Slippery Elm

Scientific Name(s): Ulmus rubra Muhl.
Common Name(s): Indian elm, Moose elm, Red elm, Slippery elm, Sweet elm

Medically reviewed by Drugs.com. Last updated on Aug 22, 2023.

Clinical Overview

Use

Slippery elm has been used in traditional medicine to treat multiple conditions due to its mucilaginous property. Limited studies have investigated the antioxidant and anti-inflammatory potential of slippery elm. However, no large clinical studies exist, and data are lacking to support use of slippery elm for any indication.

Dosing

No clinical studies exist to provide dosage guidelines. Traditional use suggests a dosage of 1 to 3 tsp of slippery elm powder in 240 mL of water up to 3 times a day.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Avoid use in pregnancy; possible abortifacient effects have been described. Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Oleoresins from several Ulmus species have been reported to cause contact dermatitis, and the pollen of slippery elm is a known allergen.

Toxicology

No data.

Scientific Family

• Ulmaceae (elm)

Botany

The genus Ulmus consists of 18 species of deciduous shrubs and trees.Hocking 1997 The slippery elm tree is native to eastern Canada and to the eastern and central United States, where it is found most commonly in the Appalachian Mountains. The tree's rough bark has vertical ridges and is reddish-brown on the trunk and gray-white on the branches. Slippery elm can grow up to 18 to 20 m in height.Chevallier 1996 In the spring, dark brown buds appear at the branch tips and open into small, clustered flowers.Magic and Medicine of Plants 1986, USDA 2020 U. rubra Muhl. was formerly known as Ulmus fulva Michx. White elm (U. americana) is a related species and has been used for similar medicinal purposes.Chevallier 1996

Related/similar drugs

Ginkgo Biloba, turmeric, milk thistle

History

American Indians and early North American settlers used the inner bark of slippery elm not only as a material for constructing canoes, shelters, and baskets, but also as a poultice and as an ingredient in a soothing drink.Chevallier 1996, Duke 2002, Tyler 1994 Upon contact with water, the inner bark yields a thick mucilage or demulcent that was used as an ointment or salve to treat urinary tract inflammation. It was also applied topically for cold sores and boils. A decoction of the leaves was used as a poultice to remove discoloration around blackened or bruised eyes. During the American Revolution, surgeons treated gunshot wounds with a similar poultice.Magic and Medicine of Plants 1986 Early North American settlers boiled bear fat with the bark to prevent rancidity.Duke 2002, Hocking 1997 In the late 19th century, a preparation of elm mucilage was officially recognized in the United States Pharmacopoeia. Other traditional uses of the plant as a demulcent, emollient, and antitussive have been reported.Lewis 1977

Chemistry

Slippery elm contains carbohydrates, including starches, with mucilage being the major constituent,Duke 1992 as well as hexoses, pentoses, and polyuronides.Chevallier 1996, Newall 1996 Other constituents include sesquiterpenes, calcium oxalate, cholesterol (and other phytosterols), and tannins,Chevallier 1996, Lewis 1977, Newall 1996 as well as beta-carotene and essential fatty acids.Rahman 2017

Uses and Pharmacology

Antioxidant activity

Animal and in vitro data

Screening studies have revealed peroxynitrite scavenging activity in the constituents of slippery elm,Choi 2002 as well as evidence of superoxide scavenging in colorectal tissue obtained from patients with inflammatory bowel disease who were treated with slippery elm.Langmead 2002 In vitro activity showed that slippery elm exhibited antioxidant capability similar to 5-aminosalicylic acid in ulcerative colitis.Langmead 2002, Rahman 2017

Clinical data

No clinical data exist regarding the use of slippery elm for antioxidant purposes. Slippery elm is one of several ingredients in the dietary supplements Essiac and Flor Essence, both of which have been described as having antioxidant activityLeonard 2006, Saleem 2009; however, the US Food and Drug Administration (FDA) has not approved either product to treat any medical condition.NCI 2015

Anti-inflammatory activity

Clinical data

A study evaluating 5 cases of psoriasis found that daily consumption of slippery elm in combination with saffron tea may result in improved psoriasis severity scores.Brown 2004

Cancer

In vitro data

An in vitro screening study described weak tumoricidal effects for slippery elm.Mazzio 2009

Dosing

No clinical studies exist to provide dosage guidelines. Traditional use suggests a dosage of 1 to 3 tsp of slippery elm powder in 240 mL of water, up to 3 times a day. Commercial preparations of liquid bark extract are available, as are capsules of slippery elm powder.Duke 2002

Pregnancy / Lactation

Avoid use in pregnancy. Abortifacient effects have been described, possibly related to vaginal use of whole bark pieces to induce abortion.Duke 2002, Rotblatt 2002 This generally ineffective practice has also resulted in reports of serious urinary tract calculi when bark pieces have migrated into the bladder.Williams 1954 Information regarding safety and efficacy of oral use in pregnancy and lactation is lacking.

Interactions

None well documented. Due to its mucilaginous property, slippery elm may decrease absorption rates of other medicines; if taken concomitantly, it may be beneficial to separate slippery elm doses from those of other medicines by 1 to several hours.Edwards 2015, Rahman 2017

Adverse Reactions

Oleoresins from several Ulmus species have caused contact dermatitis, and the pollen of slippery elm is a known allergen.Duke 2002

Toxicology

Research regarding the toxicity of slippery elm is limited.

Index Terms

• Ulmus americana
• Ulmus fulva Michx.
• White elm

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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