People’s Pharmacy: Black licorice binge could have been lethal

Q. I live in Mexico and love black licorice, but it’s almost impossible to find in my town. When I went to the U.S. for a visit, I bought a large quantity of it. Then I binged on licorice every day for about three weeks.

Around the end of that time, I developed an unrelenting headache. I checked my blood pressure, and it was high, so I took an extra blood pressure pill. No luck. I eventually went to the emergency room when I couldn’t tolerate the headache.

They admitted me to the hospital for four days. My potassium was 2.5, and my blood pressure was 230/123. I had a CT scan and an MRI and was diagnosed with PRES (posterior reversible encephalopathy syndrome). I have a history of high blood pressure and preeclampsia (high blood pressure during pregnancy).

No more licorice for me. I figured out the problem was due to the licorice, although the doctors seemed skeptical.

A. You were right on target. Licorice contains an ingredient called glycyrrhizin that can deplete potassium and raise blood pressure.

A surprisingly similar case report was published in the New England Journal of Medicine (Sept. 24), except that man died. The middle-aged construction worker had been eating a bag of licorice a day for three weeks. When he collapsed, his potassium level was so low that it triggered a fatal arrhythmia. His level, at 2.0, was only a little lower than yours (normal is 3.4 to 5.0).

Q. I have a lot of gas every day. I take MiraLax every day to prevent constipation. It really works! Could it also be causing the gas?

A. MiraLax contains polyethylene glycol 3350. It is classified as an osmotic laxative. If you think back to your high-school science class, you might remember that osmosis is the process by which water equalizes concentrations of a solute like salt or sugar on both sides of a membrane. If you drop a raisin in a glass of water, it will plump up as water moves through the skin and into the dried grape.

The lining of the digestive tract is a semipermeable membrane. Since polyethylene glycol is a concentrated solute that doesn’t get through the lining, water moves into the gut and softens the stool.

MiraLax can cause gas and bloating. Other side effects include nausea, stomach cramps, diarrhea or allergic reactions such as hives, itching or trouble breathing. The label advises against continuous use for more than a week.

For more information about natural ways to combat constipation and reduce gas, you may wish to consult our eGuide to Overcoming Digestive Disorders. This online resource can be found in the Health eGuides section of peoplespharmacy.com.

Q. I have had seasonal allergies my entire life. I was put on way too many allergy medications for years, then I had allergy shots for more than 10 years.

I started using a generic saline spray morning and night, even sometimes when I’ve just been outside for a while. It has saved me entirely! I no longer need allergy shots or any other medication at all.

I buy a store brand of saline spray with no other additives. It’s inexpensive and no mess. I carry one in my purse at all times.

A. Researchers have determined that rinsing the nasal passages with saline is effective for reducing allergy symptoms (Cochrane Database of Systematic Reviews, June 22, 2018). We’re glad this safe and inexpensive solution is working so well for you.

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 peoplespharmacy.com.