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Letters
December 3, 2003

Guggulipid and Cholesterol Levels

JAMA. 2003;290(21):2800. doi:10.1001/jama.290.21.2800-a

In Reply: We agree with Drs Firenzuoli and Gori that guggulipid, like most other herbal extracts, contains numerous other substances besides the small amounts of guggulsterones purported to be the active ingredients. This is precisely the problem with complex botanical products; it is not known what the "active" component(s) are. As an example, among the components of guggulipid, the lignans component (sesamin) has been shown to lower levels of cholesterol in animal models1 and humans,2 while various plant sterols can interfere with cholesterol absorption.3 Until the various fractions of this natural product can be isolated and tested individually, we cannot know which portion(s) of guggulipid modulate lipids, which might interfere with bioavailability as the Firenzuoli and Gori suggest, or which may have caused the rash we observed.

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