Licorice and DGL : Dosing and Safety

by MedlinePlus

(Page 2 of 3)

Standardization:

The expert panel German Commission E recommends that licorice be used for only four to six weeks unless under direct medical supervision. However, this is based on the use of relatively large daily doses (five to 15 grams per day). Many experts believe that extended treatments may be safe if lower doses are used. In a four-week study in healthy individuals, recommended doses were well tolerated, with few adverse effects. There are no standard or well-studied doses of licorice, and many different doses are used traditionally.

Adults (18 years and older):

Licorice powdered root (4 percent to 9 percent glycyrrhizin): Doses of one to four grams taken by mouth daily, divided into three or four doses, have been used.

Licorice fluid extract (10 percent to 20 percent glycyrrhizin): Doses of two to four milliliters per day have been taken by mouth.

DGL extract tablets: Doses of 380 to 1140 milligrams three times daily taken by mouth 20 minutes before meals have been used.

Carbenoxolone gel or cream: A 2 percent cream or gel has been applied five times a day for seven to 14 days for herpes simplex virus skin lesions.

3. 5 grams a day of a commercial preparation of licorice has been studied for body fat mass reduction.

Children (younger than 18 years):

There is not enough scientific evidence to recommend licorice for use in children, and licorice is not recommended due to potential side effects.

Safety

Allergies

People should avoid licorice if they have a known allergy to licorice, any component of licorice or any member of the Fabaceae ( Leguminosae ) plant family (pea family). There is a report of rash after applying a cosmetic product containing licorice to the skin.

Side Effects and Warnings

Licorice contains a chemical called glycyrrhizic acid, which is responsible for many of the reported side effects. DGL (deglycyrrhizinated licorice) has had the glycyrrhizic acid removed, and therefore is considered safer for use.

Many of the adverse effects of licorice result from actions on hormone levels in the body. By altering the activities of certain hormones, licorice may cause electrolyte disturbances. Possible effects include sodium and fluid retention, low potassium levels, and metabolic alkalosis.

Hormonal imbalances have been reported with the use of licorice, such as abnormally low testosterone levels in men or high prolactin levels and estrogen levels in women. However, study results conflict. These adverse effects may reduce fertility or cause menstrual abnormalities.

Electrolyte abnormalities may also lead to irregular heartbeats, heart attack, kidney damage, muscle weakness, or muscle breakdown. Licorice should be used cautiously by people with congestive heart failure, coronary heart disease, kidney or liver disease, fluid retention (edema), high blood pressure, underlying electrolyte disturbances, hormonal abnormalities, or those taking diuretics.

Reduced body fat mass has been observed with the use of licorice. Acute pseudo-aldosteronism syndrome has been associated with licorice. Paralysis has been reported in a patient taking licorice that contributed to low potassium levels. Thyrotoxic periodic paralysis (TPP) has been associated with licorice. Metobolic alkalosis and seizure has been reported from licorice in antacid.

Licorice has been reported to cause high blood pressure, including dangerously high blood pressure with symptoms such as headache, nausea, vomiting, and hypertensive encephalopathy with stroke-like effects (for example, one-sided weakness).

High doses of licorice may cause temporary vision problems or loss. Ocular side effects have been reported. Central retinal vein occlusion has been associated with licorice. A case report exists of licorice-induced hypokalemia associated with dropped head syndrome (DHS).

Pregnancy and Breastfeeding

Licorice cannot be recommended during pregnancy and breast-feeding due to possible alterations of hormone levels and the possibility of premature labor.

Hormonal imbalances reported with the use of licorice include abnormally low testosterone levels in men and high prolactin levels/estrogen levels in women. However, study results conflict. 17-OHP and LH levels may also be affected.

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