Overview

Slippery elm is a tree called Ulmus rubra. The inner bark of the tree is used to make tea, lozenges, and dietary supplements. People take slippery elm for many reasons, but its benefits are not well defined. It appears to be well tolerated, although there is not enough research to know what common side effects it may cause. Before taking slippery elm, make sure to tell your health care provider about any health conditions you have or medicines you are taking.

Uses

What is slippery elm used for?

Slippery elm (Ulmus rubra) is used for many reasons. However, the benefits of slippery elm are not well defined. Some common reasons that people use slippery elm include the following.

• Cough and sore throat
• Irritable bowel syndrome (IBS)
• Skin irritation
• To improve gut and digestive health

Note: The FDA has not reviewed slippery elm for safety and effectiveness. Learn more about dietary supplements here.

How does slippery elm work (mechanism of action)?

Slippery elm, also known as red elm or gray elm, is a tree called Ulmus rubra. Dietary supplements and teas that contain slippery elm are made from the inner bark of the tree, which is the softer bark found underneath the rough, outer bark. It is known as slippery elm because the inner bark becomes slippery when it is chewed or mixed with water. Slippery elm is a type of elm tree. Other forms of elm, such as the American elm, contain different chemicals and have different effects on the body.

Slippery elm contains mucilage, which is a complex, sticky substance that can help reduce swelling (inflammation). It also contains chemicals called tannins, which can reduce inflammation by acting as astringents. This has led to interest in sucking on slippery elm lozenges to help reduce cough or sore throat. But the benefits of slippery elm for any of these uses have not been well studied and are not well defined. Some slippery elm products are applied to irritated skin, but this use is also not well studied.

The mucilage in slippery elm is a form of soluble fiber, which may help keep bowel movements regular. Because of this, slippery elm supplements are sometimes taken to improve digestive health or help with gut problems, such as irritable bowel syndrome. But it is not clear if slippery elm contains enough fiber to help with these issues, and its benefits are not well defined.

Herbal products, like slippery elm, naturally contain many different chemicals. The amounts of each chemical in a specific slippery elm product may vary. Some, none, or all of these chemicals may have effects on the body. These effects may change depending on how much of each chemical is found in the product you are using.

How should I store slippery elm?

You should store slippery elm according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of slippery elm?

Slippery elm seems to be well tolerated. But there is not enough research to know what the common side effects may be. Tell your health care provider if you have any side effects that bother you.

There may be side effects of slippery elm that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of slippery elm?

While less common, the most serious side effects of slippery elm are described below, along with what to do if they happen.

Severe Allergic Reactions. Slippery elm may cause allergic reactions, which can be serious. Stop using slippery elm and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Precautions

Who should not use slippery elm?

Allergies to Ingredients. People who are allergic to any of the following should not use slippery elm.

• Gray elm
• Indian elm
• Red elm
• Slippery elm
• Ulmus rubra
• Any of the ingredients in the specific product

Your pharmacist can tell you all of the ingredients in the specific slippery elm products they stock.

What should I know about slippery elm before using it?

Slippery elm is a dietary supplement. It cannot be marketed to treat or cure a disease.

Read and follow the directions on the specific product you are using, or use it as recommended by your health care provider.

Keep slippery elm out of the reach of children.

Herbal products, such as slippery elm, naturally contain many different chemicals. The amount of each chemical in a specific slippery elm product can change for many reasons, including the area where the tree was grown, the weather during growth, the time of year when the bark was harvested, and the way it was processed after being harvested. If you switch to a new bottle or a different brand, you may not have the same effects or side effects because of this variability. Talk to your health care provider if you have questions or concerns.

Slippery elm is available in many different forms, including in lozenges, as a tea, and in tablets and capsules. It may also be added to creams or ointments that are applied to the skin. Each of these forms may contain different amounts of the chemicals naturally found in the plant.

The FDA has not tested slippery elm products to confirm that they contain the ingredients stated on their labels. Some dietary supplements have been tested by third-party organizations to confirm that they contain the ingredients listed on their labels and do not contain any harmful chemicals. Learn more about how to choose a safe dietary supplement product here.

What should I tell my health care provider before using slippery elm?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if slippery elm is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements.Slippery elm may interact with other medicines and supplements. Before taking slippery elm, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how slippery elm could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if slippery elm passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does slippery elm interact with foods or drinks?

There are no known interactions between slippery elm and foods or drinks.

It is unknown if drinking alcohol will affect slippery elm.

Does slippery elm interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

Slippery elm may affect the absorption of some medicines. Tell your health care provider about all medicines that you take or have recently taken.

The interactions between slippery elm and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with slippery elm is incomplete. Always check with your health care provider before taking slippery elm with any medicines.

Dosing

What should I do if I accidentally use too much slippery elm?

If you or someone else has used too much slippery elm, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

Slippery elm comes in many different forms. Read the product label closely and speak to a health care provider about how to take slippery elm safely. Do not use double or extra doses, even if you miss a dose.