high blood pressure asso. with licorice intake

[Guest guest]

Have any of you folks had experience with high blood pressure associated

with excessive use of licorice? I have a patient who has used licorice

in a herbal formula for the past two years (equal parts corydalis,

licorice and white peony.) She has experienced an increase in blood

pressure of 140/80, for the past year. She is no longer using any

licorice. Is this a condition that will return to balance by itself

with time? I would appreciate hearing from anyone who has had

experience with this problem.

[Guest guest]

In a message dated 11/15/00 6:46:54 PM Pacific Standard Time,

zrosenberg writes:

 

<< I'd be interested as to if any

source you know mentions diuretic effects of licorice.

>>

 

No, and if it WERE diuretic, it would lower BP, not raise it.

 

Julie Chambers

[Guest guest]

on 11/15/00 4:41 PM, Molly Greacen at m.greacen wrote:

 

> Have any of you folks had experience with high blood pressure associated

> with excessive use of licorice? I have a patient who has used licorice

> in a herbal formula for the past two years (equal parts corydalis,

> licorice and white peony.) She has experienced an increase in blood

> pressure of 140/80, for the past year. She is no longer using any

> licorice. Is this a condition that will return to balance by itself

> with time? I would appreciate hearing from anyone who has had

> experience with this problem.

>

 

Dear Molly,

Great to have you on board.

 

Studies have been done with western glycyrrhiza (glabra), that indicate

raising of blood pressure and retention of fluids. We can assume that

western licorice is a similar species with similar properties. Most Chinese

prescriptions use small amounts of gan cao or zhi gan cao, but only a few

have large doses of gan cao in them (zhi gan cao tang). Gan cao is said to

supplement qi and fluids, and is contraindicated with many draining

prescriptions, including those that encourage urination, bowel movements or

catharsis. This would indicate that it keeps stuff in the body, and

inhibits draining methods.

 

Using equal parts gan cao to yan hu suo and bai shao would be

contraindicated, perhaps, in this situation, especially when taken over such

a long period. It is quite possible that blood pressure in sensitive

individuals could go up over time.

 

Can you give more information about the patient (age, tongue, pulse,

pattern?). Then we can figure out if her blood pressure will go down by

itself, or if it will require biomedical or Chinese medical treatment. We

can also determine if the herbs influenced the blood pressure. . . .it may

be other factors as well.

 

 

[Guest guest]

maybe the BP goes up as gan cao (liquorice) from a western perspective is a

diuretic and may leech potassium in elderly people ...I don't know if low

potassium alters BP

 

 

Heiko Lade

Registered Acupuncturist / Chinese Herbalist

2 Jenkins St.

Green Island, Dunedin

New Zealand

Tel: (03) 488 4086, Fax: (03) 488 4012

http://www.lade.com/heiko

Email: heiko

[Guest guest]

on 11/15/00 5:35 PM, heiko at heiko wrote:

 

> maybe the BP goes up as gan cao (liquorice) from a western perspective is a

> diuretic and may leech potassium in elderly people ...I don't know if low

> potassium alters BP

>

 

In Chinese medicine, as I mentioned in another post, licorice is

contraindicated in most prescriptions designed to induce urination (it is in

dao chi san/guide out the red powder and liu yi san/six to one powder to

prevent excessive loss of yin fluids). I checked my Western herbal library

and was unable to find any diuretic indications for licorice. The closest

reference I could find was for urinary tract inflammation, but I assume this

is the muscelagenic quality of the herb. I'd be interested as to if any

source you know mentions diuretic effects of licorice.

 

 

[Guest guest]

Actually, it can take very little licorice to cause a rise in BP. I had

a patient several years ago who developed HBP from Panda brand licorice.

Of course, she had a predisposition towards this. Some physicians I know

use licorice to deliberatly raise BP in those w/ hypotension and adrenal

insufficiency.

 

Cara

[Guest guest]

THe tips licorice are said to be the most diuretic portion of the root.

I don't know if that can be purchased. Ken Jamison of China HErb Co said

he has never had it in his pharmacy

Cara

[Guest guest]

>on 11/15/00 5:35 PM, heiko at heiko wrote:

>

>> maybe the BP goes up as gan cao (liquorice) from a western perspective is a

>> diuretic and may leech potassium in elderly people ...I don't know if low

>> potassium alters BP

>>

>

>In Chinese medicine, as I mentioned in another post, licorice is

>contraindicated in most prescriptions designed to induce urination (it is in

>dao chi san/guide out the red powder and liu yi san/six to one powder to

>prevent excessive loss of yin fluids). I checked my Western herbal library

>and was unable to find any diuretic indications for licorice. The closest

>reference I could find was for urinary tract inflammation, but I assume this

>is the muscelagenic quality of the herb. I'd be interested as to if any

>source you know mentions diuretic effects of licorice.

>

>

==================

 

Him-che Yeung, Handbook of Chinese Herbs and Formulas, Vol 1:

 

Gan Cao

 

" Lower Blood pressure -- can decrease the concentration of

cholesterol in blood in hypertensive patients. "

 

" Toxicity: May cause edema and hypertension if taken for a long

period of time. The mechanism is due to adrenocortical action

resulting in retention of water in the body and Na ions, but with the

excretion of K ions. "

[Guest guest]

At 10:18 PM -0500 11/15/00, CAra Frank wrote:

>THe tips licorice are said to be the most diuretic portion of the root.

>I don't know if that can be purchased. Ken Jamison of China HErb Co said

>he has never had it in his pharmacy

>Cara

============

 

I don't think that is quite the issue here though - as my previous

post points out, it is the selective excretion of potassium and

retention of sodium that is the cause of the high blood pressure. The

correct ratio of sodium/potassium is essential to the cardiac

function at a cellular level, as well as many other cell types in the

body.

 

Rory

[Guest guest]

A naturopath told me .....I presumed he knew his western herbs .....he is

quite adamant about the fact that licqorice increases potassium loss.

 

I wonder if anyone has done any experimenting with gan cao in large and

small amounts. In Bensky, under ginseng he says that on animal experiments

large doses reduce blood pressure and small doses increases blood

pressure.Could gan cao have similar alternating results in regards

diuretic effect.

 

One thing I have experienced (a few times) is that on elderly patients ie

over 75 after a course of herbal medicine containing gan cao they have

reported that their doctors tests have shown low potassium levels and

thought it might be the herbs.Since then I only put a slice of gan cao in

the scripts instead of 3 grams .

 

 

Heiko Lade

Registered Acupuncturist / Chinese Herbalist

2 Jenkins St.

Green Island, Dunedin

New Zealand

Tel: (03) 488 4086, Fax: (03) 488 4012

http://www.lade.com/heiko

Email: heiko

[Guest guest]

I'll look it up and get back to you. I first learned this when I was studying w/

Ted.

Cara

 

juliej8 wrote:

 

> In a message dated 11/15/00 6:46:54 PM Pacific Standard Time,

> zrosenberg writes:

>

> << I'd be interested as to if any

> source you know mentions diuretic effects of licorice.

> >>

>

> No, and if it WERE diuretic, it would lower BP, not raise it.

>

> Julie Chambers

>

>

> Chinese Herbal Medicine, a voluntary organization of licensed healthcare

practitioners, matriculated students and postgraduate academics specializing in

Chinese Herbal Medicine, provides a variety of professional services, including

board approved online continuing education.

>

>

[Guest guest]

Look in F and S on page 95. the rx Dao chi San calls for gan cao shao- the tips.

The tips are not trly diurectic- just relativly more so. as wewll as the usual

properties: detoxicant, antispasmodic, mucilaginous...

Cara

 

juliej8 wrote:

 

> In a message dated 11/15/00 6:46:54 PM Pacific Standard Time,

> zrosenberg writes:

>

> << I'd be interested as to if any

> source you know mentions diuretic effects of licorice.

> >>

>

> No, and if it WERE diuretic, it would lower BP, not raise it.

>

> Julie Chambers

>

>

> Chinese Herbal Medicine, a voluntary organization of licensed healthcare

practitioners, matriculated students and postgraduate academics specializing in

Chinese Herbal Medicine, provides a variety of professional services, including

board approved online continuing education.

>

>

[Guest guest]

As far as I can determine blood pressure has never been known to be

raised from properly prescribed herbal preparations containing licorice

root, of either the European or Chinese varieties. It has however been

found to be raised in persons consuming large quantities of (real)

licorice candy such as Panda licorice, at doses as low as 1 ounce candy

daily and can also be attributable to (real) licorice flavored alcoholic

drinks. Candy consumption and extrapolation from constituent data are

the root of warnings about licorice and BP.

 

Quantity and refinement issues are both factors with licorice candy.

There is a significant difference in aqueous extractions and alcohol

extractions in licorice. I'm with Zev in wanting to know more about the

patient and what else she was taking. Herbs often get the rap when there

are other factors at work, especially if isolated constituents in

concentration (botanical drugs) can cause similar effects.

 

I'd also be interested in the actual effects on the physician's patients

that Cara mentions. Does this really work or are the physicians

recommending licorice root just because they heard that it raises BP? My

information is that one would need 10-45 grams per day, which is a *lot*

of licorice.

 

There are cases of persons who have unusual sensitivity (almost allergy)

to licorice, plain or DGL which may manifest with HBP. (I'd be curious

if these persons fit constitutional homeopathic profiles for licorice.

At least one such sensitive person I know of can take homeopathic

licorice without incident.)

 

I find oedemic, not diuretic indications for licorice in my western

sources. Reduced excretion of potassium (and its replacement) can be

achieved with the addition of dandelion to formulas.

 

Some constituent information which may or may not be relevant to aqueous

extractions of gan cao:

 

One active ingredient in licorice, glycyrrhizin, and it main gut

metabolite in humans, glycyrrhetic acid, both prolong the effects of

cortisol, by creatings an aldosterone-like agonist effect, thereby

causing sodium retention and potassium depletion at the distal tuble in

the nephron. Those on blood pressure medicines such as Lasix

(furosemide) or hydrochlorothiazide, heart medicines such as Lanoxin

(digoxin), or cortisone-type drugs, including prednisone may be

succeptible to cross-reactions from constituents in licorice, especially

in concentrated extracts, candy or licorice liqueurs. For over forty

years, glycyrrhizin has been a prescription drug in Japan to treat

inflammatory illnesses such as ulcers and chronic liver disease. It is

also used to decrease allergic reactions to other drugs. Glabridin,

which is not water extracted, but may be present in wan preparations, has

strong antioxidant properties

 

Researchers using a highly refined licorice extract suggest that

chemicals

in glycyrrhizin called triterpenoids may be effective against cancer.

They

may block the production of prostaglandin - a hormonelike fatty acid that

may be responsible for stimulating the growth of cancer cells - and help

get-rid of cancer-causing invaders. Triterpenoids have been shown in test

tubes to stunt the growth of rapidly multiplying cells, like cancer

cells, and

they may even help precancerous cells return to normal. Glycyrrhetic

acid is also antitumoral in low doses in estrogen sensitive cancers,

operating by tying up estrogen receptors. Large doses(> 300mg extract,

>2 gm powder, or >4 ml fluid extract) of licorice may, however, show more

of the estrogenic effects due to the higher availability of the

isoflavones. The antagonistic effects occur by competing for receptor

sites, but once all empty sites are filled, there is

no greater antagonistic effect.

 

There is some early indication for use in AIDS treatment but the research

is difficult to interpret accurately.

 

The American species (Glycyrrhiza lepidota) does not share the potential

for blood pressure elevation in concentrated doses that European and

Asian species have.

 

Karen Vaughan

CreationsGarden

***************************************

Email advice is not a substitute for medical treatment.

" The unfortunate thing about this world is that the good habits are much

easier to give up than the bad ones. " W. Somerset Maugham

 

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[Guest guest]

There was, a while back, a hypothesis that CFS was at least partially

caused by low blood pressure. Therefore, the logical treatment would be

to elevate BP. I don't remember the exact dosage. I advised a physician

who consulted me about this, to not use licorice in this way. that it

was overly simplistic and was likely to have side effects. I really

encouraged him to use a more balanced formula. Nevertheless, he tried

it.

It is also appealing because it stimulates the adrenal cortex, and

of course, adrenal insufficiency may play a role in CFS too. so, while

using licorice in this way is not w/o some merit, I don't think it's a

treatment that will have " legs " , owing to its side effects. As I

anticipated, it was not terribly effective. It is my understanding that

many Dr's who practice integrative medicine use this strategy routinely.

 

I am also reminded that I had a patient who developed HBP as a result

of drinking Sambuca nightly!

Cara

[Guest guest]

>

> CAra Frank [herbbabe]

> Friday, November 17, 2000 9:32 AM

>

> Re: high blood pressure asso. with

> licorice intake

>

>

> it.

> It is also appealing because it stimulates the adrenal cortex, and

> of course, adrenal insufficiency may play a role in CFS too.

 

Does it actually stimulate adrenal cortex or just increase the half-life of

cortisol? or both?

 

_

[Guest guest]

I'm not sure. Does anyone out there know the answer to this question? I

can probably find out.

Cara