Related Terms

• Althaea leaf, Althaea officinalis L. var robusta, Althaea radix, althaea root, Althaeae folium, althaeae radi, althea, althea leaf, althea root, Althea Rose of Sharon, altheia, apothekerstockmalve (German), bismalva (Italian), buonvischio (Italian), cheeses, Eibischwurzel (German), Guimauve (French), gul hatem (Turkish), Herba Malvae, hitmi (Turkish), kitmi (Turkish), Mallards, Malvaceae (family), malvacioni (Italian), malvavisco (Spanish), malve, mortification root, mucilage, Racine De Guimauve, sweet weed, witte malve, wymote.

• Note: Not to be confused with mallow leaf and mallow flower. Not to be confused with confectionery marshmallows; although confectionery marshmallows were once made from the Althaea officinalis plant, they now contain mostly sugar.

Background

• Both marshmallow (Althaea officinalis) leaf and root are used in commercial preparations. Herbal formulations are made from either the dried root or leaf (unpeeled or peeled). The actual mucilaginous content of the commercial product may vary according to the time of collection.

• There is a lack of available clinical trials assessing marshmallow alone for any specific health condition. Medicinal uses of marshmallow are supported mostly by traditional use and laboratory research. Limited human evidence is available studying the effects of marshmallow-containing combination products in skin conditions.

• Although clinically unproven, marshmallow may interfere with the absorption of medications taken by mouth. Therefore, ingestion of marshmallow several hours before or after other agents may be warranted.

• Marshmallow is generally regarded as safe. However, the potential for marshmallow to cause allergic reactions or low blood sugar has been noted anecdotally.

• Althaea extract has been used to make pills. Marshmallow has also been used as an aid to X-ray exams of the esophagus.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Abscesses (topical), antidote to poisons, aphrodisiac, arthritis, bee stings, boils (topical), bronchitis, bruises (topical), burns (topical), cancer, chilblains, colitis, congestion, constipation, cough, Crohn's disease, cystitis, diarrhea, diuretic, diverticulitis, duodenal ulcer, emollient, enteritis, expectorant, gastroenteritis, gum health, immunostimulant, impotence, indigestion, inflammation (small intestine), insect bites, irritable bowel syndrome, kidney stones, laxative, minor wounds, mouthwash, mucilage, muscular pain, pap smear (abnormal), peptic ulcer disease, polyuria, skin ulcers (topical), soothing agent, sore throat, sprains, toothache, ulcerative colitis, urethritis, urinary tract infection, urinary tract irritation, varicose ulcers (topical), vomiting, whitening agent, whooping cough, wound healing.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

• Historically, 5-10 grams of marshmallow in ointment or cream base or 5% powdered marshmallow leaf has been applied to the skin three times daily for skin inflammatory conditions. Daily oral doses of 5 grams of marshmallow leaf or 6 grams of marshmallow root have been suggested by mouth.

• A dose of 2 grams of marshmallow in 1 cup of cold water, soaked for 2 hours, then gargled has been used for oral and pharyngeal irritation, but is not supported by scientific evidence.

Children (younger than 18 years)

• There is not enough scientific data to recommend marshmallow for use in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

• Although there is a lack of known reports or studies about marshmallow allergy, allergic reactions to marshmallow may occur.

Side Effects and Warnings

• Historically, marshmallow is generally regarded as being safe in healthy individuals. However, since studies have not evaluated the safety of marshmallow, proper doses and duration in humans are not known. Allergic reactions may occur.

• Based on animal study, marshmallow may lower blood glucose levels. Caution is advised in patients with diabetes or low blood sugar and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels should be monitored closely and medication adjustments may be necessary.

Pregnancy and Breastfeeding

• There is not enough scientific evidence to support the safe use of marshmallow during pregnancy or breastfeeding.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

• Based on animal study, marshmallow may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. A qualified healthcare professional should monitor patients taking drugs for diabetes by mouth or insulin closely. Medication adjustments may be necessary.

• Marshmallow may interfere with the absorption of other drugs and therefore should be taken one hour before or two hours after other drugs. It may also interact with topical steroids.

Interactions with Herbs and Dietary Supplements

• Based on animal studies, marshmallow may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

• Marshmallow may interfere with the absorption of other agents and therefore should be taken one hour before or two hours after other herbs and supplements.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Basch E, Ulbricht C, Hammerness P, et al. Marshmallow (Althaea officinalis L.) monograph. J Herb Pharmacother 2003;3(3):71-81. View Abstract

2. Beaune A, Balea T. [Anti-inflammatory experimental properties of marshmallow: its potentiating action on the local effects of corticoids]. Therapie 1966;21(2):341-347. View Abstract

3. Bone K. Marshmallow soothes cough. Br J Phytother 1993;3(2):93.

4. Guarnieri A, Chiarini A, Burnelli S, et al. [Mucilage of Althaea officinalis]. Farmaco [Prat.] 1974;29(2):83-91. View Abstract

5. Iauk L, Lo Bue AM, Milazzo I, et al. Antibacterial activity of medicinal plant extracts against periodontopathic bacteria. Phytother Res 2003;17(6):599-604. View Abstract

6. Iliesen E. [Althaea extract as a pill excipient.]. Pharm Prax 1961;6:104-105. View Abstract

7. Kelly JE, Jr. The marshmallow as an aid to radiologic examination of the esophagus. N Engl J Med 12-28-1961;265:1306-1307. View Abstract

8. Kobayashi A, Hachiya A, Ohuchi A, et al. Inhibitory mechanism of an extract of Althaea officinalis L. on endothelin-1-induced melanocyte activation. Biol Pharm Bull 2002;25(2):229-234. View Abstract

9. Robertson CS, Smart H, Amar SS., et al. Oesophageal transit of marshmallow after the Angelchik procedure. Br J Surg 1989;76(3):245-247. View Abstract

10. Tomoda M, Shimizu N, Oshima Y, et al. Hypoglycemic activity of twenty plant mucilages and three modified products. Planta Med 1987;53(1):8-12. View Abstract