Indications
Glycyrrhizin (glycyrrhizic acid) is the main sweet-tasting active substance in licorice root (Glycyrrhiza glabra, known locally as jashtimadhu). It is used as an ingredient in herbal and food supplements, cough remedies and some products for digestive and liver support, and appears in some supplements aimed at reproductive health. Licorice is potent: regular or high intake can raise blood pressure and lower potassium, so it must be used with caution. Evidence for many of its claimed benefits is limited.
How It Works
Glycyrrhizin has soothing, anti-inflammatory and mild antiviral effects in laboratory studies. In the body it is converted to glycyrrhetinic acid, which blocks an enzyme in the kidney that normally inactivates the hormone cortisol. As a result, cortisol acts like the hormone aldosterone, causing the body to keep salt and water and lose potassium. This explains its main side effects.
Dosage and Administration
Take only as directed on the label of the product that contains it, and do not combine several licorice-containing products. Health authorities generally advise keeping glycyrrhizin intake from all sources below about 100 mg a day, and avoiding regular use for more than a few weeks without medical advice.
Interactions
Licorice can lower potassium further with diuretics such as Furosemide or Hydrochlorothiazide, corticosteroids such as Prednisolone, and laxatives; low potassium increases the risk of heart rhythm problems with Digoxin. It can reduce the effect of blood pressure medicines and may affect Warfarin. It may interact with hormonal contraceptives, which can increase its blood pressure effect. Tell your doctor about all medicines you take.
Contraindications
- High blood pressure, heart disease or heart failure.
- Kidney disease, liver cirrhosis or low blood potassium.
- Pregnancy.
- Hormone-sensitive conditions such as breast, uterine or ovarian cancer, or endometriosis, unless a doctor agrees.
Side Effects
With regular or high intake, glycyrrhizin can cause high blood pressure, swelling of the ankles from fluid retention, headache, low potassium with muscle weakness or cramps, and tiredness. In men it may reduce testosterone levels and sex drive.
Get urgent medical help for severe headache, chest pain, palpitations or an irregular heartbeat, marked muscle weakness or paralysis, shortness of breath, or sudden swelling.
Pregnancy and Lactation
Avoid supplements containing glycyrrhizin during pregnancy, as heavy licorice intake has been linked with preterm birth and effects on the baby’s development. Avoid it during breastfeeding as well, unless a doctor advises otherwise.
Precautions and Warnings
People over 40, and those with heart or kidney problems, are more sensitive to its effects. Check your blood pressure if you use it for more than a short time. Remember that licorice may also be present in sweets, teas and other herbal products.
Overdose
Large amounts can cause dangerous rises in blood pressure, very low potassium, muscle weakness and heart rhythm disturbances. Seek emergency medical help and take the pack with you.
Therapeutic Class
Herbal active ingredient (licorice extract)
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.