November 2020

Licorice Lovers Beware

A recent case report detailed how a malnourished man in his 50s experienced sudden cardiac arrest after eating a few bags of licorice candy every day for a few weeks. He was hospitalized and received supportive care, but his kidneys failed and he died shortly after. Make sure patients understand that regularly eating large amounts of licorice isn’t a good idea.

Licorice contains glycyrrhizin. Consuming more than 400 mg glycyrrhizin can cause abnormally low potassium levels and very high blood pressure – potentially leading to cardiac arrest and death. Most people would need to consume at least 20-30 grams of licorice products or 200 grams of licorice candy (the weight of one typical bag of candy) daily for a few weeks to experience these severe side effects. But patients who already have a poor diet, including high salt intake, might experience side effects with smaller doses. This was the case for the Massachusetts man discussed in the recent case report. He reportedly switched from eating a fruit-flavored candy each day to licorice three weeks prior to his death.

Tell patients that occasionally eating licorice isn’t concerning. And many “licorice” candies sold in the US actually contain anise oil, not licorice. But there are still many products available that do contain licorice, including many herbal teas and other candies such as jelly beans. If patients enjoy these products, advise them to avoid consuming them regularly and in large quantities, especially if they have other unhealthy dietary habits or pre-existing cardiovascular or kidney conditions.

To learn more about licorice, including its potential drug interactions, check out our recently updated monograph.

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