Myoclonus and Metabolic Alkalosis from Licorice in Antacid

Ishiguchi, Tadashi; Mikita, Naoya; Iwata, Takashi; Nakata, Hajime; Sato, Hiroaki; Higashimoto, Yuji; Fujimoto, Hisashi; Yoshida, Sohei; Itoh, Hidekazu

doi:10.2169/internalmedicine.43.59

Cited by 16 publications

(11 citation statements)

References 12 publications

(12 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One patient presented with carpal tunnel syndrome with nerve conduction studies revealing bilateral median neuropathies likely attributed to licorice-induced water retention [Tacconi et al 2009]. Other complications include hypersensitivity to glycyrrhizin [Kuriyama et al 1975], occupational asthma [Cartier et al 2002], myoclonus due to licorice-induced metabolic alkalosis [Ishiguchi et al 2004] and licoriceinduced contact dermatitis [Nugmanova and Kalitina, 1979;O'Connell et al 2008]. Table 3 demonstrates the previously reported licoricerelated complications.…”

Section: Licorice-related Complicationsmentioning

confidence: 99%

Licorice abuse: time to send a warning message

Omar

Komarova

Elghonemi

et al. 2012

Therapeutic Advances in Endocrinology

184

160

View full text Add to dashboard Cite

Licorice extract has always been recognized as a sweetener and a thirst quencher. Its nutritive value is overrated by many who consume significant amounts and are prone to complications. Glycyrrhetic acid, the active metabolite in licorice, inhibits the enzyme 11-ß-hydroxysteroid dehydrogenase enzyme type 2 with a resultant cortisol-induced mineralocorticoid effect and the tendency towards the elevation of sodium and reduction of potassium levels. This aldosterone-like action is the fundamental basis for understanding its health benefits and the wide spectrum of adverse effects. Herein, we present a comprehensive review of licorice along with the reported complications related to excess intake. Despite its apparent use in a few clinical scenarios, the daily consumption of licorice is never justified because its benefits are minor compared to the adverse outcomes of chronic consumption. The review highlights the importance of investigating the dietary habits and herbal remedies which are being used worldwide on cultural and habitual bases rather than reliable scientific evidence. Licorice is a US Food and Drug Administration (FDA) approved food supplement used in many products without precise regulations to prevent toxicity. Increased awareness among the public is required through TV commercials, newspapers, internet sites, magazines and product labels regarding the upper limit of ingestion and health hazards associated with excess intake. We hope that this review will serve as a warning message that should be transmitted from physicians to patients to avoid excessive licorice intake as well as a message to the FDA to start regulating the use of this substance.

show abstract

Section: Licorice-related Complicationsmentioning

confidence: 99%

Licorice abuse: time to send a warning message

Omar

Komarova

Elghonemi

et al. 2012

Therapeutic Advances in Endocrinology

184

160

View full text Add to dashboard Cite

show abstract

“…Licorice interacts with many drugs; with sennoside, it causes myoclonus due to metabolic alkalosis [ 17 ]; with laxative, it leads to potassium loss [ 18 ]; and with enalapril, it causes marked metabolic alkalosis with severe hypokalemia and pseudoaldosteronism [ 19 ]. Ginger inhibits the action of nonsteroidal anti-inflammatory drugs and leads to no symptomatic relief [ 20 ].…”

Section: Recent Reportsmentioning

confidence: 99%

Concept of interactions between consumable substances in Ayurveda with special reference to foods and drugs

Sarkar

Chaudhari

Chattopadhyay³

2013

Drug Metabolism and Drug Interactions

View full text Add to dashboard Cite

Ayurvedic medicines are available in the market as over-the-counter products. Today people use prescription and nonprescription medicines along with Ayurvedic medicines for quick relief from ailments. In the ancient texts of Ayurveda, the concept of interactions with various examples of food interactions and food-drug interactions are mentioned. Recent studies and publications reported drug interactions of Ayurveda medicines and modern drugs. In the present review article, the concept of interactions mentioned in the Ayurvedic texts along with the examples of food interactions, food-drug interactions and the recent research work and publications indicating the interactions of the Ayurvedic drugs and drug interactions of Ayurvedic medicines and modern drugs are compiled. This will help the consumer of the prescription and nonprescription medicines with the Ayurvedic medicines to be cautious about the probable interactions.

show abstract

“…25 Chronic, high -dose licorice consumption can cause a syndrome similar to primary hyperaldosteronism, characterized by hypertension, hypokalemia, metabolic alkalosis, low plasma renin activity, reduced plasma aldosterone concentrations, and normal urinary cortisol excretion. 45,46 Rare case reports suggest that a substantial elevation of blood pressure can occur in sensitive individuals after the chronic ingestion of licorice. 44 In cases associated with severe hypokalemia, rhabdomyolysis, renal dysfunction, and muscle paralysis can develop.…”

Section: Clinical Responsementioning

confidence: 99%

Licorice (GlycyrrhizaSpecies)

Barceloux

2008

Medical Toxicology of Natural Substances

View full text Add to dashboard Cite

Myoclonus and Metabolic Alkalosis from Licorice in Antacid

Cited by 16 publications

References 12 publications

Licorice abuse: time to send a warning message

Licorice abuse: time to send a warning message

Concept of interactions between consumable substances in Ayurveda with special reference to foods and drugs

Licorice (GlycyrrhizaSpecies)

Contact Info

Product

Resources

About