Glycyrrhiza glabra

Glycyrrhiza glabra                                     Common name: Licorice, Liquorice

Family: Fabaceae

 Part used: Dried root & rhizome

Constituents: Triterpene saponins (glycyrrhizin, glycyrrhizic & glycyrrhetinic acid), flavonoids, iso-flavonoids, phytosterols, polysaccharides (glucans), coumarins, volatile oils, amino acids, gum, lignans, starch, sugars

Actions: General tonic, anti-depressant, adrenal restorative, adrenal tonic, anti-tumor, anti-viral, anti-inflammatory, anti-tussive, mucoprotector, expectorant, detoxifier, demulcent, hepatoprotector, anti-ulcer, mild laxative, aldosterone-like action, anti-spasmodic

Medical uses: Is specific for the treatment of peptic ulcers and Addison’s disease. Also used for adrenal insufficiency, corticosteroid withdrawal, hypoglycemia and protection against cataracts in diabetes. Inflammatory conditions also benefit from it’s use such as allergies and autoimmune disease, lyme disease, and protects against carcinogens. It will soothe gastrointestinal inflammation and irritations such as GERD, gastritis, IBD, and ulcers. For rheumatism, muscle spasm & cramps, and joint inflammation it can be used both internally and topically.

Pharmacology:

• Triterpene saponins (glycyrrhizin, glycyrrhizic acid) antagonize effect of estrogen, inhibit growth of HIV & DNA/RNA viruses, and are anti-inflammatory.
• Glycyrrhetinic acid is an aglycone similar to natural corticosteroids which have an adrenocorticomimetic action. Is also anti-viral, hepatoprotective, inhibits EBV activation and is anti-inflammatory and anti-tumor.
• Glycyrrhizic acid (GZA) inhibits the type 2 isoenzyme of 11 beta-hydroxysteroid dehyrogenase (11B-HSD), which prevents local inactivation of cortisol, specifically within the renal tubules. There is increased availability of cortisol to bind to renal mineralcorticosteroid receptors resulting in excess activity or pseudohyperaldosteronism.
• Flavonoids and isoflavonoids are anti-microbial and estrogenic.
• Phytosterols have an estrogenic action.
• Polysaccharides (glucans) are demulcent.
• DGL (deglycyrrhinized licorice) is a preparation where most of the GL has been removed. It inhibits the formation of ulcers, reduces gastric secretions, and protects gastric mucosa against damage.

Pharmacy: Powdered root: 1-4g TID. Decoction: 1 tsp/cup, simmer 15 min, TID. Tincture: (1:1, 20%) 2-6ml QD.

Contraindications: Use with caution in anemia, hypertension, cardiovascular disorders, edema associated with heart failure, liver problems, kidney insufficiency, hypokalemia, hypothyroidism, fibrocystic breasts, male infertility or erectile dysfunction.

Toxicity: Minimal adverse effects if intake is less than 10mg/day. Long term use may reduce thyroid function and basal metabolic rate. High doses of long term use may cause pseudohyperaldosteronism, presenting as hypertension with sodium retention, edema, hypokalemia, metabolic alkalosis and low plasma renin activity, with resolution of symptoms after the patient stops using licorice. (Ottenbacher R, Blehm J. An Unusual Case of Licorice-Induced Hypertensive Crisis. S D Med. 2015 Aug;68(8):346-7, 349).

Interactions: With diuretics, cardiac glycosides, corticosteroids, MAOIs, blood pressure medications, spironolactone, hormonal therapies, laxatives and K+ depleting medications.