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Licorice

By Ara DerMarderosian, PhD, University of the Sciences in Philadelphia

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Patient Education

Natural licorice, which has a very sweet taste, is extracted from the root of a shrub ( Glycyrrhiza glabra) and used medicinally as a capsule, tablet, or liquid extract. Most licorice candy made in the US is flavored artificially and does not contain natural licorice. Glycyrrhizin is the active ingredient in natural licorice. For people who are particularly sensitive to the effects of glycyrrhizin, specially treated licorice products that contain a much lower amount of glycyrrhizin (about one tenth) are available. These products are called deglycyrrhizinated licorice.

Claims

People most often take licorice to suppress coughs, to soothe a sore throat, and to relieve stomach upset. Applied externally, it is said to soothe skin irritation (eg, eczema). Licorice has also been claimed to help treat stomach ulcers and complications caused by hepatitis C.

Evidence

Evidence indicates that licorice in combination with other herbs provides relief from the symptoms of functional dyspepsia and irritable bowel syndrome (1). However, clinical trials of both licorice alone and in combination are limited, and further evaluation is required. There are not enough data to determine whether licorice is effective for stomach ulcers or complications caused by hepatitis C.

Adverse effects

At lower dosages or normal consumption levels, few adverse reactions are evident. However, high doses of real licorice (> 1 oz/day) and glycyrrhizin cause renal sodium and water retention, possibly leading to high blood pressure, and potassium excretion, possibly causing low potassium levels (pseudoaldosteronism). Increased potassium excretion can be a particular problem for people who have heart disease and for those who take digoxin or diuretics that also increase potassium excretion. Such people and those who have high blood pressure should avoid taking licorice.

Licorice may increase the risk of premature delivery; thus, pregnant women should avoid licorice.

Drug interactions

Licorice may interact with warfarin and decrease its effectiveness, increasing the risk of blood clotting. As mentioned above, licorice may interact with digoxin by affecting potassium levels.

Licorice reference

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