. How can i tell if its die off or bad reaction to psyllium?

Im not taking anything else with it. My ND gave it to me. I used to be able to take Psyllum fine, it used to work fine. But since i became ill it stopped working. My ND said it should start to work again. It has worked a bit but makes feel like shit, is it Die off or is it a bad reaction. Anyway to tell?

Also ive been taking it in tablet form.
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