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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.

Firenzuoli and Gori state that guggulsterones activate the farnesoid X receptor and inhibit bile acid secretion by hepatocytes and lead to reduced intestinal . . . [Full Text of this Article]

Philippe O. Szapary, MD; Daniel J. Rader, MD
Department of Medicine
University of Pennsylvania School of Medicine
Philadelphia

Ara DerMarderosian, PhD
Department of Biology and Medicinal Chemistry
University of the Sciences in Philadelphia

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