pieces of black licorice candy

Licorice has been around for thousands of years. The plant (Glycyrrhiza glabra) from which it is derived was found in the tombs of Egyptian pharaohs and was treasured by healers in the ancient Middle East. The father of modern medicine, Hippocrates, considered licorice root a valuable healing herb. Many people today, however, encounter it as the flavoring for black licorice candy.

Is Licorice Candy or Medicine?

Although modern day herbalists still use licorice for digestive upset, coughs and arthritis, most people think of it as flavoring for candy. Many confectioners use less expensive artificial flavors or anise, but true aficionados demand the real thing. High-quality black licorice, often from Europe, contains the active ingredient glycyrrhizin.

The Dark Side of Black Licorice:

There is a dark side to licorice, though. When candy containing real licorice extract is consumed regularly or in large quantities, there can be profound metabolic consequences.

Fluid and sodium are retained, blood pressure goes up and potassium may drop to dangerously low levels. Hormonal changes can occur and may lead to weakness and in extreme cases temporary paralysis.

The Swedish Gym Teacher:

We were impressed years ago with the story of a 22-year-old Swedish gym teacher. She had been healthy, but then developed horrific headaches every month and lost her periods. She also had frighteningly high blood pressure, around 240/130. Against all of that, her primary complaint of loss of libido must have seemed insignificant.

It turned out that she had been gobbling down large quantities of black licorice. Once she stopped, all of her symptoms gradually disappeared.

The Case of the Black Jelly Beans:

In a recent case report, a 51-year old man went to the emergency department with a stomach ache that had lasted three days (Foster et al, Postgraduate Medicine, April 2017). He also reported vomiting, diarrhea and dry mouth. The workup showed alarmingly low potassium levels and blood pressure of 174/62. The doctors were puzzled since several days of treatment did not correct these problems.

They worked him up to see if his body was making too much aldosterone. Someone discovered that he’d been eating a bag of black licorice jelly beans every day, even in the hospital. On medical advice, he stopped eating the jelly beans and started taking the amiloride and spironolactone potassium-sparing blood pressure pills he had been prescribed. A few days later, blood work showed his potassium was now too high, and his blood pressure was 120/86.

The doctors discontinued the blood pressure medicine. Follow-up at ten weeks (no black licorice jelly beans) showed all his lab values were normal.

The investigators conclude:

“Prompt identification and effective management of licorice-induced hypertension may spare patients from lifelong medical therapy and prevent serious complications.”

Licorice as Medicine:

One reader recently reported her own experience, which did not involve bingeing on candy:

“A week ago at the direction of a health care professional I took a prescribed antifungal to treat Candida. I saw the ‘Licorice Root’ listed on the label and remembered hearing many years ago that licorice could raise blood pressure, but I figured a health care professional would take that into consideration. By midday, though, I was hit with a bad headache and when I took my BP it was 180/100. That scared the heck out of me. Since then it’s been as high as 190/102, which scares me even more.

“My regular doctor had just reduced the dose of my BP med because I had lost weight and my reading had been 120/68. Trying to combat this sudden spike in pressure and the unrelenting headaches, I increased the dose of my blood pressure medicine again, but it did not help. How long does it take for the effects of licorice to leave the body? I have not taken any for a week, but my pressure is still higher than it should be.”

Based on the report of the Swedish gymnastics teacher, blood pressure should return to normal within two weeks.

 

Some natural remedies contain licorice root. Just as with candy, this can pose a risk for susceptible people.

What About DGL?

One form of licorice is substantially safer. DGL (deglycyrrhizinated licorice) has most of the glycyrrhizin removed. This makes it less likely to raise blood pressure or cause hormone disruption. DGL is often used to treat heartburn, ulcers, canker sores and other digestive distress.

When it comes to licorice, whether it is candy or medicine, moderation is advisable. Before taking anything containing glycyrrhizin or licorice root, ask about the potential for side effects and what to do if they occur.

If you have had side effects from licorice, you can share them in the comments below.

Revised 6/26/2017

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  1. Lorrie
    Dripping Springs, TX
    Reply

    I have slept terribly for the last week or so. In addition, I developed a rash around my entire torso that had me itching all day and night. I eliminated two things in my diet that I had recently started eating but to no avail…. still itching. So just now, I remembered that for the last week and a half or so, I have been drinking a three-root tea that includes licorice root. I decided to look up symptoms of licorice allergy and ended up here on this page. I have not had any of the tea today so hopefully the itching will stop and I will get some sleep tonight!

  2. Chris
    Australia
    Reply

    I recently gave up drinking normal tea and was replacing it with liquorice tea. I was having at least 5 or more cups per day but woke up yesterday morning with swollen feet and legs. I also had swollen areas under my eyes. I attribute it solely to the liquorice tea after looking up its side effects. I will never go near liquorice in any form again!

  3. Allison
    WI
    Reply

    I would like to share a tale of caution regarding licorice. I recently have been dealing with some health conditions which required a prescription for Lasix, a loop diuretic. I have also been taking supplemental potassium and increasing potassium in my diet through Natural Foods. Yesterday, a couple of hours after taking my medications I chose to enjoy a piece of licorice candy.

    This was the type of licorice candy that is very strong and a higher concentration. I unfortunately learned in the most terrifying way that the licorice can additionally lower the potassium levels that my body is already challenged with by the Lasix which threw me into two 20 minute episodes of severe reactions which nearly landed me in the ER. So if for any reason anyone is taking a diuretic for any medical condition at all stay as far away from licorice as you can until you are no longer on the diuretic. This ends my cautionary Tale.

  4. Joel
    Maine
    Reply

    I am fond of black licorice as a treat and have at times eaten large amounts of it during a day/week. I am glad to report I have suffered no notable symptoms. Being finicky may work to my advantage as I am picky about the variety I consume and it’s hard to find it in my area. Perhaps I’m better off without it but, as with most things, excess is the problem, yes?

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