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Cholesterol influence studies
Commiphora mukul and its cholesterol-lowering component, guggulsterone, effectively inhibit LDL oxidation.

Guggulipid for the treatment of hypercholesterolemia: a randomized controlled trial.
JAMA. 2003.
Recently, guggulsterones have been shown to be potent antagonists of 2 nuclear hormone receptors involved in cholesterol metabolism, establishing a plausible mechanism of action for the hypolipidemic effects of these extracts. To study the short-term safety and efficacy of 2 doses of a standardized guggul extract (guggulipid, containing 2.5% guggulsterones) in healthy adults with hyperlipidemia eating a typical Western diet. Double-blind, randomized, placebo-controlled trial using a parallel design, conducted March 2000-August 2001. A total of 103 ambulatory, community-dwelling, healthy adults with hypercholesterolemia in the Philadelphia, Pa, metropolitan area. Oral, 3 times daily doses of standard-dose guggul (1000 mg), high-dose guggul (2000 mg), or matching placebo. Percentage change in levels of directly measured low-density lipoprotein cholesterol (LDL-C) after 8 weeks of therapy. Secondary outcome measures included levels of total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides, and directly measured very low-density lipoprotein cholesterol (VLDL-C), as well as adverse events reports and laboratory safety measures including electrolyte levels and hepatic and renal function. Compared with participants randomized to placebo, in whom levels of LDL-C decreased by 5%, both standard-dose guggul and high-dose guggul raised levels of LDL-C by 4% and 5%, respectively, at 8 weeks, for a net positive change of 9% to 10%. There were no significant changes in levels of total cholesterol, HDL-C, triglycerides, or VLDL-C in response to treatment with guggul in the intention-to-treat analysis. While guggul was generally well tolerated, 6 participants treated with guggul developed a hypersensitivity rash compared with none in the placebo group. Despite plausible mechanisms of action, guggul did not appear to improve levels of serum cholesterol over the short term in this population of adults with hypercholesterolemia, and might in fact raise levels of LDL-C. Guggulipid also appeared to cause a dermatologic hypersensitivity reaction in some patients.

Cancer protection
Top Curr Chem. 2013. Cancer chemopreventive and therapeutic potential of guggulsterone. Guggulsterone (GS) is a phytosterol derived from the gum resin of guggul plants that have been used traditionally to treat various disorders such as burns, wounds, gastric ulcer, cough, gum diseases, urinary complaints, diarrhea, stomach cramps, fascioliasis, and intestinal worms. It has anti-inflammatory and antioxidative properties and has recently attracted substantial attention due to its cancer chemopreventive and therapeutic potential exemplified by its antiproliferative, antimetastatic, and proapoptotic properties in many cancer cell lines and animal models.

Inflammation research
Guggul also has anti-inflammatory activity. One study reports that it may be beneficial in osteoarthritis. Myrrhanol A, a new triterpene isolated from guggul (Balsamodendron or Commiphora mukul)-gum resin, displays potent anti-inflammatory effect.

Metabolic syndrome
Angiology. 2015. Effect of a Natural Supplement Containing Curcuma Longa, Guggul, and Chlorogenic Acid in Patients With Metabolic Syndrome. The impact of a natural supplement (Kepar; Rikrea, Italy), containing several plant extracts such as curcuma longa, silymarin, guggul, chlorogenic acid, and inulin, was evaluated in 78 patients with metabolic syndrome (MetS; 45 men; age: 62 ± 9 years). Kepar at a dose of 2 pills/d was given for 4 months as add-on therapy to the ongoing treatment, maintained at fixed doses for the entire study. Anthropometric variables, plasma lipids, glucose parameters, and oxidative stress were measured at baseline and after 4 months. We found significant reductions in body weight , body mass index, and waist circumference as well as in fasting glucose and total cholesterol. No significant changes were found in the other appraised parameters, including oxidative stress. In conclusion, after few months of treatment Kepar seems to exert beneficial effects in patients with metabolic syndrome.

Osteoarthritis
The effectiveness of Commiphora mukul for osteoarthritis of the knee: an outcomes study.
Altern Ther Health Med. 2003.
One of the ingredients most commonly found in Ayurvedic arthritis formulas is guggul, an oleoresin of the herb Commiphora mukul. The authors have conducted both preclinical and clinical investigations of guggul for reduction of pain, stiffness, and improved function, and to determine tolerability in older patients with a diagnosis of OA of the knee.  Overall data indicate significant improvement with guggul for participants during the trial in both scales and objective measures used for assessment purposes. There were no side effects reported during the trial. Guggul appears to be a relatively safe and effective supplement to reduce symptoms of osteoarthritis.

Hypothyroidism
Guggul (Commiphora mukul) potentially ameliorates hypothyroidism in female mice.
Phytother Res. 2005.
The efficacy of guggul in regulating hypothyroidism was evaluated in female mice. In addition to estimating serum levels of thyroxine and triiodothyronine, hepatic 5' monodeiodinase, hepatic glucose-6-phospatase and lipid-peroxidation (LPO), the activities of the anti-oxidative enzymes, superoxide dismutase (SOD) and catalase (CAT), were investigated. While 6-n-propyl-2-thiouracil (PTU, 10.00 mg/kg/d for 30 days) induced hypothyroidism in mice, as evidenced by a decrease in thyroid hormone concentration and in hepatic 5'D-I activity, simultaneous administration of guggul (200 mg/kg/d for 30 days) reversed this effect, indicating its potential to stimulate thyroid function. Although in PTU treated animals a marginal increase in hepatic LPO was observed, when simultaneously treated with guggul, it was decreased. A parallel increase in the activity of endogenous antioxidants, SOD and CAT, in the latter group indicated the safe and antiperoxidative nature. These findings suggest the possible use of guggul in the amelioration of hypothyroidism.

Prescription drugs combination
The Journal of Pharmacology and Experimental Therapeutics.
Guggul may interfere with many prescription drugs, including the popular anti-cholesterol drugs called statins. In a preliminary study, guggulsterone, the active ingredient in the herbal remedy guggul, causes changes in human and rodent cells that induce the body to break down many drugs, including cancer drugs and AIDS medications. Resin from the guggul tree has been used for more than 3,000 years in India to treat a range of disorders. Previous research showed that guggul lowers cholesterol by blocking a substance that keeps the body from getting rid of cholesterol. Guggulsterone likely affects other drugs because it binds to a protein known as pregnane X receptor (PXR). This, in turn, induces the body to "turn on" a gene that encodes another protein that breaks down many different types of drugs, thereby reducing their levels in the body. Some anticancer drugs, such as cyclophosphamide, need to be broken down by PXR to become active. Guggulsterone may interfere by augmenting that process, thereby raising levels of the drugs in the body. Moreover, guggulsterone appears to also turn some other drugs, such as acetaminophen, into toxic compounds. St. John's wort, also activates PXR, and can therefore interfere with other drugs. Guggulsterone has been used for years, and is likely safe if people are not taking any prescription medications. However, guggulsterone should be used cautiously by people who take prescription drugs.

Side effects, danger, is it safe?
I have been taking guggul lipid 500mg Natures Sunshine for 2 days and now have a terrible rash about my neck and chest. Is this a reaction to the product?
   We have not heard of this type of reaction to guggul before but it is possible that certain people have unexpected reactions to certain herbs.

Summary and review
Guggul appears to be beneficial in those who have metabolic syndrome which includes high blood lipids, high blood sugar, obesity, and an overall inflammatory pattern. Whether it lowers cholesterol levels is still being evaluated and no convincing conclusion can be drawn at this time.

Availability
Guggul extract is sold in a variety of ways. You can find it as the plain powder or as 5 percent and 10 percent guggul lipids. I have also seen this natural product sold as a 2.5 percent guggulsterone extract and 6 percent guggul sterone extract.

The common dosage of guggulsterones is 25 mg two or three times daily. Most extracts contain 2.5–5% guggulsterones and can be taken daily for 3 to six months.

Emails
Is guggul extract only to be used for three to six months? My cholesterol problem is not dietary, and therefore would require a product that can be taken indefinitely. Can it be used for life?
   A review of medical studies published in the Western scientific literature does not show any long term studies done in humans. Therefore, it is difficult to say whether it can be used for life.

My doctor put me on Lipitor which is a cholesterol reducing statin drug. I have a friend who studies Ayurvedic medicine and she told me about guggul. Can it be combined with statin drugs?
   I am not aware of scientific studies that have been done combining the two. Some of guggul's active components, guggulsterones, work by blocking a substance that stops the body from getting rid of cholesterol. Statins, on the other hand, block the body from making more cholesterol.

Gum guggul, bedellium gum. Would it affect the liver in a negative way if the GGT is high?
   We don't have specific info on guggul and liver enzymes so we don't know how it affects GGT or other liver enzymes.

I take 500mg of guggul lipids twice a day 2.5% sterones for high cholesteral and trigliscerides. Can I safely double the amount taking 500 mg of 2.5% sterones 4 times a day
    We suggest your doctor read this page and guide you. It is not possible for us to say without having reviewed your full medical history and medical exam.

Other products
 

Commiphora mukulis is standardized to 6% guggulsterones E & Z. This Ayurvedic herb has been clinically shown to promote cardiovascular health.
Recommendation: Take 1 guggul capsule two or three times daily with food or water.
Supplement Facts: Guggul extract 425 mg (gum resin), 6% guggulsterones E & Z

Nature's Answer, buy Guggul extract, Standardized Herb, 500 mg, 60 Veggie Caps
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