Everyone knows that candy is not healthful, but can you imagine that too much could kill you? The New England Journal of Medicine (Sept. 24, 2020) published a case report describing the death of middle-aged construction worker who overdosed on black licorice.

This 54-year-old man liked candy. He had been consuming a bag or more of fruit-flavored soft candy daily. About three weeks before he was rushed to the hospital, he switched to licorice-flavored candy with real licorice in it. That was what ultimately did him in.

He was having lunch at a fast-food restaurant when he suddenly began to gasp and shake, and lost consciousness. Despite the doctors doing everything they could to figure out what was wrong, they could not save his life. His potassium levels had dropped far too low, triggering a fatal heart rhythm disturbance.

The glycyrrhizin in black licorice candy, licorice tea and licorice medicines can deplete the body of potassium. As the authors note, this compound results in unchecked activity of cortisol, which can lead to elevated blood pressure, dangerously low potassium, metabolic disruption (alkalosis), kidney failure and fatal changes in heart rhythm.

This is not the first time we have heard about serious consequences from eating too much licorice candy. Decades ago, doctors in Salt Lake City reported on a 64-year-old gentleman with fluid in his lungs and very low potassium (Western Journal of Medicine, September 1997). He was complaining of fatigue and his blood pressure was elevated, at 180/80. According to the report, “He described having eaten four packages (about 1020 grams) of black licorice (Hershey Twizzlers) during the previous 3 days.” Fortunately, this fellow recovered and avoided licorice from then on.

Some readers have related scary experiences as well. Richard wrote: “On Sunday, I checked my blood pressure and found it was 190/110. This worried me, so I took my blood pressure monitor with me to work on Monday. When I tested myself, my blood pressure was 200/114. I called my doctor and was told to head straight to the emergency room.

“As soon as I walked in, they took my blood pressure: 210/115. I’ve never had such a high reading before. They kept me in the ER for six hours and gave me a fast-acting pill. That brought my pressure down at last.

“I had no idea why this happened, but when I got home I read through the paperwork they gave me at the hospital. It said LICORICE could be a problem! I’d bought a bag of black licorice about two weeks ago and had been eating large amounts daily. I think there should be warnings on the bags of candy. After all, this stuff could actually kill people!”

Americans are not the only ones to encounter problems with licorice candy. An Australian reader told us: “My husband had a bad reaction to pigging out on Bullets (chocolate-coated licorice candies) over a fortnight. His ankles started to swell and his blood pressure went over 200. When he went to the hospital, most of the doctors did not recognize the danger of licorice candy, though a cardiologist did. I believe that consumers also need to be better informed.”

It is possible to enjoy licorice in moderation. That means not every day and not large quantities. Perhaps our Aussie reader is right. Licorice makers should add cautions to the labels.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website:


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