The cardiovascular complications of licorice

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Licorice is a US Food and Drug Administration approved food supplement present in various forms without strict policies to regulate its consumption and to prevent toxicity. It is widely utilized as a sweetener, a thirst quencher, in various candies and drinks, and has some medicinal applications. The health benefits of licorice are minor compared to the adverse outcomes of chronic use which is never justified nor recommended. The long-established belief among the community that licorice is a natural healthy substance free of side effects promotes its liberal consumption and predisposition to toxicity. This merits further nationwide education through different media types on the health hazards of chronic licorice intake and the tolerable upper limit of daily ingestion. The main mode of action is through inhibition of the enzyme 11-β-hydroxysteroid dehydrogenase, resulting in a mineralocorticoid effect. This aldosterone-like action is the basic principle for understanding its health benefits and the wide spectrum of adverse effects. Among the various complications associated with excess licorice intake, effects on the cardiovascular system are the most serious. Herein is a review of the various cardiovascular complications associated with licorice intake. I hope that this review will caution physicians, exposed patients, and manufacturing companies against the detrimental effects of licorice and impel the Food and Drug Administration to actively control the use of this substance.

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