Marshmallow (Althaea officinalis L.)
Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
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.
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.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Inflammatory skin conditions (eczema, psoriasis)
Marshmallow extracts have traditionally been used on the skin to treat inflammation. Several laboratory experiments, mostly in the 1960s, reported marshmallow to have anti-inflammatory activity but limited human study is available. Safety, dosing, and effectiveness compared to other anti-inflammatory agents have not been examined.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
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.
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.
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.
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.
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.
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).
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.
Basch E, Ulbricht C, Hammerness P, et al. Marshmallow (Althaea officinalis L.) monograph. J Herb Pharmacother 2003;3(3):71-81. View Abstract
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
Bone K. Marshmallow soothes cough. Br J Phytother 1993;3(2):93.
Guarnieri A, Chiarini A, Burnelli S, et al. [Mucilage of Althaea officinalis]. Farmaco [Prat.] 1974;29(2):83-91. View Abstract
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
Iliesen E. [Althaea extract as a pill excipient.]. Pharm Prax 1961;6:104-105. View Abstract
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
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
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
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
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017