Slippery elm (Ulmus fulva) has been used as an herbal remedy in North
America for centuries. Native Americans used slippery elm in healing salves for
wounds, boils, ulcers, burns, and skin inflammation. Antiseptic poultices made
from the mucilage or gummy secretion from the bark were applied to infected
wounds. In particular, the Cherokee used Slippery elm for coughs, skin
conditions, and as an eye wash.
Slippery elm is also one of four herbs included in a popular therapy called
essiac that is promoted for cancer treatment. This remedy was developed by a
nurse in Canada in the early 1930's. Later, the formula was expanded from its
original inclusion of slippery elm, burdock root, sheep sorrel and Turkish
rhubarb to also include red clover, water cress, blessed thistle, and kelp.
Today, reports state that there are over 40 variations of these herbal
combination remedies on the market, without scientific proof that any of them
The conditions for which slippery elm has received recognition from the U.S.
Food and Drug Administration (FDA) as a safe and effective option include sore
throat (pharyngitis) and respiratory symptoms, such as cough. Herbalists also
recommend it for external use to treat wounds, cuts, and certain skin
conditions, including diaper rash.
Because of its growing popularity, there has been an increasing demand for
slippery elm bark. However, since the wood of the slippery elm tree has no
commercial value, the trees are left to die after their bark has been harvested.
This has led the National Center for the Preservation of Medicinal Herbs to
launch an effort aimed at promoting sustainable cultivation of slippery elm.
Slippery elm is also considered a wholesome nutritional food, similar in
texture to oatmeal and can be prepared as a porridge. Consumed three times per
day, unsweetened "elm food" may be a good source of nutrients. Because it is
gentle and easily digested, it is well tolerated by people with gastritis and
other forms of intestinal problems.
Slippery elm is a medium-sized tree native to North America. It can reach
well over 50 feet in height and is topped by spreading branches that form an
open crown. The red-brown or orange branches grow downward, and the stalkless
flowers are arranged in dense clusters. The plant's leaves are long and green,
darkening in color during the fall. The bark has deep fissures, a gummy texture,
and a slight but distinct odor.
The slippery elm's inner bark is used for medicinal
Medicinal Uses and Indications
While there has been little scientific research on slippery elm, it has a
long history of use based on clinical experience. Some of the conditions that
seem to respond to slippery elm include:
Mild respiratory ailments
Gastritis, peptic ulcer, and other gastrointestinal conditions
Wounds, burns, boils, and other skin conditions (external)
Slippery elm has been used in Ayurvedic and Traditional Chinese Medicine for
gastrointestinal symptoms including bloody diarrhea. This herb is thought to
work for such intestinal problems because of its demulcent properties, which
means that it coats and soothes the digestive tract. Recent laboratory research
on slippery elm suggests that this traditional application may prove to have
scientific merit in treating inflammatory bowel disease (namely, Crohn's disease
and ulcerative colitis); the authors of this study propose that it is the
antioxidant properties of slippery elm that would offer such protection.
Conclusions regarding this preliminary information, however, will have to wait
on studies of people.
Commercial preparations are made from 10-year-old inner bark sold in long
flat pieces about two to three feet long, between 1/8 and 1/16 of an inch in
thickness. Available forms of slippery elm include the
Tablets and capsules
Finely powdered bark for drinks (infusions and decoctions and liquid
Coarsely powdered bark for poultices
How to Take It
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
slippery elm for this child would be 1/3 of the adult dose.
The following are recommended adult doses for slippery elm:
Decoction: prepare by simmering for an hour or longer one part
powdered bark to eight parts water. This will make a mucilaginous drink that can
be taken as often as needed, or added to juice or oatmeal.
Infusion: prepare by pouring 2 cups boiling water over 4 grams
(roughly 2 tablespoons) of powdered bark and then steeping for 3 to 5 minutes.
Drink three times per day
Capsules: two capsules (250 to 500 mg), three times daily
Lozenges: follow dosing instructions on label
External application: Mix coarse powdered bark with boiling water to
make a poultice.
The use of herbs is a time-honored approach to strengthening the body and
treating disease. Herbs, however, contain active substances that can trigger
side effects and interact with other herbs, supplements, or medications. For
these reasons, herbs should be taken with care, under the supervision of a
practitioner knowledgeable in the field of botanical medicine.
There are no known health hazards reported for slippery elm when it is
properly administered in recommended therapeutic doses. However, taking slippery
elm with oral medications may decrease the absorption of these medications;
therefore, it may be a good idea to take slippery elm several hours before or
after other herbs or medications you may be taking.
Based on use by and experience of herbal specialists, slippery elm is thought
to be safe in pregnant and nursing women, but this has not been tested
There are no reports in the scientific literature to suggest that slippery
elm interacts with any conventional medications. As stated in Precautions,
however, it is best to take slippery elm several hours before or after other
herbs or medications because of possible interference with absorption.
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Review Date: April 2002
Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD,
Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University
and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh
(Pediatric Dosing section February 2001), Johnson Drugs, Natick, MA; Steven
Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's
Administrative Hospital, Londonderry, NH; R. Lynn Shumake, PD, Director,
Alternative Medicine Apothecary, Blue Mountain Apothecary & Healing Arts,
University of Maryland Medical Center, Glenwood, MD; David Winston, Herbalist
(September 1999), Herbalist and Alchemist, Inc., Washington, NJ. All interaction
sections have also been reviewed by a team of experts including Joseph Lamb, MD
(July 2000), The Integrative Medicine Works, Alexandria, VA;Enrico Liva, ND, RPh
(August 2000), Vital Nutrients, Middletown, CT; Brian T Sanderoff, PD, BS in
Pharmacy (March 2000), Clinical Assistant Professor, University of Maryland
School of Pharmacy; President, Your Prescription for Health, Owings Mills, MD;
Ira Zunin, MD, MPH, MBA (July 2000), President and Chairman, Hawaii State
Consortium for Integrative Medicine, Honolulu,
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practitioner and to check product information (including package inserts)
regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed