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Slippery elm

Supplement botanical gut
Aka: Ulmus rubra
Brands seen in Singapore: NOW Foods, Nature's Way, Micro Ingredients, Solaray, J&R Port Trading
Not medical advice. Check with your doctor or pharmacist before you start, stop or change the timing of anything you take.
How to use
What it’s for
A traditional demulcent for throat and gut irritation
Take with
Water · the inner-bark mucilage swells into a gel
Pros & cons
Pros
  • Livertox: generally recognized as safe (gras)
  • No published case reports of liver injury
  • Mucilage forms a physical layer over mucosa
Cons
  • Trials of slippery elm on its own are lacking
  • The one gut trial used a 7-herb mix, no placebo
  • Rare cutaneous allergic symptoms reported
Sources
  1. NIH LiverTox (NIDDK) — Slippery Elm monograph, Bookshelf NBK599741, references updated 5 January 2024 · read 2026-08-27
    what it says
    “the inner bark … used orally to treat sore throat and gastrointestinal upset … called slippery because of the slippery texture of the inner bark when it is chewed or mixed with water”
  2. NIH LiverTox — Slippery Elm, Background (adverse-event data and GRAS status) · read 2026-08-27
    what it says
    “There is no reliable data on adverse events from slippery elm and it is designated as 'generally recognized as safe' (GRAS). There have been no large scale clinical trials that have reported on adverse events”
  3. NIH LiverTox — Slippery Elm, Background (allergic reactions) · read 2026-08-27
    what it says
    “Slippery elm has been linked to rare instances cutaneous allergic symptoms.”
  4. NIH LiverTox — Slippery Elm, Hepatotoxicity and likelihood score · read 2026-08-27
    what it says
    “despite common use, there have been no published case reports of liver injury attributed to slippery elm … Likelihood score: E (unlikely cause of clinically apparent liver injury)”
  5. Natural Products in the Management of Gastroesophageal Reflux Disease (Komolafe et al., Nutrients 2025) — section 5.6 and limitations · read 2026-08-27
    what it says
    “The mucilage content of Ulmus rubra (slippery elm) absorbs water and forms a viscous gel that constitutes a protective barrier over mucosal surfaces … research on botanicals including marshmallow root, slippery elm … is limited”
  6. Effectiveness of Nutritional Ingredients on Upper Gastrointestinal Conditions and Symptoms: A Narrative Review (Schulz, Ahuja & Slavin, Nutrients 2022) · read 2026-08-27
    what it says
    “Slippery elm has received increased interest, but trials examining its singular effect are lacking”
  7. Schulz et al., Nutrients 2022 — appraisal of the Ried 2020 multi-herb formula trial · read 2026-08-27
    what it says
    “The authors reported two mild AEs related to the trial (severe bloating and constipation) which resulted in dropout … the intervention period was a single-arm design and lacked a placebo”
  8. Schulz et al., Nutrients 2022 — Table 6, Ried 2020 intervention detail · read 2026-08-27
    what it says
    “IG: 5 g, 1×/day formula mixed with water for 4 weeks, followed by 10 g/d for the second month … (Curcumin, Aloe vera, slippery elm, guar gum, pectin, peppermint oil, and glutamine)”
  9. HSA Singapore — Guidelines on Prohibited and Restricted Ingredients in Health Supplements and Traditional Medicines, GL-CHPB-1-012 Rev. No. 001 (October 2025), Annex A (118 rows) and Annex B (4 rows) — slippery elm / Ulmus rubra not listed in either (alphabetical neighbours 103. Symphytum asperum, 104. Urginea maritima) · read 2026-08-27
    what it says
    “The objective of this guideline is to highlight the substances of concern when used in HS and TM and is not meant to be an exhaustive list.”
  10. HSA Singapore — Health Supplements Guidelines GL-CHPB-3-001 Rev. No. 020 (January 2026), clause 4.8 with Tables 4–5 (vitamins and minerals only — no botanical rows) · read 2026-08-27
    what it says
    “4.8 HS for use by the general adult population should not contain vitamins and minerals exceeding the stipulated limits stated in Tables 4 and 5.”
  11. iHerb Singapore — Slippery Elm category page, default listing order · read 2026-08-27
    what it says
    “1 - 25 of 25 results: NOW Foods, Slippery Elm; Nature's Way, Slippery Elm Bark; Micro Ingredients, Organic Slippery Elm Bark; Solaray, True Herbs, Slippery Elm; J&R Port Trading, Organic Slippery Elm Bark”
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Updated 2026-08-29. Every line above traces to a numbered source. Kozen-X is not a medical device and does not give medical advice. It lists what published sources have written down — nothing more. A pair not listed is unrecorded, not cleared. Before you start, stop or re-time anything, talk to your doctor or pharmacist.