A Massachusetts construction worker suddenly collapsed at lunch with his co-workers and later died in what doctors say was a major heart issue brought on by his love for black licorice.
The man, 54, ultimately died because he ate a bag-and-a-half of licorice after work every day for several weeks, according to a case study published recently in the New England Journal of Medicine. The black licorice contained glycyrrhizic acid, a chemical that raises a person’s blood pressure and lowers their potassium levels, especially when consumed in large amounts.
It was the man’s candy habit that killed him, according to Dr. Neel Butala, a cardiologist at Massachusetts General Hospital and author of the case study.
“Even a small amount of licorice you eat can increase your blood pressure a little bit,” Butala told The Associated Press.
The glycyrrhizic acid also left the man with dangerously low potassium levels and an imbalance in his electrolytes, Butala says.
First responders revived the man through CPR but he died the following day, according to the case study.
Glycyrrhizic acid can be found in many licorice-derived foods and dietary supplements, but concentrations should not exceed 3.1 per cent, according to rules from the U.S. Food and Drug Association (FDA). However, the FDA doesn’t regulate glycyrrhizic acid concentration by the ounce, which means it can be hard to know how much is in a bag of black licorice.
As little as 57 grams (2 ounces) of glycyrrhizic acid a day can cause heart rhythm problems within a matter of two weeks, especially for people over 40, the FDA says.
Licorice sticks are not the only source of glycyrrhizic acid, according to Dr. Robert Eckel, a University of Colorado cardiologist and former president of the American Heart Association.
“It could be jelly beans, licorice teas, a lot of things over the counter,” said Eckel, who was not involved in the man’s case. “Even some beers, like Belgian beers, have this compound in it.”
Canada has seen several glycyrrhizic acid-related cases of its own, including an 84-year-old who was admitted to the emergency room last year with a “hypertensive emergency.” The man told doctors that he’d been drinking licorice tea twice a day for two weeks prior to the episode.
In another documented case, a 49-year-old doctor suddenly gained weight and developed relative hypertension due to licorice candy cigars.
The construction worker had recently switched to black licorice after eating red fruit-flavoured twists, according to the case report. He was also a decades-long pack-a-day smoker and had an untreated hepatitis C virus infection.
Despite those factors, clinicians said, his heart and nutrient imbalance issues were likely caused by “excessive licorice consumption.”
“All of our products are safe to eat and formulated in full compliance with FDA regulations,” a spokesperson for Hershey Company, which makes Twizzlers, told the AP. He added that all foods, including candy, “should be enjoyed in moderation.”
It’s unclear whether the man ate Twizzlers, Nibs or some other form of black licorice.
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This article has been updated to include additional information about the deceased.
—With files from The Associated Press