruding navels. Steeped in water until the water thickens, it “cools abundantly.” ## Sources - Grieve, M. *A Modern Herbal*, “Plantain, Ispaghul.” As published on botanical.com. - Dioscorides. *De materia medica*, 4-70, in the modern English version of T. A. Osbaldeston and R. P. A. Wood (Johannesburg: Ibidis, 2000), after Goodyer’s translation of 1655. Internet Archive. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Plantaginis ovatae seminis tegumentum (Ispaghula husk)*. EMA/HMPC/199774/2012, 14 May 2013. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Plantaginis ovatae semen (Ispaghula Seed)*. EMA/HMPC/304390/2012, 14 May 2013. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Psyllii semen (Psyllium seed)*. EMA/HMPC/599747/2012, 14 May 2013. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Plantaginis ovatae seminis tegumentum*. EMA/HMPC/199775/2012, 14 May 2013. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Plantaginis ovatae semen*. EMA/HMPC/304360/2012, 14 May 2013. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Psyllii semen*. EMA/HMPC/599745/2012, 14 May 2013. - Gholami Z, et al. (2024). The effect of psyllium on fasting blood sugar, HbA1c, HOMA IR, and insulin control: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials. *BMC endocrine disorders*. PMID 38844885. - Clark CCT, et al. (2020). The effect of psyllium supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials. *The Korean journal of internal medicine*. PMID 32066221. - Gibb RD, et al. (2023). Psyllium is a natural nonfermented gel-forming fiber that is effective for weight loss: A comprehensive review and meta-analysis. *Journal of the American Association of Nurse Practitioners*. PMID 37163454. - Gholami Z & Paknahad Z (2025). The effect of psyllium consumption on anthropometric indices: a systematic review and dose-response meta-analysis of randomized controlled trials. *Journal of health, population, and nutrition*. PMID 41126340. - European Medicines Agency, Committee on Herbal Medicinal Products. *European Union herbal monograph on Plantaginis ovatae seminis tegumentum (Ispaghula husk)*. EMA/HMPC/199774/2012, 14 May 2013. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Plantaginis ovatae seminis tegumentum*. EMA/HMPC/199775/2012, 14 May 2013. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Plantaginis ovatae semen*. EMA/HMPC/304360/2012, 14 May 2013. - European Medicines Agency, Committee on Herbal Medicinal Products. *Assessment report on Psyllii semen*. EMA/HMPC/599745/2012, 14 May 2013. - Gholami Z, et al. (2024). The effect of psyllium on fasting blood sugar, HbA1c, HOMA IR, and insulin control: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials. *BMC endocrine disorders*. PMID 38844885. --- *Psyllium.* In *Materia Medica*, edited by B. C. P. Statema. Version 1, revised 2026-10-16. The Thinking Press. https://thethinkingpress.org/materia-medica/psyllium Historical description, not medical advice.