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[Hypertension caused by licorice consumption]

M A Seelen1, P H de Meijer, J Braun

  • 1Academisch Ziekenhuis, afd. Interne Geneeskunde, Leiden.

Nederlands Tijdschrift Voor Geneeskunde
|December 28, 1996
PubMed
Summary
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Excessive liquorice consumption can cause hypertension and hypokalaemic alkalosis. This is due to glycyrrhetic acid in liquorice inhibiting an enzyme, leading to cortisol

Area of Science:

  • Endocrinology
  • Nephrology

Background:

  • Hypertension and hypokalaemic alkalosis are significant clinical findings requiring etiological investigation.
  • Mineralocorticoid excess can mimic these clinical and biochemical abnormalities.

Observation:

  • A 38-year-old woman presented with severe hypertension and hypokalaemic alkalosis.
  • Her symptoms were linked to a daily intake of 200g of liquorice.
  • A liquorice provocation test confirmed the diagnosis.

Findings:

  • Liquorice contains glycyrrhetic acid, which inhibits 11-beta-hydroxysteroid dehydrogenase.
  • This inhibition decreases cortisol to cortisone conversion in the kidneys.
  • Elevated cortisol exhibits mineralocorticoid activity, causing sodium retention, potassium loss, and metabolic alkalosis.

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Implications:

  • This case highlights liquorice as a potential cause of secondary hypertension.
  • Understanding enzyme inhibition by glycyrrhetic acid is crucial for diagnosing such cases.
  • Awareness of liquorice-induced hypertension can prevent misdiagnosis and guide appropriate management.