Black Licorice: An Evidence-Based Guide for Patients

Black licorice is a candy and flavoring made from licorice root extract, but it is not harmless for everyone. In some people, especially with larger or repeated amounts, black licorice can raise blood pressure, lower potassium, and interact with medicines, so moderation and medical advice matter.

Overview: what black licorice is and why it matters

Black licorice is a confection and flavoring that may be made with extract from the licorice plant, Glycyrrhiza glabra. Its characteristic flavor comes from compounds in the root, especially glycyrrhizin. While many people think of black licorice as just a candy, real licorice root can have measurable effects on the body.

The main concern is that glycyrrhizin can mimic hormone-like effects that change how the body handles sodium and potassium. This may lead to fluid retention, increased blood pressure, and low potassium levels in some people. These effects are more likely with frequent intake, larger amounts, or long-term use, but sensitivity varies from person to person.

Another important point is that not every black licorice product contains real licorice root. Some candies are flavored mainly with anise or artificial flavorings. Reading the ingredient list helps clarify whether a product contains licorice extract, licorice root, or glycyrrhizin-containing ingredients.

How black licorice affects the body

Glycyrrhizin can reduce the breakdown of cortisol in the kidneys. This creates a mineralocorticoid-like effect, meaning the body may hold on to sodium and water while losing potassium. Over time, that shift can cause swelling, headaches, muscle weakness, and elevated blood pressure.

Low potassium can also affect muscles and the electrical activity of the heart. In more serious situations, this may trigger palpitations or abnormal heart rhythms. People may not notice a problem right away, which is why repeated use can sometimes become an issue before a person connects the symptoms to black licorice.

Licorice root is also used in some teas, herbal supplements, traditional remedies, and digestive products. That means intake can add up from several sources rather than candy alone. Patients who want to use licorice-containing products for digestive discomfort should discuss persistent symptoms with a clinician, especially because stomach symptoms can overlap with conditions such as gastritis.

Possible benefits and common myths

Licorice root has a long history in traditional medicine, and certain purified or modified licorice preparations have been studied for digestive and throat-related symptoms. Some people use licorice-containing teas or lozenges for cough, sore throat, or indigestion. However, this does not mean that ordinary black licorice candy is a health food or a safe remedy for regular self-treatment.

There is also a difference between whole licorice extract and deglycyrrhizinated licorice, often called DGL. DGL has much of the glycyrrhizin removed and is sometimes marketed for digestive comfort. Even so, supplements vary in quality and may not be appropriate for everyone, so patients should not assume that “natural” means risk-free.

A common myth is that small amounts are always safe for everyone. In reality, sensitivity differs based on age, body size, overall health, and medication use. Another myth is that only candy matters, when herbal products, chewing tobacco flavorings, and some teas may also contribute to exposure.

Who should be cautious or avoid it

Black licorice deserves extra caution in people with high blood pressure, heart disease, kidney disease, liver disease, or a history of low potassium. Because it can increase fluid retention and affect blood pressure control, it may worsen existing cardiovascular problems. Patients already being evaluated for high blood pressure should be especially mindful of hidden dietary contributors such as licorice extract.

It can also interact with medicines. These may include diuretics, some blood pressure medicines, corticosteroids, digoxin, and drugs that affect heart rhythm. In these settings, changes in potassium and fluid balance may make side effects or complications more likely.

Pregnant people should avoid regular use unless a doctor advises otherwise, because licorice has raised safety concerns in pregnancy. Older adults may be more vulnerable to complications because they are more likely to have chronic conditions or take several medicines. Children should not be given licorice-containing products regularly without professional guidance.

• Use caution with herbal supplements and teas containing licorice root.
• Check labels for licorice extract, licorice root, or glycyrrhizin.
• Do not use black licorice as a regular remedy for blood pressure, digestion, or cough without medical advice.

Signs of too much black licorice

Symptoms of excess black licorice can develop gradually. Some people notice swelling in the ankles, puffiness, headaches, or a feeling that their blood pressure is running higher than usual. Others may experience fatigue, muscle cramps, numbness, or weakness related to low potassium.

More concerning signs include palpitations, chest discomfort, shortness of breath, faintness, or an irregular heartbeat. These symptoms deserve prompt medical attention because they can reflect significant electrolyte imbalance or strain on the cardiovascular system. If someone has a known heart condition, this concern becomes even more important.

Ongoing abdominal discomfort, heartburn, or throat symptoms should not be repeatedly self-treated with licorice products without a diagnosis. Depending on the symptoms, a doctor may recommend evaluation for digestive disease or treatment options such as endoscopy to identify the cause rather than masking symptoms at home.

Diagnosis and what a doctor may check

Doctors diagnose black licorice-related problems by combining the history, symptoms, medication review, and basic tests. A patient may be asked how often they eat black licorice, drink herbal teas, or use supplements containing licorice root. Bringing product labels can be very helpful because ingredients are not always obvious.

Common tests may include blood pressure measurement and blood tests to check potassium and kidney function. Depending on symptoms, a clinician may also order an electrocardiogram to look for heart rhythm changes. If swelling or cardiovascular symptoms are present, further assessment may be needed to rule out underlying conditions.

Because elevated blood pressure and weakness can have many causes, clinicians also consider the broader picture. In some cases, they may recommend evaluation by specialists such as cardiology or other relevant services if symptoms suggest a heart-related issue or if blood pressure is difficult to control.

Treatment, safer use, and self-care

The first step is usually stopping or reducing products that contain real licorice root. Mild effects may improve after the exposure ends, but recovery time depends on how much was consumed, for how long, and whether complications developed. Patients should not stop prescribed medicines on their own; instead, they should review all products and medications with a clinician.

If potassium is low, treatment may include dietary advice, potassium replacement, or adjustments to medicines under medical supervision. Elevated blood pressure, swelling, or heart rhythm symptoms may need prompt care, especially in people with existing heart or kidney disease. Severe symptoms should be treated as urgent.

For safer use, moderation is key. Occasional small amounts may be tolerated by many healthy adults, but there is no single amount that is safe for everyone. Choosing products without real licorice root may reduce the specific risks linked to glycyrrhizin, though candy should still be viewed as an occasional treat rather than a health product.

Patients who need specialist assessment can benefit from coordinated care. Near the end of the care journey, some international patients choose centers such as Acibadem International, where multidisciplinary specialists in JCI-accredited hospitals evaluate and treat related concerns, including cardiovascular issues and digestive symptoms.

When to seek medical care

Medical advice is important if a person develops rising blood pressure, swelling, headaches, muscle weakness, or cramps after using black licorice or licorice-containing products. It is also wise to seek guidance before using these products regularly in the presence of kidney disease, heart disease, pregnancy, or multiple medications.

Urgent care is needed for chest pain, significant shortness of breath, fainting, severe weakness, confusion, or a pounding or irregular heartbeat. These symptoms may indicate a serious electrolyte problem or cardiovascular complication and should not be managed at home.

Even without emergency symptoms, patients should speak with a doctor if they are unsure whether a product contains real licorice or if they want help reviewing interactions with prescription drugs. This is especially relevant for anyone undergoing evaluation or treatment related to high blood pressure treatment.

Frequently asked questions

Is black licorice bad for everyone?

No. Many healthy adults may tolerate occasional small amounts, but not everyone responds the same way. People with high blood pressure, heart disease, kidney disease, pregnancy, or certain medications should be more careful and ask a doctor before regular use.

Why can black licorice raise blood pressure?

Real black licorice may contain glycyrrhizin, which can alter how the kidneys handle sodium and potassium. This can lead to fluid retention and increased blood pressure, especially with repeated or higher intake.

How can a person tell whether a product contains real licorice?

The ingredient label is the best guide. Look for terms such as licorice extract, licorice root, or glycyrrhizin, because some black licorice candies are flavored without real licorice.

Can black licorice interact with medications?

Yes. It may interact with diuretics, some blood pressure medicines, corticosteroids, digoxin, and medications that affect heart rhythm. Anyone taking regular medicines should ask a pharmacist or doctor before using licorice products often.

What symptoms suggest too much black licorice?

Possible signs include swelling, headaches, higher blood pressure, muscle cramps, weakness, fatigue, or palpitations. Severe symptoms such as chest pain, fainting, or an irregular heartbeat need urgent medical attention.

Is licorice tea safer than black licorice candy?

Not necessarily. If the tea contains real licorice root, it may carry similar glycyrrhizin-related risks. The overall effect depends on the product, amount used, frequency, and the person's health conditions.

References

• U.S. Food and Drug Administration
• National Center for Complementary and Integrative Health
• National Institutes of Health Office of Dietary Supplements
• American Heart Association
• MedlinePlus

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.