Licorice and Myopathy

[Guest guest]

Dear Prof. White:

 

> Can you provide some published or internet sources in English regarding

> licorice as a cause of myopathy? How much licorice are we talking about? I

> have a patient who has high levels of creatinine kinase (CK) which have not

> been satisfactorily explained, and who does consumes licorice daily. I'd be

> much obliged for some references on the relationship of licorice to myopathy.

> Many thanks,

> Prof. Neal White

 

Although I cannot give you any Japanese publications in English, I found

several reports through Medline:

Gross EG, Dexter JD, Roth RG

Hypokalemic myopathy with myoglobinuria associated with licorice

ingestion.

N Engl J Med (United States), Mar 17 1966, 274(11) p602-6

 

Tourtellotte CR, Hirst AE

Hypokalemia, muscle weakness, and myoglobinuria due to licorice

ingestion.

Calif Med (United States), Oct 1970, 113(4) p51-3

 

And much more...

Glycyrrhetic acid enhaces excression of potassium and may lead to

hypopotassemia that causes myopathy and pseudoaldosteronism. (Needless to

say hypertension.)

Japanese pharmacology suggests not exceeding more than 2.5g per day of

gancao if the patient has hypopotassemia, myopathy, and pseudoaldosteronism.

 

Acupuncturist Shinjiro

Shinjiro Kanazawa, L.Ac.

[Guest guest]

Dear Shinjiro Kanazawa:

Thanks for your reply and the references. Do I understand correctly that Japanese pharmacology considers continuing to take up to 2.5 grams daily of licorice is acceptable for patients already suffering from hypokalemia, myopathy, etc.? Also, do you know what form the 2.5 grams of gan cao is in? For instance, is it 2.5 grams of the dried licorice root, or 2.5 grams of a standardized extract of some sort? Many thanks, Neal.

 

-

Shinjiro Kanazawa

Sunday, March 23, 2003 10:37 PM

Re: Licorice and Myopathy

Dear Prof. White:> Can you provide some published or internet sources in English regarding> licorice as a cause of myopathy? How much licorice are we talking about? I> have a patient who has high levels of creatinine kinase (CK) which have not> been satisfactorily explained, and who does consumes licorice daily. I'd be> much obliged for some references on the relationship of licorice to myopathy.> Many thanks, > Prof. Neal WhiteAlthough I cannot give you any Japanese publications in English, I foundseveral reports through Medline: Gross EG, Dexter JD, Roth RG Hypokalemic myopathy with myoglobinuria associated with licorice ingestion. N Engl J Med (United States), Mar 17 1966, 274(11) p602-6 Tourtellotte CR, Hirst AE Hypokalemia, muscle weakness, and myoglobinuria due to licorice ingestion. Calif Med (United States), Oct 1970, 113(4) p51-3 And much more...Glycyrrhetic acid enhaces excression of potassium and may lead tohypopotassemia that causes myopathy and pseudoaldosteronism. (Needless tosay hypertension.)Japanese pharmacology suggests not exceeding more than 2.5g per day ofgancao if the patient has hypopotassemia, myopathy, and pseudoaldosteronism.Acupuncturist ShinjiroShinjiro Kanazawa, L.Ac.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.