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Glycyrrhizic acid toxicity caused by consumption of licorice candy cigars

Published online by Cambridge University Press:  21 May 2015

Christine Johns
Christine Johns*
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ont., The Ottawa Hospital Civic Campus, Ottawa, Ont.
*
Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital Civic Campus, 1053 Carling Ave., Ottawa ON K1Y 4E9; [email protected]

Abstract

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A 49-year-old female physician presented with peripheral edema, weight gain and relative hypertension caused by the consumption of licorice candy cigars containing glycyrrhizic acid (GZA) found in natural licorice extract. Although the patient's response to GZA resolved spontaneously, emergency physician awareness of the toxic effects of natural licorice extract may avert symptom progression in early-identified cases. The benefits of natural licorice extract as a flavour enhancer and herbal medicine are recognized worldwide. The Canadian public is likely not generally aware of the toxic potential of GZA, or that it may be present in the following commonly consumed products: black licorice, chewing gum, herbal teas, soft drinks, tobaccos and herbal remedies for cough, stomach ailments and constipation. Emergency physicians should inquire about the consumption of products that may contain natural licorice extract when patients present with unexplained hypertension, hypokalemia, edema, rhabdomyolysis or myoglobinuria.

Keywords

licoriceglycyrrhizic acid toxicityhypermineralocorticoid syndrome
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 11 , Issue 1 , January 2009 , pp. 94 - 96
Copyright
Copyright © Canadian Association of Emergency Physicians 2009

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