Early studies with the crude oleoresin reported numerous side effects, including diarrhea, anorexia, abdominal pain, and skin rash. Modern extracts are more purified, and fewer side effects (e.g., mild abdominal discomfort) have been reported with long-term use. Rash was reported, however, as a fairly common side effect in one recent study.²⁴ Guggul should be used with caution by people with liver disease and in cases of Crohn’s disease, ulcerative colitis, and diarrhea. A physician should be consulted before treating elevated cholesterol and triglycerides.