Is black licorice life threatening? The American Heart Association says it might be

31 Oct 2022 --- Eating large quantities of the pungent and strong tasting treat could be “acutely life threatening” due to the nutritional and chemical properties of the licorice root according to an expert cardiologist. Glycyrrhizin, a naturally occurring chemical in the plant can lower the body’s potassium levels and cause arrhythmias and, in a worst-case scenario, congestive heart failure. 

Though many manufacturers use artificial flavorings like star anise oil, the American Heart Association (AHA) says many of the most popular black brands do use the root. Moreover, it warns that overindulgence can have irreparable consequences.

In 2019, Dr. Christopher Newton-Cheh – a cardiologist at Massachusetts General Hospital and Harvard Medical School in Boston, Massachusetts, US – treated a patient experiencing cardiac arrest. 

The patient’s potassium levels had plummeted to less than half of their normal levels and the person eventually died from a brain injury sustained when staff were unable to shock the heart back into normal rhythm – a condition likely caused by low potassium.

All things in moderation
However, licorice is not usually lethal, both A Newton-Cheh and the AHA agree that there is likely no real danger to children as they go out trick-or-treating, if you over 40, you may want to consider eating less of what your child brings home on Halloween night.

“The appearance of a few pieces of black licorice in a child’s trick-or-treat haul is nothing to worry about,” says Newton-Cheh. “But overall, limiting the total amount of candy a child eats is a healthy idea.”

However, there is also no agreed upon amount regarding how much licorice is safe to eat. “It’s not well-studied,” he explains. 

People over 40 should be mindful of how much licorice they consume.The US Food and Drug Administration (FDA) has no safe limits listed regarding the consumption of black licorice though it does state that for people over 40, eating two ounces a day for a two week period could affect a person’s heart rhythm enough to land them in the hospital.

Licorice supplementation?
The AHA notes that various forms of black licorice are touted for health benefits in dietary supplements but warns that many of those claims have not been thoroughly examined.

Additionally, the FDA and the AHA state that black licorice can actually interfere with some medications and supplements, including diuretics and pharmaceuticals used to combat arrhythmia and heart failure.

“It’s very difficult to separate the untested theories that people have in the alternative medicine realm for potential health benefits of licorice,” says Newton-Cheh. “So anybody taking them should check with their physician.”

What about those who like it?
The AHA and Newton-Cheh elaborate that red licorice and artificially flavored black licorice products are both equally harmless. 

“That doesn't make them healthy; they still contain sugar, which can lead to obesity and other health problems if you consume too much,” explains Newton-Cheh. “Ingredients vary by brand, but one widely available variety pack has 140 calories and 17 gm of sugar per 40 gm serving (that’s a little less than 1 1/2 ounces).” 

Furthermore, the AHA recommends consuming no more than 6% sugar-derived calories per day. That equates to about 150 calories from sugar a day for men, and about 100 calories a day for women.

Edited by William Bradford Nichols