Marshmallow (Althea officinalis) -- the herb, not the white puffy confection roasted over a campfire -- has been used for more than 2,000 years as both a food and a medicine. The Romans, Chinese, Egyptians, and Syrians used marshmallow as a source of food, while the Arabs made poultices from its leaves and applied them to the skin to reduce inflammation. Both the root and leaves contain a gummy substance called mucilage. When mixed with water, it forms a slick gel that is used to coat the throat and stomach to reduce irritation. It is also applied topically to soothe chapped skin.

Very few scientific studies have looked at the effects of marshmallow in humans. Most of its suggested uses come from a long history of use in traditional healing systems.

• Asthma
• Bronchitis
• Common cold/sore throat
• Cough
• Inflammatory bowel diseases such as Crohn's disease and ulcerative colitis
• Indigestion
• Stomach ulcers
• Skin inflammation

Marshmallow originally grew in salty soils but now thrives in moist, uncultivated ground. It is found in southern and western Europe, western Asia, and the northeastern region of North America. Its fleshy, upright stems reach a height of 3 - 4 feet. The pale yellow roots are tapered, long, and thick, with a tough yet flexible exterior. The short-stemmed leaves are round, with irregularly toothed margins and three to five lobes. A soft and velvety down covers the leaves and stem. The flowers have five reddish-white petals. The whole plant, especially the root, is filled with mild mucilage.

The leaves and roots of marshmallow are the parts used for medicinal purposes.

Dried leaves may be used in infusions, fluid extracts, and tinctures. Marshmallow roots are available dried, peeled, or unpeeled in extracts (dry and fluid), tinctures, capsules, ointments/creams, and cough syrups.

Pediatric

There is no evidence to say what dose a child can take, so you may want to ask your pediatrician. Some doctors suggest adjusting the recommended adult dose to account for the child's weight. Most herbal dosages for adults are calculated on the basis of a 150 lb (70 kg) adult. So if a child weighs 50 lb (20 - 25 kg), the appropriate dose of marshmallow would be 1/3 of the adult dosage.

Adult

Most experts suggest a dose of about 6g per day. The following are the recommended adult doses for marshmallow:

• Leaf tea: 2 - 5 tsp of dried leaf in 5 ounces hot (not boiling) water, two to three times per day
• Root tea: 2 - 5 tsp. dried powdered root in 5 ounces hot water; let soak for an hour. Drink two to three times per day.
• Leaf tincture: 1 - 2 tsp (1:5 in 25% ethanol), two to three times daily
• Root infusion or cold-water maceration (2 - 5%): 5 ounces (1-2 tsp) taken to soothe cough and sore throat
• Capsules: 2 - 6g per day
• Marshmallow cough syrup (from root): 2 - 10g per single dose (syrup contains sugar, so people with diabetes should use with caution)
• Ointment or cream: 5 - 10% drug in ointment or cream base

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider.

Marshmallow is generally considered to be safe. It has no reported side effects. It appears to be safe for use during pregnancy and breastfeeding, although you should check with your doctor before taking it. One study suggests marshmallow may lower blood sugar levels, so people with diabetes should talk to their doctor before taking marshmallow.

Because it coats the lining of the stomach, marshmallow may interfere with the absorption of other drugs or herbs. To avoid any problems, take marshmallow several hours before or after taking other herbs or medications.

Basch E, Ulbricht C, Hammerness P, Vora M. Marshmallow (Althaea officinalis L.) monograph. J Herb Pharmacother. 2003;3(3):71-81.

Buechi S, Vogelin R, von Eiff MM, Ramos M, Melzer J. Open trial to assess aspects of safety and efficacy of a combined herbal cough syrup with ivy and thyme. Forsch Komplementarmed Klass Naturheilkd. 2005 Dec;12(6):328-32.

Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:244-248.

Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications; 1998:99.

Franz G. Polysaccharides in pharmacy. Current applications and future concepts. Planta Med. 1989; 55:493-497.

Newall C, Anderson L, Phillipson J. Herbal Medicines: A Guide for Health-care Professionals. London, England: Pharmaceutical Press; 1996:188.

Nosál'ova G, Strapková A, Kardösová A, Capek P, Zathurecký L, Bukovská E. [Antitussive action of extracts and polysaccharides of marsh mallow (Althea officinalis L., var. robusta)] [German]. Pharmazie. 1992;47(3): 224-226.

Schulz V, Hansel R, Tyler V. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 4th ed. Berlin, Germany: Springer; 2000:29,182.

Sutovska M, Nosalova G, Franova S, Kardosova A. 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):93-9.