Licorice Toxicity Presenting As Refractory Hypokalemia and Hypertension in an Elderly Patient

Licorice toxicity can present with a triad of severe hypokalemia, metabolic alkalosis, and hypertension, particularly in elderly patients. We present the intriguing case of a 78-year-old male who was referred for evaluation of refractory hypokalemia and newly developed hypertension. Despite an unremarkable systemic review and minimal symptoms, a detailed dietary history revealed significant daily consumption of licorice, initially believed by the patient to support smoking cessation. Laboratory investigations confirmed the classic biochemical profile of licorice toxicity, characterized by suppressed aldosterone and renin levels, effectively differentiating it from other conditions such as Conn's syndrome. This case underscores the diagnostic challenges posed by licorice toxicity, emphasizing the importance of a thorough clinical evaluation and awareness of dietary factors that may contribute to significant health impacts. Recognizing licorice toxicity can prevent unnecessary interventions and guide appropriate management strategies. By shedding light on this uncommon condition, we aim to enhance recognition among clinicians, avoid unnecessary interventions, and improve patient outcomes.