Licorice Root, cautions

Due to the adverse reaction profile of licorice, many studies have been performed using the deglycyrrhizinated licorice (DGL) extract that is free of glycyrrhizin.

When not to use:

Licorice and blood pressure: normally people are about 120/80 and using licorice it just goes up 5ml of mercury, compared to stress which raises it by 20.

If you take licorice in large doses for a year or so you can develop a hormonal problem called pseudoaldosteronism. This is rare but it could account for the number of reported side affects that are associated with licorice use. These side effects include high blood pressure. It is therefore recommended that you not take it for longer than 6 weeks. This should mean that the side effects are unlikely to occur.
Its use in hypertension (high blood pressure) or with digitalis should be discouraged.
Do not take licorice during pregnancy.
Avoid licorice in cases of edema, nausea, vomiting, and rapid heartbeat
contraindicated in patients with cholestatic disorders or cirrhosis of the liver, hypokalaemia, or chronic renal insufficiency,

Chinese licorice (G. uralensis) is said to be less likely to cause side effects than the European variety (G.glabra). All these precautions notwithstanding, licorice is often added in very small amounts to other herbal medicines.

Avoid in conditions of adrenal hyperfunctioning such as hypertension, water retention (especially around the heart), hyperglycemia, osteoporosis, and with excess secretions generally (as found in stomach Qi stagnation for example). Some individuals are naturally sensitive to Licorice extracts and preparations, laxatives containing a large proportion of Licorice extract , and anti-ulcer medicines made from its concentrated derivatives. For these people, DGL -- deglycyrrhizinated Licorice-- should be used instead in the treatment of ulcers. However, Licorice root is still a mild remedy with virtually no cumulative toxicity.

Don't use licorice if you eat a meat and potatoes diet. Your body needs potassium from fruit and vegetables to compensate for the excretion of potassium stimulated by licorice. If you use steroids or an asthma inhaler, licorice will increase both the effectiveness of the drug and the severity of its side effects. Its long term use is not recommended, and it is not recommended for use by pregnant women. May cause stomach upset if taken in large quantities.

Licorice is contraindicated for symptoms of excess of yin, especially with abdominal stagnation, bloating, edema and renal hypertension. Because of the yin nature of females, there is an even stronger propensity towards fluid retention so that licorice is used even more conservatively in women's formulas, sometimes adding no more than a single slice for flavoring.

In high doses of up 12 grams or more, it has pseudoalderosterone activity caused by the glycerrhetinic acid content. This can cause symptoms of hypertension, hypokalemia, sodium and water retention. Licorice, has also been found to be effective in the management of Addison's disease or adrenal failure.

Interactions with Medications

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Licorice Root can interact with digoxin, increasing toxicity risk due to potassium depletion. It may reduce the effectiveness of antihypertensive medications by causing salt and water retention. Interactions with loop diuretics can lead to dangerously low potassium levels.

Licorice might interfere with estrogens, heart rhythm medications, blood thinners like warfarin, or corticosteroids like fludrocortisone.

It can make paclitaxel and cisplatin less effective and interact with blood pressure or diuretic drugs.

Licorice taken in high dosages or used long-term causes low blood levels of potassium. Loop diuretics also cause potassium loss. Therefore one should avoid taking licorice with loop diuretics. DGL licorice should not affect potassium levels and so should not pose a danger for loop diuretic users.

Licorice should never be taken along with potassium sparing diuretics. Potassium-sparing diuretics such as Amiloride and Aldactone cause the body to retain potassium whereas licorice has the opposite effect causing the body to lose potassium and thus directly counteracts the effect of these drugs.

Licorice can interact with thiazide diuretics enhancing their effects.

Licorice may cause increased hypokalemia if used with diuretics; avoid concurrent use.

Licorice can interact with diuretics negating the blood-pressure lowering effect of these drugs and causing irregular heartbeats from increased potassium loss. Licorice mimics the effect of aldosterone, an adrenal hormone that causes sodium retention and potassium loss.

Licorice can interact with corticosteroids to enhance their effects; avoid concurrent use.

Licorice can interact with corticosteroids causing salt and water retention, lowered blood potassium, elevated blood pressure, elevated blood sugar and excessive immune suppression by inhibiting an enzyme that breaks down corticosteroids, thus increasing blood levels of the drug.

Licorice can interact with digitalis or other cardiac glycosides causing increased sensitivity, increased toxicity and increased hypokalemia; do not use concurrently.

Licorice increases the cardiac effects of anti-arrhythmic drugs and therefore do not use concurrently.

Licorice may cause increased hypokalemia if used with antihypertensives; do not use concurrently.

Licorice. Whole licorice can cause sodium retention and increase blood pressure, thus counteracting the intended effects of ACE inhibitors. DGL (deglycyrrhizinated licorice) is an altered form of the herb that should not cause these problems.

Licorice; Concurrent use of licorice and Laxatives may result in increased risk of hypokalemia.