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[Perverse effects of an apparently harmless habit...]
L Michaux1, C Lefebvre, E Coche
1Service de Médecine Interne, Cliniques Universitaires Saint-Luc, Bruxelles, Belgique.
La Revue De Medecine Interne
|February 1, 1993
Summary
A woman with difficult-to-control hypertension and low potassium was found to consume liquorice-flavored chewing gum. Glycyrrhizic acid in liquorice can mimic aldosterone, causing these symptoms.
Area of Science:
- Endocrinology
- Nephrology
- Pharmacology
Background:
- Arterial hypertension is a prevalent condition requiring consistent management.
- Uncontrolled hypertension can lead to severe cardiovascular and renal complications.
- Hypokalemia, or low potassium levels, can be a sign of underlying endocrine or medication-related issues.
Observation:
- A 47-year-old woman presented with newly resistant hypertension and hypokalemia.
- Initial investigations revealed suppressed renin and aldosterone levels with elevated urinary potassium.
- Detailed history uncovered regular consumption of liquorice-flavored chewing gum.
Findings:
- The patient's symptoms were attributed to the glycyrrhizic acid in liquorice.
- Glycyrrhizic acid inhibits the enzyme 11-beta-hydroxysteroid dehydrogenase type 2.
- This inhibition leads to mineralocorticoid excess, mimicking hyperaldosteronism and causing hypertension and potassium loss.
Implications:
- Excessive liquorice consumption can cause a reversible form of pseudoaldosteronism.
- Physicians should consider dietary factors, such as liquorice intake, in patients with unexplained hypertension and hypokalemia.
- Awareness of liquorice's effects is crucial for managing resistant hypertension and electrolyte imbalances.