Bioactive Candy: Effects of Licorice on the Cardiovascular System

Abstract

Licorice, today chiefly utilized as a flavoring additive in tea, tobacco and candy, is one of the oldest used herbs for medicinal purposes and consists of up to 300 active compounds. The main active constituent of licorice is the prodrug glycyrrhizin, which is successively converted to 3β-monoglucuronyl-18β-glycyrrhetinic acid (3MGA) and 18β-glycyrrhetinic acid (GA) in the intestines. Despite many reported health benefits, 3MGA and GA inhibit the 11-β-hydrogenase type II enzyme (11β-HSD2) oxidizing cortisol to cortisone. Through activation of mineralocorticoid receptors, high cortisol levels induce a mild form of apparent mineralocorticoid excess in the kidney and increase systemic vascular resistance. Continuous inhibition of 11β-HSD2 related to excess licorice consumption will create a state of hypernatremia, hypokalemia and increased fluid volume, which can cause serious life-threatening complications especially in patients already suffering from cardiovascular diseases. Two recent meta-analyses of 18 and 26 studies investigating the correlation between licorice intake and blood pressure revealed statistically significant increases both in systolic (5.45 mmHg) and in diastolic blood pressure (3.19/1.74 mmHg). This review summarizes and evaluates current literature about the acute and chronic effects of licorice ingestion on the cardiovascular system with special focus on blood pressure. Starting from the molecular actions of licorice (metabolites) inside the cells, it describes how licorice intake is affecting the human body and shows the boundaries between the health benefits of licorice and possible harmful effects.

An in silico Analysis of Protein Targeted by Glycyrrhizin in Common Dental Pathogens

“…Therefore it reduces the inflammation within the air cell sinus and relieves the pain doubling up on its role as an anti inflammatory agent [9]. To a lesser extent high doses of glycyrrhizin have been shown to induce hypertension and hypovolemia [10].…”

The potential of glycyrrhizin and licorice extract in combating COVID-19 and associated conditions

“…Administration of high doses of licorice extract or its constituents as glycyrrhizin inhibits the 11-β-hydrogenase type II enzyme (11β-HSD2) that oxidizing cortisol to cortisone and causes pseudohyperaldosteronism. Also, Continuous inhibition of 11β-HSD2 due to excess licorice or its constituent's consumption will cause a state of hypernatremia, hypokalemia, and increased fluid volume due to water retention ( Nazari et al, 2017 ; Deutch et al, 2019 ). However, The LD50 of glycyrrhizin in mice after oral administration was documented to be 14.2-18.0 g/kg (Vispute and Khopade, 2011).…”

Recommendations for Ramadan fasting to patients with cardiovascular diseases; Turkish Society of Cardiology consensus report

“…During Ramadan fasting, excess licorice consumption may cause hypernatremia, hypokalemia, and increased fluid volume, which may trigger severe life-threatening complications such as hypertensive pulmonary edema in patients with CVD (27). It is also important to educate and follow up patients on drugs with a narrow therapeutic window such as warfarin and digoxin during fasting because, with the changing diet and dehydration, serum concentration of these drugs could be affected, leading to increased bleeding or intoxication risk (28,29).…”