Marshmallow monograph - Foundations In Herbal Medicine

Common Name:
Botanical Name:
Althaea officinalis L.
Parts Used:
The root and leaf.
Other Names:
Marshmallow, mallards
Malvavisco, Altea
Pharmacopeial: Althaeae folium and radix
Plant Description & Collection:
Marshmallow is a perennial herb that is native to moist areas of Europe, western Asia,
and southern England. It has been naturalized in the U.S. The leaf and root are imported
primarily from Eastern Europe and what was formerly the Soviet Union. Marshmallow is
both gathered in the wild and cultivated. This perennial, pubescent plant grows up to 150
cm. in height and looks very much like the hollyhock (A. rosea). Leaves are 3-5 lobed
with a velvety pubescence and palmate nervature. The plant bears white-to-pink flowers
with the outer 6-9 sepals fused at their base. The leaf is gathered just at flowering.
Marshmallow has a woody rootstock out of which numerous roots arise, growing up to
30 cm. in length. The root is gathered in the autumn from plants that are at least two
years old. The outer bark is removed by peeling or scraping and then the roots are dried
either sliced or whole. The dried root appears whitish and fibrous and dark scars are
present as a remnant of the lateral roots. There is a faint odor and sweet, mucilaginous
The Leaf:
Mucilage polysaccharides (6-9%): the mucilage is highest in the leaves just before
flowering. The mucilage consists primarily of arabinogalactans and
Essential oil (traces)
Flavonoids: primarily 8-hydroxyluteolin 8-beta-gentiobioside.
The Root:
Mucilage polysaccharides (5-10%): the mucilage content is greatly dependent upon the
time of harvest and how the root is processed. It is highest in the autumn and lowest in
the summer. The mucilage is comprised primarily of galacturonorhamnans, arabinans,
glucans, and arabinogalactans.
Flavonoid glycosides: hypolaetin 8-glucoside, etc.
Phenolic acids (traces): caffeic, ferulic, vanillic, p-coumaric, and the coumarin
Starch (37%)
Pectins (11%)
Asparagine (2%)
Pharmacological Actions:
Demulcent (root and leaf)
Expectorant (leaf)
Anti-tussive (root and leaf)
Emollient, topical (root)
Both the leaf and root of marshmallow have been used for centuries for medicinal
purposes. Marshmallow is rich in mucilage, a substance that is very soothing to the
tissue it contacts. Historically, marshmallow was used for inflammation of the
respiratory, urinary, and gastrointestinal systems. The British Herbal Compendium
states that marshmallow root may be used for the treatment of duodenal ulcers,
ulcerative colitis and digestive inflammation.i
The mucilage from marshmallow root and leaf “coat” the mucosa of the oral and
pharyngeal cavities, as well as the gastric mucosa making them useful for mild
inflammatory conditions of these tissues.
In-vitro studies on marshmallow root extracts have demonstrated increased phagocytosis,
increased secretion of leukotrienes from neutrophils, and increased release of interleukin
6, tumor necrosis factor and cytokines from monocytes. Animal studies using isolated
mucilage polysaccharides from A. officinalis root administered intra-peritoneally also
demonstrated an increase in phagocytic activity. This suggests a non-specific immunostimulant activity to marshmallow.
Antitussive effects of marshmallow root have been demonstrated in animal studies where
both the intensity and duration of the cough was reduced. However, only the leaf has
expectorant properties.ii
A hypoglycemic response has been noted in one study conducted on mice. Intraperitoneal administration of isolated mucilage polysaccharides from marshmallow root at
doses of 10, 30, and 100 mg/kg reduced plasma glucose levels to 74%, 81%, and 65%
respectively compared to controls after 7 hours.
Clinical Applications:
Marshmallow leaf and root are often used to reduce local irritation of the mouth, throat,
esophagus, and stomach. Marshmallow may be used in cases of stomatitis, esophageal
reflux, and mild gastritis. For the latter two conditions, marshmallow combines well with
chamomile. An enema can be given in cases of proctitis. The British Herbal
Compendium also lists the use of marshmallow root for the treatment of duodenal
ulceration, ulcerative colitis and enteritis.
Both the leaf and root have antitussive activity and may be used in cases of irritable
coughs and catarrhal inflammation of the throat, however only the leaf has expectorant
properties. The pharynx and trachea contain numerous receptors that are very sensitive to
mechanical stimulation. Mucilage rich herbs inhibit cough by coating the pharyngeal
mucosa, thus protecting it from irritation. Marshmallow is extremely safe and is very
useful when taken before bed to insure a good night’s sleep while nursing a cold.
Dosage and Preparation:
Adult dosage: 0.5 - 3.0 grams in 150 ml. cold water, as a cold macerate. This should be
allowed to steep for 1-2 hours. A cold macerate helps to preserve the mucilaginous
properties. This dose can be repeated every four hours, as needed. (3 grams = 1 tsp. root
or 2 tsp. leaf.)
Children: use less according to age and weight.
None known.
Side Effects: None known.
Herb/Drug Interactions:
The absorption of other drugs may be slowed. Thus, many authorities recommend taking
medication one hour before ingesting marshmallow.
Pregnancy and Lactation:
There is no adequate data published in this area. However, there is also nothing to
suggest that there is anything harmful to mother, fetus, or nursing baby with the use of A.
officinalis. The 2nd Edition of the Botanical Safety Handbook does not contraindicate the
use of marshmallow during pregnancy or while nursing.
Author’s Notes:
Once you get past the somewhat slimy texture of marshmallow root tea, most people find
it to be an incredibly soothing liquid. I have used it for over twenty years in patients with
dry, hacking coughs. For this it combines very nicely with a little licorice root and
thyme. For gastritis and as “one part of a treatment regimen” for GERD and gastric
ulcers, I have found Althaea to be incredibly effective. Patients have sat in my office and
taken 15 ml. of thick syrup of the root and expressed how much better they felt. The
British Herbal Compendium recommends it for ulcerative colitis and other intestinal
complaints. Safe, effective - marshmallow is the herb to remember when you need to
soothe and protect irritated tissue.
Herbal Compendium Vol 1. Editor: Bradley PR. British Herbal Medicine
Association, Dorset, UK, 1992; 151-53.
iiWichtl M. Herbal Drugs and Phytopharmaceuticals. Editor: Bisset NG. Medpharm
Pub, Stuttgart, 1994: 65