Marshmallow (Althaea officinalis L.)

Category

Herbs & Supplements

Synonyms

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.

Evidence

DISCLAIMER: 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.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. 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 healthcare provider. There may be other proposed uses that are not listed below.
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

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

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

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

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.

Attribution

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Paul Hammerness, MD (Harvard Medical School); Sadaf Hashmi MD, MPH (Johns Hopkins School of Hygiene and Public Health); Van Nguyen, PharmD (Massachusetts College of Pharmacy); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration).

Bibliography

DISCLAIMER: 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.

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.

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.

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.

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

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

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.

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

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.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.