Man Likes Licorice A Little Too Much Finds Himself In The Hospital After Downing 2-1/2 Pounds
Call it a case of Twizzler trauma.
A Utah man was hospitalized with a rare case of congestive heart failure and waterlogged lungs after binging on 2-1/2 pounds of black licorice, according to an article published this month in The Western Journal of Medicine.
“The moral is balance and moderation in everything you do,” said Susan Snyder Smith, a vice president of the National Confectioners Association in Virginia.
Binging on licorice already was known to raise blood pressure and cause swelling in the face, arms and legs. It also was linked to three cases of congestive heart failure in people with existing heart disease, Utah doctors James Chamberlain and Igor Abolnik wrote.
But the 64-year-old man - who regained his health - is the first known case in which a black-licorice overdose triggered heart failure in an otherwise healthy person, the physicians said.
“It’s humongously rare,” and can be a problem only in people with sensitivity to licorice or who already have hypertension or heart disease, said Abolnik, an assistant professor of medicine at the University of Utah and attending physician at the Veterans Affairs Medical Center.
The victim came to the VA Medical Center in Salt Lake early last year complaining of shortness of breath, coughing and fatigue.
Doctors found he had swollen legs, high blood pressure, fluid in his lungs, low blood oxygen and congestive heart failure - a condition in which the heart is enlarged and pumps blood inefficiently. It is not immediately life-threatening, but can progress and become deadly if the underlying cause isn’t treated.
An electrocardiogram found no abnormality in the man’s heart. So doctors asked his wife if he consumed a lot of water or salt recently. She replied that over the past three days the man had eaten four nine-ounce packages of black licorice Twizzlers, made by Hershey’s Food Corp. in Hershey, Pa.
Natural licorice extract contains glycyrrhizic acid. The substance mimics aldosterone, which is released by the adrenal glands to control how salt is absorbed and thus regulate blood pressure. A person who consumes too much glycyrrhizic acid will retain more salt and water and experience an increase in blood pressure that can lead to congestive heart failure and fluid in the lungs, Chamberlain said.
Only black licorice flavored with natural licorice extract can cause the problem, not red or other licorice flavors or artificially flavored black licorice.
Chamberlain, a senior resident in internal medicine at University Hospital and the VA, said “anybody who has high blood pressure or congestive heart failure probably should not consume more than a (nine-ounce) package in one day.”