Marshmallow

What Is Marshmallow?

Marshmallow is a tall, soft-leaved perennial in the mallow family, valued for its thick root and the slippery mucilage it contains. Herbalists use it as a demulcent: a remedy that coats and soothes irritated mucous membranes in the throat, the airways, the gut and the urinary tract. The root and leaf are also applied to inflamed skin.

Althaea officinalis grows in damp meadows, ditches and salt marshes across Europe and western and central Asia ^{26,29,30Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →Reference 30Tang et al.G., & Dorr, LView study →}. The original marshmallow sweet was made with sugar and the sap of its root ^{29Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →}. French confectioners made a soothing root paste, pâte de guimauve, for coughs and hoarseness, though the modern sweet contains none of the plant ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}.

The mucilage is a gel of acidic polysaccharides, chiefly rhamnogalacturonans, concentrated in the root ^{5,22Reference 5Deters et al. · 2010In vitroAqueous extracts and polysaccharides from marshmallow roots: cellular internalisation and stimulation of cell physiology of human epithelial cells — in vitroView study →Reference 22Xue et al. · 2023ReviewIsolation, structural properties, and bioactivities of polysaccharides from Althaea officinalis Linn.: a review — reviewView study →}. Research has looked mainly at how it forms a protective film over irritated tissue and at its effect on the cough reflex, largely in cell and animal studies ^{2,5Reference 2Šutovská et al. · 2009AnimalPossible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan — animal (guinea pig in vivo)View study →Reference 5Deters et al. · 2010In vitroAqueous extracts and polysaccharides from marshmallow roots: cellular internalisation and stimulation of cell physiology of human epithelial cells — in vitroView study →}.

Marshmallow is easily confused with common mallow (Malva sylvestris), which country people often called marsh mallow. True marshmallow has paler flowers and a greyer, downier leaf ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}.

How Is Marshmallow Used?

• Root, as a cold-water macerate — the chopped root soaked in cold water and drunk, the traditional preparation and the one the EU herbal monograph lists ^{26,28Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}.
• Root syrup and lozenges — for a dry cough and sore throat. The syrup has long been given to children ^{26,28Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}.
• Root and leaf extracts — in cough products and throat sprays, often alongside other herbs ^{1,7,21Reference 1Fink et al. · 2018ObservationalMarshmallow root extract for the treatment of irritative cough: two surveys on users’ view on effectiveness and tolerability — observational/cohort surveyView study →Reference 7Roventa et al. · 2023RCTEffectiveness and tolerability of Ectoin mouth and throat spray Althaea honey (ERS09) for sore throat — randomised, active-controlled trialView study →Reference 21Popovych et al. · 2019RCTRandomized, open-label, multicenter comparative study of BNO 1030 extract (containing marshmallow root) in acute non-bacterial tonsillitis in children — randomised (combination product)View study →}.
• Leaf — as an infusion or tincture, traditionally reached for when the urinary and respiratory tracts are the target ^{25Reference 25Hoffmann · 2003Medical Herbalism: The Science and Practice of Herbal Medicine}.
• Root or leaf poultice and ointment — for boils, abscesses and inflamed skin ^{26,27Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →Reference 27Barnes et al. · 2007Herbal Medicines (3rd ed.)}.

Traditional Uses

Western Herbal Medicine

The root is the main part used, and the leaf the second. Both are prepared as a cold infusion, in which the chopped root is steeped in cold water ^{25,26Reference 25Hoffmann · 2003Medical Herbalism: The Science and Practice of Herbal MedicineReference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}.

Western practice uses marshmallow for respiratory catarrh and cough, peptic ulceration, inflammation of the mouth and throat, cystitis and urethritis. It is applied to abscesses, boils and varicose ulcers ^{27Reference 27Barnes et al. · 2007Herbal Medicines (3rd ed.)}.

Herbalists divide the parts by target. The root is taken for the digestive tract, and the leaf for the urinary and respiratory tracts ^{25Reference 25Hoffmann · 2003Medical Herbalism: The Science and Practice of Herbal Medicine}.

The root was boiled in wine or milk for coughs, bronchitis and whooping cough, usually with other remedies, and given as a syrup to infants and children ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}. A poultice of the fresh or powdered root was laid on inflamed skin, which earned it the old name “mortification root” ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}.

Marshmallow and the other mallows were also food. A dish of marshmallow was a Roman delicacy, and in France the young tops and tender leaves were eaten raw in spring salads ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}. Arab physicians used mallow leaves as a poultice for inflammation ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}.

Indications

• Dry, irritable cough [root; macerate, syrup or extract]
• Sore throat and irritation of the mouth and throat [root; macerate, syrup, lozenge]
• Bronchitis and respiratory catarrh [root and leaf; Western herbal use]
• Mild digestive discomfort and gastric irritation [root; macerate]
• Peptic ulcer [root; Western herbal use]
• Cystitis and urethritis [leaf and root; Western herbal use]
• Tonsillitis [root, in a combination product]
• Minor wounds, boils and abscesses [root and leaf, applied]
• Atopic dermatitis in children [ointment, applied] ⚠Caution: The one trial was a small pilot in 22 children, compared against hydrocortisone with no placebo group ¹⁵.

Botany

Marshmallow is an erect perennial herb in the mallow family (Malvaceae) ^{29Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →}, the family that also includes hibiscus, cacao, cotton and okra. It grows to about 1.5 m, with clustered stems that are softly downy with star-shaped hairs ^{29,30Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →Reference 30Tang et al.G., & Dorr, LView study →}.

The leaves are ovate or faintly three-lobed and 4–10 cm long, with irregularly toothed margins. Both surfaces are velvety with dense star-shaped hairs ^{29Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →}.

The flowers are usually pale pink, rarely white, and about 2.5 cm across. They grow singly or in small clusters in the leaf axils, from summer into autumn ^{29,30Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →Reference 30Tang et al.G., & Dorr, LView study →}. Beneath each calyx sits an outer ring of 8–12 narrow bracts ^{29Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →}. This many-parted outer calyx is one way to tell it from the common mallow ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}.

The fruit is a flat, round disc of 15–20 segments, partly hidden by the calyx; country people called these “cheeses” ^{26,29Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →}. Below ground the plant forms a thick, long, tapering root, whitish-yellow outside and white and fibrous within ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}.

Distribution

Marshmallow grows across Europe, western and central Asia and North Africa ^{29,30Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →Reference 30Tang et al.G., & Dorr, LView study →}. It favours wet ground: salt marshes, damp meadows, ditches, the banks of tidal rivers and streams, and brackish sand along the coast ^{26,29Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →}.

It has been introduced to North America, where it is grown as an ornamental and a medicine and occasionally escapes from gardens ^{29Reference 29HillHill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686View study →}. In China it is native only in Xinjiang and is cultivated elsewhere ^{30Reference 30Tang et al.G., & Dorr, LView study →}.

Growing Conditions

Cultivation snapshot for Marshmallow

SunFull sunWaterMedium to wetSoilMoist, fertile soilsLifeperennialZoneUSDA 3-9

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Harvesting & Preparation

Both root and leaf are used. The root is generally preferred for the digestive tract and the leaf for the urinary and respiratory tracts ^{25Reference 25Hoffmann · 2003Medical Herbalism: The Science and Practice of Herbal Medicine}.

The root is traditionally prepared as a cold infusion, in which the chopped root is soaked in cold water. The EU herbal monograph gives the root as a cold-water macerate, to be drunk soon after it is made ^{26,28Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}. The root is also boiled in wine or milk, or made into a syrup for coughs ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}.

The leaves are gathered in August, when the plant is just coming into flower ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}.

Pharmacology & Research

Most marshmallow research concerns its mucilage and how it acts on irritated tissue. The polysaccharides form a bioadhesive film over the mucosa, and in cell studies they also stimulate the epithelial cells beneath it ^{5Reference 5Deters et al. · 2010In vitroAqueous extracts and polysaccharides from marshmallow roots: cellular internalisation and stimulation of cell physiology of human epithelial cells — in vitroView study →}.

The human evidence comes from two consumer surveys of a root-extract lozenge and syrup, and from trials of combination products that include marshmallow root ^{1,7,21Reference 1Fink et al. · 2018ObservationalMarshmallow root extract for the treatment of irritative cough: two surveys on users’ view on effectiveness and tolerability — observational/cohort surveyView study →Reference 7Roventa et al. · 2023RCTEffectiveness and tolerability of Ectoin mouth and throat spray Althaea honey (ERS09) for sore throat — randomised, active-controlled trialView study →Reference 21Popovych et al. · 2019RCTRandomized, open-label, multicenter comparative study of BNO 1030 extract (containing marshmallow root) in acute non-bacterial tonsillitis in children — randomised (combination product)View study →}. A small pilot trial tested a marshmallow ointment in children with atopic dermatitis ^{15Reference 15Naseri et al. · 2021RCTEffect of topical marshmallow (Althaea officinalis) on atopic dermatitis in children: a pilot double-blind active-controlled clinical trial — randomisedView study →}.

The preclinical work covers cough suppression in guinea pigs and cats ^{2,3,4Reference 2Šutovská et al. · 2009AnimalPossible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan — animal (guinea pig in vivo)View study →Reference 3Šutovská et al. · 2011AnimalAntitussive activity of Althaea officinalis L. polysaccharide rhamnogalacturonan in guinea pigs with airways inflammation — animal in vivoView study →Reference 4Šutovská et al. · 2007AnimalThe antitussive activity of polysaccharides from Althaea officinalis L., varView study →}, anti-inflammatory and antioxidant activity of the root extract in human cells ^{9,10Reference 9Bonaterra et al. · 2020In vitroAnti-inflammatory and anti-oxidative effects of Phytohustil and root extract of Althaea officinalis L. on macrophages — in vitroView study →Reference 10Bonaterra et al. · 2022In vitroPhytohustil and root extract of Althaea officinalis L. exert anti-inflammatory and anti-oxidative properties and improve migratory capacity of endothelial cells — in vitroView study →}, and wound healing and gastric protection in rats ^{11,13,14,17Reference 11Hage-Sleiman et al. · 2011AnimalPharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon — animal (rat)View study →Reference 13Mohsenikia et al. · 2020AnimalAlthaea officinalis improves wound healing in rats: a stereological study — animal (rat)View study →Reference 14Rezaei et al. · 2015In vitroEvaluation of the antibacterial activity of the Althaea officinalis L. leaf extract and its wound healing potency in the rat model of excision wound — animal/in vitroView study →Reference 17Zaghlool et al. · 2019AnimalGastro-protective and anti-oxidant potential of Althaea officinalis and Solanum nigrum on pyloric ligation/indomethacin-induced ulceration in rats — animal (rat)View study →}.

No placebo-controlled trial of marshmallow on its own has been published for any indication.

1. Demulcent & Antitussive

Marshmallow’s mucilage is a complex of acidic polysaccharides, chiefly of the rhamnogalacturonan type. It forms a bioadhesive layer over irritated mucosa in the mouth, throat and gut ^{5Reference 5Deters et al. · 2010In vitroAqueous extracts and polysaccharides from marshmallow roots: cellular internalisation and stimulation of cell physiology of human epithelial cells — in vitroView study →}.

In guinea pigs, rhamnogalacturonan isolated from the root suppressed citric-acid-induced cough in a dose-dependent way, with an effect comparable to codeine ^{2,3Reference 2Šutovská et al. · 2009AnimalPossible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan — animal (guinea pig in vivo)View study →Reference 3Šutovská et al. · 2011AnimalAntitussive activity of Althaea officinalis L. polysaccharide rhamnogalacturonan in guinea pigs with airways inflammation — animal in vivoView study →}. It did not relax the airway muscle, and blocking serotonin 5-HT₂ receptors reduced the effect ^{2Reference 2Šutovská et al. · 2009AnimalPossible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan — animal (guinea pig in vivo)View study →}. In cats with mechanically induced cough, marshmallow polysaccharide was the most active of several plant polysaccharides tested, and unlike codeine it barely affected expectoration ^{4Reference 4Šutovská et al. · 2007AnimalThe antitussive activity of polysaccharides from Althaea officinalis L., varView study →}.

In vitro, a water-based root extract and its polysaccharides raised the vitality of human epithelial cells. The polysaccharides were taken up into the cells and switched on genes for cell adhesion, extracellular matrix and cytokine release ^{5Reference 5Deters et al. · 2010In vitroAqueous extracts and polysaccharides from marshmallow roots: cellular internalisation and stimulation of cell physiology of human epithelial cells — in vitroView study →}.

The human data are observational. Two pharmacy surveys followed 822 people using a water-based root-extract lozenge or syrup (STW42) for dry cough over seven days. Most reported relief within 10 minutes, with only three minor adverse events ^{1Reference 1Fink et al. · 2018ObservationalMarshmallow root extract for the treatment of irritative cough: two surveys on users’ view on effectiveness and tolerability — observational/cohort surveyView study →}.

Marshmallow root is also one ingredient in combination throat sprays and tonsillitis products tested in controlled trials ^{7,21Reference 7Roventa et al. · 2023RCTEffectiveness and tolerability of Ectoin mouth and throat spray Althaea honey (ERS09) for sore throat — randomised, active-controlled trialView study →Reference 21Popovych et al. · 2019RCTRandomized, open-label, multicenter comparative study of BNO 1030 extract (containing marshmallow root) in acute non-bacterial tonsillitis in children — randomised (combination product)View study →}. A 2020 review concluded that animal and clinical studies support its use for dry cough, and that combinations with other herbs improved the effect ^{8Reference 8Mahboubi · 2020ReviewMarsh mallow (Althaea officinalis L.) and its potency in the treatment of cough — reviewView study →}.

Gap: no placebo-controlled RCT of marshmallow monotherapy; the best human evidence is survey-based or from combination products, so the herb’s independent effect size is unquantified.

2. Anti-Inflammatory

A root extract, the active component of the cough syrup Phytohustil, reduced the release of TNF-α and IL-6 from human macrophages stimulated with bacterial lipopolysaccharide. The effect was similar to or better than diclofenac, and the extract also improved the macrophages’ ability to migrate ^{9Reference 9Bonaterra et al. · 2020In vitroAnti-inflammatory and anti-oxidative effects of Phytohustil and root extract of Althaea officinalis L. on macrophages — in vitroView study →}.

A companion study found the same extract cut IL-6 release and sped wound closure in human endothelial cells ^{10Reference 10Bonaterra et al. · 2022In vitroPhytohustil and root extract of Althaea officinalis L. exert anti-inflammatory and anti-oxidative properties and improve migratory capacity of endothelial cells — in vitroView study →}.

In rats, a water extract of the flower reduced both acute (carrageenan) and chronic (formalin) inflammation at every dose tested ^{11Reference 11Hage-Sleiman et al. · 2011AnimalPharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon — animal (rat)View study →}.

A root extract also inhibited human hyaluronidase-1 in vitro (IC₅₀ 7.7 mg/mL) and lowered its expression in skin cells ^{6Reference 6Sendker et al. · 2017In vitroPhytochemical characterization of low molecular weight constituents from marshmallow roots and inhibiting effects of the aqueous extract on human hyaluronidase-1 — in vitroView study →}.

Gap: all evidence is in vitro or rodent; the human-relevant effect is inferred from cell models of a proprietary extract, with no clinical anti-inflammatory endpoint measured.

3. Antioxidant

Antioxidant activity has been shown only in the laboratory. A root extract protected human macrophages and endothelial cells from hydrogen-peroxide damage and lowered reactive oxygen species inside the cells ^{9,10Reference 9Bonaterra et al. · 2020In vitroAnti-inflammatory and anti-oxidative effects of Phytohustil and root extract of Althaea officinalis L. on macrophages — in vitroView study →Reference 10Bonaterra et al. · 2022In vitroPhytohustil and root extract of Althaea officinalis L. exert anti-inflammatory and anti-oxidative properties and improve migratory capacity of endothelial cells — in vitroView study →}.

An acidic polysaccharide isolated from the root (639 kDa, 51% galacturonic acid) showed relatively high radical-scavenging capacity in chemical assays ^{12Reference 12Karimi et al. · 2021In vitroPolysaccharide extracted from Althaea officinalis L. root: structural, rheological and antioxidant properties — in vitroView study →}.

In rat models of gastric ulcer, liver carcinogenesis and nicotine-induced lung injury, marshmallow extracts raised antioxidant enzymes such as superoxide dismutase and lowered lipid peroxidation ^{17,19,23Reference 17Zaghlool et al. · 2019AnimalGastro-protective and anti-oxidant potential of Althaea officinalis and Solanum nigrum on pyloric ligation/indomethacin-induced ulceration in rats — animal (rat)View study →Reference 19Wang et al. · 2023AnimalProtective effects of Althaea officinalis L. extract against N-diethylnitrosamine-induced hepatocellular carcinoma in male Wistar rats — animal (rat)View study →Reference 23Kara et al. · 2026AnimalProtective effect of Althaea officinalis on nicotine-induced lung injury — animal (rat)View study →}.

No human biomarker study has been done.

4. Wound Healing

Two rat studies support topical use. In a stereological study, 5% and 10% marshmallow gels raised fibroblast numbers and dermal vessel diameter compared with gel base and no treatment. The 10% gel also increased collagen ^{13Reference 13Mohsenikia et al. · 2020AnimalAlthaea officinalis improves wound healing in rats: a stereological study — animal (rat)View study →}.

In an excision-wound study, a hydroalcoholic leaf extract applied to the wound significantly increased healing compared with controls. The same extract was active against gram-positive bacteria in vitro ^{14Reference 14Rezaei et al. · 2015In vitroEvaluation of the antibacterial activity of the Althaea officinalis L. leaf extract and its wound healing potency in the rat model of excision wound — animal/in vitroView study →}.

Gap: rodent-only, topical, small; no controlled human wound-healing trial, and the antibacterial contribution is limited to gram-positive organisms ^{14Reference 14Rezaei et al. · 2015In vitroEvaluation of the antibacterial activity of the Althaea officinalis L. leaf extract and its wound healing potency in the rat model of excision wound — animal/in vitroView study →}.

5. Skin Soothing (Atopic Dermatitis)

A pilot double-blind trial compared a 1% Althaea officinalis ointment with 1% hydrocortisone ointment in children aged 3 months to 12 years with mild-to-moderate atopic dermatitis. Twenty-two children completed it ^{15Reference 15Naseri et al. · 2021RCTEffect of topical marshmallow (Althaea officinalis) on atopic dermatitis in children: a pilot double-blind active-controlled clinical trial — randomisedView study →}.

Severity scores (SCORAD) fell in both groups. The authors reported a greater improvement with marshmallow than with hydrocortisone ^{15Reference 15Naseri et al. · 2021RCTEffect of topical marshmallow (Althaea officinalis) on atopic dermatitis in children: a pilot double-blind active-controlled clinical trial — randomisedView study →}. The same paper used computer docking to suggest that flavonoid glycosides in the plant bind TNF-α, IL-6 and phosphodiesterase-4 ^{15Reference 15Naseri et al. · 2021RCTEffect of topical marshmallow (Althaea officinalis) on atopic dermatitis in children: a pilot double-blind active-controlled clinical trial — randomisedView study →}.

Separately, a root extract blocked endothelin-1-driven activation of human pigment cells in vitro, and was proposed as a skin-lightening ingredient ^{16Reference 16Kobayashi et al. · 2002In vitroInhibitory mechanism of an extract of Althaea officinalis L. on endothelin-1-induced melanocyte activation — in vitroView study →}.

Gap: the clinical evidence is a single underpowered (n=22) active-controlled pilot with no placebo arm; the mechanistic support is docking and cell-line only, and the depigmentation finding is a single cosmetic-science study.

6. Gastroprotective

In rats, 14 days of an oral marshmallow extract before pyloric ligation and indomethacin reduced ulcer number and ulcer index, lowered acid and pepsin output, and restored antioxidant and protective factors in the stomach lining. Omeprazole and misoprostol were the comparison drugs ^{17Reference 17Zaghlool et al. · 2019AnimalGastro-protective and anti-oxidant potential of Althaea officinalis and Solanum nigrum on pyloric ligation/indomethacin-induced ulceration in rats — animal (rat)View study →}.

A water extract of the flower also protected against ethanol-induced gastric ulcers in rats at 50–250 mg/kg, with no adverse effect on liver enzymes ^{11Reference 11Hage-Sleiman et al. · 2011AnimalPharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon — animal (rat)View study →}.

Gap: rodent work in two independent models; no human gastric trial.

7. Antibacterial

Activity is real but narrow. In a screen of herbs used for sore throat, a methanolic extract of the flowers and leaves was active against multidrug-resistant bacteria, and its flavonoid fraction was active against MRSA ^{18Reference 18Mehreen et al. · 2016In vitroPhytochemical, antimicrobial, and toxicological evaluation of traditional herbs used to treat sore throat — in vitroView study →}.

A hydroalcoholic leaf extract inhibited gram-positive bacteria, including Staphylococcus aureus and Listeria monocytogenes, but not the gram-negative Pseudomonas aeruginosa or Escherichia coli ^{14Reference 14Rezaei et al. · 2015In vitroEvaluation of the antibacterial activity of the Althaea officinalis L. leaf extract and its wound healing potency in the rat model of excision wound — animal/in vitroView study →}.

Gap: entirely in vitro, restricted to gram-positive bacteria; the herb is not a systemic antimicrobial and any topical use would need pairing with a gram-negative-active agent ^{14Reference 14Rezaei et al. · 2015In vitroEvaluation of the antibacterial activity of the Althaea officinalis L. leaf extract and its wound healing potency in the rat model of excision wound — animal/in vitroView study →}.

8. Hepatoprotective

One rat study of liver cancer induced by N-diethylnitrosamine tested a flower extract at 250 and 500 mg/kg, alone and with silymarin ^{19Reference 19Wang et al. · 2023AnimalProtective effects of Althaea officinalis L. extract against N-diethylnitrosamine-induced hepatocellular carcinoma in male Wistar rats — animal (rat)View study →}.

Given with silymarin, the extract normalised liver enzymes, improved antioxidant measures, lowered inflammatory cytokines and shifted apoptosis markers (Bax, Bcl-2, p53) toward protecting normal liver cells ^{19Reference 19Wang et al. · 2023AnimalProtective effects of Althaea officinalis L. extract against N-diethylnitrosamine-induced hepatocellular carcinoma in male Wistar rats — animal (rat)View study →}. The clearest effects were in the combination groups, so marshmallow’s own contribution is not separated.

9. Hypoglycemic

In a 1987 study, twenty plant mucilages, including marshmallow’s, were tested for blood-sugar-lowering activity in non-diabetic mice ^{20Reference 20Tomoda et al. · 1987AnimalHypoglycemic activity of twenty plant mucilages and three modified products — animal (mice)View study →}. No diabetic model and no human study have followed.

Mechanisms

Marshmallow’s mucilage acts mainly as a physical layer. The rhamnogalacturonan polysaccharides form a bioadhesive film over irritated mucosa, and in cell studies they also stimulate repair in the epithelial cells beneath ^{5Reference 5Deters et al. · 2010In vitroAqueous extracts and polysaccharides from marshmallow roots: cellular internalisation and stimulation of cell physiology of human epithelial cells — in vitroView study →}. The same polysaccharide fraction suppressed the cough reflex in guinea pigs through a pathway linked to serotonin 5-HT₂ receptors ^{2Reference 2Šutovská et al. · 2009AnimalPossible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan — animal (guinea pig in vivo)View study →}.

The root extract has also been studied for its effects on inflammatory cytokines and oxidative stress in human immune and endothelial cells ^{9,10Reference 9Bonaterra et al. · 2020In vitroAnti-inflammatory and anti-oxidative effects of Phytohustil and root extract of Althaea officinalis L. on macrophages — in vitroView study →Reference 10Bonaterra et al. · 2022In vitroPhytohustil and root extract of Althaea officinalis L. exert anti-inflammatory and anti-oxidative properties and improve migratory capacity of endothelial cells — in vitroView study →}.

Clinical Trials

The published clinical work is mostly on products that combine marshmallow with other ingredients. It includes an open-label trial of an ectoine and Althaea-honey throat spray in 186 people with sore throat (NCT04203810) ^{7Reference 7Roventa et al. · 2023RCTEffectiveness and tolerability of Ectoin mouth and throat spray Althaea honey (ERS09) for sore throat — randomised, active-controlled trialView study →}, an open-label trial of a seven-herb tonsillitis extract in 238 children ^{21Reference 21Popovych et al. · 2019RCTRandomized, open-label, multicenter comparative study of BNO 1030 extract (containing marshmallow root) in acute non-bacterial tonsillitis in children — randomised (combination product)View study →}, and the atopic dermatitis ointment pilot ^{15Reference 15Naseri et al. · 2021RCTEffect of topical marshmallow (Althaea officinalis) on atopic dermatitis in children: a pilot double-blind active-controlled clinical trial — randomisedView study →}. The remaining human evidence comes from consumer surveys ^{1Reference 1Fink et al. · 2018ObservationalMarshmallow root extract for the treatment of irritative cough: two surveys on users’ view on effectiveness and tolerability — observational/cohort surveyView study →}.

Last checked: July 2026.

Phytochemistry

The main constituent of marshmallow root is its mucilage, a viscous complex of polysaccharides: rhamnogalacturonans, arabinogalactans and arabinans ^{22Reference 22Xue et al. · 2023ReviewIsolation, structural properties, and bioactivities of polysaccharides from Althaea officinalis Linn.: a review — reviewView study →}. One acidic polysaccharide isolated from the root was 51% galacturonic acid and 33% rhamnose, with a molecular weight of about 639 kDa ^{12Reference 12Karimi et al. · 2021In vitroPolysaccharide extracted from Althaea officinalis L. root: structural, rheological and antioxidant properties — in vitroView study →}. The root also contains pectin, starch, sugar and the amino acid asparagine ^{25,26Reference 25Hoffmann · 2003Medical Herbalism: The Science and Practice of Herbal MedicineReference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}.

A study of the root’s low-molecular-weight fraction found about 8% glycine betaine, about 9% total amino acids, with proline the main one, and a set of flavonoid glycosides ^{6Reference 6Sendker et al. · 2017In vitroPhytochemical characterization of low molecular weight constituents from marshmallow roots and inhibiting effects of the aqueous extract on human hyaluronidase-1 — in vitroView study →}. These include hypolaetin glycosides carrying sulphate groups, several of them new natural products, and the coumarin glycoside haploperoside D ^{6Reference 6Sendker et al. · 2017In vitroPhytochemical characterization of low molecular weight constituents from marshmallow roots and inhibiting effects of the aqueous extract on human hyaluronidase-1 — in vitroView study →}.

The leaves also contain mucilage, along with flavonoids such as kaempferol, quercetin and diosmetin glucosides, the coumarin scopoletin, and several phenolic acids.

Mucilage figures vary with the method used. Older “total mucilage” assays give about 18–35% of the dried root, and isolated water-soluble polysaccharide about 5–12% ^{25Reference 25Hoffmann · 2003Medical Herbalism: The Science and Practice of Herbal Medicine}.

Constituent Summary

Amounts are percent of the dried root unless noted.

Root

• Mucilage (18–35%) ^{25Reference 25Hoffmann · 2003Medical Herbalism: The Science and Practice of Herbal Medicine}
• Starch
• Pectin (up to ~35%) ^{25Reference 25Hoffmann · 2003Medical Herbalism: The Science and Practice of Herbal Medicine}
• Oil
• Sugar
• Asparagine (1–2%) ^{25Reference 25Hoffmann · 2003Medical Herbalism: The Science and Practice of Herbal Medicine}
• Cellulose
• Glutinous matter ^{26Reference 26Grieve · 1931A Modern Herbal — Mallow (Marsh). https://www.botanical.com/botanical/mgmh/m/mallow07.htmlView study →}

Leaves

• Mucilage
  • Including low molecular weight D-glucan
• Flavonoids
  • Kaempferol
  • Quercetin
  • Diosmetin glucosides
• Scopoletin
• Polyphenolic acids
  • Syringic acid
  • Caffeic acid
  • Salicylic acid
  • Vanillic acid
  • p-Coumaric acid

Dosage

The EU herbal monograph sets out traditional doses of the root for two uses: an irritated mouth or throat with dry cough, and mild digestive discomfort ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}.

• Root macerate, for cough and throat irritation — 0.5–3 g of chopped root in 150 mL of cold water, several times a day, up to 15 g a day for adults ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}.
• Root macerate, for digestive discomfort — 2–5 g in 150 mL of cold water, three times a day, up to 15 g a day ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}.
• Children — lower doses from age 3 for cough and throat irritation. The monograph does not recommend any root preparation under 3 years, or the digestive use under 12 ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}.

Traditional Dosage

Safety & Pregnancy

Marshmallow is well tolerated, and the EU herbal monograph lists no known side effects ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}. Its one practical caution is that the mucilage can slow the absorption of other medicines taken at the same time.

Full Safety & Interactions Detail

General tolerance. The EU herbal monograph lists no known side effects and no reported cases of overdose ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}. In two consumer surveys of 822 people using root-extract lozenges or syrup, only three minor adverse events were reported ^{1Reference 1Fink et al. · 2018ObservationalMarshmallow root extract for the treatment of irritative cough: two surveys on users’ view on effectiveness and tolerability — observational/cohort surveyView study →}.

Absorption of other medicines. The mucilage coats the gut and may delay the absorption of medicines taken at the same time. The EU monograph advises not taking marshmallow within half an hour to an hour of other medicines ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}, and herbal texts often suggest 1–2 hours ^{25Reference 25Hoffmann · 2003Medical Herbalism: The Science and Practice of Herbal Medicine}.

Animal toxicity. No liver toxicity was seen in rats given the flower extract for a month ^{11Reference 11Hage-Sleiman et al. · 2011AnimalPharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon — animal (rat)View study →}, and the acute oral toxicity of the root extract in mice was low ^{24Reference 24Benbassat et al. · 2013In vitroDevelopment and evaluation of novel lozenges containing marshmallow root extract — in vitro/pharmaceuticalView study →}. Tests for genotoxicity, reproductive toxicity and carcinogenicity have not been carried out ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}.

Children. The EU monograph does not recommend root preparations in children under 3, solid forms such as lozenges under 6, or the digestive use under 12 ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}.

When to see a doctor. A cough that persists beyond a week, digestive symptoms beyond two weeks, or breathlessness, fever or discoloured phlegm during use call for medical advice ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}.

Blood sugar. A single 1987 mouse study found the mucilage lowered blood sugar ^{20Reference 20Tomoda et al. · 1987AnimalHypoglycemic activity of twenty plant mucilages and three modified products — animal (mice)View study →}. An added effect alongside glucose-lowering drugs is possible in theory but has not been observed.

Infections. The antibacterial action is limited to gram-positive organisms ^{14Reference 14Rezaei et al. · 2015In vitroEvaluation of the antibacterial activity of the Althaea officinalis L. leaf extract and its wound healing potency in the rat model of excision wound — animal/in vitroView study →}.

Interactions. Apart from the effect on absorption, no drug interactions have been reported, and none have been formally tested ^{28Reference 28Committee on Herbal Medicinal Products ( · 2016ReviewEuropean Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015) — regulatory monographView study →}.

References

1. Fink, C., Schmidt, M., & Kraft, K. (2018). Marshmallow root extract for the treatment of irritative cough: two surveys on users’ view on effectiveness and tolerability — observational/cohort survey. Complementary Medicine Research. https://pubmed.ncbi.nlm.nih.gov/30064132/
2. Šutovská, M., Nosáľová, G., Šutovský, J., Franová, S., Prisenžňáková, Ľ., & Capek, P. (2009). Possible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan — animal (guinea pig in vivo). International Journal of Biological Macromolecules. https://pubmed.ncbi.nlm.nih.gov/19447256/
3. Šutovská, M., Capek, P., Franová, S., Joskova, M., Šutovský, J., Marcinek, J., & Kalman, M. (2011). Antitussive activity of Althaea officinalis L. polysaccharide rhamnogalacturonan in guinea pigs with airways inflammation — animal in vivo. Bratislava Medical Journal. https://pubmed.ncbi.nlm.nih.gov/22372330/
4. Šutovská, M., Nosáľová, G., Franová, S., & Kardošová, A. (2007). The antitussive activity of polysaccharides from Althaea officinalis L., var. Robusta — animal in vivo (cats). Bratislava Medical Journal. https://pubmed.ncbi.nlm.nih.gov/17685009/
5. Deters, A., Zippel, J., Hellenbrand, N., Pappai, D., Possemeyer, C., & Hensel, A. (2010). Aqueous extracts and polysaccharides from marshmallow roots: cellular internalisation and stimulation of cell physiology of human epithelial cells — in vitro. Journal of Ethnopharmacology. https://pubmed.ncbi.nlm.nih.gov/19799989/
6. Sendker, J., Böker, I., Lengers, I., et al. (2017). Phytochemical characterization of low molecular weight constituents from marshmallow roots and inhibiting effects of the aqueous extract on human hyaluronidase-1 — in vitro. Journal of Natural Products. https://pubmed.ncbi.nlm.nih.gov/28128955/
7. Roventa, D. L. C., Pieper-Fürst, U., Acikel, C., Santos, D., Sent, U., & Mösges, R. (2023). Effectiveness and tolerability of Ectoin mouth and throat spray Althaea honey (ERS09) for sore throat — randomised, active-controlled trial. Journal of Clinical Medicine. https://pubmed.ncbi.nlm.nih.gov/37762768/
8. Mahboubi, M. (2020). Marsh mallow (Althaea officinalis L.) and its potency in the treatment of cough — review. Complementary Medicine Research. https://pubmed.ncbi.nlm.nih.gov/31770755/
9. Bonaterra, G. A., Bronischewski, K., Hunold, P., et al. (2020). Anti-inflammatory and anti-oxidative effects of Phytohustil and root extract of Althaea officinalis L. on macrophages — in vitro. Frontiers in Pharmacology. https://pubmed.ncbi.nlm.nih.gov/32256361/
10. Bonaterra, G. A., Schmitt, J., Schneider, K., et al. (2022). Phytohustil and root extract of Althaea officinalis L. exert anti-inflammatory and anti-oxidative properties and improve migratory capacity of endothelial cells — in vitro. Frontiers in Pharmacology. https://pubmed.ncbi.nlm.nih.gov/36569306/
11. Hage-Sleiman, R., Mroueh, M., & Daher, C. F. (2011). Pharmacological evaluation of aqueous extract of Althaea officinalis flower grown in Lebanon — animal (rat). Pharmaceutical Biology. https://pubmed.ncbi.nlm.nih.gov/21281251/
12. Karimi, S., Ghanbarzadeh, B., Roufegarinejad, L., & Falcone, P. M. (2021). Polysaccharide extracted from Althaea officinalis L. root: structural, rheological and antioxidant properties — in vitro. Carbohydrate Research. https://pubmed.ncbi.nlm.nih.gov/34597979/
13. Mohsenikia, M., Rafiee, S., Rozei, L. S., et al. (2020). Althaea officinalis improves wound healing in rats: a stereological study — animal (rat). Drug Discoveries & Therapeutics. https://pubmed.ncbi.nlm.nih.gov/33116035/
14. Rezaei, M., Dadgar, Z., Noori-Zadeh, A., Mesbah-Namin, S. A., Pakzad, I., & Davodian, E. (2015). Evaluation of the antibacterial activity of the Althaea officinalis L. leaf extract and its wound healing potency in the rat model of excision wound — animal/in vitro. Avicenna Journal of Phytomedicine. https://pubmed.ncbi.nlm.nih.gov/25949951/
15. Naseri, V., Chavoshzadeh, Z., Mizani, A., et al. (2021). Effect of topical marshmallow (Althaea officinalis) on atopic dermatitis in children: a pilot double-blind active-controlled clinical trial — randomised. Phytotherapy Research. https://pubmed.ncbi.nlm.nih.gov/33034099/
16. Kobayashi, A., Hachiya, A., Ohuchi, A., Kitahara, T., & Takema, Y. (2002). Inhibitory mechanism of an extract of Althaea officinalis L. on endothelin-1-induced melanocyte activation — in vitro. Biological & Pharmaceutical Bulletin. https://pubmed.ncbi.nlm.nih.gov/11853172/
17. Zaghlool, S. S., Abo-Seif, A. A., Rabeh, M. A., Abdelmohsen, U. R., & Messiha, B. A. S. (2019). Gastro-protective and anti-oxidant potential of Althaea officinalis and Solanum nigrum on pyloric ligation/indomethacin-induced ulceration in rats — animal (rat). Antioxidants (Basel). https://pubmed.ncbi.nlm.nih.gov/31731465/
18. Mehreen, A., Waheed, M., Liaqat, I., & Arshad, N. (2016). Phytochemical, antimicrobial, and toxicological evaluation of traditional herbs used to treat sore throat — in vitro. BioMed Research International. https://pubmed.ncbi.nlm.nih.gov/27429983/
19. Wang, Z., et al. (2023). Protective effects of Althaea officinalis L. extract against N-diethylnitrosamine-induced hepatocellular carcinoma in male Wistar rats — animal (rat). Food Science & Nutrition. https://pubmed.ncbi.nlm.nih.gov/37576045/
20. Tomoda, M., Shimizu, N., Oshima, Y., Takahashi, M., Murakami, M., & Hikino, H. (1987). Hypoglycemic activity of twenty plant mucilages and three modified products — animal (mice). Planta Medica. https://pubmed.ncbi.nlm.nih.gov/3575513/
21. Popovych, V., Koshel, I., Malofiichuk, A., et al. (2019). Randomized, open-label, multicenter comparative study of BNO 1030 extract (containing marshmallow root) in acute non-bacterial tonsillitis in children — randomised (combination product). American Journal of Otolaryngology. https://pubmed.ncbi.nlm.nih.gov/30554882/
22. Xue, T., et al. (2023). Isolation, structural properties, and bioactivities of polysaccharides from Althaea officinalis Linn.: a review — review. International Journal of Biological Macromolecules. https://pubmed.ncbi.nlm.nih.gov/37245776/
23. Kara, O., et al. (2026). Protective effect of Althaea officinalis on nicotine-induced lung injury — animal (rat). Complementary Medicine Research. https://pubmed.ncbi.nlm.nih.gov/42348476/
24. Benbassat, N., Kostova, B., Nikolova, I., & Rachev, D. (2013). Development and evaluation of novel lozenges containing marshmallow root extract — in vitro/pharmaceutical. Pakistan Journal of Pharmaceutical Sciences. https://pubmed.ncbi.nlm.nih.gov/24191313/
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29. Hill, S. R. Althaea Linnaeus and Althaea officinalis Linnaeus — genus and species description, habitat and distribution — flora. In Flora of North America Editorial Committee (eds.), Flora of North America North of Mexico, Vol. 6 (Malvaceae, family treatment by M. M. Hanes). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200013686
30. Tang, Y., Gilbert, M. G., & Dorr, L. J. Althaea officinalis Linnaeus — species description and distribution — flora. In Wu, Z. Y., & Raven, P. H. (eds.), Flora of China, Vol. 12 (Malvaceae). http://www.efloras.org/florataxon.aspx?flora_id=2&taxon_id=200013686

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