Guggul (Commiphora mukul)
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.
African myrrh, Arabian myrrh, Balsamodendrum mukul, Balsamodendrum wightii, bdellium (Greek, Hebrew, Latin), bdellium gum, bdellium tree, Burseraceae (family), Commifora mukul, Commiphora erlangeriana, Commiphora opobalsamum, Commiphora wightii, E-guggulsterone, false myrrh (as C. mukul), fraction A, guggal, guggul (Hindi), guggul oleoresin, guggulipid, guggulipid C+, guggulsterones, guggulu (Sanskrit), guglip, gugul, gugulimax, gugulipid, Gugulmax®, gum guggul, gum guggulu, gum myrrh, Indian bdellium (as C. mukul), Indian bdellium tree (as C. mukul), Indian myrrh, mo ku er mo yao (as C. mukul) (Chinese), mo yao, myrrha, myrrhe des Indes (French), sesquiterpenoids, Vitamin World® Select Herbals Standardized Extract Guggul Plex 340mg, Z-guggulsterone.
Combination products: Sunthi guggulu, sunthi-guggulu (combination with ginger).
Note: Mirazid® is a commercial preparation of an extract of Commiphora molmol (myrrh). It is marketed as an anthelmintic (acts against parasitic worms). This monograph is primarily concerned with Commiphora mukul and does not grade the safety or efficacy of Commiphora molmol.
Guggul (gum guggul) is the common name for the mukul myrrh tree (Commiphora mukul). Guggul is also the name of the sap-like product produced by the tree. Guggulipid, which is extracted from guggul, contains guggulsterones, which may have health benefits for humans.
Guggul has been used medicinally, primarily in India, since at least 600 BC. In Ayurveda, or traditional Indian medicine, guggul has been used to treat a variety of conditions, including cancer, obesity, liver disorders, urinary complaints, intestinal worms, and sinus conditions. Guggul may haves possible effects on levels of cholesterol and other fats; however caution may be warranted when using in patients with advanced diabetic renal disease, or hypertension. However, no existing research supports the use of guggul to treat any condition in humans.
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.
Hyperlipidemia (high cholesterol)
Guggulipid supplements have been taken for high cholesterol. Early scientific studies suggested that guggulipid may be effective in reducing levels of total cholesterol, triglycerides, and LDL (low-density lipoprotein, or "bad" cholesterol) and in raising levels of HDL (high-density lipoprotein, or "good" cholesterol). Some conflicting evidence exists. Additional high-quality trials are needed.
Acne (nodulocystic, or severe)
Guggulipid has been recommended as a treatment for the severe (nodulocystic) form of common acne. Preliminary results suggest that this therapy may improve symptoms. However, further research is needed before a conclusion can be made.
Guggul has often been included in Ayurvedic (traditional Indian medicine) preparations to treat obesity. Despite this long-standing use, insufficient clinical evidence is available to support the use of guggul to treat obesity. Further research is required.
Osteoarthritis (arthritis involving cartilage breakdown)
Guggulsterone is a guggul polyphenol that has been used to treat osteoarthritis, possibly because it may have anti-inflammatory properties. Additional research is needed before a recommendation can be made.
Rheumatoid arthritis (arthritis involving inflammation of the joint lining)
Preliminary research showed that guggul may reduce symptoms of arthritis. Additional research is needed to determine if guggul or compounds prepared from guggul are effective in the treatment of rheumatoid arthritis.
*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.
Anemia, antibacterial, anticoagulant, anti-inflammatory, antiplatelet (blood thinner), antioxidant, antiparasitic (kills parasitic organisms), asthma, atherosclerosis (hardening of the arteries), bleeding, bone fractures, bronchitis, cancer, cardiovascular disease, circulation, cognitive enhancement (improved thinking and learning), colds, colitis (inflamed large intestine), cough, cystitis (inflamed bladder), dementia, diabetes, dysmenorrhea, edema (swelling), epilepsy, facial paralysis, fever, gingivitis (inflamed gums), gout (joint inflammation), hangovers, heart conditions, hemorrhoids, hepatic disorders (liver disorders), hormonal effects, intestinal worms, leprosy, leukorrhea (thick vaginal discharge), menstrual disorders, mouth infections, musculoskeletal disorders, nerve pain, nervous disorders, neuralgia, otorrhea (fluid discharge from the ear), pain, prostate cancer, psoriasis, rhinitis (stuffy nose), sciatica (back and leg pain), seizures, sinus disorders, skin conditions, sleep aid, sore throat, sores, stomach upset, syphilis, tumors, ulcers, urinary disorders, vitiligo, whooping cough, wound healing.
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)
For acne (nodulocystic), a tablet containing 25 milligrams of guggulsterone has been taken by mouth twice daily for six weeks.
For hyperlipidemia, the following doses of guggul have been taken by mouth: 2-16 grams of guggul in divided doses for up to three months; 25-2,000 milligrams of guggulsterone 2-3 times daily for up to eight weeks; 50-500 milligrams of guggulipid 2-3 times daily for up to 12 weeks; 1.5 grams daily of partially purified guggul in divided doses for up to 75 weeks; 2-4.5 grams of gum guggul 1-3 times daily for 16 weeks; and 10-15 grams of purified gum guggul taken daily for three months.
For obesity, 500 milligrams of partially purified guggul has been taken by mouth three times daily. One and one-half grams of guggulipid has been taken by mouth three times daily, together with dietary restrictions, for 30 days. Four grams of gum guggul three times daily has been taken by mouth for four weeks.
For osteoarthritis, 500 milligrams of a concentrated guggul extract has been taken by mouth three times daily with food.
For rheumatoid arthritis, three grams of guggul has been taken by mouth daily for four months.
Children (under 18 years old)
There is no proven safe or effective dose for guggul in children.
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 with known allergy or hypersensitivity to guggul (Commiphora mukul), any of its components, or other members of the Burseraceae family. Skin reactions and shortness of breath have been reported after guggul has been taken by mouth or applied to the skin.
Side Effects and Warnings
Guggul may lower blood sugar levels. Caution is advised in patients 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.
Guggul may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
Guggul may interfere with the activity of medications used to treat high blood pressure, including beta-blockers and calcium channel blockers. Caution is advised in patients taking blood pressure medications.
Guggul may interfere with the way the body processes certain drugs, herbs, or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of these agents may change in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Patients taking any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Use cautiously in patients using lipid-lowering agents, due to guggul's lipid-lowering effects.
Use cautiously in patients with gastrointestinal disorders. Stomach discomfort, diarrhea, loose stools, nausea, and vomiting have been associated with guggul use in these patients.
Use cautiously in patients using agents that affect the cardiovascular system, agents that affect the thyroid, or red yeast rice.
Avoid in large amounts in patients using estrogens.
Avoid use in pregnant or breastfeeding women.
Avoid use in patients with known allergy or hypersensitivity to guggul (Commiphora mukul), other members of the Burseraceae family, or any components of guggul.
Pregnancy and Breastfeeding
Avoid if pregnant or trying to become pregnant.
Guggul is not recommended in breastfeeding women, due to a lack of available scientific evidence.
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
Guggul may affect blood sugar levels. Caution is advised when using medications that may also affect blood sugar. Patients 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.
Guggul may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
Guggul may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may change in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Patients taking any medication should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Guggul may also interact with antiarthritics, antibiotics, anticancer agents, anti-inflammatory agents, antiobesity agents, drugs that affect the cardiovascular system such as beta-blockers and calcium channel blockers, drugs used for osteoporosis, hormonal agents, lipid-lowering agents, and thyroid hormones.
Interactions with Herbs and Dietary Supplements
Guggul may affect blood sugar levels. Caution is advised when using herbs or supplements that may also affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Guggul may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
Guggul may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may change in the blood. It may also alter the effects that other herbs or supplements potentially may have on the P450 system.
Guggul may also interact with antiarthritics, antibacterials, anticancer agents, anti-inflammatory herbs, antiobesity herbs and supplements, antioxidants, herbs and supplements that affect the cardiovascular system, hormonal agents, lipid-lowering herbs and supplements, osteoporosis agents, red yeast rice, and thyroid agents.
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.
An MJ, Cheon JH, Kim SW, et al. Guggulsterone induces apoptosis in colon cancer cells and inhibits tumor growth in murine colorectal cancer xenografts. Cancer Lett 2009;279(1):93-100.View Abstract
Cornick CL, Strongitharm BH, Sassano G, et al. Identification of a novel agonist of peroxisome proliferator-activated receptors alpha and gamma that may contribute to the anti-diabetic activity of guggulipid in Lep(ob)/Lep(ob) mice. J Nutr Biochem 2009;20(10):806-15.View Abstract
Gebhard C, Stämpfli SF, Gebhard CE, et al. Guggulsterone, an anti-inflammatory phytosterol, inhibits tissue factor and arterial thrombosis. Basic Res Cardiol 2009;104(3):285-94.View Abstract
Kalariya NM, Shoeb M, Reddy AB, et al. Prevention of endotoxin-induced uveitis in rats by plant sterol guggulsterone. Invest Ophthalmol Vis Sci 2010;51(10):5105-13.View Abstract
Kapoor S. Guggulsterone: a potent farnesoid X receptor antagonist and its rapidly evolving role as a systemic anticarcinogenic agent. Hepatology 2008;48(6):2090-1.View Abstract
Kim ES, Hong SY, Lee HK, et al. Guggulsterone inhibits angiogenesis by blocking STAT3 and VEGF expression in colon cancer cells. Oncol Rep 2008;20(6):1321-7.View Abstract
Kim JM, Kang HW, Cha MY, et al. Novel guggulsterone derivative GG-52 inhibits NF-kappaB signaling in intestinal epithelial cells and attenuates acute murine colitis. Lab Invest 2010;90(7):1004-15.View Abstract
Leeman-Neill RJ, Wheeler SE, Singh SV, et al. Guggulsterone enhances head and neck cancer therapies via inhibition of signal transducer and activator of transcription-3. Carcinogenesis 2009;30(11):1848-56.View Abstract
Nohr LA, Rasmussen LB, Straand J. Resin from the mukul myrrh tree, guggul, can it be used for treating hypercholesterolemia? A randomized, controlled study. Complement Ther Med 2009;17(1):16-22.View Abstract
Shishodia S, Harikumar KB, Dass S, et al. The guggul for chronic diseases: ancient medicine, modern targets. Anticancer Res 2008;28(6A):3647-64.View Abstract
Xiao D, Singh SV. z-Guggulsterone, a constituent of Ayurvedic medicinal plant Commiphora mukul, inhibits angiogenesis in vitro and in vivo. Mol Cancer Ther 2008;7(1):171-80.View Abstract
Xu HB, Li L, Liu GQ. Reversal of P-glycoprotein-mediated multidrug resistance by guggulsterone in doxorubicin-resistant human myelogenous leukemia (K562/DOX) cells. Pharmazie 2009;64(10):660-5.View Abstract
Yamada T, Osawa S, Hamaya Y, et al. Guggulsterone suppresses bile acid-induced and constitutive caudal-related homeobox 2 expression in gut-derived adenocarcinoma cells. Anticancer Res 2010;30(6):1953-60.View Abstract
Youn HS, Ahn SI, Lee BY. Guggulsterone suppresses the activation of transcription factor IRF3 induced by TLR3 or TLR4 agonists. Int Immunopharmacol 2009;9(1):108-12.View Abstract
Yu BZ, Kaimal R, Bai S, et al. Effect of guggulsterone and cembranoids of Commiphora mukul on pancreatic phospholipase A(2): role in hypocholesterolemia. J Nat Prod 2009;72(1):24-8.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