Licorice Information & Purchase
Also Known As:
Acide Glycyrrhizique, Acide Glycyrrhizinique, Alcacuz, Alcazuz, Bois Doux, Bois Sucré, Can Cao, Chinese Licorice, Deglycyrrhized Licorice, Gan Cao, Gan Zao, Glabra, Glycyrrhiza, Glycyrrhiza Radix, Glycyrrhizae, Glycyrrhizic Acid, Glycyrrhizinic Acid, Isoflavone, Jethi-Madh, Kanzo, Lakritze, Liquiritiae Radix, Liquirizia, Liquorice, Mulathi, Mulethi, Orozuz, Phytoestrogen, Phyto-œstrogène, Racine de Réglisse, Racine Douce, Radix Glycyrrhizae, Régalissse, Regaliz, Reglisse, Réglisse, Réglisse Déglycyrrhisée, Réglisse Espagnole, Réglisse Russe, Regaliz, Regliz, Russian Licorice, Spanish Licorice, Subholz, Sussholz, Sweet Root, Yashti-Madhu, Yashti-Madhuka, Zhi Gan Cao.
Glycyrrhiza glabra; Glycyrrhiza glabra var. glandulifera; Glycyrrhiza uralensis. Family: Fabaceae/Leguminosae.
People Use This For:
Orally, licorice is used for gastric and duodenal ulcers, sore throat, bronchitis, chronic gastritis, dyspepsia, colic, menopausal symptoms, primary adrenocortical insufficiency, cough, osteoarthritis, osteoporosis, systemic lupus erythematosus (SLE), and for bacterial and viral infections. It is also used orally for cholestatic liver disorders, hypokalemia, hypertonia, malaria, tuberculosis, abscesses, food poisoning, diabetes insipidus, chronic fatigue syndrome (CFS), and contact dermatitis.
In combination with Panax ginseng and Bupleurum falcatum, licorice is used orally to help stimulate adrenal gland function, particularly in patients with a history of long-term corticosteroid use. As a component of the herbal formula, Shakuyaku-Kanzo-To, licorice is used to increase fertility in women with polycystic ovary syndrome. In combination with other herbs, licorice is used to treat prostate cancer and atopic dermatitis (eczema).
Topically, licorice is used as a shampoo to reduce sebum secretion.
Intravenously, licorice components are used for treating hepatitis B and C.
Licorice is used as a flavoring in foods, beverages, and tobacco.
LIKELY SAFE ...when used orally in amounts commonly found in foods. Licorice has Generally Recognized as Safe (GRAS) status in the US.
POSSIBLY SAFE ...when used orally and appropriately for medicinal purposes, short-term. Long-term use increases the risk of adverse effects such as hypertension and hypokalemia.
POSSIBLY UNSAFE ...when used orally in large amounts for several weeks. Consuming 30 grams or more of licorice daily for several weeks can cause severe adverse events including hypertension, hypokalemia, alkalosis, weakness, paralysis, and occasionally encephalopathy in otherwise healthy people. As little as 5 grams per day can cause these problems in patients with hypertension, cardiovascular or kidney conditions, or a high salt intake.
PREGNANCY: UNSAFE ...when used orally. Licorice has abortifacient, estrogenic, and steroid effects; and can cause uterine stimulation. Heavy consumption of licorice, equivalent to 500 mg glycyrrhizic acid per week (about 250 grams of licorice per week), during pregnancy seems to increase the risk of delivering before gestational age of 38 weeks; avoid using.
LACTATION: Insufficient reliable information available; avoid using.
Dyspepsia. A specific combination product containing licorice (Iberogast, Medical Futures, Inc) seems to improve symptoms of dyspepsia. The combination includes licorice plus peppermint leaf, German chamomile, caraway, lemon balm, clown's mustard plant, celandine, angelica, and milk thistle (7049, 12724). A meta-analysis of studies using this combination product suggests that taking 1 mL orally three times daily over a period of 4 weeks significantly reduces severity of acid reflux, epigastric pain, cramping, nausea, and vomiting compared to placebo.
INSUFFICIENT RELIABLE EVIDENCE to RATE
Atopic dermatitis (eczema). Licorice given orally in combination with 9 other herbs (Zemaphyte) might reduce redness and skin lesions in adults and children with nonexudative atopic eczema. However, other research shows no effect.
Hepatitis. Preliminary evidence suggests that isolated constituents of licorice may be effective for treating hepatitis B and C. Glycyrrhizin- and glycyrrhizic acid-containing intravenous preparations (Stronger Neominophagen C and Remefa S) show activity against hepatitis B and hepatitis C in humans, but the trials are too small to draw any definitive conclusions.
Muscle cramps. Preliminary clinical research suggests taking a specific combination of licorice and peony (shakuyaku-kanzo-to) might reduce muscle cramps in patients with hepatic cirrhosis or in patients undergoing hemodialysis.
Peptic ulcers. There is some evidence that deglycyrrhizinated licorice (DGL) might accelerate the healing of peptic ulcers.
Weight loss. There is conflicting evidence about the effectiveness of licorice for weight loss. Some research suggests that licorice reduces body fat; however, accompanying fluid retention offsets any change in body weight (6196). However, another clinical study conducted in both obese and athletic women and men shows that taking a specific licorice flavonoid oil (Glavonoid) 300 mg daily for 8 weeks has no effect on weight or body fat compared to placebo.
More evidence is needed to rate licorice for these uses.
Mechanism of Action:
The applicable part of licorice is the root. Licorice has antispasmodic, anti-inflammatory, laxative, and soothing properties.
Licorice appears to block metabolism of prostaglandins E and F2 alpha, which suggests a possible beneficial effect on peptic ulcer. Preliminary information suggests deglycyrrhizinated licorice (DGL) may accelerate the healing of peptic ulcers. DGL seems to be similar to carbenoxolone for ulcer reduction without the fluid retention or electrolyte imbalance of carbenoxolone.
Carbenoxolone is a semisynthetic derivative of glycyrrhetic acid that is used outside the US for treating gastric and duodenal ulcer disease.
Glycyrrhizic acid (also called glycyrrhizinic acid or glycyrrhizin) is metabolized to glycyrrhetinic acid (also called glycyrrhetic acid) in the intestine. Glycyrrhetinic acid inhibits renal 11-beta-hydroxysteroid dehydrogenase, reducing conversion of cortisol to inactive cortisone in the kidneys. Cortisol has equal affinity to aldosterone for mineralocorticoid receptors in the distal portion of the renal tubules, promoting sodium and water retention and potassium excretion. Excessive licorice ingestion can therefore produce a syndrome of apparent mineralocorticoid excess, with hypokalemia, increased urinary potassium loss, alkalosis, hypertension, suppressed plasma renin and aldosterone concentrations, and an increased ratio of cortisol to cortisone in the plasma and urine.
There is considerable variation in the amount of licorice needed to cause these effects, due in part to variation in the glycyrrhizic acid content of licorice preparations. This is typically around 2-3 mg/gram (0.2% to 0.3% w/w), but can vary from 0.026-98 mg/gram. There is also variation in people's response to licorice. Those with hypertension, heart disease, kidney disease, or a high salt intake are more sensitive to its effects. Finally, case reports of adverse reactions to licorice do not always make it clear whether licorice intake is in grams of pure licorice, or grams of licorice candy or another preparation.
The metabolic abnormalities caused by licorice can lead to EKG changes, arrhythmias, muscle weakness, rhabdomyolysis, paralysis, and encephalopathy. The increases in blood pressure, and cortisol to cortisone ratio are proportional to the amount of glycyrrhizic acid ingested.
Glycyrrhetinic acid has a long half life, a large volume of distribution, and extensive enterohepatic recirculation, and it may take 1 to 2 weeks before hypokalemia resolves. Normalization of the renin-aldosterone axis and blood pressure can take up to several months.
Some research shows that Panax ginseng appears to compliment licorice by increasing serum cortisol concentrations.
Licorice appears to have anti-estrogenic and estrogenic action. Preliminary research indicates that licorice does not stimulate the growth of estrogen dependent breast cancer cells. However, the estrogenic effects of licorice might be concentration dependent. Glabridin, an isoflavone constituent of licorice, seems to have an estrogen receptor-dependent growth-promoting effect at low concentrations. At higher concentrations, it seems to have an estrogen receptor-independent antiproliferative effect. Licorice has been shown to reduce body fat, however accompanying fluid retention offsets any change in body weight.
Licorice also decreases testosterone production in men who eat licorice. This is likely due to the licorice constituent, glycyrrhetinic acid, inhibiting the enzyme 17-hydroxysteroid dehydrogenase, which converts androstenedione to testosterone. Glycyrrhetinic acid also seems to inhibit 17-20 lyase which converts 17-hydroxyprogesterone to androstenedione.
Glycyrrhizin- and glycyrrhizic acid-containing intravenous preparations (Stronger Neominophagen C and Remefa S) show activity against hepatitis B and C in humans, but the trials are too small to draw any definitive conclusions. In vitro data suggests that glycyrrhizin suppresses the production and expression of hepatitis B surface antigen (HbS-Ag). Preliminary evidence suggests that glycyrrhizin may inhibit the growth of the coronavirus, which is associated with severe acute respiratory syndrome (SARS). The exact mechanism of the antiviral effect of glycyrrhizin is not known.
Licorice appears to activate the nuclear pregnane X receptor in vitro. Activation of this receptor results in increased expression of drug metabolizing enzymes such as cytochrome P450 2C9 (CYP2C9) and cytochrome P450 3A4 (CYP3A4) and multidrug transporters. In vitro, some licorice constituents seem to inhibit CYP3A4, CYP 2B6, and CYP2C9 enzymes; however, in animal models, licorice appears to induce both CYP3A4 and CYP2C9.
Orally. excessive licorice ingestion can cause a syndrome of apparent mineralocorticoid excess, or pseudohyperaldosteronism, with sodium and water retention, increased urinary potassium loss, hypokalemia, and alkalosis. These metabolic abnormalities can lead to hypertension, edema, EKG changes, arrhythmias, headache, lethargy, muscle weakness, dropped head syndrome (DHS), rhabdomyolysis, myoglobinuria, paralysis, encephalopathy, respiratory impairment, hyperparathyroidism, and acute renal failure. These effects are most likely to occur when 30 grams or more of licorice is consumed daily for several weeks. However, some people may be more sensitive, especially those with hypertension, heart problems, or kidney problems.
Glycyrrhetinic acid has a long half life, a large volume of distribution, and extensive enterohepatic recirculation. Therefore, it may take 1-2 weeks before hypokalemia resolves. Normalization of the renin-aldosterone axis and blood pressure can take up to several months.
Because licorice can decrease serum testosterone and increase 17-hydroxyprogesterone, it might cause decreased libido and sexual dysfunction in men.
Chewing tobacco flavored with licorice has also been associated with toxicity. Chewing licorice-flavored tobacco has been associated with hypertension and suppressed renin and aldosterone levels.
Interactions with Herbs & Supplements:
CARDIAC GLYCOSIDE-CONTAINING HERBS: Theoretically, the overuse or misuse of licorice can increase the risk of cardiotoxicity due to potassium depletion. Cardioactive herbs include digitalis, lily-of-the-valley, pheasant's eye, and squill.
STIMULANT LAXATIVE HERBS: Theoretically, concomitant overuse or misuse of licorice with stimulant laxatives can increase the risk of potassium depletion. Stimulant laxative herbs include aloe, alder buckthorn, black root, blue flag, butternut bark, colocynth, European buckthorn, fo ti, gamboge, gossypol, greater bindweed, jalap, manna, Mexican scammony root, rhubarb, senna, and yellow dock.
Interactions with Drugs:
ANTIHYPERTENSIVE DRUGS Interaction Rating = Moderate Be cautious with this combination.
Theoretically, licorice might reduce the effect of antihypertensive drug therapy. Licorice increases blood pressure in a dose dependent manner.
CORTICOSTEROIDS Interaction Rating = Moderate Be cautious with this combination. Theoretically, concomitant use might potentiate the duration of activity of corticosteroids, e.g., hydrocortisone. Concomitant use of licorice and corticosteroids might also increase potassium loss and increase the risk of potassium depletion. Overuse or misuse of licorice can cause potassium depletion.
CYTOCHROME P450 2B6 (CYP2B6) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. There is preliminary evidence that licorice can inhibit the cytochrome P450 2B6 (CYP2B6) isoenzymes in vitro. Theoretically, licorice might increase levels of drugs metabolized by CYP2B6; however, as of yet, these interactions have not been reported in humans. Some drugs that are metabolized by CYP2B6 include ketamine (Ketalar), phenobarbital, orphenadrine (Norflex), secobarbital (Seconal), and dexamethasone (Decadron). Use licorice cautiously or avoid in patients taking these drugs.
CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. There is conflicting evidence about the effect of licorice on CYP2C9 enzymes. In vitro, licorice constituents seem to inhibit CYP2C9; however, in animal models, licorice appears to induce CYP2C9 metabolism. Until more is known, licorice should be used cautiously in people taking CYP2C9 substrates. Some drugs metabolized by CYP2C9 include celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), and warfarin (Coumadin).
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. There is conflicting evidence about the effect of licorice on CYP3A4 enzymes. In vitro, licorice constituents seem to inhibit CYP3A4; however, in animal models, licorice appears to induce CYP3A4 metabolism. Until more is known, licorice should be used cautiously in people taking CYP3A4 substrates. Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), clarithromycin (Biaxin), cyclosporine (Neoral, Sandimmune), diltiazem (Cardizem), estrogens, indinavir (Crixivan), triazolam (Halcion), and numerous others.
DIGOXIN (Lanoxin) Interaction Rating = Moderate Be cautious with this combination. Overuse or misuse of licorice with cardiac glycoside therapy might increase the risk of cardiac toxicity due to potassium loss.
DIURETIC DRUGS Interaction Rating = Moderate Be cautious with this combination. Overuse of licorice might compound diuretic-induced potassium loss. There is some concern that people taking licorice along with potassium depleting diuretics might have an increased risk for hypokalemia. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDIURIL, Microzide), and others.
ESTROGENS Interaction Rating = Moderate Be cautious with this combination. Theoretically, licorice might interfere with estrogen therapy due to estrogenic and anti-estrogenic effects.
ETHACRYNIC ACID (Edecrin) Interaction Rating = Moderate Be cautious with this combination Theoretically, ethacrynic acid might enhance the mineralocorticoid effects of licorice by inhibiting the enzyme that converts cortisol to cortisone; however, bumetanide (Bumex) does not appear to have this effect.
FUROSEMIDE (Lasix) Interaction Rating = Moderate Be cautious with this combination. Theoretically, furosemide might enhance the mineralocorticoid effects of licorice by inhibiting the enzyme that converts cortisol to cortisone; however, bumetanide (Bumex) does not appear to have this effect.
WARFARIN (Coumadin) Interaction Rating = Major Do not take this combination. Licorice seems to increase metabolism and decrease levels of warfarin in animal models. This is likely due to induction of cytochrome P450 2C9 (CYP2C9) metabolism by licorice. Advise patients taking warfarin to avoid taking licorice.
Interactions with Foods:
GRAPEFRUIT JUICE: Theoretically, grapefruit juice and its component naringenin might enhance the mineralocorticoid activities of licorice, by blocking the conversion of cortisol to cortisone.
SALT: A high salt diet can exacerbate adverse effects of licorice such as sodium and water retention and hypertension.
Interactions with Lab Tests:
17-HYDROXYPROGESTERONE: Licorice can increase serum 17-hydroxyprogesterone concentrations and test results in healthy volunteers who consume 7 grams of licorice per day.
BLOOD PRESSURE: Excessive use of licorice can cause hypertension and increase blood pressure readings.
POTASSIUM: Excessive use of licorice can cause hypokalemia, reducing serum potassium levels and test results.
TESTOSTERONE: Licorice can decrease serum testosterone concentrations and test results in healthy volunteers who consume 7 grams of licorice per day.
Interactions with Diseases or Conditions:
HEART DISEASE: The mineralocorticoid effects of licorice can induce fluid retention and worsen congestive heart failure. Licorice can also cause hypokalemia and increase the risk of arrhythmias. Advise patients with heart disease to avoid excessive amounts of licorice.
HORMONE SENSITIVE CANCERS/CONDITIONS: Licorice might have estrogenic effects . Women with hormone sensitive conditions should avoid using licorice. Some of these conditions include breast cancer, uterine cancer, ovarian cancer, endometriosis, and uterine fibroids.
HYPERTENSION: The mineralocorticoid effects of licorice can increase blood pressure. Advise patients with hypertension to avoid excessive amounts of licorice.
HYPERTONIA: The mineralocorticoid effects of licorice can cause hypokalemia. Licorice-induced hypokalemia can worsen hypertonia.
HYPOKALEMIA: The mineralocorticoid effects of licorice can decrease potassium serum levels and exacerbate hypokalemia.
KIDNEY INSUFFICIENCY: The mineralocorticoid effects of licorice may worsen renal function. Advise patients with severe renal insufficiency to avoid excessive amounts of licorice.
SEXUAL DYSFUNCTION: Theoretically, licorice might decrease libido and worsen erectile dysfunction by decreasing testosterone and increasing 17-hydroxyprogesterone serum concentrations.
SURGERY: Licorice might affect blood pressure. Theoretically, licorice might interfere with blood pressure control during and after surgical procedures. Tell patients to discontinue licorice at least 2 weeks before elective surgical procedures.
ORAL: For dyspepsia, a specific combination product containing licorice (Iberogast, Medical Futures, Inc) and several other herbs has been used in a dose of 1 mL three times daily.
Many "licorice" products manufactured in the US actually don't contain any licorice. Instead, they contain anise oil, which has the characteristic smell and taste called "black licorice."
General Certificate Of Analysis (COA) less manufacture date and batch number provided for different product strengths if the link is not available or manufacture date and batch number is required use the email us box to request Certificate Of Analysis (COA) emailed. Any questions about product or wholesale pricing for twenty five kilos or more. Please be sure to use product ID, Trade Name and Scientific Name.
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"These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease."