X-Message-Number: 25788
Date: Sun, 13 Mar 2005 12:44:00 -0800 (PST)
From: Doug Skrecky <>
Subject: guggulipid may not lower cholesterol

[In fact some guggulipid supplements may not even contain
guggulipid.]

JAMA. 2003 Aug 13;290(6):765-72
Guggulipid for the treatment of hypercholesterolemia: a
randomized controlled trial.
    CONTEXT: Herbal extracts from Commiphora mukul (guggul) have
been widely used in Asia as cholesterol-lowering agents, and
their popularity is increasing in the United States. Recently,
guggulsterones, the purported bioactive compounds of guggul, 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.
However, there are currently no published safety or efficacy data
on the use of guggul extracts in Western populations. OBJECTIVE:
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. DESIGN: Double-blind, randomized,
placebo-controlled trial using a parallel design, conducted March
2000-August 2001. PARTICIPANTS AND SETTING: A total of 103
ambulatory, community-dwelling, healthy adults with
hypercholesterolemia in the Philadelphia, Pa, metropolitan area.
INTERVENTION: Oral, 3 times daily doses of standard-dose
guggulipid (1000 mg), high-dose guggulipid (2000 mg), or matching
placebo. MAIN OUTCOME MEASURES: 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. RESULTS: Compared with participants
randomized to placebo (n = 36), in whom levels of LDL-C decreased
by 5%, both standard-dose guggulipid (n = 33) and high-dose
guggulipid (n = 34) raised levels of LDL-C by 4% (P =.01 vs placebo)
and 5% (P =.006 vs placebo), 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 guggulipid in the intention-to-treat
analysis. While guggulipid was generally well tolerated, 6
participants treated with guggulipid developed a hypersensitivity
rash compared with none in the placebo group. CONCLUSIONS: Despite
plausible mechanisms of action, guggulipid 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.

J AOAC Int. 2001 Jan-Feb;84(1):24-8.
Simultaneous determination of E- and Z-guggulsterones in dietary
supplements containing Commiphora mukul extract (guggulipid) by
liquid chromatography.
    Guggulipid, the standardized product from the extraction of the
ole-gum-resin from the Commiphora mukul plant, has been marketed
as a hypolipidemic agent. The ketosteroids, cis- and
trans-4,17(20)-pregnadiene-3,16-dione, known as E- and
Z-guggulsterones, respectively, are the main ingredients in
guggulipid. A liquid chromatographic method was developed for
simultaneous determination of E- and Z-guggulsterones in
guggulipid preparations using synthetic E- and Z-guggulsterone
standards. Realtively low amounts of guggulsterones (E and Z)
were found in commercial guggulipid preparations in comparison
with the manufacturer's claim of 2.5%. The mixture of E- and
Z-guggulsterones was extracted and separated on a Symmetry C18
reversed-phase column, with a mobile phase of acetonitrile--water
(46 + 54, v/v) and detected at 242 nm. The retention times of
E- and Z-guggulsterones are approximately 8 and 11 min,
respectively. Assay quantitation was based on the calibration
curve obtained from a mixture of synthetic standard E- and
Z-guggulsterones. Experimental data on selectivity, linearity,
accuracy, and recoveries are presented.

Cardiovasc Drugs Ther. 1994 Aug;8(4):659-64.
Hypolipidemic and antioxidant effects of Commiphora mukul as an
adjunct to dietary therapy in patients with hypercholesterolemia.
    The effects of the administration of 50 mg of guggulipid or
placebo capsules twice daily for 24 weeks were compared as
adjuncts to a fruit- and vegetable-enriched prudent diet in the
management of 61 patients with hypercholesterolemia (31 in the
guggulipid group and 30 in the placebo group) in a randomized,
double-blind fashion. Guggulipid decreased the total cholesterol
level by 11.7%, the low density lipoprotein cholesterol (LDL)
by 12.5%, triglycerides by 12.0%, and the total cholesterol/high
density lipoprotein (HDL) cholesterol ratio by 11.1% from the
postdiet levels, whereas the levels were unchanged in the placebo
group. The HDL cholesterol level showed no changes in the two
groups. The lipid peroxides, indicating oxidative stress,
declined 33.3% in the guggulipid group without any decrease in
the placebo group. The compliance of patients was greater than
96%. The combined effect of diet and guggulipid at 36 weeks was
as great as the reported lipid-lowering effect of modern drugs.
After a washout period of another 12 weeks, changes in blood
lipoproteins were reversed in the guggulipid group without such
changes in the placebo group. Side effects of guggulipid were
headache, mild nausea, eructation, and hiccup in a few patients.

Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=25788