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📰Read the full Licorice Root evidence review on GMJ News →Complete clinical article, references and updates on news.gmj.ge. This page is the structured safety summary.⚠ Patient on digoxin consuming licorice tea — hypokalemia → digoxin toxicity → fatal [1]
⚠ Patient on diuretics + licorice — additive K+ wasting [1]
⚠ Patient drinking licorice tea daily for months — pseudoaldosteronism risk [1]
⚠ Patient who can safely use DGL instead of whole licorice for GI complaints [1]
⚠ Pregnant patient consuming licorice — associated with shorter gestation [1]
🥗 Food first — build your daily Typical 200–600 mg; DGL safer
Check the foods you regularly eat — the bar fills toward your daily target.
Licorice root tea (1 cup)150 mg glycyrrhizin (approximate — highly variable)
European licorice candy (50 g)100 mg glycyrrhizin (approximate — highly variable)
Licorice-flavored liqueur (30 mL)20 mg glycyrrhizin (approximate — highly variable)
Check your regular foods above
🔬 Lab interpreter
Recommended test
Serum potassium
Serum potassium
Reference range / target
3.5–5.0 mEq/L
3.5–5.0 mEq/L
CRITICAL — hypokalemia is the danger signal [1].
Full lab monitoring ↓⚕ For professionals — confirm ranges against your local laboratory.
Clinical verdict
Licorice root is pharmacologically dangerous — glycyrrhizin inhibits 11β-HSD2, causing pseudoaldosteronism (hypertension + hypokalemia → cardiac arrhythmia). Fatal cases exist. The SOLUTION is DGL (glycyrrhizin removed): retains GI benefits, eliminates the danger. Maximum glycyrrhizin: 100 mg/day × ≤4 weeks. ALWAYS check for digoxin, diuretics, and antihypertensives before recommending whole licorice [1].
1 How much do I need?
👤 Adults: Specific dosage data under clinical review
👴 Elderly: Specific dosage data under clinical review
🤰 Pregnancy: See guidance
AVOID whole licorice — associated with premature birth and fetal HPA programming. DGL (glycyrrhizin removed) is likely safe [1].
👦 Pediatric: See guidance
Avoid whole licorice in children. Children are more susceptible to pseudoaldosteronism at lower doses [1].
🏃 Athletes: Standard dose
⚖️ Obesity: Standard dose
Fat-soluble compounds may require dose adjustment in obesity.
🩺 Renal: Consult specialist
Dose adjustment may be needed in renal impairment.
🌱 Vegan: Standard dose
How to take
🍽 Timing: DGL: 20 min before meals (chewable). Whole licorice: with food [1].
💊 With food: DGL must be CHEWED (salivary activation important) [1].
🚫 Avoid: Whole licorice >4 weeks. >100 mg glycyrrhizin/day. With digoxin/diuretics. During pregnancy [1].
2 Which form?
| Form | Bioavailability | Vegan | Cost |
|---|---|---|---|
| ['DGL (deglycyrrhizinated licorice)', 'preferred for GI', 'Glycyrrhizin removed (<3%). Safe long-term. 380–760 mg chewable tablets before meals for GI protection [1].'] | Standard | Check label | |
| ['Whole licorice root extract', 'therapeutic but risky', 'Contains glycyrrhizin. 200–600 mg/day for ≤4 weeks only. For adrenal/hepatic/respiratory use [1].'] | Standard | Check label | |
| ['Licorice root tea', 'traditional', '1–2 cups/day. Variable glycyrrhizin (50–300 mg/cup). Popular in Middle East and Europe [1].'] | Standard | Check label | |
| ['Licorice candy', 'food', "European-style (contains glycyrrhizin). American 'licorice' often contains anise, not real licorice [1]."] | Standard | Check label |
3 Common questions
What is DGL and why is it safer? ▼
DGL (Deglycyrrhizinated Licorice) is licorice root with glycyrrhizin removed (<3% remaining). Glycyrrhizin causes pseudoaldosteronism (hypertension, hypokalemia); removing it eliminates this risk while preserving the GI-protective flavonoids and mucus-stimulating compounds. DGL is safe for long-term use [1].
Can licorice tea kill you? ▼
Extreme cases: yes. Multiple case reports document cardiac arrest and fatal arrhythmias from chronic excessive licorice tea or candy consumption. A 2020 case involved a Massachusetts man who died after eating 1.5 bags of licorice candy daily for 3 weeks (glycyrrhizin-induced hypokalemia → cardiac arrest). These are extreme intake cases, but they illustrate the real pharmacological danger [1].
How much licorice is safe? ▼
EFSA recommends ≤100 mg glycyrrhizin/day from all sources. This equals roughly 1 cup of licorice tea or 50 g of European licorice candy. Many people unknowingly exceed this. For therapeutic use, limit whole licorice to ≤4 weeks and monitor K+ and BP. For GI use, choose DGL instead [1].
Is American licorice candy dangerous? ▼
Most American 'licorice' candy (Twizzlers, Red Vines) contains anise flavoring, NOT real licorice/glycyrrhizin. European/Scandinavian licorice (Dutch drop, salmiakki) DOES contain glycyrrhizin and is the source of toxicity cases [1].
4 Clinical evidence
Strong
Pseudoaldosteronism mechanism: 11β-HSD2 inhibition is established pharmacology — glycyrrhizin is used as the model compound for this enzyme pathway in medical education. Dose-response is well-characterized: >100 mg/day glycyrrhizin × 4+ weeks → sodium retention, K+ wasting, hypertension [1]. HIGH
Moderate
DGL for GI: DGL reduced gastric ulcer recurrence in older RCTs (1970s–80s). Modern use is for functional dyspepsia and GERD symptom relief [2]. Hepatoprotection: IV glycyrrhizin (Stronger Neo-Minophagen C, SNMC) is used in Japan for chronic hepatitis C — reduces ALT and prevents hepatocellular carcinoma progression in observational data [1]. Cough: glycyrrhizin has demulcent and expectorant properties; licorice root is in multiple traditional cough formulas [1]. Adrenal support: by prolonging cortisol half-life, licorice can theoretically support patients with adrenal insufficiency — but this is dose-dependent and risky [1]. MODERATE
Insufficient
5 Safety, toxicity & adverse events
Absolute contraindications
✕ Hypertension, heart failure, hypokalemia or significant kidney disease — glycyrrhizin causes pseudohyperaldosteronism
✕ Pregnancy — linked to preterm birth and child outcomes
Relative
⚠ Digoxin — hypokalemia raises toxicity risk
⚠ Diuretics, corticosteroids — additive potassium loss
⚠ Avoid prolonged/high intake; use DGL (deglycyrrhizinated) to avoid these effects
🚩 Red flags
● Patient on digoxin + licorice — LIFE-THREATENING hypokalemia risk [1]
● Patient on loop/thiazide diuretics + licorice — additive K+ wasting [1]
● Patient drinking >2 cups licorice tea/day chronically — exceeds safety threshold [1]
● New hypertension in a licorice consumer — check K+, stop licorice [1]
● Pregnant patient consuming licorice products — premature birth association [1]
6 Interactions
Drug interactions
Digoxin Major/life-threatening
Mechanism: Glycyrrhizin → hypokalemia → increased digoxin sensitivity → arrhythmia [1].
Effect: Potentially fatal cardiac arrhythmia [1].
Action: AVOID licorice in digoxin patients [1].
Loop/thiazide diuretics Major
Mechanism: Additive potassium wasting [1].
Effect: Severe hypokalemia [1].
Action: AVOID combination. Monitor K+ if unavoidable [1].
Supplement synergies
Marshmallow Root · DGL 380 mg + marshmallow 400 mg before meals
Complementary GI protection: DGL (mucus secretion) + marshmallow (demulcent coating) [1].
Complementary GI protection: DGL (mucus secretion) + marshmallow (demulcent coating) [1].
7 Regulatory
European Union (EFSA): 100 mg glycyrrhizin/day upper limit. Labeling required: 'Contains glycyrrhizin — people suffering from hypertension should avoid excessive consumption' for products >100 mg/kg glycyrrhizin [1].
Germany (Commission E): Approved for upper respiratory catarrh and gastric/duodenal ulcers. Maximum 4–6 week course [1].
WHO: Monograph recommends ≤100 mg glycyrrhizin/day [1].
FDA: Available as dietary supplement and food ingredient. No specific glycyrrhizin limit (unlike EU) [1].
8 US supplement products
1
on-market products containing Licorice Root (NIH DSLD)
Brands carrying Licorice Root (1)
Click a brand to see its Licorice Root products.
9 Frequently paired with
10 Cite this page
Vancouver: Pkhakadze G. Licorice Root — safety profile [Internet]. Tbilisi: PHIG; 2026 [cited 2026 Aug 07]. Available from: https://supplement.ge/ingredients/licorice-root/
APA 7th: Pkhakadze, G. (2026). Licorice Root — Safety profile. Public Health Institute of Georgia. https://supplement.ge/ingredients/licorice-root/
📋 Editorial information
Author: Prof. G. Pkhakadze, MD, MPH, PhD
Institution: Public Health Institute of Georgia (PHIG)
Affiliation: David Tvildiani Medical University (DTMU)
First published: January 2026
Last reviewed: 2026-05-29
Next review: February 2027
References: 4 cited sources
COI: SupplementIndex receives no funding from supplement manufacturers. All content independently authored by PHIG.
Process: Systematic literature review
📄 License & reuse
Published under Creative Commons Attribution 4.0 International (CC BY 4.0). You may share and adapt for any purpose with attribution.
Pkhakadze G. "Licorice Root — Safety Profile." SupplementIndex, PHIG, 2026. https://supplement.ge/ingredients/licorice-root/ CC BY 4.0.
GP
Prof. G. Pkhakadze, MD, MPH, PhD
Professor of Public Health · Head of Department, DTMU
Editor-in-Chief, Georgian Medical Journal (ISSN 3088-4322)
Chair, Public Health Institute of Georgia · UEMS Public Health Section
Educational and public health purposes. CC BY 4.0. Consult your healthcare provider before starting any supplement. Corrections: info@accreditation.ge. Publisher: PHIG