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.

No clinical trials assessing marshmallow monotherapy (used alone) have been conducted for any specific health condition. Medicinal uses of marshmallow are supported principally by traditional use and laboratory research. Limited human evidence is available studying the effects of marshmallow-containing combination products in dermatological 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 medicinal agents may be warranted.

Marshmallow is generally regarded as safe, and literature review reveals no documented adverse case-reports. However, the potential for marshmallow to cause allergic reactions or low blood sugar has been noted anecdotally.

Althaea extract has been used as a pill excipient. Marshmallow has also been used as an aid to radiologic examination of the esophagus.

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.

Evidence

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.

Uses based on scientific evidence

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. There was one human research study done in 1968. Safety, dosing, and effectiveness compared to other anti-inflammatory agents have not been examined.

Uses based on tradition or 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 healthcare provider.

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, demulcent, dermatitis (topical), diarrhea, diuretic, diverticulitis, duodenal ulcer, emollient, enteritis, expectorant, gastroenteritis, gum health, inflammation of the small intestine, immunostimulant, impotence, indigestion, inflammation, insect bites, irritable bowel syndrome, kidney stones, laxative, minor wounds, mouthwash, mucilage, muscular pain, pap smear (abnormal), peptic ulcer disease, polyuria, soothing agent, sore throat, sprains, skin ulcers (topical), 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.

Standardization

Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. Pharmacopoeia grade marshmallow must be properly identified by the naked eye and by microscope. The British Pharmacopoeia requires marshmallow leaf to be harvested before the flowering period, and to pass identification by specific scientific tests.

Adults (18 years and older)

Skin inflammatory conditions (eczema, psoriasis): 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. Daily oral doses of 5 grams of marshmallow leaf, or 6 grams of marshmallow root have been suggested by mouth.

Oral and pharyngeal irritation: A dose of 2 grams of marshmallow in 1 cup of cold water, soaked for 2 hours then gargled has been used, 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

Allergies

Although there are no 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 hypoglycemia, 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 1 hour before or 2 hours after other drugs.

Interactions with Herbs and Dietary Supplements

Based on animal study, 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. Possible examples include: Aloe vera , American ginseng, bilberry, bitter melon, burdock,fenugreek, fish oil, gymnema, horse chestnut seed extract (HCSE), milk thistle, Panax ginseng, rosemary, Siberian ginseng, stinging nettle and white horehound. Agents that may raise blood sugar levels include: Arginine, cocoa, and ephedra (when combined with caffeine).

Marshmallow may interfere with the absorption of other agents and therefore should be taken 1 hour before or 2 hours after other herbs and supplements.

Tags: Herbal Medicine

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