Regaliz

Related Terms

1-methoxyphaseollin, 17?-hydroxysteroid dehydrogenase, 18(beta)-glycyrrhetinic acid, 22?-acetoxylglycyrrhizic acid, Alcacuz (Portuguese, Spanish), alcazuz, asam boi, biogastrone, bois doux (French), CankerMelts GX, carbenoxolone, carbenoxolone sodium, chalcones, Chinese licorice, deglycyrrhizinised liquorice, deglycyrrhizinized succus Liquiritiae, DGL, duogastrone, Fabaceae (family), flavonoid, flavonoid glycosides, gan cao, gan zao, glabrene, glabridin, glabrol, GlavonoidT, glucoliquiritin apioside, glycyrrhetenic acid, glycyrrhetic acid, glycyrrhiza, Glycyrrhiza glabra, Glycyrrhiza glabra glandulifera, Glycyrrhiza glabra Linne, Glycyrrhiza glabra typica, Glycyrrhiza glabra violacea, Glycyrrhiza palidiflora, glycyrrhiza root, Glycyrrhiza uralensis, glycyrrhizic acid, glycyrrhizin, glycyrrhizinic acid, glycyrrhizol-A, hochu-ekki-to, isoflavone, isoflavonoids, isoliquiritigenin, isoliquiritin, kanzo (Japanese), lakrids (Danish), lakritze, Lakritzenwurzel (German), Leguminoseae (family), licochalcone A, licorice root, licorice saponins A3 and G2, licoricidin, licorisoflavan A, licuraside, Liquiritiae radix, Liquiritia officinalis, liquiritigenin, liquiritigenin-7,4'-diglucoside, liquiritin, liquiritin apioside, liquirizia (Italian), liquorice, ononin, orozuz, Persian licorice, phytoestrogen, Pontefract cakes, powdered succus liquiritiae, prenyllicoflavone A, Radix glycyrrhizae (Latin), regaliz, r?glisse (French), regliz, Russian licorice, salicylic acid, shinflavone, shinpterocarpin, Spanish licorice, Stronger Neo Minophagen-CT (SNMC), STW 5, subholz, Su?holzwurzel, sweet root, sweet wood, triterpene saponins, yashti-madhu (Sanskrit), YHK, Yo Jyo Hen Shi Ko (Chinese), Yokukansan, yunganoside E2, Zhi Gan Cao Tang.
Note: Not included in this monograph: Caved S (a combination of DGL, alkalizing substances, and vagolytic drugs) and carbenoxolone (Biogastrone; a synthetic substance based on glycyrrhizinic acid). In Chinese medicine, licorice root is generally derived from a different plant species, Glycyrrhiza uralensis, with similar properties.

Background

The part of licorice used for medicine is the root and dried rhizome of the low-growing shrub Glycyrrhiza glabra. Currently, most licorice is produced in Greece, Turkey, and Asia.
Licorice has been used in ancient Greece, China, and Egypt, primarily for gastritis (inflammation of the stomach) and ailments of the upper respiratory tract. Ancient Egyptians prepared a licorice drink for ritual use to honor spirits of the pharaohs. Its use became widespread in Europe and Asia for numerous indications.
In addition to its medicinal uses, licorice has been used as a flavoring agent, valued for sweetness (glycyrrhizin, a component of licorice, is 50 times sweeter than table sugar). The generic name "glycyrrhiza" stems from ancient Greek, meaning "sweet root." It was originally used as flavoring for licorice candies, although most licorice candy is now flavored with anise oil. Licorice is still used in sub-therapeutic doses as a sweetening agent in herbal medicines, lozenges, and tobacco products (doses low enough that significant adverse effects are unlikely).
Licorice has a long history of medicinal use in Europe and Asia. At high doses, there are potentially severe side effects, including high blood pressure, low blood potassium levels, and fluid retention. Most adverse effects have been attributed to the chemical component glycyrrhiza (or glycyrrhizic acid). Licorice can be processed to remove the glycyrrhiza, resulting in DGL (deglycyrrhizinated licorice), which does not appear to share the metabolic disadvantages of licorice.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Licorice extract gel applied to the skin has been shown to be effective in the treatment of atopic dermatitis in early human study. Further research is needed to confirm these results.

 B


Licorice extract gel applied to the skin has been shown to be effective in the treatment of atopic dermatitis in early human study. Further research is needed to confirm these results.

 B


Licorice has been used to treat viral hepatitis, hepatitis C, and hepatitis B, particularly in Japan. Most trials have shown some effect with a patented intravenous (IV) preparation (not available in the US) of licorice and some nonessential amino acids, but there has been a lack of reliable evidence using oral preparations. Also, although lab values have shown some beneficial results, overall, the clinical significance is unclear. Further research is needed before a firm recommendation may be made.

 B


Licorice has been used to treat viral hepatitis, hepatitis C, and hepatitis B, particularly in Japan. Most trials have shown some effect with a patented intravenous (IV) preparation (not available in the US) of licorice and some nonessential amino acids, but there has been a lack of reliable evidence using oral preparations. Also, although lab values have shown some beneficial results, overall, the clinical significance is unclear. Further research is needed before a firm recommendation may be made.

 B


Addison's disease is a relatively common disorder to endocrinologists, but is rare and potentially fatal when presenting acutely. Treatment now involves replacement of glucocorticoids and mineralocorticoids with synthetic compounds, although historically people took common salt and plant-based preparations, including licorice.

 C


Addison's disease is a relatively common disorder to endocrinologists, but is rare and potentially fatal when presenting acutely. Treatment now involves replacement of glucocorticoids and mineralocorticoids with synthetic compounds, although historically people took common salt and plant-based preparations, including licorice.

 C


Limited study suggests that licorice may be beneficial in aplastic anemia, but results are inconclusive.

 C


Limited study suggests that licorice may be beneficial in aplastic anemia, but results are inconclusive.

 C


Some research suggests that licorice extracts, DGL, and the drug carbenoxolone, may provide benefits for treating cankers sores. However, studies have been small with flaws in their designs. The safety of DGL makes it an attractive therapy if it does speed healing of these sores, but it is not clear at this time whether there is truly any benefit.

 C


Some research suggests that licorice extracts, DGL, and the drug carbenoxolone, may provide benefits for treating cankers sores. However, studies have been small with flaws in their designs. The safety of DGL makes it an attractive therapy if it does speed healing of these sores, but it is not clear at this time whether there is truly any benefit.

 C


Early research has suggested that a prepared licorice decoction exerts beneficial therapeutic effects in individuals with severe arrhythmias. However, high-quality research is lacking and is needed in this area before any firm conclusions may be made.

 C


Early research has suggested that a prepared licorice decoction exerts beneficial therapeutic effects in individuals with severe arrhythmias. However, high-quality research is lacking and is needed in this area before any firm conclusions may be made.

 C


Early research with a combination product containing licorice decreased bleeding in people after dental surgery. Although suggestive of beneficial effects, further high-quality research is needed in this area before any firm conclusions may be made.

 C


Early research with a combination product containing licorice decreased bleeding in people after dental surgery. Although suggestive of beneficial effects, further high-quality research is needed in this area before any firm conclusions may be made.

 C


Although there has been some study of DGL in this area, it is not clear what effects DGL has on gastrointestinal bleeding.

 C


Although there has been some study of DGL in this area, it is not clear what effects DGL has on gastrointestinal bleeding.

 C


Licorice has been used as part of a multi-herbal formulation and has demonstrated some beneficial antibacterial and anti-inflammatory oral effects; however, the effects of licorice alone lack elucidation. Further studies are needed prior to recommending for or against the use of glycyrrhizin in dental hygiene.

 C


Licorice has been used as part of a multi-herbal formulation and has demonstrated some beneficial antibacterial and anti-inflammatory oral effects; however, the effects of licorice alone lack elucidation. Further studies are needed prior to recommending for or against the use of glycyrrhizin in dental hygiene.

 C


Early evidence has suggested that a mult-herbal decoction containing licorice root, improves the rate of treatment efficacy and reduces the rate of relapse of hormone dependent dermatitis vs. conventional Western medicine therapy. However, due to the paucity of research in this area and the lack of licorice monotherapies, further high quality research is needed before any firm conclusions may be made.

 C


Early evidence has suggested that a mult-herbal decoction containing licorice root, improves the rate of treatment efficacy and reduces the rate of relapse of hormone dependent dermatitis vs. conventional Western medicine therapy. However, due to the paucity of research in this area and the lack of licorice monotherapies, further high quality research is needed before any firm conclusions may be made.

 C


Early study of a multi-ingredient preparation containing licorice, called ImmunoguardT, suggests possible effects in managing FMF. Well-designed study of licorice alone is necessary before a recommendation can be made.

 C


Early study of a multi-ingredient preparation containing licorice, called ImmunoguardT, suggests possible effects in managing FMF. Well-designed study of licorice alone is necessary before a recommendation can be made.

 C


Early studies indicate that the herbal preparation STW 5, which contains licorice among many other herbal extracts, may help improve symptoms in people with functional dyspepsia.

 C


Early studies indicate that the herbal preparation STW 5, which contains licorice among many other herbal extracts, may help improve symptoms in people with functional dyspepsia.

 C


Laboratory studies have found that DGL may hinder the spread and infection of herpes simplex virus. Studies in humans have been small, but they suggest that topical application of carbenoxolone cream may improve healing and prevent recurrence.

C


Laboratory studies have found that DGL may hinder the spread and infection of herpes simplex virus. Studies in humans have been small, but they suggest that topical application of carbenoxolone cream may improve healing and prevent recurrence.

C


Early evidence has suggested that licorice root extract improves the lipid profile of individuals with high cholesterol. Although promising, further high quality research is needed in this area before any firm conclusions may be made.

 C


Early evidence has suggested that licorice root extract improves the lipid profile of individuals with high cholesterol. Although promising, further high quality research is needed in this area before any firm conclusions may be made.

 C


In theory, because of the known effects of licorice, there may be some benefits of licorice for high potassium levels caused by a condition called hypoaldosteronism. There is early evidence in humans in support of this use. However, research is just starting and a qualified health care provider should supervise treatment.

 C


In theory, because of the known effects of licorice, there may be some benefits of licorice for high potassium levels caused by a condition called hypoaldosteronism. There is early evidence in humans in support of this use. However, research is just starting and a qualified health care provider should supervise treatment.

 C


Early studies suggest that glycyrrhizin may inhibit HIV replication in people with AIDS. However, human reports are lacking. Additional study is needed to make a firm recommendation.

 C


Early studies suggest that glycyrrhizin may inhibit HIV replication in people with AIDS. However, human reports are lacking. Additional study is needed to make a firm recommendation.

 C


An herbal medicine containing licorice, has been used for neuroleptic-induced hyperprolactinemia. However, additional studies are needed in this area.

 C


An herbal medicine containing licorice, has been used for neuroleptic-induced hyperprolactinemia. However, additional studies are needed in this area.

 C


Early study has suggested that recombinant roasted licorice decoction combined with low-dose glucocorticoids may be more effective than glucocorticoids alone in treating idiopathic thrombocytopenic purpura. This combination has also shown a lower adverse effect rate than glucocorticoids alone.

 C


Early study has suggested that recombinant roasted licorice decoction combined with low-dose glucocorticoids may be more effective than glucocorticoids alone in treating idiopathic thrombocytopenic purpura. This combination has also shown a lower adverse effect rate than glucocorticoids alone.

 C


Many medical conditions are marked by inflammation. Because licorice can affect the metabolism of steroids, licorice is sometimes used to help decrease inflammation. Additional study is needed to make a firm recommendation.

 C


Many medical conditions are marked by inflammation. Because licorice can affect the metabolism of steroids, licorice is sometimes used to help decrease inflammation. Additional study is needed to make a firm recommendation.

 C


In early research, the coadministration of a combination product containing licorice was comparable to the medications oseltamivir or zanamivir, for the treatment of seasonal influenza. However, due to the small amount of research in this area, especially with licorice alone, the interpretation of results is limited. Further research is needed before any firm conclusions may be made.

 C


In early research, the coadministration of a combination product containing licorice was comparable to the medications oseltamivir or zanamivir, for the treatment of seasonal influenza. However, due to the small amount of research in this area, especially with licorice alone, the interpretation of results is limited. Further research is needed before any firm conclusions may be made.

 C


Early research on the use of licorice in people with irritable bowel syndrome (IBS) has shown some beneficial effects for symptom management, although the coadministration of other herbs limits the interpretation of findings. Further research using licorice alone is needed in this area before any firm conclusions may be made.

 C


Early research on the use of licorice in people with irritable bowel syndrome (IBS) has shown some beneficial effects for symptom management, although the coadministration of other herbs limits the interpretation of findings. Further research using licorice alone is needed in this area before any firm conclusions may be made.

 C


Licorice has been studied for its liver protective effects. In early research, licorice root extract reduced abnormal elevations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in individuals with non-alcoholic fatty liver disease (NAFLD). However, findings are limited, and further high quality research is needed in this area.

 C


Licorice has been studied for its liver protective effects. In early research, licorice root extract reduced abnormal elevations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in individuals with non-alcoholic fatty liver disease (NAFLD). However, findings are limited, and further high quality research is needed in this area.

 C


Licorice has been studied for the treatment of melasma. Although promising research has been done, further study is needed before any firm conclusions may be made in this area.

 C


Licorice has been studied for the treatment of melasma. Although promising research has been done, further study is needed before any firm conclusions may be made in this area.

 C


In early research, a mixed ingredient product containing licorice, improved pain severity and the number and duration of muscle cramps associated with cirrhosis and hemodialysis. Due to the small amount of research in this area, particularly on the effects of licorice alone, further high quality research is needed before any firm conclusions may be made.

 C


In early research, a mixed ingredient product containing licorice, improved pain severity and the number and duration of muscle cramps associated with cirrhosis and hemodialysis. Due to the small amount of research in this area, particularly on the effects of licorice alone, further high quality research is needed before any firm conclusions may be made.

 C


In people with terminal cancer, the coadministration of licorice and various other herbs as part of a Taiwanese traditional herbal diet reduced self-reported pain as compared to both a control diet and a conventional hospital reference diet. Before any firm conclusions may be made in this area, further research is needed on licorice alone.

 C


In people with terminal cancer, the coadministration of licorice and various other herbs as part of a Taiwanese traditional herbal diet reduced self-reported pain as compared to both a control diet and a conventional hospital reference diet. Before any firm conclusions may be made in this area, further research is needed on licorice alone.

 C


Spironolactone is a synthetic steroid that is commonly used as a diuretic in women with polycystic ovary syndrome. Licorice has been used in combination with spironolactone to reduce side effects related to the diuretic activity of spironolactone.

 C


Spironolactone is a synthetic steroid that is commonly used as a diuretic in women with polycystic ovary syndrome. Licorice has been used in combination with spironolactone to reduce side effects related to the diuretic activity of spironolactone.

 C


In early research, dissolved licorice powder reduced the number and severity of sore throat experience after surgery in people undergoing intubation. Although promising, there is a small amount of research in this area. Further study is needed before any firm conclusions may be made.

 C


In early research, dissolved licorice powder reduced the number and severity of sore throat experience after surgery in people undergoing intubation. Although promising, there is a small amount of research in this area. Further study is needed before any firm conclusions may be made.

 C


In early research, the coadministration of licorice and milk proteins to the skin improved the severity of palmoplantar psoriasis symptoms vs. conventional steroid therapy. Further research on the effects of licorice alone are needed before any firm conclusions may be made in this area.

 C


In early research, the coadministration of licorice and milk proteins to the skin improved the severity of palmoplantar psoriasis symptoms vs. conventional steroid therapy. Further research on the effects of licorice alone are needed before any firm conclusions may be made in this area.

 C


In early research, the coadministration of licorice root and other herbs improved various outcomes after surgy vs. conventional antibiotics in people undergoing laparoscopic cholecystectomy. Although promising, further research of licorice alone is needed before any firm conclusions may be made in this area.

 C


In early research, the coadministration of licorice root and other herbs improved various outcomes after surgy vs. conventional antibiotics in people undergoing laparoscopic cholecystectomy. Although promising, further research of licorice alone is needed before any firm conclusions may be made in this area.

 C


Early data show that licorice may reduce body fat mass. Further research is needed to confirm these results.

 C


Early data show that licorice may reduce body fat mass. Further research is needed to confirm these results.

 C


In early research, a mixed ingredient formulation, containing licorice, had beneficial effects on mental stress. Although promising, further research on the effects of licorice alone is needed before any firm conclusions may be made in this area.

 C


In early research, a mixed ingredient formulation, containing licorice, had beneficial effects on mental stress. Although promising, further research on the effects of licorice alone is needed before any firm conclusions may be made in this area.

 C


Historically, licorice has been used for its expectorant and anti-tussive effects. The herbal combination product, KanJang?, has been studied for the treatment of uncomplicated upper respiratory tract infections. Results are mixed, and additional study is needed.

 C


Historically, licorice has been used for its expectorant and anti-tussive effects. The herbal combination product, KanJang?, has been studied for the treatment of uncomplicated upper respiratory tract infections. Results are mixed, and additional study is needed.

 C


Licorice extracts, DGL and carbenoxolone, have been studied for treating peptic ulcers. DGL (but not carbenoxolone) may offer some benefits. However, most studies are poorly designed and some results conflict. Therefore, it is unclear whether there is any benefit from licorice for this condition.

 D


Licorice extracts, DGL and carbenoxolone, have been studied for treating peptic ulcers. DGL (but not carbenoxolone) may offer some benefits. However, most studies are poorly designed and some results conflict. Therefore, it is unclear whether there is any benefit from licorice for this condition.

 D
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
For apthous ulcers / canker sores, a dose of 200 milligrams of DGL powder has been gargled in 200 milliliters of warm water four times daily for seven days. Additionally, a mouth patch providing 0.015-0.229 milligrams per kilogram has been applied to the affected area 16 hours daily for eight days. Bioadhesive licorice hydrogel patches have also been applied to affected areas, although information on dose and duration is unclear.
For arrhythmia, an unknown dose of a prepared licorice decoction (Zhi Gan Cao Tang) has been used by mouth for an indeterminate duration.
For bleeding stomach ulcers caused by aspirin, three tablets (175 milligrams of DGL plus 325 milligrams aspirin per tablet) has been used by mouth three times daily over two five-day periods.
For high potassium levels resulting from abnormally low aldosterone levels, a dose of 1gram of glycyrrhetinic acid has been used by mouth daily for two weeks. Additionally, a dose of 150 milligrams of licorice has been used daily by mouth for an unknown duration.
For high cholesterol, 100 milligrams of an ethanol licorice root extract (Glycyrrhiza glabra) has been used by mouth daily for one month.
For liver disease, a 2 gram capsule of licorice root extract has been taken by mouth once daily for two months.
For polycystic ovarian syndrome, a dose of 3.5 grams of licorice has been used by mouth daily for an unknown duration in addition to spironolactone to reduce the side effects of spironolactone.
For post-operative sore throat/hoarseness due to intubation, a single administration of 500 milligrams of powdered licorice dissolved in 30 milliliters of water has been gargled for 30 seconds five minutes prior to anesthesia.
For peptic ulcer disease, DGL has been used by mouth in divided doses (3-4 times daily), with up to a total daily dose of 2,280 milligrams for up to eight weeks or up to a 5,000 milligrams for up to four weeks.
For reducing body fat mass, a dose of 3.5 grams of commercial licorice has been used by mouth daily for two months. Three capsules (100 milligrams each) of licorice flavonoids (GlavonoidT) have been taken by mouth once daily for eight weeks. Additionally, a cream containing 2.5% glycyrrhetinic acid has been applied to the skin for in indeterminate duration.
For atopic dermatitis, a 1-2% licorice extract gel has been applied to the skin three times daily for up to two weeks.
For dental hygiene, a 0.25-0.50% glycyrrhizin toothpaste, brushed on the teeth, has been used twice daily for up to 42 days.
For HIV, A continuous intravenous (IV) drip infusion of 400-1,600 milligrams of licorice has been used daily (7.2-30.8 milligrams per kilogram daily), consisting of 0.2% glycyrrhizin dissolved in saline, has been used for a period of more than a month on six separate occasions.
For viral hepatitis, Stronger Neo-Minophagen CT (SNMC) containing glycyrrhizin (up to 240 milligrams) has been administered intravenously in 100 milliliters 5% glucose three times weekly for four weeks or daily for eight weeks and then 2-7 times weekly for up to 16 years. Doses of 40-100 milliliters SNMC solution have also been used for periods ranging from one month, three times weekly for eight weeks, or three times weekly for 16 weeks.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Licorice may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin?) or heparin, anti-platelet drugs such as clopidogrel (Plavix?), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin?, Advil?) or naproxen (Naprosyn?, Aleve?).
Licorice may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Licorice may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.
Licorice may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be altered in the blood, and may cause altered effects or potentially serious adverse reactions. People using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
Licorice may also interact with adrenal agents, agents for abnormal heart rhythm, agents for depression, agents for obesity, agents for pain, agents for the heart, agents for the skin, agents that prevent vomiting, alcohol, aldose reductase inhibitors, aldosterone receptor inhibitors, angiotensin converting enzyme (ACE) inhibitors, anti-inflammatory agents, antimicrobials, antivirals, benzodiazepines, cancer agents, cardiac glycosides, cholesterol lowering agents, cisplatin, corticosteroids, dental agents, digoxin, diuretics (increase urine), hormone agents, immune system stimulants, insulin, interferons, iron salts, kayealate, kidney toxins, laxatives, lithium, liver toxins, monoamine oxidase inhibitors (MAOIs), nitrofurantoin, nonsteroidal anti-inflammatory agents (NSAIDs), phosphate salts, potassium depleting agents, QT prolonging agents, selective serotonin reuptake inhibitors (SSRIs), stomach and intestine agents, ulcer agents, and urodeoxycholic acid.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

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