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Slippery elm (Ulmus fulva) has been used as an herbal remedy in the United States for centuries and is now enjoying greater popularity than ever. This plant has received recognition from the U.S. Food and Drug Administration as a safe and effective remedy for soothing throat and respiratory irritation. Herbalists also recommend it for suppressing coughs and, externally, for treating wounds and cuts. The mucilage, or gummy secretion, from the bark of the slippery elm is also considered a wholesome nutritional food, similar in texture to oatmeal.

Plant Description

Slippery elm is a small- to medium-sized tree native to North America. It can reach a height of 20 meters and is topped by spreading branches that form an open crown. The red-brown or orange branches grow downward, and the stalkless flowers are arranged in dense clusters. The plant's leaves are long and green, darkening in color during the fall. The bark has deep fissures, a gummy texture, and a slight but distinct odor.

Parts Used

The slippery elm's inner bark is used for medicinal purposes.

Medicinal Uses/Indications

Slippery elm is used to treat the following conditions and symptoms.

bulletSore throat
bulletRespiratory irritation
bulletGastrointestinal conditions

Traditionally, slippery elm has also been used as a skin softener and smoother, a cough medicine, and a nutritional food. It is used externally as a poultice to treat wounds, burns, and other skin conditions, as well as vaginitis (inflammation of the vagina, usually caused by infection) and hemorrhoids.

Available Forms

Commercial preparations are made from 10-year-old inner bark, or bast, sold in long flat pieces about two to three feet long, between 1/8 and 1/16 of an inch in thickness. Available forms include the following.

bulletFinely powdered bark for drinks (infusions and decoctions and liquid extracts)
bulletCoarsely powdered bark for poultices

How to Take It

The following are recommended doses for slippery elm.

bulletDecoction (1:8) made from powdered bark, 4 to 16 ml three times a day; or 5 to 20 ml (1:10) taken as often as needed (can be added to juice or oatmeal)
bulletInfusions: 4 g powdered bark in 500 ml boiling water three times a day as nutritional supplement
bulletCapsules: 2 to 4 g three times a day in 500 mg capsules

For external use:

Mix coarse powdered bark with boiling water for poultices.


There are no known health hazards reported for slippery elm when it is properly administered in recommended therapeutic doses.

Possible Interactions

Taking slippery elm with oral medications may decrease the absorption of these medications.

Supporting Research

Beveridge RJ, Szarek WA, Jones JK. Isolation of three oligosaccharides from the mucilage from the bark of Ulmus fulva (slippery elm mucilage). Synthesis of O-(3-)-Methyl-B-D-galactopyranosyl) (1-4)-L-rhamnose. Carbohydr Res. 1971;19:107-116.

Beveridge RJ, Stoddart JP, Szarek WA, Jones JK. Some structural features of the mucilage from the bark of Ulmus fulva (slippery elm mucilage). Carbohydr Res. 1969;9:429-439.

Blakley T. Slippery elm: Comparative study of the effects of plant spacing on plant development and yield. Research Farm Proposal No. 6088. Collaborating Team, The National Center for the Preservation of Medicinal Herbs. Project Period 1998–2008. Available at:

Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, Ore: Eclectic Medical; 1998.

British Herbal Pharmacopoeia. 4th ed. Great Britain:Biddles Ltd, Guildford and King's Lynn; 1996.

Duke JA. The Green Pharmacy. New York: St Martin's Press; 1977: 170, 209, 490 1997

Duke JA. Chemicals and their Biological Activities in: Ulmus rubra MUHLENB. (Ulmaceae)—Red Elm, Slippery Elm. Dr. Duke's Phytochemical and Ethnobotanical Databases. Agricultural Research Service (ARS), Phytochemical Database, USDA - ARS - NGRL, Beltsville Agricultural Research Center, Beltsville, Maryland. Available at:

Grieve M. A Modern Herbal. Vol. II. New York, NY: Dover; 1971.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Company; 1998.

Gysling E. Leitfaden zur Pharmakotherpie. Vienna: Huber, Bern Stuttgart; 1976:86.

Hahn HL. 1987 Husten: Mechanismen, pathophysiologie und therapie. Disch Apoth A 127. 1987;(suppl 5): 3-26.

Hoffman D. Slippery elm, 1995. Available at: 

Kurz H. 1989 Antitussiva und Expektoranzien. Wissenschaftliche. Verlagsgesellschaft Stuggart; 1989.

Morton JF. Mucilaginous plants and their uses in medicine. Biol Pharm Bull. 1993;16:735-739.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.