Slippery Elm 101: Is It Worth Taking?

For centuries, Native American healers have relied on the remarkable powers of nature to treat various ailments. Among their revered herbal remedies stands slippery elm (Ulmus rubra), its inner bark cherished for its medicinal properties.

This article explores slippery elm's potential health benefits. By diving into its ancestral uses and scientific backing, we aim to educate readers on the value of slippery elm as a supplement in today's wellness practices.

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What is Slippery Elm?

Ulmus rubra (Slippery elm) is a small tree found in Central & Northern US and Canada. The medicinal section is found within the inner bark. The first documentation of slippery elm dates back to Native American tribes who used this plant for dermatological issues. 

Historically, slippery elm has been used to treat heartburn, sore throat, flatulence, IBS, and diarrhea, as well as to relieve inflammation of the urinary tract. Slippery elm can be used topically for the treatment of ulcers, boils, and wounds (11).

Key Components and How It Works

The most important constituents of Slippery elm to note are mucilage and tannins. The mucilage is composed of carbohydrates, which form a viscous, sticky substance when added to water. 

The inner bark also contains nutrients such as vitamin E and bioflavonoids. The gel-like substance is then used to coat mucous membranes, aiding in the alleviation of coughing, GERD, or other digestive complaints (20).

The tannin properties of slippery elm contain strong antioxidant and inflammation-modulating activity. Tannins only compromise around 3% of the chemical composition of slippery elm, however, are a crucial component of this herb. Studies show that slippery elm demonstrates systemic anti-inflammatory and antioxidant activity due to the presence of tannins (20).

Potential Health Benefits of Slippery Elm

Gastrointestinal Relief: 

Slippery elm is a popular remedy used in the treatment of GERD, gastritis, and IBS, as its emollient and demulcent properties, soothe inflamed intestinal mucosa. 

In the context of GERD, slippery elm acts as a neuroprotectant to coat the lining of the esophagus. The protective coating aids in protecting the stomach and small intestine from increased acidity. It can also be used in the treatment of ulcerative colitis, Crohn's disease, and diarrhea (18).

Slippery elm is a useful remedy in patients with irritable bowel syndrome (IBS) due to its inflammation-modulating and antioxidant properties. 

A study conducted on slippery elm, aloe vera, pectin peppermint oil, and glutamine showed significant improvement in indigestion, nausea, and regurgitation, presenting promising results on the effectiveness of slippery elm for digestive upset (17).

Soothing Sore Throats:

Slippery elm has historically been used to soothe an irritated sore throat. It acts as a soothing expectorant, especially in spasmodic coughs. The soothing properties stem from the mucilage within the inner bark. The expectorant properties of slippery elm assist in clearing mucous from the lungs (1).

One study showed that those with a sore throat who consumed slippery elm as a tea showed a reduction in throat pain. The study examined other herbs (Licorice) as well (2).

Skin Health: 

Slippery elm can be used topically for the treatment of wounds, burns, skin inflammation, hemorrhoids, and boils. When applied topically, the inflammation-modulating effects aid in the healing of damaged skin. The mucilage creates a protective barrier on the skin, allowing the area to heal more effectively. While human studies are limited, promising results show that the use of slippery elm decreases wound healing by upregulating enzymes responsible for skin rejuvenation (15).

Additional Claims: 

• Weight Loss/Metabolic Conditions: Weight gain can be due to several underlying factors. However, changes in gut microbiota play a significant role in regulating metabolic processes and weight gain. As of now, evidence is anecdotal; however, it suggests that slippery elm assists in controlling blood sugar, which would help with weight loss (16).
• Cystitis: Slippery elm has occasionally been used to decrease pain and irritation in those with interstitial cystitis. There are currently no studies supporting this; however, many doctors hypothesize that the demulcent properties can soothe the irritation of the urinary tract in the same fashion as the digestive tract.

How to Use Slippery Elm

You can purchase slippery elm in the form of capsules, lozenges, or powder to make teas. The most popular and advised method for consuming Slippery elm is through decoction. 

This involves purchasing the powder and mixing 1 tsp of powder into 1 cup of cold water and let sit for 4-12 hours. This method is highly effective in extracting mucilage and delivers a delicious soothing beverage. This method is best for soothing a sore throat and providing gastrointestinal relief (13).

Dose of cold decoction tea: ½ cup 2-4x per day

For topical use, slippery elm can be used to make a poultice to treat wounds, ulcers, and boils. To make a poultice, mix 1 tsp of powder with enough boiling water to make a paste (13).

Safety and Side Effects

Slippery elm is considered a safe herb with minimal side effects and contraindications. Due to the mucilage properties, slippery elm can decrease the absorption of other medications and supplements. It is advised to take slippery elm at least 2 hours away from other medications and foods for best absorption. 

Most researchers believe slippery elm is safe during pregnancy and breastfeeding. However, there are no scientific studies to confirm this. Always consult a trained physician before starting any herbal supplement during pregnancy or breastfeeding (18).

Comparing Slippery Elm to Other Herbal Remedies

Slippery elm is not the only herbal remedy that contains soothing, demulcent properties. Other herbs with similar properties are marshmallow root and licorice root. Here is a summary of each and its potential benefits:

Marshmallow Root

• Constituents: Mucilage, flavonoids, disaccharides
• Actions: Demulcent, Emollient, Anti-Inflammatory
• Uses: Sore throat, cough, GERD, diarrhea, inflammation of the digestive system
• Evidence: A study conducted on the use of marshmallows for sore throat showed significant improvement in oral and pharyngeal irritation and symptomatic improvement of cough symptoms (14).

Licorice Root

• Constituents: Saponins, flavonoids, isoflavonoids, volatile oils
• Actions: Anti-inflammatory, Mucoprotective, adrenal tonic, demulcent
• Uses: Muco-protective, Anti-ulcer activity, Anti-viral, Anti-Inflammatory, Anti-bacterial
• Evidence: Licorice can help soothe the digestive and respiratory tracts, similar to slippery elm. Due to its high flavonoid content, licorice can be used to coat the stomach in patients with gastric ulcers. In addition, Licorice has anti-bacterial properties that are effective against H. pylori, the causative agent for most ulcers (23).

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Key Takeaways

• Slippery elm is a fantastic herbal remedy containing flavonoids, antioxidants, and mucilage to assist in healing of the gastrointestinal and respiratory system
• Slippery elm is most beneficial in cases of heartburn, IBS, IBD, sore throat, cough, and topical skin issues such as wounds, boils, and ulcers.
• Marshmallow and licorice root are great herbal demulcents with similar properties to slippery elm. Experimenting with different combinations of these herbs is recommended to maximize healing benefits.
• Considering the vast amount of research, Slippery Elm is worth taking under the supervision of your doctor
• Consult with your functional medicine doctor to determine if Slippery Elm can be beneficial for you