SuppleGut Take the quiz

Western herbalism

Marshmallow rootAlthaea officinalis

A mucilage-rich root used as a soothing coating; the EU lists it for mild stomach discomfort on tradition alone, and we found no trial of the root for the gut.

Botanical name
Althaea officinalis
Part used
root
Also called
Althaea root, Althaeae radix, Guimauve (French), Eibisch (German)
Used in
Western herbalism
Taken for
The gut lining, Indigestion, Reflux and heartburn
Sold as
tea, powder, capsules, extract, syrup

What marshmallow root is

Marshmallow root comes from Althaea officinalis, a tall, soft-leaved perennial of the mallow family found in damp ground across Europe and western Asia. The part used is the root, which is peeled and dried. It is rich in mucilage, a family of water-loving polysaccharides that swell into a slippery gel when wet, and that is the whole point of the herb.

The root is sold as a coarse cut for tea, a fine powder, capsules, a dry or liquid extract, and syrup. The traditional method is a macerate: the root left to steep in water so the mucilage comes out, and the European monograph describes it as 2 to 5 g of cut root in 150 ml of water for the gut indication, to be used immediately after preparation.

Do not confuse the root with the confectionery of the same name. Marshmallow sweets contain gelatin, and the one trial of eating them (below) concerned the gelatin, not the root. The leaf and flower of the plant also appear in the literature and are different preparations with different data.

What the traditions use it for

Western herbalism

Marshmallow root is a long-standing demulcent in European medicine, a soothing remedy meant to coat irritated surfaces. The European Medicines Agency’s herbal committee lists it as a traditional herbal medicine for oral or throat irritation with dry cough, and as a demulcent for the symptomatic relief of mild gastrointestinal discomfort, both on the basis of long-standing use alone. A review of Traditional Persian medicine, which drew on the Canon of Medicine and other classical manuscripts, records Althaea among the mucilage plants used by mouth or on the skin for respiratory, gastrointestinal, urinary, musculoskeletal and skin complaints. These are historical uses, not trial findings.

The constituents

The active material of the root is its polysaccharide mucilage. A review of the plant’s polysaccharides lists antitussive, antioxidant, antibacterial, wound-healing and immunomodulatory activities from laboratory and animal work, and notes that polysaccharides can be extracted from roots, leaves, seeds and flowers. The European monograph says tests of genotoxicity, reproductive toxicity and carcinogenicity have not been performed, so the toxicology file is thin. We could not find a human study showing that the mucilage coats or protects the stomach or intestinal lining, and the coating idea remains a proposed mechanism.

The human evidence

We could not find a randomized trial of marshmallow root, alone or in a formula, for a gut condition. A 2020 systematic review of 33 double-blind placebo-controlled trials of Western herbal medicines in irritable bowel syndrome names peppermint oil, aloe vera, asafoetida, anise oil and several formulas; marshmallow root is not among the preparations its abstract names. The EMA’s gut indication is therefore a traditional-use listing, which the agency states rests exclusively on long-standing use. The laboratory work on the mucilage polysaccharides concerns cough, wound healing and antioxidant activity, not the gut lining.

The human data for the plant are for the throat and cough. A review of animal and clinical studies reports that Althaea extracts alone were effective for dry cough, and that combinations with other herbs improved cough further, though the reviewer pooled studies of varying quality.

One trial often cited for marshmallows concerns sweets, not the root. In 31 adults with established ileostomies (28 completed), eating three marshmallows three times a day for a week cut median ileostomy output by 75 ml a day against the control week (P = 0.0054), and 71% reported thicker output. The authors credited the gelatin in the confection, so the trial says nothing about marshmallow root.

StudyDoseWhat it found
Systematic review of 33 double-blind placebo-controlled trials of Western herbal medicines in IBS PMID 31987249Various; peppermint oil, aloe vera, asafoetida, anise oil and formulas had trialsMarshmallow root not among the preparations named with placebo-controlled IBS trials
Review of animal and clinical studies of Althaea officinalis in cough (non-gut) PMID 31770755Extracts, alone and with other herbsExtracts alone effective for dry cough; combinations improved all kinds of cough
Randomized crossover trial of marshmallow sweets in 31 adults with ileostomies (confectionery, not root) PMID 25951410Three sweets three times a day for one weekMedian ileostomy output down 75 ml/day (P = 0.0054); authors credit the gelatin

Doses, in trials and in practice

No dose of marshmallow root has been tested for a gut outcome in a trial. The European monograph gives the traditional preparation for mild gastrointestinal discomfort in adults and adolescents over 12 as 2 to 5 g of comminuted root in 150 ml of water as a macerate, three times daily, with a maximum of 15 g a day, used immediately after preparation. For throat irritation and cough it lists 0.5 to 3 g in 150 ml, several times a day, and lower amounts for children from age 3. It advises seeing a practitioner if gut symptoms last beyond 2 weeks. Liquid extracts, syrup macerates and dry extracts have their own ranges in the monograph.

The amounts above are what trials and pharmacopoeias record, not a dose for you; your medicines and conditions change the answer, and a clinician or pharmacist who knows them is the person to ask.

What is known about safety

The European monograph reports no adverse reactions known and no cases of overdose, with hypersensitivity to the plant as the only contraindication. Safety in pregnancy and breastfeeding has not been established, and the monograph does not advise use in either. For the gut indication it states that use in children under 12 has not been established, and liquid extracts made with ethanol are not established under 18. The same document notes that tests of genotoxicity, reproductive toxicity and carcinogenicity have not been done. We found no case reports of harm in the sources we read, which reflects limited study as much as safety. Any claim that marshmallow root is risk-free would go beyond what the sources show.

Where it meets prescription medicines

The monograph’s one interaction warning is physical: mucilage may delay the absorption of other medicines taken at the same time. As a precaution it advises leaving a gap, stated as half an hour to an hour before or after other medicines. It lists no other interactions. We could not find a pharmacokinetic study measuring the delay for any drug, so the size of the effect is unknown. The catalog’s own drug rules are listed automatically on this page.

Medicines the site’s own interaction rules flag with marshmallow root

The quiz applies these rules when someone names a medicine. They come from published interaction references and are a reason to ask a pharmacist, not a diagnosis:

Catalog entries that list marshmallow root

If you want marshmallow root in a product rather than as a loose herb, these are the entries that carry it, with the label amounts and the reviews read.

Calming Blends Diverticulitis Tea 4.5 out of 5 from 4,259 ratings from Amazon · $0.53 per cup; the pouch directs two to three cups a day Nature’s Way Marshmallow Root Capsules 4.5 out of 5 from 3,825 ratings from Amazon · $0.31 a day Liver Medic Leaky Gut Repair 4.1 out of 5 from 3,474 ratings from Amazon · $1.00 per day at two capsules; the label’s advanced dose of four to six is $2.00 to $3.00 Terra Origin Healthy Gut Powder 4.3 out of 5 from 1,990 ratings from Amazon · $1.02 a day Renew Life PARA SMART Cleansing Formula, 15-Day Program 4.2 out of 5 from 1,398 ratings from Amazon · ~$2.04 a day across the full 15-day program Clean Nutra GI Defend 4.4 out of 5 from 1,152 ratings from Amazon · $1.00 a day NanoRevive EsoRepair Esophageal & Stomach Liquid 3.9 out of 5 from 1,003 ratings from Amazon · $2.00 a day Soothe Naturals Stomach Soothe 4.1 out of 5 from 459 ratings from Amazon · $1.53 a day The Loose Leaf Happy Intestine Tea 4.65 out of 5 from 417 ratings from thelooseleaftea.com · $0.36 a day It’s Health Tea GERD Natural Herbal Tea 4.1 out of 5 from 315 ratings from Amazon · $0.71 a day Designs for Health GI Revive Peach Powder 4.8 out of 5 from 248 ratings from iHerb · $89.49 for 225 g (28 servings), about $3.20 a day FixBIOME Gut Brain Axys 4.7 out of 5 from 187 ratings from fixbiome.com · $3.17 a day

4 more entries list it; the full catalog is grouped by the job each product does.

Want to know which products fit your symptoms?

The quiz takes about three minutes, asks what you have tried and which medicines you take, and shows the products whose trials and labels fit, with the reasons.

Take the quiz

Herbs that sit beside it

Western Slippery elm Ulmus rubra Ayurvedic / TCM / Western Licorice Glycyrrhiza glabra Western Chamomile Matricaria chamomilla (syn. Matricaria recutita) Ayurvedic / Western Psyllium Plantago ovata

What people want to know

Is there evidence that marshmallow root soothes the gut?

We could not find a randomized trial of the root for any gut condition. The European herbal committee lists it for mild gastrointestinal discomfort on the basis of long-standing use only. The coating effect is a proposed mechanism, not a measured one.

Is marshmallow root the same as marshmallow candy?

No. Marshmallow sweets contain gelatin. The one trial of eating them found less ileostomy output, and the authors credited the gelatin.

Should marshmallow root be taken with medicines?

The European monograph says mucilage may delay absorption of other medicines and advises a gap of half an hour to an hour. No study has measured the size of that delay, and the monograph reports no other interactions.

Is marshmallow root safe in pregnancy?

Safety in pregnancy and breastfeeding has not been established, and the European monograph does not advise use. The monograph also notes that genotoxicity and reproductive toxicity tests have not been done.

How is marshmallow root usually prepared?

The traditional preparation is a macerate, which means the cut root steeped in water so the mucilage comes out. The European monograph gives 2 to 5 g in 150 ml of water for the gut indication and says to use it immediately after making it.

Sources