COLEEN MURPHY, ND, LAC

Roberts’ Formula is a traditional naturopathic remedy with a long history of use for common digestive disorders. This abstract examines the origins of Roberts’ Formula, and how naturopathic luminaries like Dr Bastyr used and adapted this gentle yet powerful formula.

Roberts’ Formula is a Western herbal preparation that blends multiple herbs for a synergistic effect to treat intestinal inflammation associated with gastric ulcers or inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis (UC).¹

The herbal formula is named after Captain Frank Roberts who, after a life at sea, became a distinguished British herbalist and naturopathic practitioner with a special interest in ulcers and gallstones.²

The formula purportedly has been around an exceptionally long time; however, the first known documentation of the formula’s constituents was published in 1957 in The Encyclopedia of Digestive Disorders.²

Constituents of Traditional Roberts’ Formula

The original formulation of Roberts’ Formula included the following:

Marshmallow root (Althaea officinalis)
Wild indigo (Baptisia australis)
Purple coneflower (Echinacea angustifolia)
Goldenseal (Hydrastis canadensis)
American cranesbill (Geranium maculatum)
Pokeroot (Phytolacca Americana)
Slippery elm (Ulmus fulva)

Reevaluating the ingredients 70 years later, science has identified myriad active substances contained in this herbal formula that positively impact gut health and help regulate what does and does not pass through the lining of the digestive tract. In 1950, it was not known that Echinacea contains alkamides that reduce a key inflammatory pathway or that goldenseal contains alkaloids that help select for good gut bacteria while restoring the intestinal mucosa. Herbalists knew it worked, and the popularity of the formula among sailors became legendary.

Aside from goldenseal and Echinacea, the formula includes well-known herbs such as slippery elm bark and marshmallow extract, 2 herbs known for protecting the intestinal wall of the gastrointestinal tract. Other herbs include pokeroot, which is well known for its diuretic properties and ulcer-healing support. Wild indigo is a powerful antibacterial agent, but it also supports hepatic function. Finally, American cranesbill is an antiseptic and helps heal wounds. For a full list and description of the active constituents in the original formula herbs, see Table 1.

Bastyr Reformulation of Roberts’ Formula

Recognizing the power of Roberts’ Formula, years later, in 1991, a group of naturopathic doctors at the School of Naturopathic Medicine at Bastyr University in Seattle, WA, updated the formula. The group, led by Joseph Pizzorno, ND, added 4 more ingredients to the original 7³:

Cabbage leaf powder
Pancreatin
Niacinamide
Duodenal organotherapeutic remedy

Clearly, science had changed in the 40 years since the original Roberts’ Formula publication. The Bastyr update to this formula brought in some new thinking:

Digestive enzymes help with the assimilation of food and reduce allergenic potential
Niacinamide, a form of vitamin B3, has similar anti-inflammatory and healing effects on the intestinal lining as butyrate,^4,5a short-chain fatty acid produced by the interaction of beneficial bacteria and insoluble fiber. Many folks with IBD avoid high-fiber diets, thus miss out on this prebiotic benefit. Niacinamide helps compensate for this.
Duodenal organotherapy remedy is a homeopathic preparation that helps restore organ function, under the naturopathic principle of “like cures like”⁶
Occasionally, okra (Hibiscus esculentus) is added to the formula, as it gently promotes bowel motion and is believed to stimulate pyloric action³

Although no controlled research trials have been performed on Bastyr’s Formula, this old naturopathic remedy is recognized for helping many individuals with IBD, irritable bowel syndrome (IBS), arthritis, gastric ulcers, and various digestive issues.

A 2017 Reformulation

Today, Roberts’ Formula continues to be utilized as a gentle and effective supplement. It has been updated by a few major supplement companies. One company, for example, added turmeric, a powerful anti-inflammatory, while another company updated the formula by adding N-acetyl D-glucosamine (NAG) and bromelain and subtracting poke root and wild indigo.

Perhaps these new updates reflect changing thinking on IBD, ie, moving away from the idea of enhancing motility and elimination and toward rebuilding and repairing the intestinal mucosa and microbiota.

Here is the full list ingredients in the second company just mentioned:

Cranesbill (Geranium maculatum) root powder
Echinacea angustifolia root extract
Goldenseal (Hydrastis canadensis) root extract
Marshmallow (Althaea officinalis) root
Slippery elm (Ulmus rubra) bark
Bromelain (from pineapple)
Cabbage (Brassica oleracea var capitata) leaf
N-acetyl D-glucosamine (NAG)

Summary

All modern versions of Roberts’ Formula stay true to the intention of the original formula, which is, at its heart, antimicrobial and anti-inflammatory. Antibiotics are often used as a first line of defense against worsening IBD, UC, and C difficile infection; hence, the rationale for naturopathic physicians to prescribe antibiotic herbs such as Echinacea and goldenseal is clear.

The benefits of the herbal approach, as opposed to pharmaceutical antibiotics, stems from these herbs’ ability to select for the “good” gut bacteria that play a major role in controlling intestinal permeability. In addition to supporting normal intestinal flora, Echinacea and goldenseal are also well documented to actively improve immune system function.

The fact that Roberts’ Formula has been around over 100 years underscores the formula’s effectiveness and has provided opportunities to update and improve the active components based on advances in science. Roberts’ Formula remains a gentle yet powerful mechanism of action to “heal and seal” the gut while respecting and nourishing the intestinal microbiota.

Note: Roberts’ Formula is safe for all adults, but pregnant women should consult their primary care doctor to discuss its safety in pregnancy.

Table 1. Make-Up of Original Roberts’ Formula (1957)

Herb/Product	Active Constituents	Purpose	Notes
Marshmallow Root⁷	Polysaccharide mucilage; pectin; quercetin	Demulcent; anti-inflammatory; wound-healing	Mucilaginous; flavonoid; antioxidant
Wild Indigo Root⁸	Baptisine (an alkaloid); coumarins	Increases biliary secretions; also increases secretions of the glandular apparatus of the GI tract	Toxic in large doses; is not true Indigo; dropped from the second-generation formula
Echinacea⁹	Phenolic compounds; alkamides; polysaccharides	Antibacterial; anti-inflammatory; alkamides inhibit prostaglandin production	Selects for good gut bacteria; is immune-stimulating
Goldenseal¹⁰	Isoquinoline alkaloids, such as berberine, canadine, and hydrastine	Digestive aid; anti-microbial; restores mucous membranes	Bitter
Cranesbill¹¹	Tannins; gallic acid	Astringent; styptic (stops bleeding); antiseptic; wound-healing	Plant polyphenols and gallic acid decrease proinflammatory cytokines
Pokeroot¹²	Jagilonic acid; oleanolic acid; tannins	Slightly diuretic; emetic; purgative	Dropped from the second-generation formula
Slippery Elm¹³	Mucilage, composed of galactose, 3-methyl-D-galactose, rhamnose, and galacturonic acid	Digestive; mucilaginous; demulcent	Assists with intestinal detoxification

Table 2. “Bastyr” Formula Additions (1991)

Herb/Product	Active Constituents	Purpose	Notes
Cabbage Leaf Powder¹⁴	Polyphenols; vitamins	Anti-inflammatory; antibacterial	Assists with intestinal detoxification
Niacinamide¹⁵	(Vitamin B3)	Anti-inflammatory; supports gut integrity; assists in lipid metabolism	Use with low-fiber diets to enhance butyrate pathways
Pancreatin¹⁶	Amylase; lipase; protease	Digestion; nutrient absorption	Digestive enzymes are derived from animal sources
Duodenal Organotherapeutic Remedy	Homeopathic preparation of duodenum	(Physical): powdered bile salt aids digestion (Energetic): “Like cures like”	First described in the 1922 book, Practical Organotherapy⁶

Table 3. The 2017 Reformulation

Herb/Product	Active Constituents	Purpose	Notes
Added
Bromelain¹⁷	Proteolytic enzyme	Anti-inflammatory; reduces clumping of platelets; digestive aid	From pineapples; also shown to reduce joint pain
NAG¹⁸	N-acetyl D-glucosamine	Amino sugar precursor for epithelial glycosaminoglycan synthesis	Improves integrity of the GI epithelial barrier; ie, “Heal and seal”
Subtracted
Poke Root
Wild Indigo Root

Note: Dr. Murphy would like to thank Olivia Haas for manuscript preparation and review.

References

Roberts F. Herbal Cures of Duodenal Ulcer and Gall Stones. Wellingborough, England: Weatherby Woolnough Ltd; 1952: 35-39.

Roberts, Captain Frank. In: The Encyclopedia of Digestive Disorders. London, England: Thorsons Publishers, Ltd; 1957.

Murray M, Pizzorno J. Encyclopedia of Natural Medicine. Rocklin, CA: Prima Publishing, 1991: 249-50.

Singh N, Gurav A, Sivaprakasam S, et al. Activation of Gpr109a, receptor for niacin and the commensal metabolite butyrate, suppresses colonic inflammation and carcinogenesis. Immunity. 2014;40(1):128-139.

Karunaratne TB, Okereke C, Seamon M, et al. Niacin and Butyrate: Nutraceuticals Targeting Dysbiosis and Intestinal Permeability in Parkinson’s Disease. Nutrients. 2020;13(1):28.

Harrower HR. Practical organotherapy: The internal secretions in general practice. Gendale, CA: The Harrower Laboratory; 1922.

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Pavan R, Jain S, Shraddha, Kumar A. Properties and therapeutic application of bromelain: a review. Biotechnol Res Int. 2012;2012:976203.

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Coleen Murphy, ND, LAc is a 2003 graduate of Bastyr University School of Naturopathic Medicine and Acupuncture. She practices naturopathic medicine and acupuncture from her office in San Juan Capistrano, CA, and via telemedicine. Dr Murphy specializes in digestive disorders, mental health, and immune wellness, and is a founding member of the American Association of Psychiatric Naturopathic Doctors. Website: www.natmedworks.com