No licorice for you

I never liked licorice. And that turns out to be a good thing. Given that Halloween just happened yesterday and licorice candy is still sold in USA, I remembered the FDA’s warning against consumption of licorice from a year ago.

So I dug out the data supporting this recommendation. It’s a review paper published 6 years ago by Omar et al. (2012) meant to raise awareness of the risks of licorice consumption and to urge FDA to take regulatory steps.

The active ingredient in licorice is glycyrrhizic acid. This is hydrolyzed to glycyrrhetic acid by intestinal bacteria possessing a specialized ß-glucuronidase. Glycyrrhetic acid, in turn, inhibits 11-ß-hydroxysteroid dehydrogenase (11-ß-HSD) which results in cortisol activity increase, which binds to the mineralcorticoid receptors in the kidneys, leading to low potassium levels (called hypokalemia). Additionally, licorice components can also bind directly to the mineralcorticoid receptors.

Eating 2 ounces of black licorice a day for at least two weeks (which is roughly equivalent to 2 mg/kg/day of pure glycyrrhizinic acid) is enough to produce disturbances in the following systems:

  • cardiovascular (hypertension, arrhythmias, heart failure, edemas)
  • neurological (stroke, myoclonia, ocular deficits, Carpal tunnel, muscle weakness)
  • renal (low potassium, myoglobinuria, alkalosis)
  • and others

144 licorice - Copy

Although everybody is affected by licorice consumption, the most vulnerable populations are those over 40 years old, those who don’t poop every day, or are hypertensive, anorexic or of the female persuasion.

Unfortunately, even if one doesn’t enjoy licorice candy, they still can consume it as it is used as a sweetener or flavoring agent in many foods, like sodas and snacks. It is also used in naturopathic crap, herbal remedies, and other dangerous scams of that ilk. So beware of licorice and read the label, assuming the makers label it.

144 licorice products - Copy
Licorice products (Images: PD, Collage: Neuronicus)

REFERENCE: Omar HR, Komarova I, El-Ghonemi M, Fathy A, Rashad R, Abdelmalak HD, Yerramadha MR, Ali Y, Helal E, & Camporesi EM. (Aug 2012). Licorice abuse: time to send a warning message. Therapeutic Advances in Endocrinology and Metabolism, 3(4):125-38. PMID: 23185686, PMCID: PMC3498851, DOI: 10.1177/2042018812454322. ARTICLE | FREE FULLTEXT PDF

By Neuronicus, 1 November 2018

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