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Licorice Side Effects: 9 Medications To Avoid when Taking the Extract

Licorice side effects from drug interaction

Licorice side effects are often attributed to its glycyrrhizic acid content which may produce physiological effects at high doses that can be detrimental to health if care is not taken, because of its ability to interact with certain medications.

Although, Glycyrrhiza glabra aka Licorice root is a herb that has been used for centuries for its medicinal properties. It contains compounds that have antioxidant, anti-inflammatory, antimicrobial, and antiviral potential, making it beneficial for treating coughs, sore throats, ulcers, inflammation, and skin problems.

This article provides in-depth insight into Licorice side effects on humans. It also highlights medications that should not be taken with the licorice extract, including some people who should stay away from this plant due to their health status.

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Licorice benefits

Some of the potential benefits of licorice root include:

  • Potential against viral and bacterial infections
  • Relieving coughs and sore throats
  • Treating ulcers
  • Reducing inflammation: helps relieve inflammatory disorders of the lung.
  • Boosting the immune system
  • Protecting the skin
  • Improving digestion

Licorice side effects

The knowledge of licorice side effects is important and should be considered before using licorice root. Here are some possible negative impacts of consuming the extract in large amounts.

  1. Lowers potassium levels
  2. Excessive intake can increase the stress hormone known as cortisol
  3. Licorice may affect fertility by lowering testosterone levels
  4. May increase blood pressure
  5. Licorice can cause electrolyte imbalance

Lowers potassium levels

According to recent findings, licorice can cause hypokalemia (low potassium levels in the blood) and inhibit certain cytochrome P450 (CYP450) enzymes. CYP450 enzymes are involved in the metabolism of many drugs, so inhibition of these enzymes can lead to drug interactions [1, 2].

Excessive intake of licorice extract can increase cortisol levels.

glycyrrhiza glabra root extract contains a compound called glycyrrhizic acid, which can inhibit the activity of an enzyme called 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) [3, 4, 5]. This enzyme normally converts cortisol into a less active form called cortisone [6]. When 11β-HSD2 is inhibited, cortisol levels can build up in the body [7, 8].

Cortisol is a stress hormone that helps the body cope with physical and emotional stressors [9].

The effects of glycyrrhiza glabra extract on cortisol levels vary from person to person. Some people may be more sensitive to the effects of licorice than others. It is also important to note that the amount of glycyrrhizic acid in licorice extract can vary depending on the brand and preparation method.

Also, high levels of cortisol can have negative health effects such as:
high blood pressure, heart disease, diabetes, weight gain, bone loss, sleep problems, mood disorders [10, 11].

Licorice may affect fertility by lowering testosterone levels.

Glycyrrhiza glabra root contains a compound called glycyrrhizic acid, which can inhibit the activity of an enzyme called 17-hydroxysteroid dehydrogenase (17HSD). This enzyme is involved in the production of testosterone, a hormone that is important for fertility in both men and women [12, 13, 14, 15].

When 17HSD is inhibited, testosterone levels can decrease. This can lead to problems with fertility, such as:

  • In men: Low sperm count, poor sperm quality, and erectile dysfunction
  • In women: Irregular menstrual cycles, infertility, and polycystic ovary syndrome (PCOS).

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May increase blood pressure

A review of the toxicological effects of glycyrrhiza glabra shows that excessive or prolonged intake of licorice extract can cause hypertension and hypokalemia, a condition attributed to the glycyrrhizin compound found in the extract of glycyrrhiza glabra. However, Licorice has a cytotoxicity effect and may also kill certain types of cancer by inhibiting their growth [16].

A similar review also noted that licorice can mimic the effects of the hormone aldosterone, which can lead to high blood pressure, low potassium levels, and other health problems. This is because licorice can inhibit an enzyme called 11β-HSD2, which normally converts cortisol into a less active form. It can also bind to the mineralocorticoid receptor, which is the receptor that aldosterone binds to [17].

Licorice can cause electrolyte imbalance

Licorice can cause several electrolyte disturbances, which may increase fluid retention. One case study was a woman who was taking oral contraceptives and ingesting licorice chronically, she developed headaches, weakness, upper-limb edema, and a generalized convulsive seizure [18].

It was noted that her plasma potassium, aldosterone, renin activity, and albumin levels were below normal. Abdominal echography and computerized tomography scan showed a perihepatic and perisplenic thin liquid layer with liquid collection in the pelvis. Bioelectrical impedance suggested a hyperhydration state.

After stopping the licorice, the laboratory and bioelectrical values normalized, and the clinical upper-limb edema and the liquid in the abdomen disappeared in a few days.

One other case report and research journal also pointed out the possibility that licorice may cause sodium and water retention in case of excessive consumption [19], which can be linked to its glycyrrhizic acid content.

People who should avoid licorice extract

Avoid licorice extract if you have any of these conditions:

  • Pregnant: may cause stillbirth.
  • Diabetes:
  • Kidney disease
  • Liver disease
  • Hypokalemia (Low potassium)
  • Hypertension (High blood pressure)
  • Heart failure
  • Heart disease
  • Erectile dysfunction

Licorice Medication Interactions

Licorice Medication Interactions can not be overlooked despite the promising benefits of Licorice extracts, You should know that licorice can interact with certain medications [20, 21].

Here are some of the medications that may interact with licorice:

  1. ACE inhibitors and diuretics: Licorice can increase the risk of side effects from these medications, such as high blood potassium levels.
  2. Digoxin: Licorice can increase the risk of digoxin toxicity.
  3. Corticosteroids: Licorice can increase the effects of corticosteroids.
  4. Insulin or drugs for diabetes: Licorice can affect blood sugar levels.
  5. Laxatives: Licorice can cause potassium loss in people taking stimulant laxatives.
  6. MAO inhibitors: Licorice can make the effects of MAO inhibitors stronger.
  7. Oral contraceptives: Licorice can increase the risk of high blood pressure and low potassium levels in women taking oral contraceptives.
  8. Warfarin (Coumadin): Licorice can decrease the levels of warfarin in the body, meaning it may not work as well.
  9. Medications processed by the liver: Licorice can interfere with the metabolism of certain medications by the liver.

Precautions when using licorice product or extract.

Licorice side effects should be taken seriously especially if you are on certain medication. It also should not be consumed in large amounts. Recently, findings suggest not to use any licorice extract or product without consulting health experts and shouldn’t use it for more than 6 weeks in a row. Here are precautions to take when using licorice products or extracts.

  • Licorice should not be taken by children.
  • Don’t use licorice products without instructions from health experts.
  • Always stick to the instructions given
  • Don’t use licorice extract longer than 2 weeks without consulting with your doctor

Final thought

Licorice extract can affect cortisol levels in some people, although the effects of licorice on testosterone levels are less well-understood, the possibility is not insignificant. If you are considering taking licorice, it is important to talk to your doctor first.

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