Licorice stick side effects: a comprehensive guide to the risks

The side effects of licorice root can be significant with excessive or prolonged consumption. Although natural, this root poses real risks that should be understood for safe use.

Hypertension, the main danger

Cardiovascular risk is the most common and dangerous adverse effect of licorice. Glycyrrhizin causes a rise in blood pressure after just two weeks of daily use by mimicking the action of aldosterone, a hormone that regulates blood pressure.

This artificial hypertension can quickly become severe, resistant to usual antihypertensive treatments. People who already have hypertension risk sudden decompensation, sometimes requiring hospitalization. Serious complications include strokes, myocardial infarction, and acute heart failure.

Dangerous electrolyte imbalances

Licorice deeply disrupts the body's mineral balance. It causes severe hypokalemia (potassium deficiency) associated with excessive sodium retention. This imbalance, called artificial Conn's syndrome, leads to a cascade of complications.

Low potassium manifests as progressive muscle weakness, painful cramps, and extreme fatigue. In severe cases, it can cause flaccid paralysis of the limbs and potentially fatal heart rhythm disorders. Hypokalemia also increases the risk of ventricular arrhythmias, which are particularly dangerous in people with heart conditions.

Water retention and kidney complications

Sodium accumulation leads to significant fluid retention. Patients observe rapid weight gain of 2 to 3 kilograms in a few days, accompanied by edema of the ankles, face, and eyelids. This fluid overload can cause shortness of breath during exertion and a persistent feeling of heavy legs.

Prolonged use can impair kidney function itself. A decrease in glomerular filtration rate is sometimes accompanied by proteinuria and can progress to functional renal failure, which is fortunately usually reversible upon discontinuation.

Multiple hormonal disturbances

Licorice interferes with cortisol metabolism by inhibiting the enzyme 11β-HSD2. This inhibition increases the concentration of active cortisol, creating a mild Cushingoid syndrome with redistribution of body fat and insulin resistance.

Effects on fertility affect both sexes. In women, licorice can disrupt the menstrual cycle and decrease libido. In men, it causes a decrease in testosterone, a reduction in sperm production, and sometimes gynecomastia.

Concerning neurological manifestations

Severe hypokalemia dramatically affects the nervous system. Patients develop neuromuscular disorders with paresthesias, nocturnal cramps, and abnormal fatigability. Extreme cases can present with flaccid paralysis requiring urgent hospital care.

At the central level, toxicity manifests as mental confusion, particularly in elderly individuals, memory problems, and persistent headaches. These neurological symptoms generally regress completely after correction of electrolyte disturbances.

Toxicity thresholds and at-risk populations

Adverse effects appear from 100mg of glycyrrhizin per day, equivalent to 2 to 3 sticks depending on their concentration. Toxicity becomes moderate at 200mg daily for two weeks, and severe beyond 400mg per day or in cases of chronic use.

Certain populations have increased vulnerability. People over 65 metabolize glycyrrhizin more slowly. Patients with renal insufficiency poorly eliminate active compounds. Patients on diuretics risk potentiated hypokalemia, while a low-potassium diet creates a favorable environment for complications.

Critical drug interactions

Licorice interacts dangerously with several drug classes. The combination with thiazide diuretics causes major hypokalemia. In patients taking digitalis, the drop in potassium considerably increases the cardiac toxicity of these medications.

Laxatives create a particularly perilous cumulative electrolyte loss. The combination with corticosteroids adds mineralocorticoid effects. Other medications require increased monitoring without being formally contraindicated.

Course of action and recovery

In the event of adverse effects, complete and immediate cessation of licorice is the first measure. Rapid medical consultation is necessary in cases of severe symptoms, with a biological workup including ionogram and renal function.

Treatment aims to correct imbalances: oral or intravenous potassium supplementation depending on severity, adapted temporary antihypertensives, diuretics under medical supervision for edema. Cardiac arrhythmias require urgent cardiological management.

Fortunately, most side effects are fully reversible. Blood pressure normalization occurs in 2 to 4 weeks, electrolyte correction in 1 to 2 weeks. Renal recovery is generally complete, and sequelae remain exceptional if management is initiated early.

Conclusion

The side effects of licorice root warrant cautious and informed use. Adhering to recommended dosages and paying attention to warning signs allows one to enjoy its benefits without risking one's health.

Consult our guides on the benefits of licorice and specific precautions for optimal and safe use.