Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
Benefiber®, C. tetragonolobus, Cal-Ban 3000®, cattle fodder, Choltrol®, cluster bean, cluster plant, clusterbean, Cyamopsis tetragonoloba, Cyamopsis tetragonoloba (L.) Taub., Cyamopsis tetragonoloba (L.) Taubert, Cyamopsis tetragonolobus, galactomannan, guaran, Guarem®, Guarina®, Indian cluster bean, Indische Büschelbohne (German), jaguar gum, M60, M90, M150, M175, Meyprofin®, Novafibra®, Novasource GI control®, soluble dietary fiber, Sunfiber®.
Selected combination products: Fiber Plan® (guar gum, psyllium husk, pectin, and locust bean gum); Minolest™ (containing guar gum and psyllium).
Guar gum is an extract of the guar bean (Cyamopsis tetragonoloba). The plant is primarily grown in Pakistan and India. Guar gum is widely used as a food-thickening agent and as an ingredient in nutritional supplements.
Guar gum is considered a plant-based dietary fiber, meaning that it is the edible part of a plant that may otherwise be hard to digest and absorb in the intestines. Dietary fibers may help promote bowel movements and may reduce cholesterol and blood sugar levels.
There is much evidence supporting the use of guar gum in reducing cholesterol levels. Guar gum may help enhance the function of the gastrointestinal (GI) tract and may help people who have diarrhea, constipation, or irritable bowel syndrome (IBS). Studies have also shown that guar gum may lower blood sugar following meals, as well as insulin levels in people with and without diabetes.
According to some research, guar gum may not be effective for weight loss. Following reports of side effects, the U.S. Food and Drug Administration (FDA) moved to ban guar gum as a weight loss ingredient.
Commonly reported side effects associated with guar gum include stomach pain, diarrhea, and gassiness. Guar gum may also affect how the body absorbs drugs given at the same time, such as metformin and penicillin.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
There is good scientific evidence showing that guar gum may help lower levels of total and low-density lipoprotein (LDL, or "bad") cholesterol. More research is needed to determine the effectiveness of different guar gum treatments to maximize these benefits.
Some studies have reported that guar gum, especially chemically treated guar gum that is water soluble, may reduce diarrhea in both adults and children. Most trials used Benefiber® and used guar gum in addition to other treatments.
Numerous studies have shown that guar gum may be effective in reducing blood sugar levels in people with types 1 and 2 diabetes. However, results are not consistent, and more research is needed before further conclusions can be made.
Blood pressure control
Some studies suggest that guar gum may help control blood pressure. Further research is needed to better understand these findings.
Bowel function improvement
Like other dietary fibers, guar gum has been used to improve bowel function by stimulating the removal of waste and toxins from the body. However, there have been conflicting results as to the effectiveness of guar gum on constipation. High-quality studies evaluating guar gum for this condition and for improving bowel function are needed.
Studies have looked into whether guar gum may help pregnant women with blocked bile flow (cholestasis). Results have been mixed and evidence is still lacking for this benefit. Additional research is needed.
Many studies have looked into the potential blood sugar-lowering effects of guar gum in people with and without diabetes. Well-designed, long-term studies are needed before a conclusion can be made.
Irritable bowel syndrome
Guar gum may help improve bowel function, regulate bowel movements, and promote the removal of waste and toxins from the bowel and colon. It may be beneficial in reducing symptoms of irritable bowel syndrome (IBS) in adults. Well-designed clinical trials are needed to confirm these findings.
Guar gum was believed to support weight loss by expanding in the stomach and reducing appetite. However, researchers reported that guar gum is not effective for this use and is associated with side effects. Following these reports, the U.S. Food and Drug Administration (FDA) moved to ban guar gum as a weight loss ingredient.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Gastric disorders (stomach problems).
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)
To reduce appetite, 2.5 grams of guar gum has been taken by mouth three times daily with a low-energy, semisolid meal. A diet containing 20 grams of a water-soluble guar gum supplement has been taken by mouth for one week.
To control blood pressure, 10 grams of guar gum has been taken by mouth three times daily before meals for six weeks. A dose of 3.5 grams of water-soluble guar gum has been taken by mouth three times daily for six months before meals.
To reduce blood pressure, a 300-milliliter beverage containing nine grams of guar gum, 30 milliliters of lemon juice, 20 megabecquerels of technetium-99-sulfur colloid, and 50 grams of glucose has been taken by mouth.
To improve bowel function, 10 grams of water-soluble guar gum has been taken by mouth for 15 days. A dose of 15 grams of guar gum-containing fiber has been taken by mouth for 18 days. A dose of 20 grams of guar gum has been taken by mouth daily.
To treat cholestasis (bile flow blockage) and pruritus (itching) in pregnancy, 5-15 grams of guar gum has been taken by mouth daily, with dosage increases at three-day intervals, until childbirth.
To improve cholesterol levels, 15-18 grams of guar gum has been taken by mouth daily in three divided doses for 3-24 months. A dose of 10 grams of guar gum has been taken by mouth three times daily with meals. A dose of 7.5 grams of guar gum has been taken by mouth daily for one week, then increased to 15 grams daily a second week; after the second week, the guar gum dose has been increased by five grams daily every two weeks, up to 30 grams daily.
To reduce cholesterol levels in type 2 diabetics, guar gum has been added to bread. A dose of 31.6 grams of guar gum has been taken by mouth daily by diabetics. For type 1 diabetics, five grams of guar gum has been taken by mouth four times daily before meals for six weeks.
To improve blood sugar control in diabetics, 15 grams of guar gum has been taken by mouth daily in three of four divided doses for up to 48 weeks in people with type 2 diabetes. Guar gum has been taken by mouth for four weeks by diabetics. A dose of 7.6 grams of guar gum added to bread containing 75 grams of carbohydrate has been taken by mouth by diabetics. A dose of 15 grams has been taken by mouth with a high-carbohydrate, low-fat, low-energy diet in overweight type 2 diabetics. A dose of five grams of guar gum has been taken by mouth before meals four times daily for six weeks by type 2 diabetics. A dose of nine grams of guar gum has been added to 30 grams of natural fibers to be taken by mouth daily for two months by diabetics.
To treat diarrhea, a two-percent guar gum-enriched tube feeding has been taken by people in the intensive care unit for four days. Doses of 25 or 50 grams of water-soluble guar gum added to World Health Organization Oral Rehydration Solution (WHO ORS) has been taken by adults with cholera. A 500-milliliter beverage containing 11 grams of water-soluble guar gum plus Lactobacillus rhamnosus GG (probiotics) has been taken by mouth daily eight days per month on chemotherapy cycle days 7-14 by chemotherapy patients.
To reduce blood sugar levels in nondiabetics, 10 grams of guar gum has been taken by mouth three times daily before meals for six weeks. A dose of five grams of guar gum has been taken by mouth with a meal containing 50 grams of carbohydrate. A dose of 2.5 grams of guar gum has been taken three times daily with a low-energy semisolid meal for two weeks. A dose of 100 grams of guar gum per kilogram of body weight has been used to replace wheat flour in bread. Doses of guar gum ranging from 2.9 to 9.1 grams have been added to biscuits. A dose of five grams of guar gum has been taken by mouth three times daily before meals for two weeks. Guar gum has been added to rolls.
To treat irritable bowel syndrome (IBS), five grams and 10 grams of water-soluble guar gum mixed in 60 milliliters of apple-flavored beverage have been taken by mouth daily before breakfast for 12 weeks.
To promote weight loss, 3.5 grams of water-soluble guar gum has been taken by mouth three times daily before meals for six months. A dose of 10 grams of water-soluble guar gum has been dissolved in 200 milliliters of water, coffee, or orange juice and taken by mouth twice daily for 14 months. A dose of 2.5 grams of guar gum has been taken three times daily with a low-energy semisolid meal. A dose of 15 grams of guar gum has been taken by mouth daily in divided doses for up to six months. A formula diet containing 20 grams of water-soluble guar gum has been taken by mouth for one week.
To control blood pressure in healthy people, an infusion of 50 grams of glucose (dissolved in 300 milliliters of water) and four grams of guar gum has been delivered to the duodenum at a rate of five milliliters per minute for 60 minutes.
Children (under 18 years old)
To treat acute (less than 48 hours) or persistent (more than 14 days) diarrhea, 20 grams of water-soluble guar gum has been added to the World Health Organization Oral Rehydration Solution (WHO ORS) and taken by mouth for seven days or until recovery by children aged 4-24 months.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid in people who have a known allergy or hypersensitivity to guar gum, any of its parts, Cyamopsis tetragonoloba, or members of the Fabaceae family.
Side Effects and Warnings
Guar gum is considered safe when used in amounts normally found in food (less than 15 grams daily in divided doses) by nonallergic people. However, guar gum, especially high doses (more than 50 grams), can cause diarrhea. Other mild adverse effects that may be caused by guar gum include a bad taste in the mouth, esophageal obstruction (blockage in the esophagus), electrolyte imbalances, gassiness, heartburn, loose stools, mineral imbalances, skin itching, stomach cramps or discomfort, and vitamin imbalances.
Guar gum may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Guar gum may cause low blood pressure. Caution is advised in people taking drugs or herbs and supplements that lower blood pressure.
Use cautiously in people who are taking antidiarrhea agents, calcium, diuretics, estrogen, laxatives, metformin, penicillin, vitamin A supplements, vitamin E supplements, and zinc supplements.
Use cautiously in people who are at risk for having hypomagnesemia (extremely low amounts of magnesium), hypokalemia (low amounts of potassium), or hyponatremia (low amounts of sodium) in the blood, as well as in people who are taking magnesium, potassium, or sodium supplements. Guar gum may increase the excretion of these materials in the urine.
Use cautiously in pregnant women when treating intrahepatic cholestasis (bile flow blockage) and pruritus (itchiness), as these conditions may worsen. Use cautiously when breastfeeding.
Use cautiously in people who have poor nutrition, especially vitamin A or vitamin E deficiencies, as guar gum may cause vitamin, mineral, or electrolyte imbalances.
Guar gum may cause blockage of the esophagus and intestines. Avoid using in people who have disorders of the stomach or esophagus, including esophagitis, gastric stapling, hiatal hernia, muscular dystrophy, peptic stricture, pyrosis, or Schatzki ring.
Avoid using in children younger than four months of age.
Pregnancy and Breastfeeding
Guar gum is likely safe in amounts normally found in food in nonallergic pregnant or breastfeeding women. Doses of 15 grams daily at three-day intervals have been safely used to treat cholestasis (bile flow blockage) and pruritus (itching) during pregnancy. However, a doctor should be consulted before using guar gum during pregnancy, as it may cause these conditions to worsen. Mild stomach distress, diarrhea, and gassiness may occur.
Avoid doses higher than 15 grams daily during pregnancy, due to a lack of safety information.
Use cautiously when breastfeeding.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Guar gum may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Guar gum may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.
Guar gum may also interact with alcohol, antibiotics, antidiarrheal agents, antiobesity agents, calcium salts, cardiac glycosides (drugs used to treat heart failure), cholesterol-lowering agents, diuretics (water pills), estrogens, laxatives, magnesium, metformin, potassium-reducing agents, potassium salts, progestins, and sodium.
Interactions with Herbs and Dietary Supplements
Guar gum may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Guar gum may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.
Guar gum may also interact with antidiarrheal herbs and supplements, antiobesity herbs and supplements, antioxidants, calcium, cholesterol-lowering herbs and supplements, diuretics, magnesium, phytoestrogens, phytoprogestins, potassium, potassium-reducing herbs and supplements, sodium, vitamin A, vitamin E, and zinc.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Alam, N. H., Meier, R., Sarker, S. A., Bardhan, P. K., Schneider, H., and Gyr, N. Partially hydrolysed guar gum supplemented comminuted chicken diet in persistent diarrhoea: a randomised controlled trial. Arch.Dis.Child 2005;90(2):195-199. View Abstract
Alam, N. H., Meier, R., Schneider, H., Sarker, S. A., Bardhan, P. K., Mahalanabis, D., Fuchs, G. J., and Gyr, N. Partially hydrolyzed guar gum-supplemented oral rehydration solution in the treatment of acute diarrhea in children. J.Pediatr.Gastroenterol.Nutr. 2000;31(5):503-507. View Abstract
Ebeling, P., Yki-Jarvinen, H., Aro, A., Helve, E., Sinisalo, M., and Koivisto, V. A. Glucose and lipid metabolism and insulin sensitivity in type 1 diabetes: the effect of guar gum. Am.J.Clin.Nutr. 1988;48(1):98-103. View Abstract
Groop, P. H., Aro, A., Stenman, S., and Groop, L. Long-term effects of guar gum in subjects with non-insulin-dependent diabetes mellitus. Am.J.Clin.Nutr. 1993;58(4):513-518. View Abstract
Gylling, H., Riikonen, S., Nikkila, K., Savonius, H., and Miettinen, T. A. Oral guar gum treatment of intrahepatic cholestasis and pruritus in pregnant women: effects on serum cholestanol and other non-cholesterol sterols. Eur.J.Clin.Invest 1998;28(5):359-363. View Abstract
Halama, W. H. and Mauldin, J. L. Distal esophageal obstruction due to a guar gum preparation (Cal-Ban 3000). South.Med.J. 1992;85(6):642-645. View Abstract
Harju, E., Heikkila, J., and Larmi, T. K. Effect of guar gum on gastric emptying after gastric resection. JPEN J.Parenter.Enteral Nutr. 1984;8(1):18-20. View Abstract
Harju, E. and Larmi, T. K. Efficacy of guar gum in preventing the dumping syndrome. JPEN J.Parenter.Enteral Nutr. 1983;7(5):470-472. View Abstract
Hunninghake, D. B., Miller, V. T., LaRosa, J. C., Kinosian, B., Jacobson, T., Brown, V., Howard, W. J., Edelman, D. A., and O'Connor, R. R. Long-term treatment of hypercholesterolemia with dietary fiber. Am.J.Med. 1994;97(6):504-508. View Abstract
Knopp, R. H., Superko, H. R., Davidson, M., Insull, W., Dujovne, C. A., Kwiterovich, P. O., Zavoral, J. H., Graham, K., O'Connor, R. R., and Edelman, D. A. Long-term blood cholesterol-lowering effects of a dietary fiber supplement. Am.J.Prev.Med. 1999;17(1):18-23. View Abstract
Lewis, J. H. Esophageal and small bowel obstruction from guar gum-containing "diet pills": analysis of 26 cases reported to the Food and Drug Administration. Am.J.Gastroenterol. 1992;87(10):1424-1428. View Abstract
Pittler, M. H. and Ernst, E. Guar gum for body weight reduction: meta-analysis of randomized trials. Am.J.Med. 6-15-2001;110(9):724-730. View Abstract
Riikonen, S., Savonius, H., Gylling, H., Nikkila, K., Tuomi, A. M., and Miettinen, T. A. Oral guar gum, a gel-forming dietary fiber relieves pruritus in intrahepatic cholestasis of pregnancy. Acta Obstet.Gynecol.Scand. 2000;79(4):260-264. View Abstract
Salenius, J. P., Harju, E., Jokela, H., Riekkinen, H., and Silvasti, M. Long term effects of guar gum on lipid metabolism after carotid endarterectomy. BMJ 1-14-1995;310(6972):95-96. View Abstract
Vuorinen-Markkola, H., Sinisalo, M., and Koivisto, V. A. Guar gum in insulin-dependent diabetes: effects on glycemic control and serum lipoproteins. Am.J.Clin.Nutr. 1992;56(6):1056-1060. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017