A Montreal man was sent to the emergency room after consuming too much homemade licorice tea, a new report has found.
According to a recent case study in the Canadian Medical Association Journal, the 84-year-old man was treated for high blood pressure at the McGill University Health Centre in Montreal.
“His blood pressure was severely elevated, and he was suffering from a headache, light sensitivity, chest pain, fatigue and fluid retention in the calves,” authors said in a statement.
The patient, who had a history of high blood pressure, told doctors he had been consuming one to two cups of the tea every day. The homemade tea, called erk sous, was made with licorice root extract. The patient told doctors he had consumed the tea for two weeks before his hospital visit.
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“Erk sous is a popular Egyptian drink, sought after for its thirst-quenching effect, especially during the month of Ramadan. It is traditionally prepared by combining licorice root and baking soda in a cloth and adding water to it drop by drop over several hours,” authors wrote.
Dr. Jean-Pierre Falet of the department of neurology at McGill University told Global News the severe side effects from licorice are still considered uncommon, and these products (in any form) can be consumed safely in moderation.
“Rarely, if consumed in excess, patients can develop severe blood pressure elevations which can lead to problems such as heart failure, hypertensive encephalopathy or stroke,” he explained. “Some patients have also presented with muscle weakness and cardiac arrhythmias.”
Some dangers of excess licorice roots
According to experts at the U.S. Food and Drug Administration, black licorice contains the compound glycyrrhizin, a compound from licorice root.
“Glycyrrhizin can cause potassium levels in the body to fall. When that happens, some people experience abnormal heart rhythms, as well as high blood pressure, edema (swelling), lethargy and congestive heart failure,” the site noted.
Falet added glycyrrhizin gives licorice its sweet taste.
“The main mechanism of action is in the kidney where it increases re-absorption of salt and water leading to high blood pressure and water retention.”
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The agency reported there were also reports of people “overdosing” by eating too much licorice candy during Halloween. Other medical journals have pointed out black licorice could lead to health problems for people over the age of 40, especially those with a history of heart disease or high blood pressure.
The study authors added licorice is known to “exacerbate high blood pressure” in patients with hypertension.
Falet added there are many regulations around safe concentrations of glycyrrhizin, but sometimes, the concentration of the compound is difficult to estimate in practice.
“The concentration and absorption can be highly variable depending on the product, especially in homemade licorice extract like the drink produced by our patient,” he continued.
“It would therefore be advisable for patients to refer to the product packaging, their local regulatory body and their physician, to know if they are consuming amounts in excess of what is thought to be safe.”
He added this does not mean patients should stop drinking licorice tea or other products containing licorice root extract altogether.
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“They should be mindful of its potential side effects and discuss the matter with their healthcare provider if they have a concern.”
Falet said hypertension does not typically happen unless the person’s blood pressure is significantly elevated or if there was damage to other organs as a consequence of the hypertension.
“Some of the symptoms in hypertensive crises include headaches, chest pain, difficulty breathing, water retention, various neurological symptoms including changes in wakefulness, agitation, confusion, seizures, or symptoms of stroke), vision loss, nausea or vomiting.”
Authors stressed given Canada’s multicultural population, doctors should consider screening patients for licorice root intake if they present symptoms of “difficult-to-control hypertension.”
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