Licorice Stick and High Blood Pressure: Benefits, Risks, and Contraindications

Licorice sticks can cause severe high blood pressure in some people, especially those already predisposed. This increase in blood pressure is the most documented and dangerous side effect of regular licorice consumption.

Mechanism of Blood Pressure Elevation

Action of Glycyrrhizin

Glycyrrhizin mimics the action of aldosterone, a hormone that regulates blood pressure. It causes excessive sodium retention in the kidneys, increased potassium excretion (hypokalemia), an increase in circulating blood volume, and a mechanical elevation of blood pressure.

Enzymatic Inhibition

Licorice blocks the enzyme 11β-hydroxysteroid dehydrogenase, allowing cortisol to abnormally activate mineralocorticoid receptors. This activation leads to a cascade of reactions resulting in hypertension.

High-Risk Populations

Known Hypertensives

People who already have high blood pressure risk a sudden decompensation of their hypertension, resistance to antihypertensive treatments, hypertensive crises requiring hospitalization, and accelerated cardiovascular complications.

Associated Risk Factors

Age over 50 increases renal sensitivity. Kidney failure reduces the elimination of active compounds. Diabetes weakens the pre-existing vascular system. Obesity constitutes an unfavorable cardiovascular ground. Family history reveals a genetic predisposition.

Dangerous Dosages

Identified Critical Thresholds

Studies show blood pressure elevations starting from 50mg of glycyrrhizin per day (1-2 sticks depending on concentration). Daily consumption for 2 consecutive weeks is sufficient. Significant one-off doses (>200mg at once) also present risks.

Individual Variability

Sensitivity varies enormously depending on individual hepatic metabolism, baseline renal function, mineralocorticoid receptor genetics, and associated medications.

Hypertensive Warning Symptoms

Early Signs

Persistent headaches, particularly occipital, are the first signal. New tinnitus (ringing in the ears), unusual fatigue linked to hypokalemia, and ankle edema due to water and sodium retention complete the picture.

Signs of Severity

Shortness of breath on exertion reveals early heart failure. Chest pain suggests possible coronary involvement. Visual disturbances indicate hypertensive retinopathy. Mental confusion signifies hypertensive encephalopathy.

Critical Drug Interactions

Antihypertensives

Licorice antagonizes the effect of many medications. ACE inhibitors and ARBs see their efficacy reduced by sodium retention. Diuretics lose their efficacy with increased hypokalemia. Beta-blockers experience a decreased antihypertensive effect. Calcium channel blockers see their action partially neutralized.

Digitalis

Induced hypokalemia potentiates the toxicity of digoxin, risking severe cardiac arrhythmias.

Course of Action in Case of Hypertension

Immediate Measures

Stop all licorice consumption immediately. Monitor blood pressure with repeated measurements over several days. Consult a doctor promptly if blood pressure exceeds 160/90 mmHg. Perform a biological workup: electrolyte panel, kidney function.

Gradual Normalization

Blood pressure generally normalizes in 1-2 weeks for moderate elevations, 3-4 weeks for severe hypertension, sometimes several months if consumption was very prolonged.

Prevention and Monitoring

Preventive Screening

Before regularly consuming licorice, have a baseline blood pressure measurement taken by your doctor, a simple renal workup (creatinine, electrolyte panel), and an evaluation of cardiovascular risk factors.

Monitoring During Use

In case of regular use, perform weekly self-monitoring of blood pressure, remain attentive to the described warning symptoms, and consult preventively every month if you have a risk factor.

Alternatives for Hypertensives

Safe Natural Substitutes

Linden offers soothing properties without affecting blood pressure. Hawthorn is cardioprotective and slightly hypotensive. Passionflower relaxes and is compatible with hypertension. Lemon balm aids digestion without cardiovascular impact.

Caution with Other Plants

Some plants can also raise blood pressure. Ginseng requires monitoring. Ma huang (ephedra) is strictly contraindicated. Yohimbe should be absolutely avoided.

Special Cases

White Coat Hypertension

Even in these patients, licorice can trigger permanent hypertension by sensitizing baroreceptors.

Pregnancy and Hypertension

Double contraindication: maternal AND fetal risk, with possible development of pre-eclampsia.

Conclusion

Licorice stick is formally contraindicated in hypertensives and requires blood pressure monitoring in all regular users. Caution is especially necessary after 50 years of age or in the presence of cardiovascular risk factors.

Discover all the possible side effects of licorice and consult our guide to its general benefits to understand when this plant remains beneficial.