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Common names: Plantain also is known as Spanish psyllium, French psyllium, blond plantago, Indian plantago, psyllium seed, flea seed, and black psyllium.

ÒÒÒ…Positive clinical trials

Plantain is a perennial weed with almost worldwide distribution. There are about 250 species. P. lanceolataand P. major are among the most widely distributed, and they grow aggressively. Plantain is wind-pollinated, facilitating its growth where there are no bees and few other plantain plants. P. major produces 13,000 to 15,000 seeds per plant, and the seeds have been reported to remain viable in soil for up to 60 years. P. lanceolata produces 2,500 to 10,000 seeds per plant and has a somewhat shorter seed viability. Plantain seeds can survive passage through the gut of birds and other animals, facilitating their distribution. Plantain, or psyllium seeds, are small (1.5 to 3.5 mm), oval, boat-shaped, dark reddish-brown, odorless, and nearly tasteless. They are coated with mucilage, which aids in their transportation by allowing adhesion to various surfaces.

Plantain has long been associated with agriculture. Certain species have been spread by human colonization, particularly that of Europeans. As such, North American Indians and New Zealand Maori refer to plantain as “Englishman’s foot,” because it spread from areas of English settlement. P. lanceolata and P. major have been used in herbal remedies and sometimes were carried to colonies intentionally for that purpose. Psyllium seed has been found in malt refuse (formerly used as fertilizer) and wool imported to England. It has been commonly used in birdseed. Pulverized seeds are mixed with oil and applied topically to inflamed sites. Decoctions have been mixed with honey for sore throats. The seeds and refined colloid are used commonly in commercial bulk laxative preparations.

The psyllium in plantain has been used as GI therapy, to treat hyperlipidemia, for anticancer effects, and for respiratory treatment. In human studies, plantain has been effective for chronic bronchitis, asthma, cough, and cold. Clinical studies show that psyllium seed is useful as a bulk laxative. Many reports on psyllium have concluded that it can be helpful in treating various hyperlipidemias. A polyphenolic compound from P. majorleaves was found to exhibit cholesterol-lowering activity. In addition, the mechanism by which plantago reduces cholesterol also may include enhancement of cholesterol elimination as fecal bile acids. Research reveals no information regarding the use of plantain as an anticancer agent.

Plantain leaves have been given as a tea for cold and cough at 3 to 6/day.

Contraindications have not yet been identified.

Documented adverse effects. Avoid use. Uterine activity, laxative.

Patients taking lithium or carbamazepine should avoid coadministration of plantain. Caution patients receiving lithium or carbamazepine to consult their health care provider before using herbal products.

Adverse events include anaphylaxis, chest congestion, sneezing and watery eyes, occupational asthma, and a situation involving the occurrence of a giant phytobezoar (a gastric concretion composed of vegetable matter) composed of psyllium seed husks.

The pollen contains allergenic glycoproteins, as well as components that bind IgE. IgE antibodies have been demonstrated. The IgE-mediated sensitization has contributed to seasonal allergy.

1. Plantain. Review of Natural Products. factsandcomparisons4.0 [online]. 2005. Available from Wolters Kluwer Health, Inc. Accessed April 19, 2007.

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