We actually learned about this in med school last week, but I never thought it actually happened to people... Licorice contains glycyrrhetinic acid which inhibits the conversion of cortisol to cortisone. If you have too much cortisol floating around because of this, that cortisol starts activating receptors in your kidneys that are normally activated by aldosterone. This in turn increases your sodium resorption and potassium excretion, so you get high blood pressure and low potassium which can cause arrhythmias. It's called the Syndrome of Apparent Mineralocorticoid Excess and is a usually genetic problem with the enzyme that breaks down cortisol.
One time, I was awake for ~3 days straight. I ended up in the hospital (visual hallucinations) and the only thing remarkable was low potassium and high BP.
But I've had this long running hypothesis that body has trouble with cortisol regulation when I'm extremely fatigued. If I miss a night of sleep, the next night it is extremely hard for me to fall asleep (cortisol inhibits sleep) and I have that terrible 'stress sweat' odor.
Remeron will then knock me out... where as hypnotics will not. Remeron being interesting because it inhibits the production of cortisol.
I would suggest that the hallucinations were simply a symptom of your sleep deprivation. I've experienced the same after a similar amount of time awake coding.
I starting to suspect I have a variety of such genetic endowments- gout because I can't break down uric acid, high blood pressure that gets instantly elevated when I eat black licorice (which I loved as a kid), variety of allergies, Type II Diabetes (along with most of my sibs, regardless of their diets.)
Not necessarily. Believe it or not, dexamethasone (another corticosteroid) is actually a second-line treatment for this disease because it reduces endogenous cortisol production without binding too tightly to the mineralocorticoid receptor in the kidneys.
Strong black licorice, "lakrids," abounds in Denmark. My brother visited me when I was living there and ate a pound or so of little, tobacco-pipe shaped licorice in an afternoon. He got profoundly ill with a racing heartbeat, lightheaded, dizzy and nauseous. I almost took him to the hospital but he refused. It took a couple of days before he felt good enough to get out of the apartment.
Sometime after, I mentioned this to a Danish friend and he said, "Oh, yeah, you never want to eat much of that. People have damaged their eyesight from eating too much."
I went to the doctor with acute high blood pressure that appeared out of nowhere. Symptoms were an untreatable headache and swelling in the facial region, lasting for a few days.
In the end, I figured out that the cause was eating a big package of the same soft sweet black licorice. I even kept eating it during symptoms, making the condition worse.
My main reaction, after learning that the licorice could cause this, was how the hell is there not a huge warning on the packaging? I can only imagine how bad it could get if I had been already suffering from hypertension when eating it.
I had a similar issue with the acute HBP out of nowhere and constant headaches. My liver levels were also all out of whack. I never figure out what caused it but it did resolve after several weeks. My BP and liver are completely normal now. The best I could do was narrow it down to recently starting to drink a ton of green tea or some supplements that I had started taking. I just cut it all out and it went away.
That reminds me of the time I learned that dates are diuretic while in Morocco. They were so delicious I would eat a bag per day. Even while swearing I must have dysentery.
On a similar note, I used to not smoke anything but gladly partake in a hookah pipe while out, I liked the different flavors and assumed the “fog” was benign.
I stopped AS SOON AS I heard about how much worse hookah was. I had no clue and am completely appalled at the lack of warnings.
I’ve met many other people that say the same thing.
I still don't smoke anything, and also cut hookah out.
The origin of salty licorice was as a throat lozenge (same reason a singer might gargle salt water ever so often to keep their throat healthy) in cold/freezing fishing waters. (The salt was the important bit, the licorice was just the flavor the fisherman really like to make it sweeter and easier to chew.) It wasn't invented to be an appetite suppressor, though for a lot of people it certainly is. (Not many people like salty licorice, given a choice.) (Also, ironically, salt in general is not an appetite suppressant and there are documentaries about why salt was added to so many foods to increase consumption.)
The licorice pipes were not the super-strong shiny black variety but the somewhat sweet, softer black licorice that, when torn, is a dark brown inside.
As many other Danes, I have a total weakness for licorice. But I believe it’s common knowledge that you’re not supposed to eat a lot of it at once. Certain types do have warnings printed on them like “For adults, not for kids” but most do not.
The sneaky part that the article also describes is that you don’t really feel any symptoms until it’s too late. So once in a while when I buy a pack I spread it out over several days, preferably with space in between just to be sure.
Also, my mom ate a bunch of one of those ‘not for kids’ types of licorice when she was pregnant with me which is kind of concerning. I don’t know exactly how much though, hopefully not dangerous amounts. At least I don’t know that I have suffered any direct consequences of that habit.
What? I’m Danish and I’ve eaten 45 of those (lakridspiber), and felt nothing but shame.
Were they the yellow or pink ones?
I generally don’t eat a lot of candy, but maybe once a year in a while I’ll eat quite a lot of whatever crave springs up. Sometimes that is lakrids. Maybe I should be more careful?
Yeah it’s odd, one pack is usually 16-20 and one pack is around a pound if my calculations aren’t way off. One packs is nearing the limit for a session but I can’t ever remember having any headaches or anything from them.
Just want to point out that your post make it sound like the tobacco-pibe shaped licorice is strong licorice. It is actually some of the mildest you can possibly make.
> If you’re 40 or older, eating 2 ounces of black licorice a day for at least two weeks could land you in the hospital with an irregular heart rhythm or arrhythmia.
I love black licorice but as far as I'm concerned that's enough of a reason to do without. Just because the damage is visible after two weeks doesn't mean that it doesn't occur in quantities below that amount.
You almost certainly do not need to completely drop black licorice. From what the article you linked says, it doesn't sound like it directly damages the heart or the things that regulate heart rhythm.
The glycyrrhizin in black licorice lowers potassium levels, and heart rhythm regulation depends on potassium levels. Stop eating glycyrrhizin, and the potassium levels come back to normal.
If you only eat black licorice occasionally, and limit your quantity then so that you do not get enough glycyrrhizin to lower potassium levels to where they actually cause anything bad to happen, you should be perfectly safe. As a precaution, next time you have occasion to have a blood test, get your doctor to include a potassium test. If that doesn't come back close to the low end of the normal range, an occasional bit of licorice should be fine.
If a potassium test isn't too expensive, it might be interesting to have another test shortly after you have consumed some licorice, to try to get an idea of how much it affects potassium for you.
I wonder if the potassium lowering effect of glycyrrhizin could be countered by eating the licorice with something else that is high in potassium. Eat a banana with your licorice, say. Or maybe take a potassium supplement on days you want to eat licorice?
As someone who takes a considerable amount of a potassium-sparing diuretic every day for medical reasons, it just occurred to me that I might benefit from eating more licorice, as hyperkalemia is an actual risk of my meds.
Twizzlers aren't exactly Pomfrey (Pontefract) cakes. You'd really need to go to town on them. On t'other hand, if you pick through Allsorts to avoid the more creamy ones (ugh), or actually dealing with Pomfrey cakes (or their other Nothern European relatives) you really have to watch it. But then, if you're doing 60-ish grams of any sweet daily, you might want to rethink your diet.
2 ounces of liquorice per day seems like a lot, though. I'm sure a few grams is fine. Drinking ten cups of coffee a day for two weeks will likely cause similar issues, that doesn't mean one or two cups every day is harmful.
Dr. Hibbert: Another broccoli-related death.
Marge: But I thought broccoli was—
Dr. Hibbert: Oh yes. One of the deadliest plants on Earth. Why, it tries to warn you itself with its terrible taste.
I was starting to get worried that I was the only one. There should be laws prohibiting the placement of the word candy anywhere near the word liquorice. It's the worst form of false advertisement I've come across. Candy is supposed to taste good!
That childhood trauma is still with me to this day. I feel disgust and anger at the mention of liquorice.
Black licorice is one of those foods that is polarizing. People either absolutely love it or think it’s vile and shouldn’t be legal. I don’t think I’ve ever encountered someone who is ambivalent about it.
Humor aside: oven-roasted or pan-seared broccoli with garlic, salt, and butter tastes amazing! And depending on how much salt and butter you add, is probably way safer to eat than black liquorice.
Another variation, which my family really enjoys is: cut fresh broccoli into small florets; toss with olive oil and (optionally) salt/pepper; roast in oven at high temp until desired softness.
I tried butter with my broccoli once, and I found it tasted unpleasantly fatty. (And I'm no stranger to fatty foods.)
I don’t really buy that it makes that much of a difference. As a child I hated all forms of broccoli, could barely stomach it. Now that I’ve grown older I find even the plain steamed stuff edible. While I certainly like it prepped like you described, it still in the end has the taste of broccoli in it. I have a hard time imagining someone who hates the vegetable caring about how it was prepared.
I've always wondered if it's something like cilantro. They've identified a gene that makes cilantro taste soapy to some. Maybe there's something similar with licorice since I've noticed many people seem to have a strong negative reaction to it. (I find the flavor mild but interesting, like vanilla.)
I’ve wondered the same about grapefruit and bitterness as well.
I’ve compared relative bitterness of things to a grapefruit. My partner thinks grapefruit is less bitter than beer, or many items I consider barely bitter at all. Yet I find grapefruit to be incredibly bitter, out doing almost everything.
> "We are told that this patient has a poor diet and eats a lot of candy. Could his illness be related to candy consumption?" Dr Elazer R Edelman said.
> The patient had also recently changed the type of sweets he was eating. A few weeks before his death, he switched from red fruit-flavoured twists to another type made with black liquorice.
It sounds like this person was already on an EXTREMELY bad diet. I have personally known construction workers who live off of three square meals of gas station junk food for weeks at a time.
I'm not sure if I'm reading this correctly but this might also be one of those cases where the English language didn't help in the slightest:
"Red liquorice" is not what a German/Dutch/Scandinavian person would call liquorice. It's just red soft candy. It doesn't contain the same active ingredients.
So "switching from red to black liquorice" is in fact just a complete switch of diet, not a slight change at all.
Yep, I worked at a golf course in groundskeeping for a summer after HS. The diet of the "old timers" was absolutely ridiculous.
The worst, Jim, his lunch every day was literally a can of Coca-Cola and a can of Vienna Sausages (shitty canned tiny hot dogs for those that don't know). God knows what he ate before/after work.
He had a heart attack one day at work. Was only in his early 50s.
If any of you drink Traditional Medicinals or Yogi brand teas when you're sick (Throat Coat, Cold Care, etc), note that many of them contain licorice root and therefore glycyrrhizic acid. It drives me crazy that there weren't more prominent warnings on these because people tend to drink dozens of cups a day when they're sick, which can be dangerous for certain people
I always knew the Dutch Apekoppen or 'banana monkeys' were the perfect way to enjoy the dangerous black stuff. The mix of high potassium banana with the lethal liquorice makes it both delicious and safe
There was a case when a woman in Germany also ate lots of liquorice on a daily basis and developed health problems. The case went to court because she thought that she should have been warned by the producer. It was dismissed with a reason like "common sense dictates that this was a bad idea" (think: "lol, wut? u dumb").
I don't see what's frivolous about it. I hate liquorice but had no idea it was dangerous to consume in quantity,a nd in general I'm quite health/diet conscious.
I don’t know, seems reasonable to me. How many people on the street would know when asked what the safe dosage of liquorice is? Guess most would say it’s no worse than any sugary candy. Is it not similar to an allergy?
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We actually learned about this in med school last week, but I never thought it actually happened to people... Licorice contains glycyrrhetinic acid which inhibits the conversion of cortisol to cortisone. If you have too much cortisol floating around because of this, that cortisol starts activating receptors in your kidneys that are normally activated by aldosterone. This in turn increases your sodium resorption and potassium excretion, so you get high blood pressure and low potassium which can cause arrhythmias. It's called the Syndrome of Apparent Mineralocorticoid Excess and is a usually genetic problem with the enzyme that breaks down cortisol.
One time, I was awake for ~3 days straight. I ended up in the hospital (visual hallucinations) and the only thing remarkable was low potassium and high BP.
But I've had this long running hypothesis that body has trouble with cortisol regulation when I'm extremely fatigued. If I miss a night of sleep, the next night it is extremely hard for me to fall asleep (cortisol inhibits sleep) and I have that terrible 'stress sweat' odor.
Remeron will then knock me out... where as hypnotics will not. Remeron being interesting because it inhibits the production of cortisol.
Hopefully Dad's Parkinsons isn't genetic...
Sometime after, I mentioned this to a Danish friend and he said, "Oh, yeah, you never want to eat much of that. People have damaged their eyesight from eating too much."
In the end, I figured out that the cause was eating a big package of the same soft sweet black licorice. I even kept eating it during symptoms, making the condition worse.
My main reaction, after learning that the licorice could cause this, was how the hell is there not a huge warning on the packaging? I can only imagine how bad it could get if I had been already suffering from hypertension when eating it.
I stopped AS SOON AS I heard about how much worse hookah was. I had no clue and am completely appalled at the lack of warnings.
I’ve met many other people that say the same thing.
I still don't smoke anything, and also cut hookah out.
Usually I can only make it 2/3rd through a single piece before the ammonia flavor is too over powering.
It's a very acquired flavor... just like I absolutely cannot get used to the taste of IPAs.
The sneaky part that the article also describes is that you don’t really feel any symptoms until it’s too late. So once in a while when I buy a pack I spread it out over several days, preferably with space in between just to be sure.
Also, my mom ate a bunch of one of those ‘not for kids’ types of licorice when she was pregnant with me which is kind of concerning. I don’t know exactly how much though, hopefully not dangerous amounts. At least I don’t know that I have suffered any direct consequences of that habit.
Were they the yellow or pink ones?
I generally don’t eat a lot of candy, but maybe once a year in a while I’ll eat quite a lot of whatever crave springs up. Sometimes that is lakrids. Maybe I should be more careful?
People have died from drinking too much water, probably more than have been killed by liquorice.
Dead Comment
https://www.licoriceinternational.com/licorice/pc/Danish-Lic...
https://www.fda.gov/consumers/consumer-updates/black-licoric...
> If you’re 40 or older, eating 2 ounces of black licorice a day for at least two weeks could land you in the hospital with an irregular heart rhythm or arrhythmia.
I love black licorice but as far as I'm concerned that's enough of a reason to do without. Just because the damage is visible after two weeks doesn't mean that it doesn't occur in quantities below that amount.
The glycyrrhizin in black licorice lowers potassium levels, and heart rhythm regulation depends on potassium levels. Stop eating glycyrrhizin, and the potassium levels come back to normal.
If you only eat black licorice occasionally, and limit your quantity then so that you do not get enough glycyrrhizin to lower potassium levels to where they actually cause anything bad to happen, you should be perfectly safe. As a precaution, next time you have occasion to have a blood test, get your doctor to include a potassium test. If that doesn't come back close to the low end of the normal range, an occasional bit of licorice should be fine.
If a potassium test isn't too expensive, it might be interesting to have another test shortly after you have consumed some licorice, to try to get an idea of how much it affects potassium for you.
I wonder if the potassium lowering effect of glycyrrhizin could be countered by eating the licorice with something else that is high in potassium. Eat a banana with your licorice, say. Or maybe take a potassium supplement on days you want to eat licorice?
I love licorice in all its forms but gave it up years ago. I always felt weird after drinking a cup of licorice tea.
Same. It's a shame because it's often added to some blends that I would otherwise enjoy and would not expect licorice root to be added.
It's not like each dose does a certain amount of damage. If you don't cause an imbalance then it's harmless (as far as this mechanism goes).
People have died from drinking too much water. Or breathing too much oxygen.
I feel the same about Liquorice
I was starting to get worried that I was the only one. There should be laws prohibiting the placement of the word candy anywhere near the word liquorice. It's the worst form of false advertisement I've come across. Candy is supposed to taste good!
That childhood trauma is still with me to this day. I feel disgust and anger at the mention of liquorice.
It's the culinary equivalent of bleach and ammonia Tide pods.
I tried butter with my broccoli once, and I found it tasted unpleasantly fatty. (And I'm no stranger to fatty foods.)
I’ve compared relative bitterness of things to a grapefruit. My partner thinks grapefruit is less bitter than beer, or many items I consider barely bitter at all. Yet I find grapefruit to be incredibly bitter, out doing almost everything.
Maybe that’s why I don’t like it much?
(and have to admit, that occasionally I enjoy the taste of liquorice, though I only eat it extremely rarely)
> The patient had also recently changed the type of sweets he was eating. A few weeks before his death, he switched from red fruit-flavoured twists to another type made with black liquorice.
It sounds like this person was already on an EXTREMELY bad diet. I have personally known construction workers who live off of three square meals of gas station junk food for weeks at a time.
"Red liquorice" is not what a German/Dutch/Scandinavian person would call liquorice. It's just red soft candy. It doesn't contain the same active ingredients.
So "switching from red to black liquorice" is in fact just a complete switch of diet, not a slight change at all.
The worst, Jim, his lunch every day was literally a can of Coca-Cola and a can of Vienna Sausages (shitty canned tiny hot dogs for those that don't know). God knows what he ate before/after work.
He had a heart attack one day at work. Was only in his early 50s.
Deleted Comment
https://www.mrsbeightons.co.uk/wp-content/uploads/2016/08/Ba...
PS not endorsed by any kind of real science...
And this is why Europe is less litigious than the US (that and reasonable healthcare costs): the courts won't stand for frivolous cases.