Key Constituents

Mucilage polysaccharides (rhamnogalacturonans, arabinans, glucans, arabinogalactans)^{[2, 5, 11, 12]}

The principal soothing, film-forming constituents; the isolated rhamnogalacturonan also shows direct antitussive activity in animal models.

PolysaccharidesMucilage

Flavonoids and phenolic acids^[13]

Antioxidant constituents.

Phenolic acidsFlavonoids

Pectin and starch^[11]

Other carbohydrate constituents of the root.

PectinStarch

Pharmacological Actions

Antitussive (cough suppressant)^{[1, 11, 12, 14]}

Demulcent (soothing mucilage)^{[1, 7, 11, 13]}

Demulcent for irritation of the mouth or throat and associated dry cough (mucilage coats and soothes); Eases mild stomach and gut discomfort, including heartburn / acid reflux and indigestion (protective mucilage)

Emollient / skin-soothing^{[3, 6, 13]}

Topical soothing for irritated skin

Traditional & Indicated Uses

Acid reflux^[11]Traditional · 1/10

Eases mild stomach and gut discomfort, including heartburn / acid reflux and indigestion (protective mucilage)

more plants for acid reflux →detailed sources →

Cough^{[1, 11, 12, 13, 14]}Good · 7/10

Antitussive (calms dry, irritating cough) - in animal studies the root rhamnogalacturonan suppresses the cough reflex dose-dependently, comparably to codeine, via 5-HT2 receptors rather than bronchodilation; Demulcent for irritation of the mouth or throat and associated dry cough (mucilage coats and soothes)

more plants for cough →detailed sources →

Eczema^{[6, 13]}Moderate · 5/10

inferred from emollient action

more plants for eczema →detailed sources →

Indigestion^[11]Traditional · 1/10

Eases mild stomach and gut discomfort, including heartburn / acid reflux and indigestion (protective mucilage)

more plants for indigestion →detailed sources →

Skin irritation^{[3, 6, 13]}Moderate · 5/10

Topical soothing for irritated skin

more plants for skin irritation →detailed sources →

Sore throat^[11]Traditional · 1/10

more plants for sore throat →detailed sources →

Safety, Cautions & Contraindications

Safety note^{[11, 13]}Info

Very well tolerated. The mucilage can slow the absorption of other medicines, so take other drugs about an hour before or after marshmallow.

Safety note^[11]Caution

It may mildly lower blood sugar (caution alongside antidiabetic medicines). Use in pregnancy and breastfeeding is not recommended in the absence of adequate data.

References

REF-1368, REF-1369, REF-1370, REF-1371, REF-1372, REF-1373, REF-1374, REF-1375, REF-1376, REF-1377

References & Sources

Mahboubi, M (2020) 'Marsh Mallow (Althaea officinalis L.) and Its Potency in the Treatment of Cough', Complementary Medicine Research, 27(3), pp. 174-183. doi:10.1159/000503747 Meta-analysis / review
https://doi.org/10.1159/000503747
Xue, T., Ruan, K., Tang, Z., Duan, J. and others (2023) 'Isolation, structural properties, and bioactivities of polysaccharides from Althaea officinalis Linn.: A review', International Journal of Biological Macromolecules, 242(Pt 4), pp. 125098. doi:10.1016/j.ijbiomac.2023.125098 Meta-analysis / review
https://doi.org/10.1016/j.ijbiomac.2023.125098
Mohsenikia, M., Rafiee, S., Rozei, L.S., Ebrahimi, A. and others (2020) 'Althaea officinalis improves wound healing in rats: a stereological study', Drug Discoveries & Therapeutics, 14(5), pp. 239-242. doi:10.5582/ddt.2020.03056 Preclinical
https://doi.org/10.5582/ddt.2020.03056
Wang, Z., Jiang, X., Zhang, L. and Chen, H (2023) 'Protective effects of Althaea officinalis L. extract against N-diethylnitrosamine-induced hepatocellular carcinoma in male Wistar rats through antioxidative, anti-inflammatory, mitochondrial apoptosis and PI3K/Akt/mTOR signaling pathways', Food Science & Nutrition, 11(8), pp. 4756-4772. doi:10.1002/fsn3.3455 Preclinical
https://doi.org/10.1002/fsn3.3455
Karimi, S., Ghanbarzadeh, B., Roufegarinejad, L. and Falcone, P.M (2021) 'Polysaccharide extracted from Althaea officinalis L. root: New studies of structural, rheological and antioxidant properties', Carbohydrate Research, 510, pp. 108438. doi:10.1016/j.carres.2021.108438 Preclinical
https://doi.org/10.1016/j.carres.2021.108438
Naseri, V., Chavoshzadeh, Z., Mizani, A., Daneshfard, B. and others (2021) 'Effect of topical marshmallow (Althaea officinalis) on atopic dermatitis in children: A pilot double-blind active-controlled clinical trial of an in-silico-analyzed phytomedicine', Phytotherapy Research, 35(3), pp. 1389-1398. doi:10.1002/ptr.6899 Randomized trial
https://doi.org/10.1002/ptr.6899
Bonaterra, G.A., Schmitt, J., Schneider, K., Schwarzbach, H. and others (2022) 'Phytohustil and root extract of Althaea officinalis L. exert anti-inflammatory and anti-oxidative properties and improve the migratory capacity of endothelial cells', Frontiers in Pharmacology, 13, pp. 948248. doi:10.3389/fphar.2022.948248 Preclinical
https://doi.org/10.3389/fphar.2022.948248
Xue, T.T., Yang, Y.G., Tang, Z.S., Duan, J.A. and others (2022) 'Evaluation of antioxidant, enzyme inhibition, nitric oxide production inhibitory activities and chemical profiles of the active extracts from the medicinal and edible plant: Althaea officinalis', Food Research International, 156, pp. 111166. doi:10.1016/j.foodres.2022.111166 Preclinical
https://doi.org/10.1016/j.foodres.2022.111166
Amini, F., Namjooyan, F., Zomorodian, K., Zareshahrabadi, Z. and others (2023) 'The efficacy of complementary treatment with marshmallow (Althaea officinalis L.) on vulvovaginal candidiasis: A randomized double-blinded controlled clinical trial', Explore (NY), 19(6), pp. 813-819. doi:10.1016/j.explore.2023.04.005 Randomized trial
https://doi.org/10.1016/j.explore.2023.04.005
Berry, J (1884) 'Althaea officinalis', The Hospital, 1(6), pp. 85-86. Traditional / reference
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European Medicines Agency (HMPC) (n.d.) 'European Union herbal monograph on Althaea officinalis L., radix (Althaeae radix)'. Available at: https://www.ema.europa.eu/en/medicines/herbal/althaeae-radix Traditional / reference
https://www.ema.europa.eu/en/medicines/herbal/althaeae-radix
Sutovska, M., Nosalova, G., Sutovsky, J., Franova, S., Prisenznakova, L. and Capek, P (2009) 'Possible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan in guinea pigs test system', International Journal of Biological Macromolecules, 45(1), pp. 27--32. doi:10.1016/j.ijbiomac.2009.03.008 Preclinical
https://doi.org/10.1016/j.ijbiomac.2009.03.008
ESCOP (European Scientific Cooperative on Phytotherapy) (n.d.) 'Althaeae radix (Marshmallow Root) monograph', pp. com. Available at: https://www.escop.com/downloads/althaea-radix-marshmallow-root/ Traditional / reference
https://www.escop.com/downloads/althaea-radix-marshmallow-root/
Sutovska, M., Capek, P., Franova, S., Joskova, M., Sutovsky, J., Marcinek, J. and Kalman, M (2011) 'Antitussive activity of Althaea officinalis L. polysaccharide rhamnogalacturonan and its changes in guinea pigs with ovalbumine-induced airways inflammation', Bratislavske Lekarske Listy, 112(12), pp. 670--675. Preclinical
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