The People's Perspective on Medicine

Can Licorice Lead to a Hypertensive Emergency?

A patient who came to the emergency department in a hypertensive emergency with blood pressure of 196/66 had been drinking licorice tea for a few weeks.
Raw liquorice roots isolated at white background

 

Licorice root is a traditional herbal medicine that may be used to ease ulcers or heartburn. Europeans use it for coughs and colds. Moreover, people around the world often enjoy licorice in food or tea for its distinctive flavor. And let’s not forget licorice candy. Many people love this sweet treat. But could too much licorice trigger a hypertensive emergency?

Older Man Experienced a Hypertensive Crisis:

A case report from the Canadian Medical Association Journal serves as a reminder that too much licorice can be quite dangerous (CMAJ, May 27, 2019). An 84-year-old man came to the emergency department with headache, sensitivity to light, fatigue and chest pain. In addition, his blood pressure had been high when he took it at home. When he showed up at the hospital, his reading was 196/66, a hypertensive emergency. In addition, his potassium level was alarmingly low.

Licorice Tea Was to Blame:

The patient admitted to consuming a glass or two of Egyptian-style licorice tea (“erk sous”) every day for two weeks. He knew that excessive licorice could raise blood pressure, but he didn’t consider his consumption excessive.

He spent nearly two weeks in the hospital, and his blood pressure was 140/80 when he was discharged. Three weeks after that, at a follow-up visit, the doctors measured his blood pressure at 110/57 and his potassium at 3.8 mm/L. These levels are considered completely normal. He had not resumed his licorice tea consumption after leaving the hospital.

The Canadian doctors may have been paying close attention in part because of a widely reported case in Canada a few years ago. A 51-year-old man showed up at the hospital with very low potassium and high blood pressure. It turns out he had been gobbling licorice jelly beans. 

Swollen Feet from Too Much Licorice!

There are many other side effects from overdoing it on licorice. Fluid retention (edema) can be an adverse reaction. Other complications include irregular heart rhythms, headaches and lowered libido. Here is a link to several case reports including one about a Swedish gymnastics instructor. She too ended up in a hypertensive emergency. She had horrendous headaches and impaired libido. 

Licorice Side Effects Can Be Scary If Not Life Threatening

Is There a Safer Licorice?

We defy you to pronounce this word quickly without getting tongue tied. We have a hard time with it ourselves: 

“deglycyrrhizinated licorice”

It’s no wonder it has been shortened to DGL. The problematic ingredient in licorice, glycyrrhizin, is mostly removed from DGL. That way it is safer than regular licorice. This person got into trouble when her naturapath prescribed licorice pills for digestive upset. They still contained glycyrrhizin. 

Prescription for Licorice Pills Was Almost Lethal

The Moral of the Tale:

Even a seemingly safe “herbal” tea can sometimes get you into trouble, especially if it contains licorice root. A hypertensive emergency needs to be avoided. As much as we love licorice, we treat it with respect and always try to maintain moderation when consuming this licorice as candy. 

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Citations
  • Falet JP et al, " Hypertensive emergency induced by licorice tea." Canadian Medical Association Journal, May 27, 2019. https://doi.org/10.1503/cmaj.180550
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