The Active Compound in Licorice: Glycyrrhizin
Licorice root tea, derived from the plant Glycyrrhiza glabra, is a popular herbal remedy known for its distinct sweet flavor and potential health benefits for digestion and respiratory health. However, its powerful effects stem from a compound called glycyrrhizin, which is responsible for most of its potential side effects. Glycyrrhizin acts in a way similar to mineralocorticoids, hormones that regulate sodium and potassium levels in the body. This can cause the body to retain sodium (and water) while losing potassium, leading to a cascade of health issues. While generally safe in small amounts for healthy adults, the high concentration of this compound in tea makes it potentially dangerous for several at-risk groups.
Cardiovascular and Blood Pressure Concerns
One of the most significant risks of drinking licorice tea is its effect on the cardiovascular system. Due to its impact on electrolytes, licorice can cause a dangerous increase in blood pressure. This is particularly risky for individuals who already have hypertension, as it can counteract the effects of blood pressure medications and worsen their condition. A case study highlighted how a 45-year-old woman developed severe hypertension and low potassium levels from drinking excessive licorice tea, symptoms that resolved once she stopped. Furthermore, the resulting low potassium levels (hypokalemia) can lead to abnormal heart rhythms (arrhythmia), and fluid retention can exacerbate heart failure.
Individuals with the following conditions should avoid licorice tea:
- High blood pressure (hypertension)
- Congestive heart failure
- Irregular heart rhythm (arrhythmia)
- History of stroke
Pregnancy and Breastfeeding
Expectant mothers should completely avoid licorice tea. Research has shown that excessive maternal consumption of licorice extract during pregnancy can have severe consequences, including an increased risk of preterm delivery. Some studies have also linked high intake during pregnancy to developmental issues in children, such as lower cognitive test scores. The reasons for these risks are complex, but are thought to be related to glycyrrhizin increasing levels of the stress hormone cortisol, which can negatively affect fetal development. The safety of licorice during breastfeeding is not well-documented, so it is also generally advised to avoid it during this period.
Kidney and Liver Disease
For those with compromised kidney function, licorice tea is a significant risk. Because the kidneys are responsible for filtering and regulating potassium and sodium levels, they can be overwhelmed by the effects of glycyrrhizin. High consumption of licorice can make pre-existing kidney disease worse. Similarly, those with certain liver disorders, such as chronic hepatitis or cholestatic liver disease, should steer clear of licorice.
Low Potassium Levels (Hypokalemia)
As noted, glycyrrhizin causes potassium depletion. Individuals who already have low potassium levels or are taking medications that deplete potassium, such as diuretics, should not drink licorice tea. Symptoms of hypokalemia include muscle weakness, fatigue, and cramping, and in severe cases, it can lead to dangerous cardiac arrhythmias.
Hormone-Sensitive Conditions
Licorice contains compounds that can mimic the effects of estrogen in the body. This makes it unsuitable for anyone with a hormone-sensitive condition, including breast, uterine, and ovarian cancers, as well as endometriosis and uterine fibroids. In men, long-term, high consumption may lower testosterone levels, potentially contributing to erectile dysfunction and reduced libido.
Drug Interactions
Licorice tea can have significant interactions with various medications by affecting liver enzymes or impacting electrolyte levels. These include:
- Diuretics and Blood Pressure Medications: Licorice can increase blood pressure, reducing the effectiveness of antihypertensive drugs. It also amplifies the potassium-depleting effects of diuretics.
- Blood Thinners: Licorice can interfere with the metabolism of blood-thinning medications like warfarin, potentially increasing the risk of clotting.
- Corticosteroids: Licorice can slow the breakdown of corticosteroids, increasing their effects and potential side effects.
- Digoxin: For people taking digoxin, a heart medication, low potassium levels caused by licorice can increase the risk of side effects from digoxin.
- Hormone Therapies: Licorice can interact with estrogen therapies, including birth control pills, potentially altering their effects.
- Chemotherapy Drugs: Some chemotherapy drugs, like Cisplatin, can have their effectiveness reduced by licorice.
Regular vs. DGL Licorice Tea Comparison
To avoid the side effects associated with glycyrrhizin, many opt for Deglycyrrhizinated Licorice (DGL). This form has had most of the glycyrrhizin removed, making it a safer option for those concerned about its effects on blood pressure and potassium.
| Feature | Regular Licorice Tea | DGL (Deglycyrrhizinated) Licorice Tea |
|---|---|---|
| Active Compound | Contains glycyrrhizin | Glycyrrhizin removed |
| Cardiovascular Risk | High risk of raising blood pressure and causing irregular heart rhythms | Low risk; does not typically affect blood pressure |
| Potassium Levels | Can cause dangerous drops in blood potassium | Does not significantly affect potassium levels |
| Drug Interactions | Significant interactions with many medications, including diuretics and blood thinners | Minimal drug interaction risk related to glycyrrhizin effects |
| Pregnancy/Breastfeeding | Unsafe; high risks associated with consumption | Safer, but still best to consult a doctor; some herbal preparations are still cautioned |
| Hormonal Effects | Can act like estrogen, interfering with hormone-sensitive conditions | Minimal risk of estrogenic activity due to processing |
Conclusion
While licorice root tea has been used for centuries as a traditional remedy, its active component, glycyrrhizin, poses serious risks for certain individuals and medical conditions. Anyone with high blood pressure, heart disease, kidney issues, or low potassium should strictly avoid this tea. Pregnant women, those with hormone-sensitive cancers, and people taking a range of medications also face significant contraindications. For those seeking the digestive benefits of licorice without the associated risks, consulting a healthcare provider and considering DGL licorice is a safer alternative. As with any herbal supplement, it is best to discuss consumption with a doctor to ensure it is safe for your specific health profile. For more information on herbal remedies, visit the National Center for Complementary and Integrative Health.
