The general public’s growing mistrust of the pharmaceutical industry and its perception of the lack of adverse effects of “natural” therapy have lead to the increasing use of “alternative drugs” for hypercholesterolemia. A sixty-three year old woman presented with severe hypertransaminasemia that had developed progressively over a few weeks. For six months she had been taking Equisterol, an over-the-counter lipid-lowering product containing guggulsterol and red yeast rice extract. The choice of an alternative medicine approach in this case subjected the patient to “re-challenge” with the official medicine agent that had previously caused mild hepatotoxicity. Physicians should keep in mind that “alternative” medicine is not always the safest alternative and sometimes it is not even “alternative.”

– Acute hepatitis caused by a natural lipid-lowering product: when “alternative” medicine is no “alternative” at all. — Grieco A, Miele L, Pompili M, Biolato M, Vecchio FM, Grattagliano I, Gasbarrini G. — J Hepatol. 2009 Jun;50(6):1273-7. Epub 2009 Mar 31.

Guggul can have an effect on cholesterol levels in the body.
– Satyavati GV, Dwarakanath C, Tripathi SN. — Experimental studies on the hypocholesterolemic effect of Commiphora mukul. Engl. (Guggul). — Indian J Med Res. 1969 Oct;57(10):1950-62.

Guggul has anti-inflammatory properties.
– Arzneimittelforschung 1977 Jul;27(7):1455-7 — Comparison of the anti-inflammatory activity of Commiphora mukul (an indigenous drug) with those of phenylbutazone and ibuprofen in experimental arthritis induced by mycobacterial adjuvant. –Sharma JN, Sharma JN.

Inhibits platelet aggregation.
– Mester L, Mester M, Nityanand S. — Inhibition of platelet aggregation by “guggulu” steroids.
Planta Med. 1979 Dec;37(4):367-9.

Concomitant oral administration with propranolol (Inderal) or diltiazem (Cardizem) can reduce their bioavailability and might reduce their therapeutic effects. Because of it’s action on the thyroid (guggulsterone has thyroid-stimulating activity) caution should be used when administering with thyroid drugs.
– J Assoc Physicians India 1994 Jun;42(6):454-5 — Effect of gugulipid on bioavailability of diltiazem and propranolol. — Dalvi SS, Nayak VK, Pohujani SM, Desai NK, Kshirsagar NA, Gupta KC.

Stimulates the thyroid gland.
– Planta Med 1984 Feb;(1):78-80 — Thyroid stimulating action of Z-guggulsterone obtained from Commiphora mukul. — Tripathi YB, Malhotra OP, Tripathi SN.

Side effects of guggulipid were headache, mild nausea, eructation, and hiccup in a few patients.
– Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. — Singh RB, et al. — Cardiovasc Drugs Ther. 1994 Aug;8(4):659-64.

Other possible side effects include interactions with several prescription and over the counter drugs. Consult your physician before using especially if you are pregnant or nursing.

Allergic contact dermatitis to guggul was experienced after using a slimming cream.

– Contact Dermatitis. 2007 May;56(5):286-7. — Salavert M, Amarger S, Le Bouedec MC, Roger H, Souteyrand P, D’incan M.