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TUESDAY, Aug. 12, 2003 (HealthDayNews) -- Sometimes even wise men get it wrong.
Extract of the ancient plant myrrh has been touted as a "natural" alternative to cholesterol-lowering drugs. But a new study has found the diet supplement, called guggul, fails to lower cholesterol. Worse yet, it may increase levels of the most harmful blood fat, low-density lipoprotein (LDL). If that weren't enough, some people also developed skin allergies to the substance, which disappeared when they stopped taking the plant.
"When it comes to LDL, we found no positive effect from guggul and the suggestion that it could raise it," says study leader Dr. Philippe Szapary, a cholesterol expert at the University of Pennsylvania School of Medicine.
A 1-percentage point drop in LDL leads to a 1 percent decline in a person's risk of coronary heart disease, says the National Cholesterol Education Program. About one in four American adults has high cholesterol.
Lifestyle changes such as a low-fat diet and regular exercise can reduce LDL and total cholesterol. Doctors often advise people with unhealthy cholesterol to consider drugs called statins, which have been shown to drive down LDL.
"Statins are time-proven and tested. They reduce cholesterol and they reduce mortality" from cardiovascular disease, Szapary says. "They are by far the first choice, and should almost always be the first choice" for people with high cholesterol.
A report on the findings appears in the Aug. 13 issue of the Journal of the American Medical Association.
Guggul, which comes from the resin of the Commiphora mukul tree, has been used in Eastern medicine for more than 2,000 years to treat obesity, arthritis and other conditions. For the past 35 years or so, modern science has studied the ability of the compound to lower cholesterol, a family of fatty molecules that play an important role in heart and vessel health.
In the latest research -- the first trial in the United States to pit guggul against dummy pills -- Szapary and his colleagues gave the supplements to 67 men and women with moderately high LDL cholesterol. Of those, 33 took the conventional dose of a gram a day, and 34 took twice that amount. Another 36 took sugar pills.
Over the next eight weeks the people taking sugar tablets saw their LDL cholesterol fall by an average of 5 percent. But LDL rose by 4 percent and 5 percent in those taking the standard or high dose of guggul, respectively -- a 9 percent or 10 percent swing the wrong way when compared with doing nothing.
Although the researchers saw hints the supplement might reduce another form of blood fat called triglycerides, the effect wasn't strong. The supplements had no effect on high-density lipoprotein (HDL), the "good" cholesterol that protects the heart.
Most people tolerated the supplements well. However, six volunteers developed skin rashes that resolved after they stopped taking guggul.
The Pennsylvania study looked at guggul in people with elevated cholesterol, so the work leaves open the possibility that the supplement might help keep LDL low in people without unhealthy blood fats.
Still, "it is clear [the results do] not support the widespread use of gugulipid in Western populations," says David D. Moore, a molecular biologist at Baylor College of Medicine in Houston who has studied the substance.
The study was funded by the National Institutes of Health and Sabinsa Corp., a Piscataway, N.J., firm that makes guggul and other diet aids.
Sabinsa, however, called the study "an incomplete representation of the overall safety and efficacy data that was documented." The company sells the product under the brand name Gugulipid.
"Cardiovascular disease is currently seen as a process where multiple lipid fractions, not only LDL, play an important role," reads a statement from Dr. Vladimir Badmaev, Sabinsa's vice president of medical and scientific affairs. "In fact, there are known cholesterol-lowering drugs which actually increase LDL, while lowering other important lipids, like triglycerides."
The company also says it is exploring ways to reduce guggul's skin-irritating properties.
More information
For more on cholesterol and how to keep it low, visit the American Heart Association or the National Institutes of Health.
