Marshmallow (Althea officinalis)—the herb, not the white puffy confection you roast on a campfire—has been used for centuries as both a food and a medicine. Its name comes from the Greek word "altho," which means "to cure." The Romans, Chinese, Egyptians, and Syrians used mallow as a source of food, while the Arabs made poultices from its leaves to treat inflammation. Studies show that the mucilage, or gummy secretion, in the leaves and particularly the root is excellent for soothing sore throats and smoothing skin.

Found in southern and western Europe, western Asia, and the northeastern region of North America, marshmallow originally grew on salty soils but now thrives in moist, uncultivated ground. Its fleshy, erect stems reach a height of three to four feet. The stems give off simple branches or, at most, a few sideways branches. 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 perennial root, is filled with mild mucilage.

The following parts of marshmallow are used for medicinal purposes:

• Flowers
• Leaves
• Roots

Marshmallow is used to treat the following conditions and symptoms:

• Sore throat and dry cough
• Gastric and intestinal conditions
• Ulcers

Marshmallow is also used to gently increase urine production, reduce inflammation, prevent formation of kidney stones, and promote wound healing. Traditionally, marshmallow is also used as a topical treatment for abscesses, boils, and other conditions.

Marshmallow is available in the following forms:

• Leaf
• Flowers
• Infusion or cold-water maceration
• Dried root
• Tincture
• Marshmallow syrup
• Ointments, creams

Pediatric

• Adjust 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. Therefore, if the child weighs 50 lb (20 to 25 kg), the appropriate dose of marshmallow for this child would be 1/3 of the adult dosage.

Adult

The following are the recommended adult doses for marshmallow:

• Leaf: 5 g or equivalent preparations daily
• Flowers: 5 g mallow as gastrointestinal tea
• Root: infusion or cold-water maceration (2% to 5%): 150 mL (1 to 2 tsp) taken to soothe cough and sore throat
• Dried root: 2 to 6 g or equivalent preparations daily (cold infusion three times per day)
• Tincture: 5 to 15 mL (1:5 in 25% ethanol) three times per day
• Marshmallow syrup (from root): 2 to 10 g per single dose (syrup contains sugar, which should be taken into consideration by diabetics)
• Root topical preparations: 5% to 10% drug in ointment or cream base

There are no reported side effects of marshmallow, and it reportedly causes no problem for use during pregnancy or breastfeeding.

Although clinical relevance is unknown, marshmallow may interfere with the absorption of certain medications; therefore, ingestion of marshmallow several hours before or after other herbs or medications may be warranted.

No noteworthy interactions (positive or negative) between marshmallow and conventional medications are known to have been reported in the literature to date.

Blumenthal M, ed. The Complete German Commission E Monographs. Boston, Mass: Integrative Medicine Communications; 1998:166-167.

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

British Herbal Pharmacopoeia. 4th ed. Great Britain: Biddles Ltd, Guildford and King's Lynn; 1996: 151-152.

Dorland's Illustrated Medical Dictionary. 25th ed. Philadelphia, Pa: WB. Saunders; 1974.

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

Grieve M. A Modern Herbal. Vol. II. New York, NY: Dover; 1971: 507-508.

Gysling E. Leitfaden zur Pharmakotherpie. Vienna: Huber, Bern Stuttgart; 1976:86.

Hahn HL. Husten: Mechanismen, pathophysiologie und therapie. Disch Apoth A. 1987;127(suppl 5):3-26.

Kurz H. 1989 Antitussiva und Expektoranzien. Wissenschaftliche. Verlagsgesellschaft Stuggart; 1989.

Mascolo N, et al. Biological screening of Italian plants for anti-inflammatory activity. Phytotherapy Res. 1987;I:28-31.

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). Pharmazie. 1992;47(3): 224-226.

Recio MC, et al. Antimicrobial activity of selected plants employed in the Spanish Mediterranean area. Part II. Phytotherapy Res. 1989;3:77-80.

Schulz V, Hansel R, Tyler V. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 3rd ed. Berlin, Germany: Springer; 1998:150,183.

Thomson WA. Medicines from the Earth: A Guide to Healing Plants. Maidenhead, England: McGraw-Hill Book Company; 1978:41.

Tomoda M, Norika S, Oshima Y, Takahashi M, Murakami M, Hikino H. Hypoglycemic activity of twenty plant mucilages and three modified products. Planta Med. 1987;53:8-12.

White L, Mavor S. Kids, Herbs, Health. Loveland, Colo: Interweave Press; 1998:22, 35-36.