Licorice Poisoning Clinical Presentation

Updated: Apr 11, 2022
  • Author: Seth Schonwald, MD, FACEP; Chief Editor: Sage W Wiener, MD  more...
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Most patients with licorice poisoning report chronic toxicity from daily excessive ingestion of natural licorice products (not artificial licorice flavoring). Cases of poisoning are mostly chronic in nature, not acute; however, binging on licorice has also resulted in toxicity. Symptoms of licorice toxicity may include the following:

  • Fatigue and muscle cramping
  • Dark urine (myoglobinuria)
  • Weakness (hypokalemia, myopathies)
  • Polyuria/nocturia (increased extracellular volume)
  • Edema (increased extracellular volume)
  • Dyspnea (pulmonary edema)
  • Headache (hypertension)
  • Paresthesias/dysesthesias (eg, burning sensations of extremities)
  • Impotence and diminished libido
  • Amenorrhea

Physical Examination

Findings on physical examination may include the following:

  • Edema (peripheral, pulmonary), secondary to increased extracellular fluid from water retention
  • High blood pressure, [22, 23] including dangerously high blood pressure with symptoms such as headache, nausea, vomiting, and hypertensive encephalopathy with strokelike effects (eg, hemiplegia)
  • Spasms/tetany
  • Hyporeflexia, muscle wasting, weakness, flaccid paralysis [24, 25]
  • Myoglobinuria/rhabdomyolysis [26]
  • Trousseau and Chvostek signs (from hypokalemia with alkalosis)
  • Cardiac arrest, dysrhythmias (rare) from hypokalemia