Licorice Root Extract: Side Effects, Interactions, and Safety Precautions

Licorice root has been used for centuries as a natural remedy in traditional medicine, but its potent active compounds, particularly glycyrrhizin, bring both health benefits and risks. Understanding the possible side effects, interactions, and who should avoid licorice root extract is critical for safe and informed use. This comprehensive guide explores the side effects—ranging from common to life-threatening—potential drug interactions, and essential safety precautions.

What Is Licorice Root Extract?

Licorice root extract is derived from the root of the Glycyrrhiza glabra plant and contains a sweet-tasting compound called glycyrrhizin. While licorice is frequently used to flavor candies, herbal teas, and supplements, it is important to distinguish between regular licorice extract and deglycyrrhizinated licorice (DGL), which is processed to remove glycyrrhizin and reduce the risk of certain side effects.

Common Side Effects of Licorice Root Extract

Licorice root is recognized as “generally safe” in foods by authorities like the FDA, but higher intake from supplements or chronic use can lead to a variety of adverse effects. The most prevalent side effects are usually caused by the glycyrrhizin component, which mimics the hormone aldosterone in your body and affects fluid and electrolyte balance.

• High Blood Pressure (Hypertension): Glycyrrhizin can cause sodium retention and potassium loss, resulting in elevated blood pressure.
• Edema (Fluid Retention): This often appears as swelling in the legs, ankles, or other extremities.
• Low Potassium (Hypokalemia): Potassium depletion can lead to muscle weakness, cramping, and abnormal heart rhythms.
• Headache and Lethargy: These nonspecific symptoms are associated with changes in blood pressure and electrolyte levels.

Other Frequently Reported Symptoms

• Mild digestive discomfort, including nausea and bloating
• Tiredness or a general sense of fatigue
• Loss of appetite

Serious and Rare Side Effects

Apart from more common complaints, excessive or prolonged consumption of licorice root extract can result in rare and possibly life-threatening complications:

• Cardiac Arrhythmias & Cardiac Arrest: Due to severe hypokalemia and electrolyte disturbances, the risk of abnormal or fatal heart rhythms increases.
• Pulmonary Edema: Fluid accumulation in the lungs can occur in severe cases of water retention.
• Congestive Heart Failure: Sustained sodium retention may lead to worsening heart function, especially in those with pre-existing heart disease.
• Embolic Ischemia: Rare instances have been documented where licorice toxicity led to blood clots.
• Stroke & Intracranial Hemorrhage: Cases have linked excessive licorice use with neurological events due to imbalanced blood pressure and electrolytes.
• Rhabdomyolysis: Extreme muscle breakdown, sometimes necessitating emergency care.
• Carpal Tunnel Syndrome: Water retention associated with licorice overuse has been linked to nerve compression syndromes.
• Metabolic Alkalosis: A dangerous shift in blood pH due to potassium loss.
• Kidney Failure & Acute Tubular Necrosis: The combination of hypokalemia and muscle breakdown can stress or damage the kidneys.

Note: These rare outcomes usually affect individuals taking high doses or using licorice-containing products for an extended period.

Health Conditions That Increase Risk

Certain individuals are at higher risk for complications from licorice root extract. Do not use licorice root extract without medical supervision if you have:

• Hypertension (high blood pressure)
• Heart disease, heart rhythm abnormalities, or cardiac insufficiency
• Chronic kidney disease or severe kidney problems
• Liver disease, including cirrhosis and hepatitis
• Low potassium levels (hypokalemia) or a history of electrolyte disturbances
• Endocrine disorders, such as aldosteronism and untreated hypothyroidism
• A tumor in the adrenal gland (pheochromocytoma)

Pregnant and breastfeeding women, as well as those who consume excessive alcohol or are fasting, should avoid the use of licorice root extract.

Drug Interactions With Licorice Root Extract

Licorice root can interact with numerous medications, posing additional health risks. Notable interactions include:

• Blood Pressure Medications: Licorice can raise blood pressure, possibly reducing the effectiveness of antihypertensive drugs.
• Diuretics (Water Pills): Using licorice with diuretics, especially thiazides, increases the risk of potassium loss, which may lead to severe hypokalemia.
• Blood Thinners (e.g., Warfarin): Licorice may increase the metabolism of warfarin, potentially reducing its efficacy or causing fluctuations in blood clotting.
  • There have been case reports of warfarin potentiation due to effects on liver enzymes.
• Corticosteroids: Licorice compounds can prolong or intensify the effects of cortisone medications.
• Digoxin: Licorice-induced hypokalemia increases sensitivity to digoxin, heightening toxicity risk.
• Estrogen-Based Contraceptives: May interact through effects on hormones and liver metabolism.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Risk of enhanced adverse effects.
• Cytochrome P450 Interactions: Licorice root extract can inhibit P450 enzymes (especially CYP3A4), affecting the metabolism of multiple medications.
• Other: Possible interactions with insulin and cyclosporine.

Allergic and Hypersensitivity Reactions

• Allergic Contact Dermatitis: Skin reactions have occurred after topical or oral exposure.
• Occupational Asthma: In rare cases, exposure to powdered licorice root has induced asthma-like symptoms in workers.

Summary Table: Reported Complications of Licorice Root Extract

Who Should Avoid Licorice Root Extract?

The following groups should avoid licorice root extract unless supervised by a healthcare provider:

• Individuals with high blood pressure
• People with heart disease, kidney disease, or liver disease
• Those suffering from hypokalemia or at risk of electrolyte imbalances
• People with adrenal gland disorders (such as aldosteronism)
• Pregnant or breastfeeding women
• Heavy alcohol consumers or those fasting
• Anyone taking drugs that interact adversely with licorice root (see section above)

Precautions When Consuming Licorice Root Extract

• Consult Your Doctor: Always talk to a healthcare professional before using licorice root extract, especially if you have underlying health conditions or are on medication.
• Limit Duration and Dosage: Avoid high doses and prolonged use. Even foods containing real licorice (such as black licorice candy) can pose risks when eaten excessively.
• Monitor for Early Symptoms: Watch for signs such as swelling, muscle weakness, headaches, or changes in blood pressure.
• Consider DGL as an Alternative: Deglycyrrhizinated licorice may offer some benefits with fewer side effects, but seek medical guidance before use.
• Inform Your Healthcare Provider: Share with your doctor if you are ingesting licorice root in any form, particularly before surgery or if you are pregnant.
• Do Not Use While Fasting: Licorice use during fasting states may amplify electrolyte imbalances and adverse effects.

Potential Benefits and Safe Uses (Brief Overview)

While this article focuses on the risks, it is important to note that licorice root extract does have some traditional uses, including digestive aid and soothing sore throats. However, benefits must be weighed against potential side effects, especially for those in high-risk groups or taking it long-term.

Frequently Asked Questions (FAQs)

Q: What is the active compound in licorice root that causes most side effects?

A: Glycyrrhizin is the primary compound responsible for many of licorice root extract’s serious side effects, such as hypertension and hypokalemia.

Q: Can I take licorice root extract if I have high blood pressure?

A: No. Licorice root extract can significantly increase blood pressure and is not recommended for those with hypertension.

Q: Is licorice root extract safe during pregnancy?

A: Pregnant women should avoid licorice root extract; heavy intake has been linked to preterm labor and developmental risks.

Q: What are signs of licorice overdose?

A: Symptoms may include swelling (edema), high blood pressure, headache, muscle weakness, lethargy, irregular heartbeats, and even cardiac arrest in severe cases.

Q: Can licorice root extract interact with medications?

A: Yes, it can interact with antihypertensives, diuretics, blood thinners (like warfarin), corticosteroids, digoxin, and several other drug classes.

Takeaway

Licorice root extract offers some traditional therapeutic benefits but can cause a wide range of serious side effects and dangerous drug interactions. It is especially risky for those with underlying health conditions or who are pregnant. Always use licorice root extract cautiously and only under medical supervision, preferably in low doses and for brief periods. Choose deglycyrrhizinated licorice (DGL) as a safer alternative when appropriate.

Author

Sneha TeteBeauty & Lifestyle Writer

 

Sneha is a relationships and lifestyle writer with a strong foundation in applied linguistics and certified training in relationship coaching. She brings over five years of writing experience to thebridalbox, crafting thoughtful, research-driven content that empowers readers to build healthier relationships, boost emotional well-being, and embrace holistic living.

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