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Marshmallow (Althaea officinalis)

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Also listed as: Althaea officinalis
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • 2-O-alpha-D-galacturonopyranosyl-l-rhamnose, acidic polysaccharide, Althea, althea leaf, Althaea officinalis L., Althaea officinalis L. var robusta, althaea radix, althea root, Althaeae folium, althaeae radi, Altheia, amines, Apothekerstockmalve (German), arabinans, arabinogalactans, asparagines, bismalva (Italian), buonvischio (Italian), caffeic acid, calcium oxalate, cheeses, chlorgenic acid, coumarins, D-galactose, D-glucuronic acid, Eibischwurzel (German), flavanoids, galacturonorhamnans, galacuonnic acid, glucan, glucaris, glycosides, Guimauve (French), gul hatem (Turkish), Herba Malvae, hitmi (Turkish), kaempferol, kitmi (Turkish), L-rhamsose, Mallards, Malvaceae (family), malvacioni (Italian), malve, malvavisco (Spanish), marshmallow leaf, marshmallow mucilage, marshmallow root, minerals, mortification root, mucilage polysaccharides, p-coumaric acid, pectin, phenolic acid, quercetin, Racine De Guimauve, scopoletin, sterols, sweet weed, tannin, witte malve, wymote, xylose.
  • Combination product examples: Dexalta® (a combination of dexamethasone acetate 0.05mg, fluid extract of marshmallow 20g, Vaseline® 5g, and lanolin anhydrated 100g), Weleda Hustenelixier (ivy leaf, thyme, aniseed, marshmallow), Z-HE (a topical mixture of pure extracts from A. rosa, A. officinalis, and other Leguminosae, Fabaceae, Malvaceae, and Lythraceae species).
  • Note: Marshmallow is not to be confused with mallow leaf, mallow flower, or confectionery marshmallows; although confectionery marshmallows were once made from the Althaea officinalis plant, they now primarily contain sugar.

Background
  • Both marshmallow leaf and root are used in commercial products. Herbal formulas are made from either the dried root or leaf (unpeeled or peeled). The actual content of the commercial product depends on the time of collection.
  • There is a lack of evidence to support the use of marshmallow alone for any condition. The medical uses of marshmallow are supported by traditional use and early research. Limited human evidence is available on the effectiveness of marshmallow-containing products for skin conditions.
  • Marshmallow may affect the way the body absorbs some medications taken by mouth. Marshmallow should be consumed several hours before or after other medicinal agents.
  • Marshmallow is generally considered safe. However, allergic reactions or low blood sugar have been reported.

Evidence Table

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. GRADE *


Marshmallow has been studied for the treatment of coughs caused by ACE inhibitors, agents that treat high blood pressure and other heart conditions. Early research suggests that marshmallow may help prevent coughing by forming a protective coating in the lungs. However, more evidence is needed to confirm the effectiveness of marshmallow in humans.

C


Marshmallow may help treat infections from parasites. Marshmallow preparations have been used in combination with steroids for skin conditions. The plant is believed to have anti-inflammatory activity that increases the effect of steroids applied to the skin. Further research is needed to confirm these findings.

C


Marshmallow extracts have been applied to the skin to treat inflammation. However, research is limited in this area. More information is needed before a firm conclusion can be made.

C
* 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 for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

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.

  • Abnormal pap smears, abscess (pus build-up), antibacterial, antidote to poisons, antimicrobial, antioxidant, arthritis, bee stings, bladder inflammation, boils, breast tenderness, bronchitis, bruises, burns, cancer, chilblains (inflammation of toes and fingers caused by cold exposure), colon inflammation, congestion, constipation, cough (general), Crohn's disease, demulcent (soothing agent), dental hygiene (mouthwash), diarrhea, diverticulitis (inflammation of the intestine lining), enteritis (inflammation of the small intestine), expectorant (promotes mucus), frequent urination, gastroenteritis (stomach flu), hyperglycemia (high blood sugar levels), ileitis (inflammation of the ileum, a part of the small intestine), immune function, impotence, improving urine flow, increasing breast milk, indigestion, inflammation, insect bites, irritable bowel syndrome, laxative, mucilage, muscle pain, peptic ulcer disease (defect in lining of stomach and/or small intestine), promoting healing, sexual arousal, skin care, skin ulcers, sore throat, sprains, stomach disorders, stomach ulcer, toothache, ulcerative colitis (inflammatory bowel disease affecting the colon), urethritis (inflammation of urethra), urinary irritation, urinary stones, urinary tract infection, varicose ulcers, vomiting, whooping cough, wounds (minor).

Dosing

Adults (18 years and older)

  • Marshmallow has been taken by mouth daily in doses of 5 grams of leaf or equivalent preparation or 6 grams of root or equivalent preparation. Use caution in people taking other medications by mouth, as marshmallow may affect the body's absorption of these agents.
  • For coughs (associated with blood pressure medications), 20-40 milligrams of marshmallow (given as 20 drops) has been taken by mouth three times daily for four weeks.
  • Doses of 5-10 grams of marshmallow in an ointment or cream, or 5 percent powdered marshmallow leaf, have been applied to the skin three times daily.
  • As a gargle for mouth and throat irritation, 2 grams of marshmallow has been soaked in one cup of cold water for two hours before gargling.

Children (younger than 18 years)

  • There is no proven safe or effective dose for marshmallow 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

  • Avoid in people with known allergy or sensitivity to marshmallow (Althaea officinalis), its parts, or members of the Malvaceae family.

Side Effects and Warnings

  • Marshmallow is likely safe when taken by mouth in food amounts.
  • Marshmallow is possibly safe when taken by mouth or applied to the skin in recommended doses for medical purposes.
  • Marshmallow may cause allergic reactions or changes in the body's absorption of medications.
  • Marshmallow may lower blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
  • Use cautiously in people who are taking other medications by mouth or steroids applied to the skin.
  • Use cautiously in children and in pregnant or breastfeeding women, due to a lack of safety information.
  • Avoid in people with known allergy or sensitivity to marshmallow (Althaea officinalis), its parts, or members of the Malvaceae family.

Pregnancy and Breastfeeding

  • There is a lack of scientific evidence on the use of marshmallow during pregnancy or breastfeeding. Use cautiously in women who are pregnant or breastfeeding.

Interactions

Interactions with Drugs

  • Marshmallow may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Marshmallow may also interact with ACE inhibitors, agents that affect the immune system, agents that are taken by mouth, agents used for the stomach and intestines, agents used to treat cough, antibiotics, anti-inflammatory agents, antimicrobial agents, antiprotozoals, and steroids applied to the skin.

Interactions with Herbs and Dietary Supplements

  • 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 also interact with antibacterials, anti-inflammatory herbs and supplements, antimicrobial herbs and supplements, antiprotozoals, herbs and supplements that are taken by mouth, and herbs and supplements used to treat cough.

Attribution
  • 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).

Bibliography
  1. Buechi S, Vogelin R, von Eiff MM, et al. Open trial to assess aspects of safety and efficacy of a combined herbal cough syrup with ivy and thyme. Forsch.Komplementarmed.Klass.Naturheilkd. 2005;12(6):328-332.
  2. Cravotto G, Boffa L, Genzini L, et al. Phytotherapeutics: an evaluation of the potential of 1000 plants. J Clin Pharm Ther 2010;35(1):11-48.
  3. Gudej J. Flavonoids, phenolic acids and coumarins from the roots of Althaea officinalis. Planta Med 1991;57:284-285.
  4. Kardosova A and Machova E. Antioxidant activity of medicinal plant polysaccharides. Fitoterapia 2006;77(5):367-373.
  5. Keren S and Argaman E. [Marshmallow for investigating functional disturbances of the esophageal body]. Harefuah 1992;123(5-6):161-165.
  6. Keren S, Argaman E, and Golan M. Solid swallowing versus water swallowing: manometric study of dysphagia. Dig.Dis Sci. 1992;37(4):603-608.
  7. 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.
  8. Nosal'ova G, Strapkova A, Kardosova A, et al. [Antitussive action of extracts and polysaccharides of marsh mallow (Althea officinalis L., var. robusta)]. Pharmazie 1992;47(3):224-226.
  9. Puodziuniene G, Janulis V, Milasius A, et al. [Development of cough-relieving herbal teas]. Medicina (Kaunas.) 2005;41(6):500-505.
  10. Robertson C, Smart H, Amar S, et al. Oesophageal transit of marshmallow after the Angelchik procedure. Br J Surg 1989;76(3):245-247.
  11. Rouhi H, Ganji F. Effect of Althaea officinalis on cough associated with ACE inhibitors. Pakistan Journal of Nutrition 2007;6:256-258.
  12. Scheffer J and König W. Einfluss von Radix althaeae und Flores chamomillae Extrakten auf Entzündungsreaktionen humaner neutrophiler Granulozyten, Monozyten und Rattenmastzellen. Abstracts of 3rd Phytotherapie-Kongress 1991;Abstract P9.
  13. Sutovska M, Nosalova G, Franova S, et al. The antitussive activity of polysaccharides from Althaea officinalis l., var. Robusta, Arctium lappa L., var. Herkules, and Prunus persica L., Batsch. Bratisl.Lek.Listy 2007;108(2):93-99.
  14. Watt K, Christofi N, and Young R. The detection of antibacterial actions of whole herb tinctures using luminescent Escherichia coli. Phytother Res 2007;21(12):1193-1199.
  15. Zerehsaz F, Salmanpour R, Handijani F, et al. A double-blind randomized clinical trial of a topical herbal extract (Z- HE) vs. systemic meglumine antimoniate for the treatment of cutaneous leishmaniasis in Iran. Int J Dermatol 1999;38(8):610-612.

Copyright © 2011 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.


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