Guggul (Commiphora mukul) is the resin of a thorn shrub native to India and Arabia. It is used in various Ayurvedic medicines to increase white blood cells and normalize lipid levels as well as appetite. It's also taken to treat respiratory problems and the swelling associated with arthritis. PHAs experiencing high cholesterol and triglycerides associated with antiretroviral drugs may be most interested in the lipid normalizing properties of guggul. Clinical trials have shown that gugulipid, a standardized extract from the guggul plant, is effective at reducing cholesterol and triglyceride levels. (In India, it is approved as a drug for this purpose). No studies have examined the use of gugulipid in HIV-positive people with these symptoms. Nor is it known whether guggulipid would interact with any of the drugs used by PHAs. Raw guggul may cause rashes and gastrointestional upset, such as diarrhea and nausea. The same side effects have been observed in people who use the standardized extract but they appear to occur less often. Caution is also advised for people suffering from thyroid disorders.