The sweet flavor of licorice, derived from the root of the Glycyrrhiza glabra plant, has been used in candies, teas, and herbal remedies for centuries. However, the key active compound in real licorice, glycyrrhizin, can lead to serious health complications, especially for certain individuals. Its effect on the body, similar to the hormone aldosterone, can cause significant mineral and water imbalances. For many, consuming small, occasional amounts is safe, but for a number of high-risk groups, licorice should be avoided entirely.
High-Risk Medical Conditions
Certain health conditions are made significantly worse by the effects of glycyrrhizin, primarily due to its impact on electrolytes and blood pressure. The following groups should be particularly cautious or avoid licorice altogether.
Individuals with Hypertension (High Blood Pressure)
One of the most well-documented side effects of licorice is its ability to raise blood pressure. Glycyrrhizin causes the kidneys to retain sodium and water, which increases blood volume and, consequently, blood pressure. Even a moderate daily intake of licorice can lead to significant increases in blood pressure, making it a critical item to avoid for anyone with pre-existing hypertension.
People with Heart Conditions
For those with existing heart issues, licorice can be especially dangerous. The potassium depletion caused by glycyrrhizin can lead to serious and potentially fatal irregular heart rhythms (cardiac arrhythmias) and, in extreme cases, cardiac arrest. The increased fluid retention can also exacerbate heart failure.
Those with Kidney or Liver Disease
Individuals with kidney disease struggle to regulate fluids and electrolytes, a process directly impacted by glycyrrhizin. The compound's effect of causing sodium retention and potassium excretion places additional strain on already compromised kidneys, potentially leading to or worsening kidney failure. Similarly, some types of liver disease, such as cholestatic liver disease and cirrhosis, are also contraindications for licorice consumption.
Specific Populations and Circumstances
Beyond chronic conditions, certain stages of life and dietary habits also warrant avoidance of licorice.
Pregnant and Breastfeeding Women
Consuming high amounts of licorice during pregnancy is considered unsafe and can lead to negative developmental outcomes for the child. Studies have linked high licorice intake to issues like reduced cognitive scores and an increased risk of ADHD in children. While more research is needed, experts advise pregnant women to avoid licorice root and related herbal remedies as a precaution. The safety for breastfeeding women is also not well-established, and avoidance is often recommended.
Individuals Over 40
The FDA warns that for people over 40, consuming just two ounces of black licorice a day for two weeks could trigger cardiac issues. This age-specific warning highlights an increased sensitivity in older adults to the side effects of glycyrrhizin.
People Prone to Low Potassium
Those who are already susceptible to low potassium levels (hypokalemia), whether due to diet or other medical reasons, should avoid licorice. The compound's potassium-lowering effect could dangerously compound the issue.
Drug Interactions to Monitor
Licorice can interact with numerous medications, altering their effectiveness and increasing the risk of side effects. It is vital to consult a healthcare provider if you take any of the following and consume licorice:
- Diuretics: Especially thiazide and loop diuretics, as the potassium-depleting effect is compounded.
- Digoxin: Lowered potassium levels can amplify the effects of this heart medication, increasing toxicity risk.
- Corticosteroids: Licorice can increase the side effects of medications like prednisone.
- Blood Thinners (Warfarin): Can make warfarin less effective, increasing the risk of blood clots.
- ACE Inhibitors and Angiotensin Receptor Blockers (ARBs): Licorice can counteract the blood pressure-lowering effects of these medications.
Licorice vs. Deglycyrrhizinated Licorice (DGL)
For those who wish to enjoy the flavor or some of the potential benefits of licorice without the risk of glycyrrhizin, deglycyrrhizinated licorice (DGL) is an important alternative. DGL has been processed to remove the glycyrrhizin compound, making it much safer for most people.
Comparison: Licorice vs. DGL
| Feature | Regular Licorice | Deglycyrrhizinated Licorice (DGL) |
|---|---|---|
| Contains Glycyrrhizin? | Yes, the active compound responsible for risks. | No, glycyrrhizin is removed or reduced to undetectable levels. |
| Effect on Blood Pressure | Can significantly raise blood pressure due to sodium and water retention. | Safe for those with hypertension, as it doesn't cause the same electrolyte imbalances. |
| Safety in Pregnancy | Unsafe; linked to negative developmental outcomes. | Generally considered safer, but still requires consultation with a healthcare provider. |
| Risk of Drug Interactions | High risk, especially with heart medications and diuretics. | Low risk of interaction, as the problematic compound is absent. |
| Common Use | Flavoring, traditional herbal remedies. | Digestive support (e.g., acid reflux, stomach ulcers). |
| Overall Risk Profile | High for sensitive groups and with chronic use. | Much lower; a safer alternative for many. |
Conclusion: Prioritize Safety Over Flavor
While licorice has been cherished for its distinct flavor and traditional uses, the health risks posed by its glycyrrhizin content cannot be ignored for certain populations. The potential for serious cardiovascular and electrolyte-related complications means that those with high blood pressure, heart disease, kidney issues, and pregnant women should abstain from consuming real licorice. Furthermore, potential drug interactions with common medications like diuretics and warfarin make consultation with a healthcare provider essential before consuming licorice products. For those who want the flavor without the risk, DGL offers a much safer alternative. Prioritizing your health by avoiding licorice when necessary is a simple but important dietary decision.
For more information on herbal safety, you can consult resources like the National Center for Complementary and Integrative Health.
