Can Black Licorice Trigger Loss of life? Poisoning, Dosage, and Extra

There’s really no in between when it comes to liking black liquorice – either you love it or you hate it.

If you enjoy eating black licorice, you may become saddened by the rumors that people are dying from too much black licorice. Is this peppery, controversial candy deadly at high doses?

This article reveals whether high doses of black licorice can be lethal, along with information about healthy servings, necessary precautions, and tasty alternatives to black licorice.

Reports of people dying from too much black liquorice are rare, but they do exist.

Several case reports show that daily consumption of black licorice leads to a condition called pseudohyperaldosteronism, which if left untreated can be fatal.

The most recent report – published on September 23, 2020 – was about a 54-year-old man who was in a fast food restaurant when he suddenly lost consciousness (1).

Rescue workers arrived at the restaurant and found the man had ventricular fibrillation, a severe type of irregular heartbeat.

The man was hospitalized, but died 32 hours later of electrolyte imbalances and multiple organ failure.

The doctor concluded that the patient died of pseudohyperaldosteronism, a condition in which your body mimics the effects of increased aldosterone in high blood pressure. This suggests that excessive intake of black liquorice caused ventricular fibrillation.

Pseudohyperaldosteronism is a condition characterized by high blood pressure, low blood potassium levels, an acid-base disorder in your body, and low levels of renin, an enzyme that regulates blood pressure (2).

A discussion with the man’s family revealed that 3 weeks ago he had switched from soft, fruit-flavored candy to black liquorice. He also ate 1-2 large packets a day.

In a previous case report in 2008, a similar incident was described in which a 55-year-old woman was admitted to a clinic with low potassium and high blood pressure. She was found to be unresponsive to antihypertensive drugs (3).

She said she ate 1-2 packs of black liquorice a day for 4 years after quitting smoking.

After another medical examination, the doctor diagnosed her with pseudohyperaldosteronism, which is due to excessive consumption of black licorice root.

She was instructed to cut licorice from her diet, eat a diet high in potassium, and take potassium supplements to treat her low potassium levels.

She followed the doctor’s instructions and a few months later her blood pressure was checked and her laboratory results – including potassium – were all normal.

summary

Several case reports have linked excessive daily consumption of black licorice to a condition called pseudohyperaldosteronism, which can be fatal.

Licorice contains a compound called glycyrrhizic acid. This acidity gives licorice sweets their sweetness.

Glycyrrhizic acid is said to be 50 times sweeter than sucrose or table sugar (3).

Your body converts glycyrrhizic acid to glycyrrhetinic acid, which is relatively harmless in small amounts (1).

But in large amounts, glycyrrhetinic acid and its digestive byproducts inhibit an enzyme that helps your body convert active cortisol into inactive cortisone (4).

This causes more cortisol to bind to its receptor and exert its effects in the body, leading to pseudohyperaldosteronism.

In most cases, eliminating licorice from your diet can correct pseudohyperaldosteronism within a few weeks or months. However, high blood pressure can sometimes persist due to other causes (4).

summary

Licorice contains glycyrrhizic acid, which your body converts to glycyrrhetinic acid. In large quantities, this acid inhibits an enzyme that can eventually lead to pseudohyperaldosteronism, a potentially fatal condition.

Licorice root has been used in traditional medicine for thousands of years to treat coughs, asthma, abdominal pain, insomnia, and infections (5).

In fact, licorice contains several beneficial botanicals that have anti-inflammatory, antioxidant, and antimicrobial properties (6).

However, despite its long – and presumably safe – history of use, scientific organizations have advised caution not to eat too much licorice, as it can raise blood pressure and cause electrolyte imbalances (7).

The World Health Organization (WHO) estimates that an intake of up to 100 mg glycyrrhizic acid per day is safe for the majority of adults (8).

This amount corresponds to about 60-70 grams of licorice.

Nevertheless, it is difficult to make a safe recommendation for the consumption of black licorice candy, as the glycyrrhizic acid content can vary by up to 30 times from product to product (3).

The Food and Drug Administration (FDA) suggests that consuming 57 grams of licorice per day for at least 2 weeks can cause an irregular heart rhythm that may require hospitalization by the time you’re 40 or older (9).

Remember that many herbal teas and supplements contain licorice root extract.

To be clear, red licorice – despite its name – does not contain licorice root extract, so it does not provide glycyrrhizin.

Products containing liquorice must be labeled. Manufacturers list licorice extract or glycyrrhizic acid in the list of ingredients.

summary

According to the WHO, up to 100 mg of glycyrrhizic acid per day, which corresponds to about 60-70 grams of licorice, is safe for the majority of adults.

If you have a condition that affects your heart or kidneys, you should be extra careful about how much black licorice you eat – and how often you consume it.

Licorice has a long half-life, which means it stays in your body long before you excrete it (10).

This allows glycyrrhetinic acid to build up in your body the more you eat licorice. This consistent build-up increases your risk of pseudohyperaldosteronism.

If you have a pre-existing condition that affects your heart or kidneys, pseudohyperaldosteronism can be fatal.

summary

If you already have heart or kidney disease, be extra careful with the amount and frequency of consuming licorice.

Black licorice and other sources of licorice contain glycyrrhetinic acid. In large quantities, this acid inhibits an enzyme that enables more active cortisol to bind to its receptor.

So too much licorice – or too often – can lead to high blood pressure, low potassium, and other signs of pseudohyperaldosteronism. This can be fatal, especially in people with pre-existing heart or kidney disease.

The WHO suggests that most healthy adults can safely eat up to 100 mg of glycyrrhizic acid per day, or around 60-70 grams of licorice.

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