Licorice during Pregnancy

Pregnancy and Licorice

Licorice during pregnancy: introduction

Licorice (in English “liqueur” or in American “licorice”) is the common name of a botanically defined herbaceous plant G. glabra.

Licorice, especially in roots, has a number of food applications. On the other hand, this product contains some dubious active ingredients whose safety is often the subject of controversy.

In this article we will deal in detail with the implications that consuming licorice during pregnancy can have.

General information on licorice

The root of liquorice is consumed, having a sweet and sour taste and characteristic flavour, as well as various phytotherapeutic properties attributable above all to the active ingredient called glycyrrhizinic acid. By virtue of its pharmacological characteristics, the consumption of licorice can have various useful applications but also several contraindications. In this article we will better explain its role in the diet during pregnancy.

Licorice root is not eaten, rather it is chewed and sucked. However, it is possible to obtain the drug, the extract and the pure aroma, which are widely used both in industrial and home production.

Further information: botanical notes on liquorice

The liquorice plant is a perennial herbaceous plant that belongs to the Fabaceae family, that is, that of legumes, genus Glycyrrhiza and species glabra. Native to southern Europe and some parts of Asia, such as India, licorice is not “related” to other plants with a similar taste such as anise, star anise, wild fennel.

Ownership and Use

Properties of liquorice

Licorice extracts have a number of medical applications and are also used in herbal medicine or as herbal remedies. Its properties are: painkiller-anti-inflammatory for the stomach, bronchodilator, expectorant and laxative.

Glycyrrhizin has also demonstrated antiviral, antimicrobial, anti-inflammatory, hepatoprotective, and blood pressure-increasing effects in vitro and in vivo. Additionally, intravenous glycyrrhizin slows the progression of viral and autoimmune hepatitis. In a clinical study, licorice applied topically demonstrated positive activity against atopic dermatitis. It may also be useful in the treatment of hyperlipidemia (high amount of fat in the blood). It also appears effective in the treatment of inflammatory skin hyperpigmentation. Some data suggest that it may find application in the prevention of neurodegenerative diseases and dental caries.

Use of licorice

For thousands of years, licorice has been used for healing purposes for indigestion, inflammation of the gastro-duodenal mucosa (gastritis), gastro-duodenal ulcer, cough and constipation. This is one of the rare cases in which the application of folk medicine corresponds to that of traditional medicine.

Toxicity in Pregnancy

Pregnancy, licorice and the child's intelligence

Some scientists from the University of Helsinki (in Finland) have hypothesized that one of the active ingredients contained in licorice, when taken during pregnancy, could influence the intelligence quotient of the unborn child, memory capacity and even cause attention deficit/hyperactivity disorder (ADHD).

Researchers have discovered that eating licorice during pregnancy can be linked to a series of fetal development problems. This is confirmed by research (also published in the “Journal of Epidemiology”) carried out on 378 adolescents with an average age of 12.5 years (born in 1998). In Finland, compared to the rest of the European Union countries, liquorice consumption is higher thanks to the popularity of “salmiakki”, a savory snack flavored with the famous root. According to the research, girls whose mothers consumed large amounts of licorice during pregnancy (over 500 mg of glycyrrhizin per week, compared to a lower limit of 249 mg/day) were more likely to enter early puberty. Furthermore, girls and boys whose mothers had consumed high quantities of liquorice scored on average seven points lower in intelligence tests, and at the same time a higher score in attention deficit hyperactivity disorder (ADHD).

Controversies over the study of licorice during pregnancy

As with many other dietary studies, the overall picture is too complex to establish a direct cause-and-effect correlation. Furthermore, glycyrrhizin (the active ingredient of liquorice) is not exclusive to this plant and is also found in other products. However, only licorice intake was measured in the study, so the actual amount of glycyrrhizin the women consumed is only a rough estimate. There are many factors that influence cognitive development and it is not clear whether researchers have actually taken them into account.

Is licorice bad for pregnancy?

Hard to say. At the moment there are no guidelines that suggest that pregnant women should completely avoid licorice. However, as a precaution, it is advisable to avoid consuming licorice root, herbal remedies, extracts, drugs and flavorings that contain it.

Side effects

Side effects of excess licorice

Excessive consumption of licorice, estimated at over 2 mg of active ingredient per kilogram of body weight per day, can cause various side effects. In particular, the following appear to be more frequent and unexplained: hypokalemia (abnormal reduction in potassium in the blood), maintenance of natremia (sodium in the blood), muscle weakness, reduction in aldosterone, decline in the renin-angiotensin system and increase in atrial natriuretic hormone (for compensate for changes in homeostasis).

Licorice intoxication is therefore responsible for an impairment of corticosteroid metabolism (hypermineralocorticosteroid syndrome). In particular, glycyrrhizin and enoxolone exert an inhibitory effect on the degradation of cortisol and its main active constituents. For this reason, in addition to the clinical signs and symptoms described above, the following also easily appear: edema, weight gain or loss and arterial hypertension.


Safety of licorice consumption

The United States Food and Drug Administration (FDA) considers foods containing licorice and derivatives (including the active ingredient glycyrrhizin) to be generally safe, as long as they are not consumed in excess.

Although in healthy people approximately 400 mg/day of active ingredient (approximately 200 g of sweets) should be needed to trigger symptoms, other jurisdictions suggest not to exceed 100-200 mg/day of glycyrrhizin, which translates into approximately 70-150 g of liquorice.

A normal, healthy person should be able to consume 10 mg of glycyrrhizin per day without experiencing any side effects.

As we anticipated in the paragraph regarding the consumption of licorice during pregnancy, it is advisable to avoid it in large quantities. Reasonable consumption (< 249 mg/week of glycyrrhizin) should not have any adverse effects.


Contraindications of the use of licorice

They must avoid large quantities of licorice, or in any case dosages equal to or greater than 100 mg/day, especially people:

  • Cardiopatiche
  • Suffering from renal failure
  • Hypertensive
  • During pregnancy (but only in considerable quantities).

In these cases, 50 mg/day of licorice can be considered safe.

Other Uses

Other uses of licorice

Most of the licorice marketed (90%) is used as a flavoring agent for tobacco, particularly for US cigarettes, to which licorice gives sweetness and a characteristic flavour. Nonetheless, the licorice drug exerts a bronchodilator effect that improves smoke inhalation.

The liquorice flavor (from extract or aroma) is also widely used (5% of production) in the confectionery industry for sweets and chewingum, ice cream, synthetic sweeteners (in some European and Middle Eastern countries) and in the pharmaceutical industry as an excipient ( 5% of production).


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