Licorice Root

Source

A very potent Licorice Root with 26% glycyrrhizin is used at Mymmunity

Botanical Details

Family Fabaceae

Genus Glycyrrhiza L

Species Glycyrrhiza glabra L.

Immune support

In human research, consumption of a licorice herbal tincture stimulated immune cells, as quantified by CD69 expression on CD4 and CD8 T cells. In animal research, an herbal product containing licorice increased the number of leukocytes in the spleen and liver and increased splenic natural killer toxicity. However, in this study, the product did not affect the production of inflammatory cytokines or other agents. Furthermore, in laboratory research, the aglycone derivative of glycyrrhizin, beta-glycyrrhetinic acid, inhibited human complement activity.

Other uses

Eczema (atopic dermatitis). There is some evidence that applying licorice to the skin can improve symptoms of eczema. Applying a gel containing licorice three times daily for 2 weeks seems to reduce redness, swelling, and itching.

Side effects in people after breathing tube removal. Sucking on a licorice lozenge or gargling with a licorice fluid shortly before placement of a breathing tube seems to help prevent cough and sore throat from occurring when the tube is removed.

How it works

The chemicals contained in licorice are thought to decrease swelling, thin mucus secretions, decrease cough, and increase the chemicals in our body that heal ulcers.

Safety

When taken by mouth: Licorice is LIKELY SAFE for most people when taken by mouth in amounts found in foods. Licorice is POSSIBLY SAFE when taken by mouth in larger amounts for medicinal purposes for a short amount of time. However, it is POSSIBLY UNSAFE when taken by mouth in large amounts for more than 4 weeks or in smaller amounts long-term. Consuming licorice daily for several weeks or longer can cause severe side effects including life-threatening high blood pressure, low potassium levels, weakness, paralysis, and occasionally brain damage in otherwise healthy people. In people who eat a lot of salt or have heart disease, kidney disease, or high blood pressure, as little as 5 grams per day can cause these problems.

Other side effects of licorice use may include tiredness, absence of a menstrual period in women, headache, water and sodium retention, and decreased sexual interest and function in men.

People who chew tobacco flavored with licorice, drink licorice tea, or ingest large amounts of candy or lozenges that contain licorice might develop high blood pressure and other serious side effects.

When applied to the skin: Licorice is POSSIBLY SAFE when applied to the skin for a short amount of time. It may cause a rash in some people.

Special Precautions & Warnings:

Pregnancy and breast-feeding: It is UNSAFE to take licorice by mouth if you are pregnant. High consumption of licorice during pregnancy, about 250 grams of licorice per week, seems to increase the risk of early delivery. It might cause a miscarriage or early delivery. There isn't enough reliable information available about the safety of taking licorice when breast-feeding. Stay on the safe side and avoid use.

Heart disease: Licorice can cause the body to store water, and this can make congestive heart failure worse. Licorice can also increase the risk of irregular heartbeat. Don't consume licorice if you have heart disease.

Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Licorice might act like estrogen in the body. If you have any condition that might be made worse by exposure to estrogen, don't use licorice.

High blood pressure: Licorice can raise blood pressure. Don't consume large amounts of it if you have high blood pressure.

A muscle condition caused by nerve problems (hypertonia): Licorice can cause the level of potassium to drop in the blood. This can make hypertonia worse. Avoid licorice if you have hypertonia.

Low potassium levels in the blood (hypokalemia): Licorice can lower potassium in the blood. If your potassium is already low, licorice might make it too low. Don't use licorice if you have this condition.

Kidney disease: Overuse of licorice could make kidney disease worse. Don't use it.

Sexual problems in men: Licorice can lower a man's interest in sex and also worsen erectile dysfunction (ED) by lowering levels of a hormone called testosterone.

Surgery: Licorice might interfere with blood pressure control during and after surgery. Stop taking licorice at least 2 weeks before a scheduled surgery.

Interactions with medications

Cisplatin (Platinol-AQ)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Cisplatin (Platinol-AQ) is used to treat cancer. There is some concern that licorice might decrease how well cisplatin (Platinol-AQ) works for cancer.

Digoxin (Lanoxin)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Large amounts of licorice can decrease potassium levels in the body. Low potassium levels can increase the side effects of digoxin (Lanoxin).

Estrogens

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Licorice seems to change hormone levels in the body. Taking licorice along with estrogen pills might decrease the effects of estrogen pills.

Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.

Ethacrynic acid (Edecrin)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Licorice can cause the body to get rid of potassium. Ethacrynic acid (Edecrin) can also cause the body to get rid of potassium. Taking licorice and ethacrynic acid (Edecrin) together might cause potassium to become too low.

Furosemide (Lasix)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Licorice can cause the body to get rid of potassium. Furosemide (Lasix) can also cause the body to get rid of potassium. Taking licorice and furosemide together might cause the potassium levels in your body to go too low.

Medications changed by the liver (Cytochrome P450 2B6 (CYP2B6) substrates)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Some medications are changed and broken down by the liver. Licorice might decrease how quickly the liver breaks down some medications. This might increase the effects and side effects of these medications. Before taking licorice, talk to your healthcare provider if you take any medications that are changed by the liver.

Some of these medications changed by the liver include ketamine (Ketalar), phenobarbital, orphenadrine (Norflex), secobarbital (Seconal), dexamethasone (Decadron), and others.

Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Some medications are changed and broken down by the liver. Licorice might decrease how quickly the liver breaks down some medications. This might increase the effects and side effects of these medications. Before taking licorice, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.

Medications changed by the liver (Cytochrome P450 2C8 (CYP2C8) substrates)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Some medications are changed and broken down by the liver. Licorice might decrease how quickly the liver breaks down some medications. This might increase the effects and side effects of these medications. Before taking licorice, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include amiodarone (Cardarone), paclitaxel (Taxol); nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Cataflam, Voltaren) and ibuprofen (Motrin); rosiglitazone (Avandia); and others.

Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Some medications are changed and broken down by the liver. Licorice might change how quickly the liver breaks down some medications. This might increase or decrease the effects of these medications. Before taking licorice, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications changed by the liver include celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), and warfarin (Coumadin).

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Some medications are changed and broken down by the liver. Licorice might change how quickly the liver breaks down some medications. This might increase or decrease the effects of these medications. Before taking licorice, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.

Medications for high blood pressure (Antihypertensive drugs)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Large amounts of licorice seem to increase blood pressure. By increasing blood pressure, licorice might decrease the effectiveness of medications for high blood pressure.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.

Medications for inflammation (Corticosteroids)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Some medications for inflammation can decrease potassium in the body. Licorice might also decrease potassium in the body. Taking licorice along with some medications for inflammation might decrease potassium in the body too much.

Some medications for inflammation include dexamethasone (Decadron), hydrocortisone (Cortef), methylprednisolone (Medrol), prednisone (Deltasone), and others.

Midazolam (Versed)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Midazolam (Versed) is changed and broken down by the body. Licorice might increase how quickly this medication is broken down by the body. Licorice should be used cautiously if you are taking midazolam (Versed).

Paclitaxel (Abraxane, Onxol)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Paclitaxel is changed and broken down by the body. Licorice might increase how quickly the body breaks down paclitaxel. Taking licorice with paclitaxel might increase the breakdown and decrease the effectiveness of paclitaxel.

Warfarin (Coumadin)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Warfarin (Coumadin) is used to slow blood clotting. The body breaks down warfarin (Coumadin) to get rid of it. Licorice might increase the breakdown and decrease the effectiveness of warfarin (Coumadin). Decreasing the effectiveness of warfarin (Coumadin) might increase the risk of clotting. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Water pills (Diuretic drugs)

Interaction Rating = Moderate Be cautious with this combination.

Talk to your health provider.

Large amounts of licorice can decrease potassium levels in the body. "Water pills" can also decrease potassium in the body. Taking licorice along with "water pills" might decrease potassium in the body too much.

Some "water pills" that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDIURIL, Microzide), and others.


Interactions with Herbs, Supplements, and Foods

Grapefruit

Drinking grapefruit juice when taking licorice might increase licorice's ability to cause potassium depletion.

Herbs that contain cardiac glycosides

Using too much licorice can decrease potassium in the body. This can damage the heart. Using licorice with herbs that can damage the heart might make this effect worse. Herbs that might damage the heart include digitalis, lily-of-the-valley, pheasant's eye, and squill.

Stimulant laxative herbs

Using too much licorice can decrease potassium in the body. Herbs that have a stimulant laxative effect can also lower potassium in the body. Using licorice along with these herbs can increase the risk of lowering potassium levels too much. Stimulant laxative herbs include aloe vera, alder buckthorn, European buckthorn, cascara sagrada, castor oil, rhubarb, and senna.

Salt-containing foods

Licorice use can increase sodium and water retention and increase blood pressure. Also, eating a lot of salt can make the side effects of licorice even worse.


References

Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.

Tyler VE. Herbs of Choice. Binghamton, NY: Pharmaceutical Products Press, 1994.

Farese RV Jr, Biglieri EG, Shackleton CH, et al. Licorice-induced hypermineralocorticoidism. N Engl J Med 1991;325:1223-7.

Sigurjonsdottir HA, Ragnarsson J, Franzson L, Sigurdsson G. Is blood pressure commonly raised by moderate consumption of liquorice? J Hum Hypertens 1995;9:345-8.

Prudden JF. The treatment of human cancer with agents prepared from bovine cartilage. J Biol Response Mod 1985;4:551-84.

Armanini D, Bonanni G, Palermo M. Reduction of serum testosterone in men by licorice. N Engl J Med 1999;341:1158.

Abe Y, Ueda T, Kato T, Kohli Y. [Effectiveness of interferon, glycyrrhizin combination therapy in patients with chronic hepatitis C]. Nippon Rinsho 1994;52:1817-22.

Takahara T, Watanabe A, Shiraki K. Effects of glycyrrhizin on hepatitis B surface antigen: a biochemical and morphological study. J Hepatol 1994;21:601-9.

Sato H, Goto W, Yamamura J, et al. Therapeutic basis of glycyrrhizin on chronic hepatitis B. Antiviral Res 1996;30:171-7.

Acharya SK, Dasarathy S, Tandon A, et al. A preliminary open trial on interferon stimulator (SNMC) derived from Glycyrrhiza glabra in the treatment of subacute hepatic failure. Indian J Med Res 1993;98:69-74.

Zhang XH, Lowe D, Giles P, et al. Gender may affect the action of garlic oil on plasma cholesterol and glucose levels of normal subjects. J Nutr 2001;131:1471-8.

Armanini D, Lewicka S, Pratesi C, et al. Further studies on the mechanism of the mineralocorticoid action of licorice in humans. J Endocrinol Invest 1996;19:624-9.

Lee YS, Lorenzo BJ, Koufis T, et al. Grapefruit juice and its flavonoids inhibit 11 beta-hydroxysteroid dehydrogenase. Clin Pharmacol Ther 1996;59:62-71.

Zhang YD, Lorenzo B, Reidenberg MM. Inhibition of 11 beta hydroxysteroid dehydrogenase obtained from guinea pig kidney by furosemide, naringenin and some other compounds. J Steroid Biochem Mol Biol 1994;49:81-5.

Kase Y, Saitoh K, Ishige A, et al. Mechanisms by which Hange-shashin-to reduces prostaglandin E2 levels. Biol Pharm Bull 1998;21:1277-81.

Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182

Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.

Armanini D, De Palo CB, Mattarello MJ, et al. Effect of licorice on reduction of body fat mass in healthy subjects. J Endocrinol Invest 2003;26:646-50.

Pfeifer BL, Pirani JF, Hamann SR, Klippel KF. PC-SPES, a dietary supplement for the treatment of hormone-refractory prostate cancer. BJU Int 2000;85:481-5.

Holtmann G, Madisch A, Juergen H, et al. A double-blind, randomized, placebo-controlled trial on the effects of an herbal preparation in patients with functional dyspepsia [Abstract]. Ann Mtg Digestive Disease Week 1999 May.

Strandberg TE, Jarvenpaa AL, Vanhanen H, McKeigue PM. Birth outcome in relation to licorice consumption during pregnancy. Am J Epidemiol 2001;153:1085-8.

Sigurjonsdottir HA, Franzson L, Manhem K, et al. Liquorice-induced rise in blood pressure: a linear dose-response relationship. J Hum Hypertens 2001;15:549-52.

Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause 2002;9:145-50.

Cinatl J, Morgenstern B, Bauer G, et al. Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus. Lancet 2003;361:2045-6..

Kent UM, Aviram M, Rosenblat M, Hollenberg PF. The licorice root derived isoflavan glabridin inhibits the activities of human cytochrome P450S 3A4, 2B6, and 2C9. Drug Metab Dispos 2002;30:709-15..

Yoshida S, Takayama Y. Licorice-induced hypokalemia as a treatable cause of dropped head syndrome. Clin Neurol Neurosurg 2003;105:286-7..

Tamir S, Eizenberg M, Somjen D, et al. Estrogenic and antiproliferative properties of glabridin from licorice in human breast cancer cells. Cancer Res 2000;60:5704-9..

Strandberg TE, Andersson S, Jarvenpaa AL, et al. Preterm birth and licorice consumption during pregnancy. Am J Epidemiol 2002;156:803-5..

Hussain RM. The sweet cake that reaches parts other cakes can't! Postgrad Med J 2003;79:115-6..

van Marle J, Aarsen PN, Lind A, van Weeren-Kramer J. Deglycyrrhizinised liquorice (DGL) and the renewal of rat stomach epithelium. Eur J Pharmacol 1981;72:219-25..

Turpie AG, Runcie J, Thomson TJ. Clinical trial of deglydyrrhizinized liquorice in gastric ulcer. Gut 1969;10:299-302.

Tewari SN, Wilson AK. Deglycyrrhizinated liquorice in duodenal ulcer. Practitioner 1973;210:820-3.

Amaryan G, Astvatsatryan V, Gabrielyan E, et al. Double-blind, placebo-controlled, randomized, pilot clinical trial of ImmunoGuard--a standardized fixed combination of Andrographis paniculata Nees, with Eleutherococcus senticosus Maxim, Schizandra chinensis Bail. and Glycyrrhiza glabra L. extracts in patients with Familial Mediterranean Fever. Phytomedicine 2003;10:271-85.

Sheehan M, Rustin MHA, Atherton DJ, et al. Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis. Lancet 1992;340:13-17.

Sheehan MP, Atherton DJ. A controlled trial of traditional Chinese medicinal plants in widespread non-exudative atopic eczema. Br J Dermatol 1992;126:179-84.

Zhang W, Leonard T, Bath-Hextall F, et al. Chinese herbal medicine for atopic eczema. Cochrane Database Syst Rev 2004;4:CD002291.

Fung AY, Look PC, Chong LY, et al. A controlled trial of traditional Chinese herbal medicine in Chinese patients with recalcitrant atopic dermatitis. Int J Dermatol 1999;38:387-92 .

Morris DJ, Davis E, Latif SA. Licorice, tobacco chewing, and hypertension. N Engl J Med 1990;322:849-50.

Quinkler M, Stewart PM. Hypertension and the cortisol-cortisone shuttle. J Clin Endocrinol Metab 2003;88:2384-92.

Madisch A, Holtmann G, Mayr G, et al. Treatment of functional dyspepsia with a herbal preparation. A double-blind, randomized, placebo-controlled, multicenter trial. Digestion 2004;69:45-52.

Westman EC, Guthrie GP. Licorice, tobacco chewing, and hypertension. N Engl J Med 1990;322:850.

Armanini D, Bonanni G, Mattarello MJ, et al. Licorice consumption and serum testosterone in healthy man. Exp Clin Endocrinol Diabetes 2003;111:341-3.

Melzer J, Rosch W, Reichling J, et al. Meta-analysis: phytotherapy of functional dyspepsia with the herbal drug preparation STW 5 (Iberogast). Aliment Pharmacol Ther 2004;20:1279-87.

Kumada T, et al. Effect of Shakuyaku-kanzo-to (Tsumura TJ-68) on muscle cramps accompanying cirrhosis in a placebo-controlled double-blind parallel study. J Clin Ther Med 1999;15:499-523.

Hyodo T, Taira T, Kumakura M, et al. The immediate effect of Shakuyaku-kanzo-to, traditional Japanese herbal medicine, for muscular cramps during maintenance hemodialysis. Nephron 2002;90:240.

Hinoshita F, Ogura Y, Suzuki Y, et al. Effect of orally administered shao-yao-gan-cao-tang (Shakuyaku-kanzo-to) on muscle cramps in maintenance hemodialysis patients: a preliminary study. Am J Chin Med 2003;31:445-53. .

Mu Y, Zhang J, Zhang S, et al. Traditional Chinese medicines Wu Wei Zi (Schisandra chinensis Baill) and Gan Cao (Glycyrrhiza uralensis Fisch) activate pregnane X receptor and increase warfarin clearance in rats. J Pharmacol Exp Ther 2006;316:1369-77.

Yasue H, Itoh T, Mizuno Y, Harada E. Severe hypokalemia, rhabdomyolysis, muscle paralysis, and respiratory impairment in a hypertensive patient taking herbal medicines containing licorice. Intern Med 2007;46:575-8.

Brayley J, Jones J. Life-threatening hypokalemia associated with excessive licorice ingestion (letter). Am J Psychiatry 1994;151:617-8.

de Klerk GJ, Nieuwenhuis G, Beutler JJ. Hypokalaemia and hypertension associated with use of liquorice flavoured chewing gum. BMJ 1997;314:731-2.

Dellow EL, Unwin RJ, Honour JW. Pontefract cakes can be bad for you: refractory hypertension and liquorice excess. Nephol Dial Transplant 1999;14:218-20.

Elinav E, Chajek-Shaul T. Licorice consumption causing severe hypokalemic paralysis. Mayo Clin Proc 2003;78:767-8.

Eriksson JW, Carlberg B, Hillom V. Life-threatening ventricular tachycardia due to liquorice-induced hypokalemia. J Intern Med 1999;245:307-10.

Janse A, van Iersel M, Hoefnagels WH, Olde Rikker MG. The old lady who liked liquorice: hypertension due to chronic intoxication in a memory-impaired patient. Neth J Med 2005;63:149-50.

Lin SH, Yang SS, Chau T, Halperin ML. An unusual cause of hypokalemic paralysis: chronic licorice ingestion. Am J Med Sci 2003;325:153-6.

van den Bosch AE, van der Klooster JM, Zuidgeest DM, et al. Severe hypokalemic paralysis and rhabdomyolysis due to ingestion of liquorice. Neth J Med 2005;63:146-8.

van Uum SH. Liquorice and hypertension. Neth J Med 2005;63:119-20.

Russo S, Mastropasqua M, Mosetti MA, et al. Low doses of liquorice can induce hypertension encephalopathy. Am J Nephrol 2000;20:145-8.

Stormer FC, Reistad R, Alexander J. Glycyrrhizic acid in liquorice - evaluation of health hazard. Food Chem Toxicol 1993;31:303-12.

Sontia B, Mooney J, Gaudet L, Touyz RM. Pseudohyperaldosteronism, liquorice, and hypertension. J Clin Hypertens (Greenwich) 2008;10:153-7.

Francini-Pesenti F, Puato M, Piccoli A, Brocadello F. Liquorice-induced hypokalaemia and water retention in the absence of hypertension. Phytother Res 2008;22:563-5.

Lapi F, Gallo E, Bernasconi S, et al. Myopathies associated with red yeast rice and liquorice: spontaneous reports from the Italian Surveillance System of Natural Health Products. Br J Clin Pharmacol 2008;66:572-4.

Bell ZW, Canale RE, Bloomer RJ. A dual investigation of the effect of dietary supplementation with licorice flavonoid oil on anthropometric and biochemical markers or health and adiposity. Lipids Health Dis 2011;10:29.

Madisch A, Melderis H, Mayr G, et al. [A plant extract and its modified preparation in functional dyspepsia. Results of a double-blind placebo controlled comparative study]. Z Gastroenterol 2001;39(7):511-7.

Chen MF, Shimada F, Kato H, Yano S, Kanaoka M. Effect of glycyrrhizin on the pharmacokinetics of prednisolone following low dosage of prednisolone hemisuccinate. Endocrinol Jpn 1990;37:331-41.

Teelucksingh S, Mackie AD, Burt D, McIntyre MA, Brett L, Edwards CR. Potentiation of hydrocortisone activity in skin by glycyrrhetinic acid. Lancet 1990;335(8697):1060-3.

Heidemann HT, Kreuzfelder E. Hypokalemic rhabdomyolysis with myoglobinuria due to licorice ingestion and diuretic treatment. Klin Wochenschr 1983;61:303-5.

Hukkanen J, Ukkola O, Savolainen MJ. Effects of low-dose liquorice alone or in combination with hydrochlorothiazide on the plasma potassium in healthy volunteers. Blood Press 2009;18:192-5.

Kraus SD, Kaminskis A. The anti-estrogenic action of beta-glycyrrhetinic acid. Exp Med Surg 1969;27:411-20.

Bisogni V, Rossi GP, Calò LA. Apparent mineralcorticoid excess syndrome, an often forgotten or unrecognized cause of hypokalemia and hypertension: case report and appraisal of the pathophysiology. Blood Press. 2014 Jun;23(3):189-92.

Dehours E, Vallé B, Rougé-Bugat ME, Florent B, Bounes V, Franchitto N. Suspected hypokalaemia following liquorice ingestion on board ship. J Telemed Telecare. 2013 Jun;19(4):227-8.

Gupta D, Agrawal S, Sharma JP. Effect of preoperative licorice lozenges on incidence of postextubation cough and sore throat in smokers undergoing general anesthesia and endotracheal intubation. Middle East J Anaesthesiol. 2013 Jun;22(2):173-8.

Kormann R, Languille E, Amiot HM, Hertig A. Dying for a cup of tea. BMJ Case Rep. 2012 Oct 19;2012.

Menati L, Khaleghinezhad K, Tadayon M, Siahpoosh A. Evaluation of contextual and demographic factors on licorice effects on reducing hot flashes in postmenopause women. Health Care Women Int. 2014 Jan;35(1):87-99.

Panduranga P, Al-Rawahi N. Licorice-induced severe hypokalemia with recurrent torsade de pointes. Ann Noninvasive Electrocardiol. 2013 Nov;18(6):593-6.

Räikkönen K, Seckl JR, Heinonen K, Pyhälä R, Feldt K, Jones A, Pesonen AK, Phillips DI, Lahti J, Järvenpää AL, Eriksson JG, Matthews KA, Strandberg TE, Kajantie E. Maternal prenatal licorice consumption alters hypothalamic-pituitary-adrenocortical axis function in children. Psychoneuroendocrinology. 2010 Nov;35(10):1587-93.

Robles BJ, Sandoval AR, Dardon JD, Blas CA. Lethal liquorice lollies (liquorice abuse causing pseudohyperaldosteronism). BMJ Case Rep. 2013 Sep 19;2013.

Ruetzler K, Fleck M, Nabecker S, Pinter K, Landskron G, Lassnigg A, You J, Sessler DI. A randomized, double-blind comparison of licorice versus sugar-water gargle for prevention of postoperative sore throat and postextubation coughing. Anesth Analg. 2013 Sep;117(3):614-21.

Baykul, T., Alanoglu, E. G., and Kocer, G. Use of Ankaferd Blood Stopper as a hemostatic agent: a clinical experience. J Contemp Dent Pract 2010;11(1):E088-E094.

Purnak, T., Ozaslan, E., Beyazit, Y., and Haznedaroglu, I. C. Upper gastrointestinal bleeding in a patient with defective hemostasis successfully treated with ankaferd blood stopper. Phytother.Res. 2011;25(2):312-313.

Eyi, E. G., Engin-Ustun, Y., Kaba, M., and Mollamahmutoglu, L. Ankaferd blood stopper in episiotomy repair. Clin Exp Obstet Gynecol 2013;40(1):141-143.

Chamberlain, J. J. and Abolnik, I. Z. Pulmonary edema following a licorice binge. West J Med 1997;167(3):184-185.

Barrella, M., Lauria, G., Quatrale, R., and Paolino, E. Hypokaliemic rhabdomyolysis associated with liquorice ingestion: report of an atypical case. Ital.J Neurol.Sci 1997;18(4):217-220.

Cataldo, F., Di Stefano, P., Violante, M., Traverso, G., and Mule, M. [Pseudohyperaldosteronism secondary to licorice poisoning associated with hemorrhagic gastritis]. Pediatr Med Chir 1997;19(3):219-221.

Brush, J., Mendenhall, E., Guggenheim, A., Chan, T., Connelly, E., Soumyanath, A., Buresh, R., Barrett, R., and Zwickey, H. The effect of Echinacea purpurea, Astragalus membranaceus and Glycyrrhiza glabra on CD69 expression and immune cell activation in humans. Phytother Res 2006;20(8):687-695.

Chien, C. F., Wu, Y. T., and Tsai, T. H. Biological analysis of herbal medicines used for the treatment of liver diseases. Biomed.Chromatogr. 2011;25(1-2):21-38.

Hawrelak, J. A. and Myers, S. P. Effects of two natural medicine formulations on irritable bowel syndrome symptoms: a pilot study. J Altern Complement Med 2010;16(10):1065-1071.

Xu, L., Jiang, J., and Du, F. Z. [Application of dannang recipe no. 2 in the perioperative stage of laparoscopic cholecystectomy]. Zhongguo Zhong.Xi.Yi Jie.He.Za Zhi 2008;28(12):1090-1092.

Reuter, J., Merfort, I., and Schempp, C. M. Botanicals in dermatology: an evidence-based review. Am J Clin Dermatol 2010;11(4):247-267.

Liang, R. N., Liu, J., and Lu, J. [Treatment of refractory polycystic ovary syndrome by bushen huoxue method combined with ultrasound-guided follicle aspiration]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2008;28(4):314-317.

Fugh-Berman, A. Herb-drug interactions. Lancet 2000;355(9198):134-138.

Hasani-Ranjbar, S., Nayebi, N., Moradi, L., Mehri, A., Larijani, B., and Abdollahi, M. The efficacy and safety of herbal medicines used in the treatment of hyperlipidemia; a systematic review. Curr.Pharm.Des 2010;16(26):2935-2947.

Goto, F., Asama, Y., and Ogawa, K. Sho-saiko-to-ka-kikyo-sekko as an alternative treatment for chronic tonsillitis to avoid surgery. Complement Ther Clin Pract. 2010;16(4):216-218.

Luper, S. A review of plants used in the treatment of liver disease: part two. Altern Med Rev 1999;4(3):178-188.

Hasegawa, J., Suyama, Y., Kinugawa, T., Morisawa, T., and Kishimoto, Y. Echocardiographic findings of the heart resembling dilated cardiomyopathy during hypokalemic myopathy due to licorice-induced pseudoaldosteronism. Cardiovasc.Drugs Ther 1998;12(6):599-600.

Hossain, M. S., Takimoto, H., Hamano, S., Yoshida, H., Ninomiya, T., Minamishima, Y., Kimura, G., and Nomoto, K. Protective effects of hochu-ekki-to, a Chinese traditional herbal medicine against murine cytomegalovirus infection. Immunopharmacology 1999;41(3):169-181.

van Rossum, T. G., Vulto, A. G., Hop, W. C., Brouwer, J. T., Niesters, H. G., and Schalm, S. W. Intravenous glycyrrhizin for the treatment of chronic hepatitis C: a double-blind, randomized, placebo-controlled phase I/II trial. J Gastroenterol Hepatol 1999;14(11):1093-1099.

van Rossum, T. G., Vulto, A. G., Hop, W. C., and Schalm, S. W. Pharmacokinetics of intravenous glycyrrhizin after single and multiple doses in patients with chronic hepatitis C infection. Clin Ther 1999;21(12):2080-2090.

Dobbins, K. R. and Saul, R. F. Transient visual loss after licorice ingestion. J Neuroophthalmol. 2000;20(1):38-41.

Doeker, B. M. and Andler, W. Liquorice, growth retardation and Addison's disease. Horm.Res 1999;52(5):253-255.

Lozano, P., Flores, D., Martinez, S., Artigues, I., Rimbau, E. M., and Gomez, F. Upper limb ischemia induced by chronic licorice ingestion. J Cardiovasc.Surg (Torino) 2000;41(4):631-632.

van Gelderen, C. E., Bijlsma, J. A., van Dokkum, W., and Savelkoul, T. J. Glycyrrhizic acid: the assessment of a no effect level. Hum.Exp Toxicol. 2000;19(8):434-439.

van Rossum, T. G., Vulto, A. G., Hop, W. C., and Schalm, S. W. Glycyrrhizin-induced reduction of ALT in European patients with chronic hepatitis C. Am J Gastroenterol 2001;96(8):2432-2437.

Serra, A., Uehlinger, D. E., Ferrari, P., Dick, B., Frey, B. M., Frey, F. J., and Vogt, B. Glycyrrhetinic Acid decreases plasma potassium concentrations in patients with anuria. J Am Soc Nephrol 2002;13(1):191-196.

Zhou, Y., Huang, Z., and Huang, T. [Clinical study of shengxue mixture in treating aplastic anemia]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 2000;20(3):173-175.

Fuhrman, B., Volkova, N., Kaplan, M., Presser, D., Attias, J., Hayek, T., and Aviram, M. Antiatherosclerotic effects of licorice extract supplementation on hypercholesterolemic patients: increased resistance of LDL to atherogenic modifications, reduced plasma lipid levels, and decreased systolic blood pressure. Nutrition 2002;18(3):268-273.

Sigurjonsdottir, H. A., Manhem, K., Axelson, M., and Wallerstedt, S. Subjects with essential hypertension are more sensitive to the inhibition of 11 beta-HSD by liquorice. J Hum Hypertens 2003;17(2):125-131.

Luo, Y. G., Liu, Y. Q., and Hu, J. [Clinical study on effect of recombinant roasted licorice decoction combined with low-dose glucocorticoids in treating idiopathic thrombocytopenic purpura]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 2001;21(7):501-503.

Lin, J. C. Mechanism of action of glycyrrhizic acid in inhibition of Epstein-Barr virus replication in vitro. Antiviral Res 2003;59(1):41-47.

Caradonna, P., Gentiloni, N., Servidei, S., Perrone, G. A., Greco, A. V., and Russo, M. A. Acute myopathy associated with chronic licorice ingestion: reversible loss of myoadenylate deaminase activity. Ultrastruct Pathol 1992;16(5):529-535.

Saeedi, M., Morteza-Semnani, K., and Ghoreishi, M. R. The treatment of atopic dermatitis with licorice gel. J Dermatolog Treat 2003;14(3):153-157.

Roussak NJ. Fatal hypokalaemic alkalosis with tetany during liquorice and P.A.S. therapy. Brit Med J 1952;1:360-361.

Eisenburg, J. [Treatment of chronic hepatitis B. Part 2: Effect of glycyrrhizic acid on the course of illness]. Fortschr.Med 7-30-1992;110(21):395-398.

Armanini, D., Mattarello, M. J., Fiore, C., Bonanni, G., Scaroni, C., Sartorato, P., and Palermo, M. Licorice reduces serum testosterone in healthy women. Steroids 2004;69(11-12):763-766.

Shintani, S., Murase, H., Tsukagoshi, H., and Shiigai, T. Glycyrrhizin (licorice)-induced hypokalemic myopathy. Report of 2 cases and review of the literature. Eur Neurol 1992;32(1):44-51.

Armanini, D., Nacamulli, D., Francini-Pesenti, F., Battagin, G., Ragazzi, E., and Fiore, C. Glycyrrhetinic acid, the active principle of licorice, can reduce the thickness of subcutaneous thigh fat through topical application. Steroids 2005;70(8):538-542.

Ai, M., Yamaguchi, T., Odaka, T., Mitsuhashi, K., Shishido, T., Yan, J., Seza, A., and Saisho, H. Objective assessment of the antispasmodic effect of shakuyaku-kanzo-to (TJ-68), a Chinese herbal medicine, on the colonic wall by direct spraying during colonoscopy. World J Gastroenterol 2-7-2006;12(5):760-764.

Visavadiya, N. P. and Narasimhacharya, A. V. Hypocholesterolaemic and antioxidant effects of Glycyrrhiza glabra (Linn) in rats. Mol Nutr Food Res 2006;50(11):1080-1086.

Armanini, D., Castello, R., Scaroni, C., Bonanni, G., Faccini, G., Pellati, D., Bertoldo, A., Fiore, C., and Moghetti, P. Treatment of polycystic ovary syndrome with spironolactone plus licorice. Eur J Obstet Gynecol.Reprod Biol 2007;131(1):61-67.

Mumoli, N. and Cei, M. Licorice-induced hypokalemia. Int J Cardiol 2008;124(3):e42-e44.

Hattori, M., Sakamoto, T., Kobashi, K., and Namba, T. Metabolism of glycyrrhizin by human intestinal flora. Planta Med 1983;48(5):38-42.

Chin, Y. W., Jung, H. A., Liu, Y., Su, B. N., Castoro, J. A., Keller, W. J., Pereira, M. A., and Kinghorn, A. D. Anti-oxidant constituents of the roots and stolons of licorice (Glycyrrhiza glabra). J Agric Food Chem 6-13-2007;55(12):4691-4697.

Chen, M. F., Shimada, F., Kato, H., Yano, S., and Kanaoka, M. Effect of oral administration of glycyrrhizin on the pharmacokinetics of prednisolone. Endocrinol Jpn 1991;38(2):167-174.

Cooper, H., Bhattacharya, B., Verma, V., McCulloch, A. J., Smellie, W. S., and Heald, A. H. Liquorice and soy sauce, a life-saving concoction in a patient with Addison's disease. Ann Clin Biochem 2007;44(Pt 4):397-399.

Final report on the safety assessment of Glycyrrhetinic Acid, Potassium Glycyrrhetinate, Disodium Succinoyl Glycyrrhetinate, Glyceryl Glycyrrhetinate, Glycyrrhetinyl Stearate, Stearyl Glycyrrhetinate, Glycyrrhizic Acid, Ammonium Glycyrrhizate, Dipotassium Glycyrrhizate, Disodium Glycyrrhizate, Trisodium Glycyrrhizate, Methyl Glycyrrhizate, and Potassium Glycyrrhizinate. Int J Toxicol 2007;26 Suppl 2:79-112.

Aoki, F., Nakagawa, K., Kitano, M., Ikematsu, H., Nakamura, K., Yokota, S., Tominaga, Y., Arai, N., and Mae, T. Clinical safety of licorice flavonoid oil (LFO) and pharmacokinetics of glabridin in healthy humans. J Am Coll.Nutr 2007;26(3):209-218.

Fiore, C., Eisenhut, M., Krausse, R., Ragazzi, E., Pellati, D., Armanini, D., and Bielenberg, J. Antiviral effects of Glycyrrhiza species. Phytother Res 2008;22(2):141-148.

Lee, C. H., Park, S. W., Kim, Y. S., Kang, S. S., Kim, J. A., Lee, S. H., and Lee, S. M. Protective mechanism of glycyrrhizin on acute liver injury induced by carbon tetrachloride in mice. Biol Pharm Bull. 2007;30(10):1898-1904.

Lee, C. K., Park, K. K., Lim, S. S., Park, J. H., and Chung, W. Y. Effects of the licorice extract against tumor growth and cisplatin-induced toxicity in a mouse xenograft model of colon cancer. Biol Pharm Bull 2007;30(11):2191-2195.

Isaia, G. C., Pellissetto, C., Ravazzoli, M., and Tamone, C. Acute adrenal crisis and hypercalcemia in a patient assuming high liquorice doses. Minerva Med 2008;99(1):91-94.

Burgess, J. A., van der Ven, P. F., Martin, M., Sherman, J., and Haley, J. Review of over-the-counter treatments for aphthous ulceration and results from use of a dissolving oral patch containing glycyrrhiza complex herbal extract. J Contemp.Dent Pract. 2008;9(3):88-98.

Martin, M. D., Sherman, J., van der Ven, V., and Burgess, J. A controlled trial of a dissolving oral patch concerning glycyrrhiza (licorice) herbal extract for the treatment of aphthous ulcers. Gen Dent 2008;56(2):206-210.

Wu, T. H., Chiu, T. Y., Tsai, J. S., Chen, C. Y., Chen, L. C., and Yang, L. L. Effectiveness of Taiwanese traditional herbal diet for pain management in terminal cancer patients. Asia Pac.J Clin Nutr 2008;17(1):17-22.

Tancevski, I., Eller, P., Spiegel, M., Kirchmair, R., and Patsch, J. R. Images in cardiovascular medicine. Malicious licorice. Circulation 2008;117(13):e299.

Yuan, H. N., Wang, C. Y., Sze, C. W., Tong, Y., Tan, Q. R., Feng, X. J., Liu, R. M., Zhang, J. Z., Zhang, Y. B., and Zhang, Z. J. A randomized, crossover comparison of herbal medicine and bromocriptine against risperidone-induced hyperprolactinemia in patients with schizophrenia. J Clin Psychopharmacol 2008;28(3):264-370.

Jin, C. Y., Wang, D. L., and Fang, Z. D. [Effect of integrative Chinese and Western medicine in treating chronic urticaria and its impact on interleukin-10 and interleukin-8 in peripheral blood]. Zhongguo Zhong.Xi.Yi Jie.He.Za Zhi 2008;28(4):358-360.

Zheng, A. and Moritani, T. Effect of the combination of ginseng, oriental bezoar and glycyrrhiza on autonomic nervous activity and immune system under mental arithmetic stress. J Nutr Sci Vitaminol.(Tokyo) 2008;54(3):244-249.

Moghadamnia, A. A., Motallebnejad, M., and Khanian, M. The efficacy of the bioadhesive patches containing licorice extract in the management of recurrent aphthous stomatitis. Phytother Res 2009;23(2):246-250.

Brasseur, A. and Ducobu, J. [Severe hypokalemia after holidays return]. Rev Med Brux 2008;29(5):490-493.

Johns, C. Glycyrrhizic acid toxicity caused by consumption of licorice candy cigars. CJEM 2009;11(1):94-96.

Bocker, D. and Breithardt, G. [Induction of arrhythmia by licorice abuse]. Z Kardiol 1991;80(6):389-391.

Bai, Y. S., Zhou, C. Y., and Wang, J. Q. [Clinical observation on auxiliary treatment of hormone dependence dermatitis by shufeng liangxue decoction]. Zhongguo Zhong.Xi.Yi Jie.He.Za Zhi 2008;28(12):1121-1123.

Rosenblat, M. and Aviram, M. Paraoxonases role in the prevention of cardiovascular diseases. Biofactors 2009;35(1):98-104.

Tacconi, P., Paribello, A., Cannas, A., and Marrosu, M. G. Carpal tunnel syndrome triggered by excessive licorice consumption. J Peripher.Nerv.Syst. 2009;14(1):64-65.

Kinoshita, H., Okabayashi, M., Kaneko, M., Yasuda, M., Abe, K., Machida, A., Ohkubo, T., Kamata, T., and Yakushiji, F. Shakuyaku-kanzo-to induces pseudoaldosteronism characterized by hypokalemia, rhabdomyolysis, metabolic alkalosis with respiratory compensation, and increased urinary cortisol levels. J Altern Complement Med 2009;15(4):439-443.

Agarwal, A., Gupta, D., Yadav, G., Goyal, P., Singh, P. K., and Singh, U. An evaluation of the efficacy of licorice gargle for attenuating postoperative sore throat: a prospective, randomized, single-blind study. Anesth Analg 2009;109(1):77-81.

Crean, A. M., Abdel-Rahman, S. E., and Greenwood, J. P. A sweet tooth as the root cause of cardiac arrest. Can J Cardiol 2009;25(10):e357-e358.

Schleimer, R. P. Potential regulation of inflammation in the lung by local metabolism of hydrocortisone. Am J Respir.Cell Mol.Biol. 1991;4(2):166-173.

Yamaguchi, H., Kidachi, Y., Kamiie, K., Noshita, T., Umetsu, H., and Ryoyama, K. Glycyrrhetinic acid induces anoikis-like death and cytoskeletal disruption in the central nervous system tumorigenic cells. Biol.Pharm Bull. 2010;33(2):321-324.

Yamamoto, T., Hatanaka, M., Matsuda, J., Kadoya, H., Takahashi, A., Namba, T., Takeji, M., and Yamauchi, A. [Clinical characteristics of five elderly patients with severe hypokalemia induced by glycyrrhizin derivatives]. Nihon Jinzo Gakkai Shi 2010;52(1):80-85.

Tu, J. H., He, Y. J., Chen, Y., Fan, L., Zhang, W., Tan, Z. R., Huang, Y. F., Guo, D., Hu, D. L., Wang, D., and Hong-Hao Zhou. Effect of glycyrrhizin on the activity of CYP3A enzyme in humans. Eur J Clin Pharmacol 2010;66(8):805-810.

Chen, W. G. and Ba, Z. M. Prof. ZHANG Yi's experience in treating severe arrhythmia. J Tradit.Chin Med 2010;30(1):47-50.

Caubet-Kamar, N., Tubery, M., Garrouste, C., Lauque, D., and Kamar, N. Harmful effect of saline infusion in a patient with glycyrrhizic acid poisoning. CJEM 2010;12(3):224-225.

Goultschin, J., Palmon, S., Shapira, L., Brayer, L., and Gedalia, I. Effect of glycyrrhizin-containing toothpaste on dental plaque reduction and gingival health in humans. A pilot study. J Clin Periodontol 1991;18(3):210-212.

Hsu, Y. L., Wu, L. Y., Hou, M. F., Tsai, E. M., Lee, J. N., Liang, H. L., Jong, Y. J., Hung, C. H., and Kuo, P. L. Glabridin, an isoflavan from licorice root, inhibits migration, invasion and angiogenesis of MDA-MB-231 human breast adenocarcinoma cells by inhibiting focal adhesion kinase/Rho signaling pathway. Mol.Nutr Food Res 2011;55(2):318-327.

Badr, A. E., Omar, N., and Badria, F. A. A laboratory evaluation of the antibacterial and cytotoxic effect of Liquorice when used as root canal medicament. Int Endod.J 2011;44(1):51-58.

Yorgun, H., Aksoy, H., Sendur, M. A., Ates, A. H., Kaya, E. B., Aytemir, K., and Oto, A. Brugada syndrome with aborted sudden cardiac death related to liquorice-induced hypokalemia. Med Princ Pract 2010;19(6):485-489.

Mohire, N. C. and Yadav, A. V. Chitosan-based polyherbal toothpaste: as novel oral hygiene product. Indian J Dent Res 2010;21(3):380-384.

Scali, M., Pratesi, C., Zennaro, M. C., Zampollo, V., and Armanini, D. Pseudohyperaldosteronism from liquorice-containing laxatives. J Endocrinol Invest 1990;13(10):847-848.

Chatterjee, N., Domoto-Reilly, K., Fecci, P. E., Schwamm, L. H., and Singhal, A. B. Licorice-associated reversible cerebral vasoconstriction with PRES. Neurology 2010;75(21):1939-1941.

Peters, M. C., Tallman, J. A., Braun, T. M., and Jacobson, J. J. Clinical reduction of S. mutans in pre-school children using a novel liquorice root extract lollipop: a pilot study. Eur.Arch.Paediatr.Dent 2010;11(6):274-278.

Imtiaz, K. E. Sweet root, bitter pill: liquorice-induced hyperaldosteronism. QJM 2011;104(12):1093-1095.

Cassano, N., Mantegazza, R., Battaglini, S., Apruzzi, D., Loconsole, F., and Vena, G. A. Adjuvant role of a new emollient cream in patients with palmar and/or plantar psoriasis: a pilot randomized open-label study. G Ital Dermatol Venereol 2010;145(6):789-792.

Costa, A., Moises, T. A., Cordero, T., Alves, C. R., and Marmirori, J. Association of emblica, licorice and belides as an alternative to hydroquinone in the clinical treatment of melasma. An Bras Dermatol 2010;85(5):613-620.

van Beers, E. J., Stam, J., and van den Bergh, W. M. Licorice consumption as a cause of posterior reversible encephalopathy syndrome: a case report. Crit Care 2011;15(1):R64.

Lorenzin, F., Degen, C., Milani, A., Siciliano, M., and Rossi, L. [Pseudo-hyperaldosteronism caused by licorice. Pathogenetic considerations and presentation of a clinical case]. Clin Ter 1990;132(1):55-58.

MacKenzie, M. A., Hoefnagels, W. H., Jansen, R. W., Benraad, T. J., and Kloppenborg, P. W. The influence of glycyrrhetinic acid on plasma cortisol and cortisone in healthy young volunteers. J Clin Endocrinol Metab 1990;70(6):1637-1643.

Messier, C., Epifano, F., Genovese, S., and Grenier, D. Licorice and its potential beneficial effects in common oro-dental diseases. Oral Dis 2012;18(1):32-39.

Sheth, V. M. and Pandya, A. G. Melasma: a comprehensive update: part II. J Am Acad Dermatol 2011;65(4):699-714.

Hajiaghamohammadi, A. A., Ziaee, A., and Samimi, R. The efficacy of licorice root extract in decreasing transaminase activities in non-alcoholic fatty liver disease: a randomized controlled clinical trial. Phytother Res 2012;26(9):1381-1384.

Lee, I. T., Lee, W. J., Tsai, C. M., Su, I. J., Yen, H. T., and Sheu, W. H. Combined extractives of red yeast rice, bitter gourd, chlorella, soy protein, and licorice improve total cholesterol, low-density lipoprotein cholesterol, and triglyceride in subjects with metabolic syndrome. Nutr Res 2012;32(2):85-92.

Nabeshima, S., Kashiwagi, K., Ajisaka, K., Masui, S., Takeoka, H., Ikematsu, H., and Kashiwagi, S. A randomized, controlled trial comparing traditional herbal medicine and neuraminidase inhibitors in the treatment of seasonal influenza. J Infect.Chemother. 2012;18(4):534-543.

Celik, M. M., Karakus, A., Zeren, C., Demir, M., Bayarogullari, H., Duru, M., and Al, M. Licorice induced hypokalemia, edema, and thrombocytopenia. Hum Exp Toxicol 2012;31(12):1295-1298.

Ruiz-Granados, E. S., Shouls, G., Sainsbury, C., and Antonios, T. A salty cause of severe hypertension. BMJ Case Rep 2012;2012.

Korri, H., Awada, A., Baajour, W., Beaini, M., and Nasreddine, W. [Rapidly progressing quadriparesis secondary to licorice (souss) intoxication]. J Med Liban 2012;60(2):117-119.

Steinberg, D., Sgan-Cohen, H. D., Stabholz, A., Pizanty, S., Segal, R., and Sela, M. N. The anticariogenic activity of glycyrrhizin: preliminary clinical trials. Isr J Dent Sci 1989;2(3):153-157.

Hattori, T., Ikematsu, S., Koito, A., Matsushita, S., Maeda, Y., Hada, M., Fujimaki, M., and Takatsuki, K. Preliminary evidence for inhibitory effect of glycyrrhizin on HIV replication in patients with AIDS. Antiviral Res 1989;11(5-6):255-261.

Das SK, Das V, Gulati AK, and et al. Deglycyrrhizinated liquorice in aphthous ulcers. J Assoc Physicians India 1989;37(10):647.

Baba, M. and Shigeta, S. Antiviral activity of glycyrrhizin against varicella-zoster virus in vitro. Antiviral Res 1987;7(2):99-107.

Nussbaumer, U., Landolt, M., Rothlisberger, G., Akovbiantz, A., Keller, H., Weber, E., Blum, A. L., and Peter, P. [Postoperative stress hemorrhage: ineffective prevention with pepsin inhibitor and deglycyrrhizinized licorice extract. Prospective study]. Schweiz Med Wochenschr 2-26-1977;107(8):276-279.

Ito, M., Sato, A., Hirabayashi, K., Tanabe, F., Shigeta, S., Baba, M., De Clercq, E., Nakashima, H., and Yamamoto, N. Mechanism of inhibitory effect of glycyrrhizin on replication of human immunodeficiency virus (HIV). Antiviral Res 12-11-1988;10(6):289-298.

Ito, M., Nakashima, H., Baba, M., Pauwels, R., De Clercq, E., Shigeta, S., and Yamamoto, N. Inhibitory effect of glycyrrhizin on the in vitro infectivity and cytopathic activity of the human immunodeficiency virus [HIV (HTLV- III/LAV)]. Antiviral Res 1987;7(3):127-137.

Bardhan, K. D., Cumberland, D. C., Dixon, R. A., and Holdsworth, C. D. Clinical trial of deglycyrrhizinised liquorice in gastric ulcer. Gut 1978;19(9):779-782.

Balakrishnan, V., Pillai, M. V., Raveendran, P. M., and Nair, C. S. Deglycyrrhizinated liquorice in the treatment of chronic duodenal ulcer. J Assoc Physicians India 1978;26(9):811-814.

Beretta-Piccoli, C., Salvade, G., Crivelli, P. L., and Weidmann, P. Body-sodium and blood volume in a patient with licorice-induced hypertension. J Hypertens 1985;3(1):19-23.

Cotterill, J. A. and Cunliffe, W. J. Self-medication with liquorice in a patient with Addison's disease. Lancet 2-10-1973;1(7798):294-295.

Wilson, J. A. A comparison of carbenoxolone sodium and deglycyrrhizinated liquorice in the treatment of gastric ulcer in the ambulant patient. Br J Clin Pract 1972;26(12):563-566.

Engqvist, A., von Feilitzen, F., Pyk, E., and Reichard, H. Double-blind trial of deglycyrrhizinated liquorice in gastric ulcer. Gut 1973;14(9):711-715.

Anonymous. Treatment of duodenal ulcer with glycyrrhizinic-acid-reduced liquorice. A multicentre trial. Br Med J 1971;3(773):501-503.

Rees, W. D., Rhodes, J., Wright, J. E., Stamford, L. F., and Bennett, A. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand.J Gastroenterol. 1979;14(5):605-607.

Koster, M. and David, G. K. Reversible severe hypertension due to licorice ingestion. N Engl J Med 1968;278(25):1381-1383.

Corse, F. M., Galgani, S., Gasparini, C., Giacanelli, M., and Piazza, G. Acute hypokalemic myopathy due to chronic licorice ingestion: report of a case. Ital J Neurol Sci 1983;4(4):493-497.

Gibertoni, M., Bonito, V., Colombo, A., Falasca, A., and Nichelli, P. [Licorice-induced myopathy. Report of a new case]. Riv Patol Nerv Ment 1983;104(4):179-183.

Mitscher, L. A., Park, Y. H., Clark, D., and Beal, J. L. Antimicrobial agents from higher plants. Antimicrobial isoflavanoids and related substances from Glycyrrhiza glabra L. var. typica. J Nat Prod 1980;43(2):259-269.

Cumming, A. M., Boddy, K., Brown, J. J., Fraser, R., Lever, A. F., Padfield, P. L., and Robertson, J. I. Severe hypokalaemia with paralysis induced by small doses of liquorice. Postgrad Med J 1980;56(657):526-529.

Berlango Jimenez A., Jimenez Murillo L., Montero Perez F. J., Munoz Avila J. A., Torres Murillo J., and Calderon de la Barca Gazquez J. M. [Acute rhabdomyolysis and tetraparesis secondary to hypokalemia due to ingested licorice]. An Med Interna 1995;12(1):33-35.

Bernardi, M., D'Intino, P. E., Trevisani, F., Cantelli-Forti, G., Raggi, M. A., Turchetto, E., and Gasbarrini, G. Effects of prolonged ingestion of graded doses of licorice by healthy volunteers. Life Sci 1994;55(11):863-872.

Luchon, L., Meyrier, A., and Paillard, F. [Hypokalemia without arterial hypertension by licorice poisoning]. Nephrologie 1993;14(4):177-181.

Murakami, T. and Uchikawa, T. Effect of glycyrrhizine on hyperkalemia due to hyporeninemic hypoaldosteronism in diabetes mellitus. Life Sci 1993;53(5):PL63-8.

van der Zwan A. Hypertension encephalopathy after liquorice ingestion. Clin Neurol Neurosurg 1993;95(1):35-37.

Werner, S., Brismar, K., and Olsson, S. Hyperprolactinaemia and liquorice. Lancet 2-10-1979;1(8111):319.

Da Nagao, Y., Sata, M., Suzuki, H., Tanikawa, K., Itoh, K., and Kameyama, T. Effectiveness of glycyrrhizin for oral lichen planus in patients with chronic HCV infection. J Gastroenterol 1996;31(5):691-695.

Kroes, B. H., Beukelman, C. J., van den Berg, A. J., Wolbink, G. J., van Dijk, H., and Labadie, R. P. Inhibition of human complement by beta-glycyrrhetinic acid. Immunology 1997;90(1):115-120.

Arase, Y., Ikeda, K., Murashima, N., Chayama, K., Tsubota, A., Koida, I., Suzuki, Y., Saitoh, S., Kobayashi, M., and Kumada, H. The long term efficacy of glycyrrhizin in chronic hepatitis C patients. Cancer 1997;79(8):1494-1500.

Bannister, B., Ginsburg, R., and Shneerson, J. Cardiac arrest due to liquoriceinduced hypokalaemia. Br Med J 9-17-1977;2(6089):738-739.

Yamada, K., Kanba, S., Yagi, G., and Asai, M. Effectiveness of herbal medicine (shakuyaku-kanzo-to) for neuroleptic-induced hyperprolactinemia. J Clin Psychopharmacol 1997;17(3):234-235.

Yamashiki, M., Nishimura, A., Suzuki, H., Sakaguchi, S., and Kosaka, Y. Effects of the Japanese herbal medicine "Sho-saiko-to" (TJ-9) on in vitro interleukin-10 production by peripheral blood mononuclear cells of patients with chronic hepatitis C. Hepatology 1997;25(6):1390-1397.

Nishioka, K. and Seguchi, T. Contact allergy due to oil-soluble licorice extracts in cosmetic products. Contact Dermatitis 1999;40(1):56.

Kumada T, et al. Effect of Shakuyaku-kanzo-to (Tsumura TJ-68) on muscle cramps accompanying cirrhosis in a placebo-controlled double-blind parallel study. Journal of Clinical Therapeutics Medicine. 1999;15:499-523.

Suzuki H, Ohta Y, Takino T, and et al. Effects of glycyrrhizin on biochemical tests in patients with chronic hepatitis -- double blind trial. Asian Medical Journal 1984;26(7):423-438.

Mattarello MJ, Karbowiak I, Ermolao A, and et al. Licorice reduces body fat mass in obese men and women. 83rd Annual Meeting of the Endocrine Society, June 20-23 2001;abstract P1-573.

Thom E and Wollan T. A controlled clinical study of kanjang mixture in the treatment of uncomplicated upper respiratory tract infections. Phytotherapy Research 1997;11:207-210.

Ito A, Hayashi N, Katayama K, and et al. Effect of glycyrrhizin on viral replication and quasispecies in patients with type C chronic hepatitis. Int Hepatol Comm 1997;233-238.

Davis EA, Morris DJ. Medicinal uses of licorice through the millennia: the good and plenty of it. Mol Cell Endocrinol. 1991;78(1-2):1-6.

Kondo K1, Shiba M, Nakamura R, Morota T, Shoyama Y. Constituent properties of licorices derived from Glycyrrhiza uralensis, G. glabra, or G. inflata identified by genetic information. Biol Pharm Bull. 2007;30(7):1271-7.

American Herbal Products Association's Botanical Safety Handbook, Second Edition. Ed. Gardner Z, McGuffin M. Boca Raton, FL: CRC Press, 2013.

Yoshino T, Yanagawa T, Watanabe K. Risk factors for pseudoaldosteronism with rhabdomyolysis caused by consumption of drugs containing licorice and differences between incidence of these conditions in Japan and other countries: case report and literature review. J Altern Complement Med. 2014 Jun;20(6):516-20.

Nahidi F, Zare E, Mojab F, Alavi-Majd H. Effects of licorice on relief and recurrence of menopausal hot flashes. Iran J Pharm Res 2012;11(2):541-8.

Li G, Simmler C, Chen L, et al. Cytochrome P450 inhibition by three licorice species and fourteen licorice constituents. Eur J Pharm Sci. 2017;109:182-190.

Li J, Fan X, Wang Q. Hypertensive crisis with 2 target organ impairment induced by glycyrrhizin: a case report. Medicine (Baltimore) 2018;97(11):e0073.

Foster CA, Church KS, Poddar M, Van Uum SH, Spaic T. Licorice-induced hypertension: a case of pseudohyperaldosteronism due to jelly bean ingestion. Postgrad Med 2017;129(3):329-31.

Gallacher SD, Tsokolas G, Dimitropoulos I. Liquorice-induced apparent mineralocorticoid excess presenting in the emergency department. Clin Med (Lond) 2017;17(1):43-5.

Arentz S, Smith CA, Abbott J, Fahey P, Cheema BS, Bensoussan A. Combined Lifestyle and Herbal Medicine in Overweight Women with Polycystic Ovary Syndrome (PCOS): A Randomized Controlled Trial. Phytother Res. 2017 Sep;31(9):1330-1340.

Dai DW, Singh I, Hershman JM. Lozenge-induced hypermineralcorticoid state--a unique case of licorice lozenges resulting in hypertension and hypokalemia. J Clin Hypertens (Greenwich) 2016;18(2):159-60.

O'Connell K, Kinsella J, McMahon C, Holian J, O'Riordan S. Posterior reversible encephalopathy syndrome (PRES) associated with liquorice consumption. Ir J Med Sci 2016;185(4):945-7.

Man SC, Li XB, Wang HH, et al. Peony-glycyrrhiza decoction for antipsychotic-related hyperprolactinemia in women with schizophrenia: a randomized controlled trial. J Clin Psychopharmacol 2016;36(6):572-9.

Yu IC, Tsai YF, Fang JT, Yeh MM, Fang JY, Liu CY. Effects of mouthwash interventions on xerostomia and unstimulated whole saliva flow rate among hemodialysis patients: a randomized controlled study. Int J Nurs Stud 2016;63:9-17.

Hajiaghamohammadi AA, Zargar A, Oveisi S, Samimi R, Reisian S. To evaluate of the effect of adding licorice to the standard treatment regimen of Helicobacter pylori. Braz J Infect Dis 2016;20(6):534-8.

Hataya Y, Oba A, Yamashita T, Komatsu Y. Hyponatremia in an elderly patient due to isolated hypoaldosteronism occurring after licorice withdrawal. Intern Med 2017;56(2):175-9.

Yoon JY, Cha JM, Hong SS, et al. Fermented milk containing Lactobacillus paracasei and Glycyrrhiza glabra has a beneficial effect in patients with Helicobacter pylori infection: a randomized, double-blind, placebo-controlled study. Medicine (Baltimore) 2019;98(35):e16601.

Kuriyama A, Maeda H. Topical application of licorice for prevention of postoperative sore throat in adults: a systematic review and meta-analysis. J Clin Anesth 2019;54:25-32.

Ha Y, Wang T, Li J, et al. Herb-Drug Interaction Potential of Licorice Extract and Paclitaxel: A Pharmacokinetic Study in Rats. Eur J Drug Metab Pharmacokinet. 2020;45(2):257-264.

Kinoshita T, Maruyama K, Yamamoto N, Saito I. The effects of dietary licorice flavonoid oil supplementation on body balance control in healthy middle-aged and older Japanese women undergoing a physical exercise intervention: a randomized, double-blind, placebo-controlled trial. Aging Clin Exp Res. 2020.

Petramfar P, Hajari F, Yousefi G, Azadi S, Hamedi A. Efficacy of oral administration of licorice as an adjunct therapy on improving the symptoms of patients with Parkinson's disease, A randomized double blinded clinical trial. J Ethnopharmacol. 2020;247:112226.