Korean J Nephrol.  2001 Nov;20(6):1021-1025.

Licorice Induced Hypokalemia

• Cho S
• Lim B
• Cho H
• Joung J
• Choi Y
• Kim D
• Shin G
• Kim H

Abstract

A high intake of licorice can cause hypermineralocorticoidism with sodium retention and potassium loss, edema, increased blood pressure and depression of renin-angiotensin-aldosterone system. Glycyrrhizic acid, a component of licorice, produces hypermineralocorticoidism through the inhibition of 11beta-hydroxysteroid dehydrogenase. We report a 55-year-old woman with severe muscle weakness with hypokalemia(Serum K+ : 1.7 mEq/ L) due to raw licorice tea. She boiled the licorice 50 g in water and drunk intermittently for 4 months due to her foreign body sensation on her throat. In Korea there is a traditional recipe that licorice works out for the above symptom. Her serum renin activity and aldosterone level were far beyond normal range which was typical to licorice ingestion. She also had metabolic alkalosis with pH 7.55 and hypertension. After quitting the licorice, hypokalemia and muscle weakness gradually improved and her blood pressure returned to normal.

Keyword

Licorice; Glycyrrhizic acid; Hypermineralocorticoidism 11beta-hydroxysteroid dehydrogenase; Hypokalemia

MeSH Terms

11-beta-Hydroxysteroid Dehydrogenases
Aldosterone
Alkalosis
Blood Pressure
Depression
Eating
Edema
Female
Foreign Bodies
Glycyrrhiza*
Glycyrrhizic Acid
Humans
Hydrogen-Ion Concentration
Hypertension
Hypokalemia*
Korea
Middle Aged
Muscle Weakness
Pharynx
Potassium
Reference Values
Renin
Renin-Angiotensin System
Sensation
Sodium
Tea
Water
11-beta-Hydroxysteroid Dehydrogenases
Aldosterone
Glycyrrhizic Acid
Potassium
Renin
Sodium
Tea
Water