Liquorice Benefits, Usage, Medicinal Properties, Nutrition, Dosage, Preparations, safety, science backed and traditional view

Liquorice (Glycyrrhiza glabra L., Glycyrrhiza uralensis Fischer ex De Candolle) also known as Sweet Root, Licorice, Gan Cao, Lukrecja.

 

The plants are graceful, with light, spreading, pinnate foliage, presenting an almost feathery appearance from a distance. The leaflets (like those of the False Acacia) hang down during the night on each side of the midrib, though they do not meet beneath it. From the axils of the leaves spring racemes or spikes of papilionaceous small pale-blue, violet, yellowish-white or purplish flowers, followed by small pods somewhat resembling a partly-grown peapod in form. In the type species glabra, the pods are smooth, hence the specific name; in others they are hairy or spiny.

 

The underground system, as in so many Leguminosae, is double, the one part consisting of a vertical or tap root, often with several branches penetrating to a depth of 3 or 4 feet, the other of horizontal rhizomes, or stolons, thrown off from the root below the surface of the ground, which attain a length of many feet. These runners are furnished with leafbuds and throw up stems in their second year. The perennial downward-running roots as well as the long horizontal stolons are equally preserved for use.

 

Various indications point to the habit of this plant of fixing atmospheric nitrogen, as do many others of the family.

 

In the species glandulifera (W. and K.) the pods are covered with thick, glandular spines, and the whole plant is pubescent or roughly glandular. The underground portion is not so spreading and produces a carrot-shaped root larger than the Spanish root derived from G. glabra. This species is indigenous to South-east Europe, Syria and Western Asia, and is both wild and cultivated in Russia. Both the Russian and Persian Liquorice of commerce is derived from G. glandulifera, the Russian reaching this country is peeled or unpeeled: its taste although sweet, is accompanied by a more or less perceptible bitterness. It consists chiefly of roots, not runners.

 

Part Used: Root , Rhizome

 

Constituents: Oleane triterpenes (incl. Glycyrrhizin 5%), Glycyrrhizic acid as magnesium and calcium salts 2-15%, Chalcones (incl. rhamnoisoliquirytin, echinatin, liquiritegein, licuraside, neosoliliquiritin, licochalcones), polysaccharides (glucans), triterpenoid saponins, phytosterols (estrogens), coumarins (umbelliferone, glycirin, liqcoumarin, herniarin), mannitol, triterpenoids, resinous oil 15%, starch 20%, glucose 3%, saccharose 3%, asparagin 2-6%,  atropine, betain, cholin, steroids analogous too ACHT, bitters, progesterone-related substances, essential oil (incl. benzaldehyde, linalool, fenchone), amino acids

 

Flavour/Temps: moist, very sweet, neutral

Softening, Restoring, Relaxing, Calming; Air and Warmth bodies

 

Tropism: Intestines, Stomach, Pituitary, Lungs, Bladder, Adrenal Cortex

 

Meridians: 12 main Meridians

 

Key actions in western medicine: Antitumor, Anti-ulcer, Immune Enhancer, Demulcent, Antimicrobial, Anti-inflammatory, Laxative, Antidiabetic, Mucoprotective, Mild laxative.

 

Indications in western medicine: Allergies (immediate, incl. otitis, asthma, urticaria, rhinitis); Adrenocortical deficiency (incl. gonadal insufficiency, with vagotonia) menopausal Syndrome, Addison`s disease, adrenal failure; Hypoglycaemia; Chronic joint inflammation; Irritable, catarrhal and dry bronchial conditions; Hypercholesterolemia; Urinary irritation and pain (all types incl. hyperuricemia); Malabsorption syndrome, metabolic acidosis, malnutrition; Debility and fatigue from illness, overwork or stress; Skin eruptions (incl. pruritus, dermatitis, cysts, eczema); Autoimmune disorders (cell-mediated allergies, e.g. chronic hepatitis, ulcerative colitis, contact dermatitis, rheumatoid arthritis); Estrogen deficiency disorders ( incl. Depression, menopause, amenorrhea, PMS with dry skin); Respiratory infections with fever incl. pneumonia, whooping cough; Intestinal colic, IBS; Food poisoning mineral/herb/animal poisoning (incl. diphtheria, tetanus); Dry cough, dry sore throat, hoarseness; Gastric hyperacidity, peptic ulcers; Bacterial and Viral infections (esp. digestive, urogenital, respiratory incl. pneumonia, peptic ulcer, laryngitis, lung TB, hepatitis) Throat, Eye, Mouth and tongue inflammations (incl. laryngitis, aphthous sores, stomatitis); Tumors ( incl. granuloma, liver cancer); Chronic joint inflammations.

 

Key actions in eastern medicine: Reduces infections, Protects Liver and Stimulates immunity; Moisten the lungs, resolves vicious sputum, Promotes expectoration, Relieves Wheezing and Coughing; Tonifies digestive Qi, relieves fatigue and promotes absorption; Clears Heat, Reduces inflammation and heat, antidotes poison; Regulates immunity and reduces allergy; Benefits the skin; Stop spasm and relieves pain; Restores Adrenal gland and Pancreas, promotes weight.

 

Indication in eastern medicine: Fire toxin: furuncles, boils, abscesses (esp. with fever); Intestines Qi constraint: abdominal spasm, indigestion, cramping abdominal pain; Stomach and intestines Qi deficiency: Loose stool, weakness, appetite and weight loss; Lung-phlegm dryness: wheezing, dry cough, difficult expectoration of vicious sputum; Adrenal and Pancreas Yin deficiency: loss of stamina, sweet cravings, fatigue between or after meals; Lung heat (dryness): dry mouth, thirst, feverishness, dry cough, throat and nose with tickle in throat.

 

Ground: Melancholic and Phlegmatic krases

All three constitutions

Sensitive/Tai Yin Metal and Dependant/Tai Yin earth biotypes

 

Preparations: Decoction, Tincture, Liquid extract, Sirup

 

Dosage 3 times a day unless instructed otherwise by Herbalist:

Decoction 1-4 g

Tincture 1-3 ml, 1:2 25% alcohol

Liquid extract 0.7-2 ml, 1:1 25% alcohol

Note: Decoction should be used in Hot or hyperacidic gastric conditions (without or with ulcers) and best to be taken after meals. To improve intestinal absorption root should be roasted before decocting.

Note: Liquorice sirup is the great and used for thousands of years preparation for bronchial conditions (respiratory restorative, stimulant, demulcent recipe from Schroeder`s dispensatory Licorice root, Yarrow herb, Scabious herb, Elecampane root, Lungwort herb, Coltsfoot herb, Speedwell herb, Date fruit, Jujube berry, Meadow saffron petals).

Note: Washes are great remedy for local inflammations.

Note: High doses of Liquorice should not be taken over long time, Commission E advise that liquorice root should not be taken over period of 6-8 weeks without supervision of professional.  However, this is related to relatively high doses Commission E advise (5-15g dry root equivalent). Using lower doses Liquorice can be administered over longer period of time without risk of side effects.

Note: Since higher doses of Liquorice can cause Aldosterone-like side effects, Liquorice must be taken within recommended therapeutic range. Careful assessment of blood pressure and other medication is highly required before start treatment with Liquorice.

Note: High Potassium intake will minimalize potential adverse reaction of Liquorice treatment.

Note: Liquorice is Synergistic herb, and it is always best to utilise Liquorice in blends or formulas. Liquorice should be part of formula due to three reasons, firstly it has unique properties of harmonizing and softening any harshness of the herb it is combined with, whether they taste, moisture, warmth or toxicity, secondly  it makes them more acceptable for stomach, thirdly it has various combined synergistic actions (which include immune stimulation).

 

Synergy example: Combine with Echinacea, Ginseng, Hawthorn or Ashwagandha to make strengthening tonics for the immune system, the heart, the adrenal glands and the nerves.

 

Cautions: Liquorice is Mild remedy with minimal chronic toxicity.

Liquorice root should be avoided in conditions of adrenal hyperfunctioning such as water retention (especially near heart), hyperglycaemia, hypertension, osteoporosis, and with excess secretion (for example Stomach Qi stagnation)

Aside from several key areas of caution, much of the worry about the safety of Liquorice is unnecessary and, when used with care and respect, Liquorice is an extremely safe herb to use for the young and old, during pregnancy or whilst breast-feeding.

 

'Use with care' is largely a matter of simply not taking too much of it! The World Health Organisation (WHO) recommends a safe daily dose of Liquorice to be between 5 and 20grams of Liquorice root a day (equivalent to 200-800mg of glycyrrhizin) but this is already much higher than the amounts we typically use in herbal medicine, even in quite robust treatment programs, which at the higher end equate to not more than 3 or 4 grams a day of the dried herb in a concentrated liquid form, often considerably less than that when using Liquorice within a formula of other herbs.

Taking Liquorice root at the same time as using steroidal drugs (e.g, predisone, cortisone) is likely to increase the blood levels of the drugs and lengthen the time that they are active in the body as seen in several case studies. This may or may not be a good thing depending on why the drugs are being used but there would be an expected increased risk of side effects from the drugs in this situation.

Using substantial doses of Liquorice with a person who is using drugs that contain cardiac glycosides could increase the risk of hypokalaemia (low potassium levels), likewise for a person who is taking diuretics such as chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDIURIL, Microzide). Liquorice seems to increase metabolism and decrease levels of warfarin in animal models. This is likely due to induction of cytochrome P450 2C9 (CYP2C9) metabolism by liquorice.

Most people will need to take between 20 to 30 grams a day before they are at risk of side effects from Liquorice. That said, a person with high blood pressure, impaired kidney function and/or who had a high salt diet could potentially get some adverse responses to Liquorice with as little as 5 grams a day. For some people even small amounts of Liquorice will increase their blood pressure and, if a person has a history of high blood pressure, then I will be unlikely to use Liquorice root just in case it could do some harm. However, if there were some compelling reasons to use Liquorice (e.g. a bad cough, an inflamed stomach) Herbalist may be willing to take a 'try and see' approach whilst carefully monitoring their blood pressure or whether they began to retain fluid. This can be done safely with home blood-pressure monitors and some education about the plant.

People who are prescribed Liquorice preparations high in GL for prolonged use should be placed on high potassium/low sodium diet. They should have closely monitored for increased blood pressure and weigh gain.  Special precautions should be taken with elderly and people with renal, cardiac, hypertension and hepatic disease, they should not receive Liquorice preparation high in GL for prolonged periods.

 

Commission E advises that Liquorice is contraindicated in pregnancy, however doses up to 3g per day are likely to be safe, and it is often used in tiny amount as part of formulas, no side effects has been ever reported within therapeutic dosage.

 

Contraindications: Contraindications advised by Commission E include hypokalaemia, cholestatic liver disorders, severe kidney insufficiency, hypertension, liver cirrhosis and pregnancy.

 

Interactions with drugs:  Using substantial doses of Liquorice with a person who is using drugs that contain cardiac glycosides could increase the risk of hypokalaemia (low potassium levels), likewise for a person who is taking diuretics such as chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDIURIL, Microzide). Liquorice seems to increase metabolism and decrease levels of warfarin in animal models. This is likely due to induction of cytochrome P450 2C9 (CYP2C9) metabolism by liquorice.

Taking Liquorice root at the same time as using steroidal drugs (e.g, predisone, cortisone) is likely to increase the blood levels of the drugs and lengthen the time that they are active in the body as seen in several case studies. This may or may not be a good thing depending on why the drugs are being used but there would be an expected increased risk of side effects from the drugs in this situation.

There is slight chance that Liquorice may counteract contraceptive pills, prolonged high doses use should be avoided while on contraceptive pills.  

Loss of Potassium level may be severe if taken with potassium depleting drugs (slimming diuretics, laxatives or thiazides), following that potassium depletion sensitivity to cardiac glycosides increase. Also taking Liquorice may exaggerate effect of high salt diet.

 

Side effect: withing therapeutic dose none know

Note: Overdosing Liquorice can cause pseudo-aldosteronism, hypertension, myopathy, oedema, hypokalaemia, inhibition of renin-angiostensin system, rhabdomyolysis.

 

History, Folklore and Science:

Mrs M. Grieve write:

“The Liquorice of medicine and commerce is derived from the sweet root of various species of Glycyrrhiza, a genus which contains about fourteen species, natives of warmer temperate countries in both the New and Old Worlds, ten of them having roots more or less sweet, but most of them not sufficiently so to be of use.

Hundreds of tons of Liquorice for commercial and medicinal purposes are imported annually from Spain, Russia, Germany, France and the East, most of our supply coming from Spain and Italy.

 

There are several well-marked species: G. glabra, glandulifera, echinata, etc. The chief source of the drug is G. glabra, which is cultivated in England, but is imported chiefly from Spain and Italy. There are several other varieties in commerce - Russian and Persian Liquorice - but these are not recognized by the British Pharmacopoeia as suitable for medicinal purposes.

 

The use of the Liquorice plant was first learnt by the Greeks from the Scythians. Theophrastus (third century B.C.), in commenting on the taste of different roots (Hist. Plant. lib. IX. c. 13), instances the sweet Scythian root which grows in the neighbourhood of the Lake Maeotis (Sea of Azov), and is good for asthma, dry cough and all pectoral diseases.

 

Dioscorides, who names the plant Glyrrhiza (Greek glukos, sweet, and riza, a root), from his description of the plant possibly had in view G. echinata, as well as G. glabra.

 

The plant is often found under the name Liquiritia officinalis. The Latin name Liquiritia, whence is derived the English name Liquorice (Lycorys in the thirteenth century), is a corruption of Glycyrrhiza, as shown in the transitional form Gliquiricia. The Italian Regolizia, the German Lacrisse or Lakriz, the Welsh Lacris and the French Reglisse have the same origin.

 

The Roman writers, Celsus and Scribonius Largus, mention Liquorice as Radix dulcis. Pliny who describes it as a native of Cilicia, and Pontus makes no allusion to its growing in Italy.

 

Liquorice Extract was known in the times of Dioscorides and appears to have been in common use in Germany during the Middle Ages. In 1264, Liquorice (apparently the extract, not the root) is charged in the Wardrobe Accounts of Henry IV. Saladinus, who wrote about the middle of the fifteenth century, names it among the wares kept by the Italian apothecaries and it is enumerated in a list of drugs of the City of Frankfurt, written about the year 1450.

 

A writer in the first half of the sixteenth century notices the Liquorice plant as abundant in many parts of Italy and describes the manner of making the Succus or Extract by crushing and boiling the fresh root.

 

The plant is described as being cultivated in Italy by Piero de Cresenzi of Bologna, who lived in the thirteenth century. As a medicine, the drug was well known in Germany in the eleventh century, and an extensive cultivation of the plant was carried on in Bavaria in the sixteenth century, but it is not mentioned in mediaeval lists of plants.

 

Cultivation on a small scale has existed in England for a very long time. It appears from Turner's Herbal that it was cultivated in England in 1562, and Stow says 'the planting and growing of liquorish began about the first year of Queen Elizabeth (1558).' Gerard, in 1597, tells us that he has plenty in his garden. It was known to and described by Culpepper who says: 'It is planted in fields and gardens, in diver’s places of this land and thereof good profit is made.'

 

John Parkinson grew Liquorice in his Holborn garden and John Josselyn gives the recipe for a beer which he used to brew for the Indians when they had bad colds. It was strongly flavoured with elecampane, liquorice, aniseed, sassafras and fennel.

 

Culpepper says:

'The English liquorice root shoots up several woody stalks, whereon are set, at several distances, many narrow, long green leaves, set together on both sides of the stalks and an odd one at the end, nearly resembling a young ash tree sprung up from the seed. . . . This, by many years of continuance in a place without removal, and not else, will bring forth numerous flowers, standing together spike fashion, one above another upon the stalks in the form of pea-blossoms, but of a very pale blue colour, which turn into long, somewhat flat and smooth pods, wherein is contained small, round, hard seed. The root runneth down exceeding far into the ground, with divers smaller roots . . . they shoot out suckers in every direction, by which means the product is greatly increased.'

Liquorice is official in all pharmacopoeias, which differ as to the variety or varieties recognized, as to the botanical name employed and as to the drug being peeled or unpeeled, dried Liquorice root being supplied in commerce either with or without the thin brown coat. In the latter state it is known as peeled or decorticated. The British Pharmacopoeia requires that it be peeled, but others require that it be unpeeled.”

 

In the West, liquorice root is often thought of as a candy flavouring agent. In the East, it is respected as a tonifying and important herb for guiding other herbs into the parts of the body needing healing. While it is used in herbal formulas and some candy recipes for its sweetening flavour, most typically what you are eating and tasting when a candy or beverage says “liquorice” is the herb anise, which has a very similar flavour to liquorice, though it is less sweet. Liquorice root is very popular in Europe as a candy, with salt added to it in Scandinavia. In Italy, people enjoy it in its natural root form, while in Spain and Syria, it is a popular drink. It is the most widely used herb in TCM (Traditional Chinese Medicine) and is second only to Ginseng in importance. Liquorice is traditionally used to treat digestive disorders, and respiratory infections, support the adrenal glands, and endocrine system, and boost the immune system. 

Early Egyptians used liquorice root as a cure-all. Roots were found in King Tut’s 3,000-year-old tomb, attesting to the herbs’ value in ancient Egypt. It was later imported to China where it became a fundamental medicinal herb used in many healing formulas and revered for its ability to counter toxins, improve the immune system, and act as a guide herb leading other herbs through the whole body.

The ancient Hindus made a tonic-milk using liquorice root to increase vitality and the Chinese have long used the herb as a longevity herb that can help slow the signs of aging and keep a person strong and healthy.

European tradition holds that the roots are so nutritious and thirst-quenching that just a small piece held under the tongue could keep a person alive for 10 to 12 days.

Liquorice is known to contain 20 triterpenoids and almost 300 flavonoids, compounds known to have powerful antioxidant, anticancer, and anti-inflammatory properties. 

The compound glycyrrhizin, found in liquorice root, can cause potassium levels to temporarily drop leading to abnormal heart rhythms, high blood pressure, swelling, and lethargy. In extreme cases, or if inappropriately high doses are used, it can lead to heart failure in some people. Liquorice root is also available in forms that eliminate the compound called DGL liquorice (deglycyrrhizinated liquorice). This form is safer for taking over longer periods of time if needed. 

The name liquorice is derived from the old French and Greek words that translate to “sweet root.” Traditionally, it has been used as a medicine in Ayurveda for rejuvenation. In Sanskrit, it is called “Yastimadhu.”.

Many so-called “liquorice” products in the U.S. do not actually contain liquorice, but anise which has the smell and taste of what is commonly called “black liquorice.” 

Liquorice root is commonly used in TCM as a “guide herb.” Guide herbs help direct herbs to the area of the body and health most needing healing. Liquorice is considered unique in TCM as one of the very few herbs that can enter all twelve of the energetic Meridian systems allowing it to guide herbs through the entire Bodily system. It is considered to help Invigorate Qi, Reduce Toxicity, and Support the digestive and respiratory systems.

Chinese studies reveal liquorice can help eliminate or neutralize 1,200 known toxins.

Liquorice has a whole-body tonic effect, the immune system, the energy levels, the nerves, the digestion, the liver function, all improve, often significantly, with a little bit of Liquorice root extract every day.

 

Medicinal Liquorice has been used for many centuries as an agent to soothe, heal and tonify. It is probably the most important herbal medicine for ulcers of the mouth, stomach or duodenum and it is hard to imagine an herbal cough medicine without at least some Liquorice in it.

Liquorice features prominently in the first great Chinese herbal, the Pen Tsao Ching (Classic of Herbs) and Chinese medicine has used Liquorice as a remedy for strength and long life for thousands of years. Today it is still found in most Chinese formulas, in large part because it is seen as the ‘ambassador’, the herb that helps the other herbs to harmonise with each other and within the body.

Liquorice was carried by the armies of Alexander the Great to allay thirst and provide endurance. It was similarly carried by Roman soldiers all over Europe.

German abbess/herbalist St Hildegard of Bingen prescribed Liquorice for stomach and heart problems and it was frequently mentioned in German and Italian herbals from the 14th and 15th century as a cough and respiratory remedy.

The British Herbal Pharmacopoeia (BHP) describes Liquorice’s actions as expectorant, demulcent, spasmolytic, anti-inflammatory, adrenal agent and mild laxative and says it is indicated for bronchial catarrh, bronchitis, chronic gastritis, peptic ulcer, colic and primary adrenocortical insufficiency and specifically indicated for gastric or duodenal ulcer and Addison's disease. The BHP suggests a dose of 1-4 g or by decoction and recommends 2-5ml of the liquid extract up to 3 x daily.

In recent decades an increase in understanding liquorice, both how it works and what it does, has seen it being recommended for people that are recovering from overuse of steroids. Liquorice has ingredients in it called steroidal saponins that appear to be able to nourish adrenal glands back to health, effectively helping our bodies to rebuild our own production of steroidal hormones.

Back in 1946 a Dutch pharmacist noticed that liquorice candies and cough remedies were unusually popular in patients who had gastro-intestinal ulcers. They told him that the Liquorice gave them better and longer lasting relief than the actual ulcer medications they had tried. Intrigued he published a report since which Liquorice has been the subject of several clinical trials which have shown to it to a highly effective medicine for peptic, gastric and duodenal ulcers, so long as it used wisely.

For mouth ulcers (canker sores) clinical research suggests that gargling with warm water containing deglycyrrhizinated liquorice powder 200 mg four times daily for 7 days improves pain in 75% of patients by day one and results in complete healing in 75% of patients by day three.

For patients with non-alcoholic fatty liver disease, clinical research has shown that taking licorice root extract 2 grams daily for 2 months reduces levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) compared to baseline.

Licorice stimulates the body's own natural anti-viral compound interferon and a study published in Microbiology and Immunology showed that it made a significant positive difference to the treatment of the common infection Herpes simplex. Numerous other laboratory studies have shown that Licorice helps fight disease causing bacteria and fungiLicorice extract in quite high doses demonstrated a dramatic effect in maintaining electrolyte balance in patients with Addison's disease. Licorice extract may also be of benefit in the treatment of Parkinsons disease and Graves’ disease although this has not been scientifically investigated so this recommendation is based on anecdotal evidence of benefit.

In human research, consumption of a licorice herbal tincture stimulated immune cells, as quantified by CD69 expression on CD4 and CD8 T cells.

 Licorice root in reasonably modest doses (approx. 1 gram a day or 2 ml of a 1:2 fluid extract) significantly reduced the severity and number of hot flushes in menopausal women.

For cholesterol, clinical research suggests that taking licorice root extract 0.1 grams daily for one month reduces plasma total cholesterol levels by 5%, plasma low-density lipoprotein (LDL) cholesterol levels by 9%, and plasma triglyceride levels by 14% compared with baseline in patients with moderate hypercholesterolemia.

 

British Herbal Pharmacopeia suggest combining Liquorice with:

Lobelia, Linseed and Cayenne in bronchitis

Lobelia and Grindelia in asthma and bronchitis

Marshmallow leaf, White horehound and Coltsfoot  for pulmonary disease

Comfrey, Meadowsweet, Roman Chamomile, and marshmallow root for peptic ulcer

Senna fruit, Ginger,  Cascara sagrada, Barberry in constipation

Dandelion leaf in Addison`s disease

Adiantum and wild cherry bark in tracheitis

Irish moss and Cinnamon in bronchial catarrh

Alder Buckthorn and Senna in constipation

White horehound, Ground ivy, Elecampane and Coltsfoot for cough

 

Commission E monograph suggest combining Liquorice with:

Peppermint and German Chamomile for acute and chronic inflammation for gastric mucosa with spasmodic complaints in the gastrointestinal region

Aniseed oil, Fennel Oil, and Thyme  for colds and upper respiratory  tract complaints with  viscid catarrh

Aniseed, Ivy, Bitter fennel  for colds and upper respiratory  tract complaints with  viscid catarrh

Ivy and thyme for colds and upper respiratory  tract complaints with  viscid catarrh

 

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