Licorice lands 71-year-old man in ICU: Aussie case
Six weeks of munching through a birthday box of confectionery has landed man in his 70s in ICU with severe hypokalaemia, Australian doctors report.
The 71-year-old’s daughter had gifted him licorice-containing sweets which he proceeded to consume at the rate of about 720mg of raw licorice per day.
This meant he was ingesting in excess of the ‘safe’ level of the licorice metabolite glycyrrhizin to avoid pseudohyperaldosteronism, his treating doctors from Townsville Hospital and Health Service in north Queensland wrote in Clinical Case Reports.
The man had been referred to the ED by his cardiologist because of low potassium just as he was being readied for a coronary angiogram for stable angina.
The patient had experienced intermittent palpitations over the previous month and had a history of ischaemic heart disease, a coronary artery stent and treatment for sleep apnoea, hypertension and dyslipidaemia.
On admission to hospital he had serum potassium of 2.3mmol/L which dropped to a low of 1.9mmol/L on day two, necessitating aggressive potassium replacement via catheter in the ICU, the doctors wrote.
On day six of admission he was moved to a ward, being stable at 4.0mmol/L on oral potassium 1800mg four times daily.
He was discharged from the hospital on day nine with no potassium supplementation and advice to stop eating licorice.
“Clinical risk factors for pseudohyperaldosteronism in our patient was his older age and concomitant intake of a thiazide diuretic for hypertension,” the doctors noted.
They said the quantity of licorice consumed suggested he was getting a daily dose of between 14.1mg and 180mg of glycyrrhizin, the metabolite which can cause toxicity.
The WHO had stipulated an upper limit of 100mg of glycyrrhizin daily as unlikely to cause adverse effects in most adults, the team said.
They added that, given pseudohyperaldosteronism including severe hypokalaemia could be a life-threatening emergency, manufacturers of licorice food products should be required to specific daily consumption limits on their labels.
Read more:
- How this ‘stinky’ fruit landed a woman in hospital: case
- The patient who swallowed 200 pieces of chewing gum a day
More information: Clin Case Rep 2025; 12 Jan.
