What Are the Benefits and Risks of Licorice Root?

Commonly known as licorice root, Glycyrrhiza glabra has been used for centuries in traditional medicine systems—including Traditional Chinese Medicine (TCM) and Ayurveda—for its purported anti-inflammatory, antitussive, and gastroprotective properties. Modern pharmacological research supports several of these traditional uses: glycyrrhizin, the primary bioactive triterpenoid saponin in licorice, demonstrates demonstrated corticosteroid-like activity, inhibits 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2), and modulates immune cell function. Clinical evidence suggests modest efficacy in soothing upper respiratory tract irritation and supporting gastric mucosal integrity in mild functional dyspepsia.

However, licorice consumption carries well-documented risks, particularly with prolonged or high-dose intake. Glycyrrhizin-induced inhibition of 11β-HSD2 leads to cortisol-mediated mineralocorticoid excess, resulting in hypokalemia, hypertension, sodium retention, and edema—collectively termed pseudohyperaldosteronism. These effects are dose-dependent and may manifest after as little as two weeks of daily ingestion exceeding 100 mg of glycyrrhizin (roughly equivalent to 5–15 g of raw root). Individuals with preexisting hypertension, heart failure, renal impairment, or hypokalemia are at heightened risk and should avoid licorice altogether.

Notably, deglycyrrhizinated licorice (DGL)—a preparation with >97% of glycyrrhizin removed—is widely available and retains mucosal protective effects without the mineralocorticoid side effects. DGL is commonly used in clinical practice for short-term management of occasional heartburn or gastric discomfort. Still, even DGL should be used under professional guidance when symptoms persist beyond two weeks, as chronic gastrointestinal complaints warrant formal evaluation to rule out serious underlying pathology such as peptic ulcer disease, Barrett’s esophagus, or malignancy.

In summary, while licorice offers biologically plausible benefits rooted in its phytochemistry, its therapeutic window is narrow. Its use demands careful consideration of dose, duration, and individual risk factors. Patients should always disclose licorice supplement use to their healthcare providers—especially those managing cardiovascular or endocrine conditions—to prevent clinically significant drug–herb interactions and adverse metabolic sequelae.