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Licorice

Deglycyrrhizinated Licorice (DGL) ; Licorice; Glycyrrhiza glabra

Proposed Uses
  • ORAL USES (DGL FORM):  Heartburn (Esophageal Reflux); Mouth Sores; Ulcers
  • TOPICAL USES (WHOLE HERB):  Eczema; Herpes; Psoriasis
  • ORAL USES (WHOLE HERB):  Asthma; Chronic Fatigue Syndrome; Cough

Licorice root has been used since ancient times both as food and as medicine.
Licorice contains a substance called glycyrrhizin which causes fluid retention, increased blood pressure, and loss of potassium. To prevent this, manufacturers remove glycyrrhizin from licorice, producing the safer product deglycyrrhizinated licorice, or DGL.

DGL has shown some promise for the treatment of ulcers.  Weak evidence hints that it might also help prevent ulcers caused by anti-inflammatory drugs.

DGL is also sometimes recommended for relieving the discomfort of canker sores and other mouth sores, but this potential use has not been studied scientifically.

Creams containing whole licorice (often combined with chamomile extract) are advocated for a variety of skin diseases, including eczema, psoriasis, and herpes, but as yet there is only supporting evidence for the first of these uses

Whole licorice, not DGL, is used as an expectorant for respiratory problems such as coughs and asthma.

Licorice has been suggested as a treatment for chronic fatigue syndrome (CFS), based on the observation that people with CFS appear to suffer from low levels of certain adrenal hormones. The glycyrrhizin portion of licorice may relieve symptoms by mimicking the effects of these hormones. However, this is a fairly dangerous approach to treatment that should be tried only under medical supervision.

Dosage
For supportive treatment of ulcer pain along with conventional medical care, the standard dose is two to four 380-mg tablets of DGL taken before meals and at bedtime. The same tablets can be allowed to slowly dissolve in the mouth for possible relief of mouth sore pain.

A typical dose of whole licorice is 5 to 15 g daily. However, we do not recommend the use of doses this high for more than a few weeks. For long term consumption, about 0.3 g of licorice root daily should be safe for most adults. Individuals who wish to take a higher dose should do so only under the supervision of a physician.

For the treatment of eczema, psoriasis, or herpes, 2% licorice gel or cream is applied twice daily to the affected area.

Safety Issues
Use of whole licorice has not been associated with significant adverse effects in the short term. However, two or more weeks of use may cause high blood pressure, fluid retention, and symptoms related to loss of potassium.  Such effects are especially dangerous for people who take the drug digoxin or medications that deplete the body of potassium (such as thiazide and loop diuretics), or who have high blood pressure, heart disease, diabetes, or kidney disease.

Whole licorice possesses significant estrogenic activity,  and some evidence indicates that licorice increases risk of premature birth. For these reasons, it shouldn't be taken by pregnant or nursing women, or women who have had breast cancer.

Maximum safe doses for young children, nursing women, or those with severe liver or kidney disease have not been established.

It is believed, but not proven, that most or all of the major side effects of licorice are due to glycyrrhizin. For this reason, DGL has been described as entirely safe. However, comprehensive safety studies on DGL have not been reported.

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