Licorice: sweet candy, soothing remedy, but easy to overdo

Centuries before Twizzlers, Good 'n Plenty and black jellybeans arrived on the scene, licorice root was revered by the Chinese, Egyptians and Greeks. The Latin name for the most popular variety of licorice, Glycyrrhiza glabra, derives from the Greek words for "sweet root" and "smooth."

Licorice root has been used as a medicinal herb and food flavoring for more than 3,000 years. It is 50 times sweeter than sugar and masks the bitter taste of drugs, perfectly suiting it for use as a flavoring in cough syrups, throat lozenges, gum and candy. Surprisingly, though, 90% of licorice in the U.S. is used to flavor tobacco products like cigarettes and chewing tobacco.

What It Might Do: As a medicinal herb, licorice has an extensive folk history for soothing stomach irritations and as a cough remedy and expectorant. More recently, in Europe, deglycyrrhizinated licorice (DGL) has been used to treat stomach and duodenal ulcers.

How It Works: Glycyrrhizin (glycyrrhetic acid) is the main active component of licorice. It is a chemical cousin to adrenal steroid hormones, which control water and salt balance in the body as well as reduce inflammation. Flavonoids, also abundant in licorice, are believed to exert their own anti-inflammatory effect, separate from glycyrrhizin. As a cough medicine, licorice may soothe the lining of the throat or may actually suppress the cough reflex.

Caution: Glycyrrhizin can be dangerous in large amounts. More than 50 grams a day of natural licorice over several weeks can lead to potassium loss, sodium retention, fluid buildup and dangerously high blood pressure. Natural licorice in any form (except DGL) is not recommended for people with high blood pressure, heart disease, diabetes or for pregnant or lactating women.

If You Take: Licorice is sold in herbal preparations, as dried root powder or liquid. Herbalists contend that adverse reactions to licorice have been limited to overindulgence in licorice candy and gum rather than from herbal preparations. Several reports from the medical literature verify this. Still, as with most medicinal herbs, licorice root is not advised for long-term use. The recommended daily dose is 5 to 15 grams (one to two teaspoons) of dried root, containing 200 to 600 milligrams of glycyrrhizin. It can be made into an infusion, then strained, to drink as tea. Discontinue use after four to six weeks to prevent side effects. Taking the deglycyrrhizinated form (DGL) is safer, though it may not be as effective.

Candy lovers should know that much of the licorice candy in the U.S.--all of the more popular red licorice and some of the black--contains no natural licorice; it is flavored instead with anise (Pimpinella anisum). But if you're among the minority that savors black licorice, be aware that most of it--including popular Twizzlers brand--does contain natural licorice, as licorice root extract, typically in combination with anise oil. The Food and Drug Administration allows candy to contain up to 3% natural licorice by weight, but most contain no more than 2%, or about 0.5 gram in four twisted "ropes."

In Europe, where strongly flavored black licorice is popular, candy and cough drops contain 5% to as much as 65% natural licorice. Some specialty stores in the U.S. import such products.

EN Weighs In: Limit use of herbal preparations of licorice to no more than four to six weeks. Fans of black licorice candy should avoid overindulgence, particularly of imports, which contain much more natural licorice than American confections.

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