The People's Perspective on Medicine

Licorice Led to Life-Threatening Loss of Potassium

Consuming too much licorice, either as a supplement, in candy or as tea, could lead to a potentially lethal loss of potassium.

You may have heard someone express the opinion that natural medicines are safer than synthetic ones. That isn’t always the case, however. Sometimes botanical medications can have scary side effects. Licorice, for example, helps heal ulcers (Yang et al, Journal of Ethnopharmacology, March 6, 2017), alleviate hot flashes due to menopause (Ghazanfarpour et al, International Journal of Reproductive Biomedicine, March 2016), soothe the throat and calm a cough. The herb also has antiviral and hepatoprotective activity. These are all useful, but too much licorice can lead to a dangerous loss of potassium.

The Dangers of Loss of Potassium:

Q. My mother was just released from the hospital. She went in when her potassium dropped to 1.2. She could have died, and doctors were surprised that she didn’t.

I looked online and found a case study of a man who ate a lot of licorice cough drops; his potassium dropped to 1. I asked my mother and found out she has been taking a licorice root supplement for quite some time.

The doctors never asked her about anything she was taking. They just pumped her full of potassium. Three days in a hospital could have been avoided.

A. Normal potassium levels in the blood should range from 3.6 to 5.2. If potassium drops below 2.5, it becomes a medical emergency. Symptoms such as weakness, muscle cramps, irregular heart rhythms and confusion signal loss of potassium.

Licorice and Loss of Potassium:

Licorice (Glycyrrhiza glabra) is known to deplete the body of potassium. Too much, either in candy or as a supplement, can also lead to high blood pressure, fluid retention, headaches and hormonal imbalance.

Another reader shared this experience:

“I take meds for high blood pressure. I started eating licorice candy for about a week, and my blood pressure went from 135/80 to 180/98!”

Is Red Licorice a Problem?

Red “licorice” and black licorice candy flavored with anise instead of real licorice root do not cause the dangerous loss of potassium we are describing. We sometimes hear that question from readers like this person:

Q. I was alarmed to read that eating licorice can lead to high blood pressure, weakness, fatigue, loss of libido and mineral imbalance. Is this only true of black licorice?

I eat a good deal of strawberry licorice (Twizzler’s). Besides the obvious excess sugar, are there any problems with this product?

A. You have nothing to worry about (except for the calories). The ingredient that can cause so many serious side effects is glycyrrhizin. This is the natural flavor found in black licorice, but it is absent from red “licorice.”

An occasional treat rarely causes people any trouble, but those who eat black licorice regularly can experience hormone imbalance and potassium loss. This is especially dangerous for those taking diuretics, prednisone or digoxin (Lanoxin).

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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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İ have experienced abnormal heart rhytyms with licorice too.

Where can I buy licorice without the bad thing in it?

Once in a while I enjoy licorice as a candy. When I have acid stomach, though, it’s DGL. Chocolate(?) flavored, it ain’t bad, but it’ll not be mistaken for candy. It will, however, take care of most acid upset.

I take licorice for hypotension. It works better than prescription meds. However, I do worry about side effects. So far my potassium levels have always been fine. I wonder why it would affect some people and not others. Perhaps diet? I eat a lot of fruits and vegetables.

I’ve been taking DGL (Deglycyrrhizinated icorice) to treat reflux. It seems to work for me. Does the deglycyrrhizination process prevent potassium issues?

I take DGL (deglycyrrhizinated licorice root extract) for an upset stomach quite often. I suffer from frequent leg cramps but I hope you will agree that DGL is not the culprit. Any thoughts?

I use a supplement occasionally to alleviate upset stomach called DGL (deglycerized licorice). I assume this is safe because the licorice has been “changed” to a safe form. Correct? It works and I have not had any complications from using it. It is chocolate flavored and delicious.

Does the deglycyrrhizinated version of the licorice supplement also deplete potassium?

PLAIN licorice root contains STEROID-LIKE factors in it, naturally, that (like steroid “drugs”/”medications”) can cause a dangerous loss of Potassium, and can also cause edema (holding onto fluid, causing swelling), etc.

Luckily, some genius, some years ago, figured out how to REMOVE these steroid-like factors from plain licorice root, leaving DGL (De-Glycyrrhizinated Licorice) remaining behind. (De = without, and Glycyrrhizins = steroid-like components/ingredients normally found in plain licorice root).

One should make sure that there are no ADDED chemicals in a “DGL” formulation, that could possibly have adverse (bad) side effects on the person!

For example, if one happens to have gout, don’t buy a “DGL” formulation that contains the amino acid “glycine”, because “glycine” is “contra-indicated” (forbidden) for gout patients!

For those who don’t have gout, the glycine is OK, because it is said to help digestion.

And, DGL has many healing properties.

From label instructions, it says that the DGL should be briefly chewed (a few seconds) to get the DGL to be mixed with saliva. This apparently activates the DGL to do its job of helping to prevent gastric reflux, and to help heal injured stomach linings, by promoting the re-growth of destroyed mucus-producing cells in the lining of the stomach.

I think it would be helpful to mention that deglycyrrihized licorice in capsule form is widely available, provides the same benefits, and does not present the dangers of the “natural” form.

Licorice needs to be chewed and mixed with saliva for the benefits, not taken as a capsule. Reference; The Encyclopedia of Natural Medicine, 3rd edition. Michael T. Murray, ND, and Joseph Pizzorno, ND. Pg 880-81 (peptic ulcer).

Smokeless tobacco is another source of this aldosterone analog. I remember an Eastern NC lineman up on a pole getting dangerously weak and dizzy with licorice use and hypokalemia (also likely hypomagnesemia- we didn’t test for that in the 80’s).

What about DGL ULTRA.

I was placing a vitamin order recently and on a whim, threw in a small box of good European black licorice. I ate it over two days and on the third day noticed that my ankles and feet were hugely swelled. At first I had no idea what was going on, but was very worried.

Congestive heart failure, I thought? Then it occurred to me that the licorice was the culprit. I immediately started to drink coconut water and ate a banana and also took powdered potassium, a very small amount at a time. It took a few days, but the swelling left. I will never eat black licorice again. I feel like if I had eaten even more, it could have been a fatal overdose of candy. Imagine that. How would you like that listed on an autopsy report as the cause of death?

This article raises a question for me. I take DGL which is deglycyrrhizinated licorice. Is that a problem with potassium levels?

DGL is not supposed to affect potassium.

How much is too much?
I take abt 1/2t of DGL daily for ulcers.

DGL has been prescribed my my practitioners for my GERD, hernia, ulcer (fed by Sibo). I have been sprinkling on my salad with every meal for about 5 -7 months.

Does this seem a problem? How can I verify my levels ?

Thank you! I have reading you for years and recently found your great podcast. You both sound great!

Thank you!

Your doctor can order a test of potassium. We suggest you request that for reassurance.

About four years ago I walked into my local health food store looking for something to help with a situation, which I can’t recall anymore. The saleslady in the supplement department handed me a large bottle of expensive pills.

When I got home I took just one of the pills, and almost immediately I felt horrible. As time went by I felt panicky and then took my blood pressure, which was over 200 over another high number.

It was then that I read the ingredients on the label and saw that it contained licorice root.

I had a vague memory about having heard that licorice root was dangerous, so I began researching on the Internet and realized I was in major trouble.

I made an emergency visit to my doctor the next day. To my amazement his PA had studied this problem in a course he took, so he undertook treating me. It took several weeks to get my blood pressure back down to normal again and for me to feel human again. I think I might have had a stroke had he not been able to help me. Now I scrupulously read labels on supplements. It was a terrifying experience.

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