Licorice

A member of the pea family, licorice root has been used since ancient times both as food and as medicine. In Chinese herbology, licorice is an ingredient in nearly all herbal formulas for the traditional purpose of \"harmonizing\" the separate herbs involved. The herb licorice contains a substance called glycyrrhizin. When taken in high enough amounts, glycyrrhizin produces effects similar to those of the natural hormone aldosterone, causing fluid retention, increased blood pressure, and loss of potassium. To prevent this, manufacturers have found a way to remove glycyrrhizin from licorice, producing the safer product deglycyrrhizinated licorice, or DGL.

Licorice appears to have a positive effect on the cells of the stomach, including increasing blood flow. Licorice or DGL was once a standard European treatment for ulcers. Although it has been replaced by synthetic medications, incomplete evidence suggests that DGL may be helpful. It might also help prevent ulcers caused by anti-inflammatory drugs. Licorice (primarily DGL) is sometimes recommended for relieving the discomfort of canker sores and other mouth sores, but this has not been studied scientifically. Similarly, creams containing whole licorice (often combined with chamomile extract) are often used for eczema, psoriasis, and herpes, but do not have substantiating evidence that they really do work. Whole licorice, not DGL, is used as an expectorant for respiratory problems such as coughs and asthma. Licorice has been suggested as a treatment for chronic fatigue syndrome (CFS), based on the observation that people with CFS appear to suffer from low levels of certain adrenal hormones. The glycyrrhizin portion of licorice may relieve symptoms by mimicking the effects of these hormones. However, this is a fairly dangerous approach to treatment that should be tried only under medical supervision. In addition, studies of drugs that even more closely imitate adrenal hormones have not found benefit. Whole licorice has also been suggested as a treatment for numerous other conditions, including hepatitis and menopausal symptoms, and for the prevention of cancer, but there is as yet no meaningful evidence that it is effective for these conditions.

Ulcer Treatment Two controlled studies suggest that regular use of DGL in a combination product also containing antacids can heal ulcers as effectively as drugs in the Zantac family. Unfortunately, these studies do not prove that DGL was effective; antacids themselves can help heal ulcers, and the studies were not double-blind. Furthermore, if it does work, DGL would have to be taken continuously to avoid ulcer recurrence. In some cases, drug treatment can prevent the recurrence of ulcers permanently by eradicating the bacteria Helicobacter pylori. There is no evidence that DGL can do the same. Ulcer Prevention A very preliminary study suggests that DGL might help prevent ulcers caused by aspirin and related medications (eg. ibuprofen).

For supportive treatment of ulcer pain along with conventional medical care, the standard dose of DGL is two to four 380-mg tablets of DGL taken before meals and at bedtime. The same tablets can be allowed to slowly dissolve in the mouth for possible relief of mouth sore pain. A typical dose of whole licorice is 5–15 grams daily. However, we do not recommend the use of doses this high for more than a few weeks. For long term consumption, about 0.3 grams of licorice root daily should be safe for most adults. (See Safety Issues) Individuals who wish to take a higher dose should do so only under the supervision of a physician. For the treatment of eczema, psoriasis, or herpes, licorice cream is applied twice daily to the affected area.

Use of whole licorice has not been associated with significant adverse effects in the short term. However, two or more weeks of use may cause high blood pressure, fluid retention, and loss of potassium. Such effects are especially dangerous for people who take digitalis, or who have high blood pressure, heart disease, diabetes, or kidney disease. Current evidence indicates that individuals who wish to take whole licorice on a long term basis without any risk of these side effects should not consume more than 0.2 mg of glycyrrhizin per kilogram of body weight daily. For a person who weighs 130 pounds, this works out to 12 mg of glycyrrhizin daily. Based on a typical 4% glycyrrizin content, this is the equivalent of 0.3 grams of licorice root. Whole licorice may have other side effects as well. . For example, it appears to reduce testosterone levels in men. For this reason, men with impotence, infertility, or decreased libido may wish to avoid this herb. Licorice may also increase both the positive and negative effects of corticosteroids such as prednisone and hydrocortisone cream. In addition, some evidence suggests that licorice might affect the livers ability to metabolize other medications as well, but the extent of this effect has not been fully determined. Whole licorice possesses significant estrogenic activity, and some evidence indicates that licorice increases risk of premature birth. For these reasons, it shouldnt be taken by pregnant or nursing women, or women who have had breast cancer. Maximum safe doses for young children, nursing women, or those with severe liver or kidney disease has not been established. It is believed, but not proven, that most or all of the major side effects of licorice are due to glycyrrhizin. For this reason, DGL has been described as entirely safe. However, comprehensive safety studies on DGL have not been reported.

If you are taking:

•  Digitalis drugs: Long-term use of licorice can be dangerous.
•  Thiazide or loop diuretics: Use of licorice might lead to excessive potassium loss.18
•  Corticosteroid treatment: Licorice could increase both its negative and positive effects. Do not take licorice internally if using corticosteroids.
•  Aspirin or other anti-inflammatory drugs: Regular use of DGL might help lower the risk of ulcers.