Compound Monograph

Inulin

Carbohydrates Fructans & Inulin Natural (plant-derived)

Inulin is not one molecule but a family — every linear β(2→1) fructan, from short oligofructose chains to long polymers. It is the storage carbohydrate of dandelion, burdock and chicory roots, indigestible by human enzymes, and fermented in the colon instead. That is what makes it a prebiotic, what gives it a real 33-trial glycaemic meta-analysis, and what makes it a FODMAP that some people with irritable bowel cannot tolerate.

Sources · 11

Where Does It Come From?

Inulin is a naturally occurring fructan (class — linear β(2→1) fructose polymers), found in Burdock, Dandelion, Couchgrass and 8 other sources. It is well tolerated orally (low toxicity).

Also found in
Agave, onion, garlic, leek and wheat Monograph coming soon
Chicory root Monograph coming soon
Chicory root — the main industrial source Monograph coming soon
Dandelion root Monograph coming soon
Jerusalem artichoke Monograph coming soon
Jerusalem artichoke, elecampane, balsamroot and camas Monograph coming soon

Concentration

Content by Source

Reported concentrations across the plants that contain inulin — the bar marks the typical level, the line shows the reported range.

Typical level Reported range % dry wt
Burdock (Arctium lappa) root 40–50 [11]
Couchgrass (Elymus repens) rhizome (as triticin) 3–8 [12]

Literature figures for varying plant parts and preparations. Read them as a comparative guide, not exact assays.

Inulin at a Glance

Inulin is a class, not a molecule, and reading it as a single compound is the commonest mistake made about it. The term inulin-type fructans covers all linear β(2→1) fructans — chains of fructose units with a terminal glucose — and the chains vary in length: native inulin runs from 2 to about 60 units with an average near 12, oligofructose is the short fraction at 2 to 8 units averaging 4, and high-performance inulin is the long fraction at 10 to 60 units averaging 25 1Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →. A root does not contain “inulin” the way it contains a flavonoid; it contains a distribution of chain lengths, and chain length changes how fast the material ferments and how well it is tolerated.

What unites them is a bond human enzymes cannot break. The β(2→1) linkage passes through the small intestine intact and arrives in the colon, where gut bacteria ferment it to short-chain fatty acids. Everything else follows from that single fact. Inulin behaves as dietary fibre, acts as a prebiotic by selectively feeding particular bacteria 1,2Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →Reference 2Wilson B · 2017ReviewPrebiotic inulin-type fructans and galacto-oligosaccharides: definition, specificity, function, and application in gastrointestinal disorders — reviewView study →, has a real body of human trial evidence in glycaemic control 3Reference 3Wang L et al. · 2019Meta-analysisInulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials — meta-analysisView study →, and is a FODMAP — a fermentable carbohydrate that reliably produces gas, and that a subset of people with irritable bowel syndrome cannot tolerate 6Reference 6Chumpitazi BP et al. · 2018RCTFructans exacerbate symptoms in a subset of children with irritable bowel syndrome — randomised controlled trialView study →.

In herbal medicine it is the storage carbohydrate of the Asteraceae roots: burdock, dandelion, chicory, elecampane and Jerusalem artichoke. Its presence in those roots is not incidental — at up to half the dry weight of burdock root 11Reference 11Chan YS et al. · 2011ReviewA review of the pharmacological effects of Arctium lappa (burdock) — reviewView study →, inulin is most of what those medicines physically are.

What Inulin Actually Is

Fructans are plant storage carbohydrates built from fructose rather than glucose, and inulin-type fructans are the linear ones, joined β(2→1), usually capped with a glucose at one end. Degree of polymerisation — the number of sugar units in a chain — is the variable that matters, and commercial products are sold by it 1Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →:

FractionChain length (DP)Average
Oligofructose (fructo-oligosaccharides)2–84
Native inulin2–6012
Long-chain inulin (inulin HP)10–6025

Short chains ferment fast and early in the colon; long chains ferment slowly and reach further along it. That is not a detail — it decides where the fermentation happens, which bacteria get fed, how much gas is produced at once, and how well a given person tolerates a given dose. Products combining both fractions were developed for exactly this reason, and it is the combination that carries the strongest calcium-absorption evidence 1,5Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →Reference 5Abrams SA et al. · 2005RCTA combination of prebiotic short- and long-chain inulin-type fructans enhances calcium absorption and bone mineralization in young adolescents — randomised controlled trialView study →.

For a herb, the practical consequence is that “contains inulin” describes a raw material whose behaviour depends on chain-length distribution nobody has measured for most medicinal roots.

Why Cooking Changes It

One of the more satisfying facts about inulin is that it explains a cooking method.

Because human enzymes cannot hydrolyse the β(2→1) bond, an inulin-rich root is largely indigestible raw — the calories pass to the colon rather than being absorbed. Prolonged heat does what human enzymes cannot, slowly hydrolysing the fructan chains into digestible fructose and shorter sugars. That is the chemical basis for the long pit-cooking traditionally applied to inulin-rich roots such as balsamroot and camas, sometimes for a day or more: the process converts an indigestible storage carbohydrate into food, and produces the characteristic sweetness of a well-cooked inulin root.

The same chemistry runs the other way in a modern kitchen. Roasting chicory root develops sweetness and the coffee-like flavour of chicory “coffee”, and gently prepared inulin roots are correspondingly less sweet and more fermentable. A raw dandelion root and a long-roasted one are different foods, and the difference is where the fructan ends up.

What It's Used For

Inulin has a larger and better human evidence base than most herbal constituents, because it is also a mainstream food ingredient. Read the rows for what they are: fibre and microbiology, not pharmacology.

Genuine prebiotic activity, but not the simple story:inulin fermentation shifts the gut ecosystem rather than merely raising bifidobacteria, with specific changes in Anaerostipes, Bilophila and Bifidobacterium; the fall in Bilophila tracked softer stools and better constipation-related quality of life 4Reference 4Vandeputte D et al. · 2017RCTPrebiotic inulin-type fructans induce specific changes in the human gut microbiota — randomised controlled trialView study →.
Glycaemic control, with real numbers:across 33 randomised trials and 1,346 participants, inulin-type fructans lowered fasting glucose by 0.60 mmol/L and HbA1c by 0.58% in prediabetes and type 2 diabetes, both graded high-quality, with about 10 g a day for six weeks or more recommended 3Reference 3Wang L et al. · 2019Meta-analysisInulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials — meta-analysisView study →.
Calcium absorption and bone:a combination of short- and long-chain inulin-type fructans increased calcium absorption and bone mineralisation in adolescents, the claim its principal reviewer called scientifically substantiated 1,5Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →Reference 5Abrams SA et al. · 2005RCTA combination of prebiotic short- and long-chain inulin-type fructans enhances calcium absorption and bone mineralization in young adolescents — randomised controlled trialView study →.
A double edge:the same fermentation makes it a FODMAP. Fructans exacerbated symptoms in a subset of children with irritable bowel syndrome in a double-blind crossover trial 6Reference 6Chumpitazi BP et al. · 2018RCTFructans exacerbate symptoms in a subset of children with irritable bowel syndrome — randomised controlled trialView study →, and in IBS generally low doses may help while larger doses are neutral or worse 2Reference 2Wilson B · 2017ReviewPrebiotic inulin-type fructans and galacto-oligosaccharides: definition, specificity, function, and application in gastrointestinal disorders — reviewView study →.
The honest headline for herbs:this is a class with food-ingredient evidence at 5–20 g doses. A herbal root delivers it too, but nobody has measured the chain-length distribution or the delivered dose of any medicinal root preparation.
Evidence by IndicationStrength of support · Beta

Mechanisms

Target / pathwayEffectRelevant to
β(2→1) glycosidic bondNot hydrolysed by human digestive enzymes → reaches the colon intact
Everything below
Colonic saccharolytic bacteriaSelective fermentation; shifts in Bifidobacterium, Anaerostipes, Bilophila
Prebiotic effect
Short-chain fatty acid productionColonocyte fuel; colonic acidification
Bowel functionmineral absorption
Colonic pH and mineral solubilityIncreased calcium and magnesium absorption
Bone mineralisation
Gut peptide secretion and lipid metabolismModulated — proposed route for appetite and metabolic effects
Glycaemic and metabolic outcomes
Osmotic load and gas productionWater retention and fermentation gas in the lumen
BloatingflatulenceIBS symptoms
Prolonged heatHydrolysis to fructose and shorter sugars
Why inulin roots are pit-cooked or roasted

The same property drives the benefit and the problem: a carbohydrate that humans cannot digest but their bacteria can.

Pharmacokinetics

There is nothing conventional to describe, because inulin is essentially not absorbed. Human enzymes cannot hydrolyse the β(2→1) bond, so the material passes the small intestine intact, is fermented in the colon, and leaves as short-chain fatty acids, gas, bacterial biomass and water 1,2Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →Reference 2Wilson B · 2017ReviewPrebiotic inulin-type fructans and galacto-oligosaccharides: definition, specificity, function, and application in gastrointestinal disorders — reviewView study →. Nothing systemic is measured, and no plasma concentration is relevant.

What varies instead is fermentation kinetics. Short chains ferment early and fast, long chains later and further along the colon, so the same gram dose can produce different symptoms and different bacterial effects depending on chain length 1Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →. Tolerance studies exist for particular preparations — agave inulin and a roasted chicory extract have both been assessed for gastrointestinal tolerance in healthy adults 7,8Reference 7Holscher HD et al. · 2014RCTGastrointestinal tolerance and utilization of agave inulin by healthy adults — randomised controlled trialView study →Reference 8Ripoll C et al. · 2010RCTGastrointestinal tolerance to an inulin-rich soluble roasted chicory extract after consumption in healthy subjects — randomised controlled trialView study → — and this, rather than absorption, is the practical dosing question.

Clinical Trials

Human trials are extensive, but they are food-ingredient trials of purified fructans: 33 randomised trials pooled for glycaemic outcomes 3Reference 3Wang L et al. · 2019Meta-analysisInulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials — meta-analysisView study →, randomised crossover work on microbiota and constipation 4Reference 4Vandeputte D et al. · 2017RCTPrebiotic inulin-type fructans induce specific changes in the human gut microbiota — randomised controlled trialView study →, calcium absorption in adolescents 5Reference 5Abrams SA et al. · 2005RCTA combination of prebiotic short- and long-chain inulin-type fructans enhances calcium absorption and bone mineralization in young adolescents — randomised controlled trialView study →, IBS symptom provocation 6Reference 6Chumpitazi BP et al. · 2018RCTFructans exacerbate symptoms in a subset of children with irritable bowel syndrome — randomised controlled trialView study →, and tolerance studies 7,8Reference 7Holscher HD et al. · 2014RCTGastrointestinal tolerance and utilization of agave inulin by healthy adults — randomised controlled trialView study →Reference 8Ripoll C et al. · 2010RCTGastrointestinal tolerance to an inulin-rich soluble roasted chicory extract after consumption in healthy subjects — randomised controlled trialView study →. No trial has tested a herbal inulin-bearing root as a source of inulin.

CompletedPlannedTerminatedPreclinical
Extensive: glycaemic (33 RCTs), microbiota, calcium absorption, tolerance, IBS provocation——Antioxidant activity of burdock root fructan 9Reference 9Liu W et al. · 2014In vitroIn vitro and in vivo antioxidant activity of a fructan from the roots of Arctium lappa LView study →

Last checked: September 2026.

Isolate vs. Plant Studies

The gap here is unusually clean. All the human evidence uses purified inulin-type fructans at defined chain lengths and doses of roughly 5–20 g a day 1,3,5Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →Reference 3Wang L et al. · 2019Meta-analysisInulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials — meta-analysisView study →Reference 5Abrams SA et al. · 2005RCTA combination of prebiotic short- and long-chain inulin-type fructans enhances calcium absorption and bone mineralization in young adolescents — randomised controlled trialView study →. All the herbal use delivers an unmeasured chain-length distribution inside a root that also contains phenolics, sesquiterpene lactones and mucilage.

Two things do carry across. The dose is plausible: at up to about half the dry weight of burdock root 11Reference 11Chan YS et al. · 2011ReviewA review of the pharmacological effects of Arctium lappa (burdock) — reviewView study →, an ordinary culinary or decoction quantity of root supplies grams of fructan, which is the right order of magnitude for the trials. And the traditional indications rhyme with the mechanism — burdock and dandelion root are classic “alterative” and digestive-tonic herbs, and a substrate that changes colonic fermentation is a reasonable partial explanation for a reputation built on digestion and elimination.

Two do not. Nobody has measured the chain-length distribution of any medicinal root, so tolerance and fermentation behaviour are unknown. And preparation decides how much survives: a long decoction or a roasted root has hydrolysed part of its fructan to simple sugars, so it is not the same material as a raw root or a purified supplement.

Its Role in Plants

Fructans are how a large fraction of the world’s plants store energy without using starch, and inulin-type fructans are the Asteraceae’s version. They accumulate in roots, rhizomes and tubers over the growing season and are drawn down for regrowth, which is why traditional harvesting of inulin roots is autumn work: the fructan reserve peaks after the aerial parts die back and falls once the plant starts growing again.

They also serve a second purpose. Fructans are highly water-soluble and osmotically active, and they are implicated in drought and cold tolerance, helping stabilise membranes and hold water in the tissue. In couchgrass rhizome the closely related fructan triticin, at roughly 3–8%, hydrolyses to fructose and mannitol and contributes the demulcent, soothing quality that underlies the herb’s urinary use 12Reference 12Zhakipbekov KS et al. · 2026ReviewElymus repens (L.) Gould: phytochemistry, pharmacological activities and therapeutic potential with future perspectives — reviewView study →.

That storage role explains the herbal distribution neatly: the plants richest in inulin are the ones with big perennial storage roots, and those are exactly the roots Western herbal medicine dug in autumn.

Prevalence in Nature

Inulin-type fructans are widespread, and concentrated in the Asteraceae roots.

Burdock root is the richest herbal source, reported at up to about 40–50% of dry weight, highest in autumn-dug first-year roots before flowering 11Reference 11Chan YS et al. · 2011ReviewA review of the pharmacological effects of Arctium lappa (burdock) — reviewView study →. Dandelion root is the other classic, where inulin is the major storage carbohydrate, peaks in autumn, and is named among the constituents behind the root’s metabolic and digestive use 10Reference 10Wirngo FE et al. · 2016ReviewThe physiological effects of dandelion (Taraxacum officinale) in type 2 diabetes — reviewView study → — although no reliable quantified figure was found. Chicory root is the main industrial source of commercial inulin, and Jerusalem artichoke, elecampane — the plant that gave inulin its name — balsamroot and camas are all inulin-storage species. Artichoke and arnica both carry it as a listed constituent.

Outside the Asteraceae, couchgrass rhizome stores the related fructan triticin at 3–8% 12Reference 12Zhakipbekov KS et al. · 2026ReviewElymus repens (L.) Gould: phytochemistry, pharmacological activities and therapeutic potential with future perspectives — reviewView study →, and inulin-type fructans are ordinary components of the diet in onion, garlic, leek, wheat and agave — which is why the FODMAP question is a dietary one and not just a supplement one.

Discovery & Synthesis

Inulin was isolated in 1804 by Valentin Rose from the root of elecampane, Inula helenium, and named for the genus. It was among the earliest plant polysaccharides to be characterised, and its identity as a fructose polymer rather than a starch was established through the nineteenth century.

Commercial production is agricultural, not synthetic. Chicory root is the dominant industrial source: the fructans are extracted with hot water, purified, and then separated by chain length into oligofructose, native inulin and long-chain fractions, or recombined into defined mixtures — which is why food-science papers specify a fraction rather than “inulin” 1Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →. Agave and Jerusalem artichoke are secondary sources. Partial enzymatic hydrolysis converts long chains to oligofructose, and the same reaction happens slowly under prolonged cooking.

Toxicity & Safety

Inulin carries a low flag, and its safety question is not toxicity but tolerance. It is an ordinary food component eaten daily in onions, wheat and garlic, it is not absorbed, and it has no systemic toxicity.

What it reliably does is ferment. Gas, bloating, flatulence, borborygmi and osmotic looseness are dose-related and expected rather than adverse in the usual sense, and gastrointestinal tolerance has been formally assessed for particular preparations in healthy adults 7,8Reference 7Holscher HD et al. · 2014RCTGastrointestinal tolerance and utilization of agave inulin by healthy adults — randomised controlled trialView study →Reference 8Ripoll C et al. · 2010RCTGastrointestinal tolerance to an inulin-rich soluble roasted chicory extract after consumption in healthy subjects — randomised controlled trialView study →. Tolerance improves with gradual introduction, and it depends on chain length as much as on grams — the short, fast-fermenting fractions produce more early gas.

The group that needs the caution is people with irritable bowel syndrome or fructan malabsorption, for whom fructans are a FODMAP and a documented symptom trigger: in a double-blind crossover trial, fructans exacerbated symptoms in a subset of children with IBS 6Reference 6Chumpitazi BP et al. · 2018RCTFructans exacerbate symptoms in a subset of children with irritable bowel syndrome — randomised controlled trialView study →, and in adults larger prebiotic doses can be neutral or worse even though low doses may help 2Reference 2Wilson B · 2017ReviewPrebiotic inulin-type fructans and galacto-oligosaccharides: definition, specificity, function, and application in gastrointestinal disorders — reviewView study →. That is a genuine tension worth stating plainly — the same molecule is a prebiotic to be encouraged in one guideline and a FODMAP to be restricted in another, and both positions are evidence-based for their populations.

For herbs the implication is practical rather than alarming: a large decoction of burdock or dandelion root is a meaningful fructan dose, and someone who reacts to onions and wheat may react to it too.

Safety at a Glance
Low / no toxicity
  • Not absorbed and not toxic. An ordinary dietary carbohydrate; the human evidence base is food-ingredient-scale and reassuring.
  • Real human evidence at ~10 g/day — a 33-trial meta-analysis found fasting glucose and HbA1c reductions graded high-quality.
  • A FODMAP. Fructans exacerbated symptoms in a subset of children with irritable bowel syndrome; those with IBS or fructan malabsorption may react at low doses.
  • Gas and bloating are dose-related and expected, more so with short-chain fractions; introduce gradually.
  • A large root decoction is a fructan dose. Burdock root is up to about half inulin by dry weight.

Dosage

These are doses studied in research and are not a personal recommendation.

ContextFormDose
Glycaemic control (prediabetes, type 2 diabetes)Purified inulin-type fructans~10 g/day for 6 weeks or longer 3Reference 3Wang L et al. · 2019Meta-analysisInulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials — meta-analysisView study →
Prebiotic / bowel functionPurified inulin-type fructansFood-ingredient doses, typically 5–15 g/day 1,4Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →Reference 4Vandeputte D et al. · 2017RCTPrebiotic inulin-type fructans induce specific changes in the human gut microbiota — randomised controlled trialView study →
Calcium absorption (adolescents)Short- plus long-chain combinationTrial dosing of the combined preparation 1,5Reference 1Roberfroid MB · 2007ReviewInulin-type fructans: functional food ingredients — reviewView study →Reference 5Abrams SA et al. · 2005RCTA combination of prebiotic short- and long-chain inulin-type fructans enhances calcium absorption and bone mineralization in young adolescents — randomised controlled trialView study →
Tolerance ceilingAnyBloating and flatulence rise with dose; short chains ferment fastest 7,8Reference 7Holscher HD et al. · 2014RCTGastrointestinal tolerance and utilization of agave inulin by healthy adults — randomised controlled trialView study →Reference 8Ripoll C et al. · 2010RCTGastrointestinal tolerance to an inulin-rich soluble roasted chicory extract after consumption in healthy subjects — randomised controlled trialView study →
HerbalBurdock or dandelion root decoctionNot standardised; root is up to ~40–50% inulin by dry weight 11Reference 11Chan YS et al. · 2011ReviewA review of the pharmacological effects of Arctium lappa (burdock) — reviewView study →, so grams of fructan per dose

References

  1. Roberfroid MB (2007). Inulin-type fructans: functional food ingredients — review. J Nutr. https://pubmed.ncbi.nlm.nih.gov/17951492/
  2. Wilson B, Whelan K (2017). Prebiotic inulin-type fructans and galacto-oligosaccharides: definition, specificity, function, and application in gastrointestinal disorders — review. J Gastroenterol Hepatol. https://pubmed.ncbi.nlm.nih.gov/28244671/
  3. Wang L, Yang H, Huang H, et al. (2019). Inulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials — meta-analysis. J Transl Med. https://pubmed.ncbi.nlm.nih.gov/31805963/
  4. Vandeputte D, Falony G, Vieira-Silva S, et al. (2017). Prebiotic inulin-type fructans induce specific changes in the human gut microbiota — randomised controlled trial. Gut. https://pubmed.ncbi.nlm.nih.gov/28213610/
  5. Abrams SA, Griffin IJ, Hawthorne KM, et al. (2005). A combination of prebiotic short- and long-chain inulin-type fructans enhances calcium absorption and bone mineralization in young adolescents — randomised controlled trial. Am J Clin Nutr. https://pubmed.ncbi.nlm.nih.gov/16087995/
  6. Chumpitazi BP, McMeans AR, Vaughan A, et al. (2018). Fructans exacerbate symptoms in a subset of children with irritable bowel syndrome — randomised controlled trial. Clin Gastroenterol Hepatol. https://pubmed.ncbi.nlm.nih.gov/28970147/
  7. Holscher HD, Doligale JL, Bauer LL, et al. (2014). Gastrointestinal tolerance and utilization of agave inulin by healthy adults — randomised controlled trial. Food Funct. https://pubmed.ncbi.nlm.nih.gov/24664349/
  8. Ripoll C, Flourié B, Megnien S, et al. (2010). Gastrointestinal tolerance to an inulin-rich soluble roasted chicory extract after consumption in healthy subjects — randomised controlled trial. Nutrition. https://pubmed.ncbi.nlm.nih.gov/19931416/
  9. Liu W, Wang J, Zhang Z, et al. (2014). In vitro and in vivo antioxidant activity of a fructan from the roots of Arctium lappa L. Int J Biol Macromol. https://pubmed.ncbi.nlm.nih.gov/24508920/
  10. Wirngo FE, Lambert MN, Jeppesen PB (2016). The physiological effects of dandelion (Taraxacum officinale) in type 2 diabetes — review. Rev Diabet Stud. https://pubmed.ncbi.nlm.nih.gov/28012278/
  11. Chan YS, Cheng LN, Wu JH, et al. (2011). A review of the pharmacological effects of Arctium lappa (burdock) — review. Inflammopharmacology. https://pubmed.ncbi.nlm.nih.gov/20981575/
  12. Zhakipbekov KS, Serikbayeva EA, Tleubayeva MI, et al. (2026). Elymus repens (L.) Gould: phytochemistry, pharmacological activities and therapeutic potential with future perspectives — review. Int J Mol Sci. https://pubmed.ncbi.nlm.nih.gov/42278456/