People tend to have a love-hate relationship with black licorice. It is either their favorite treat or the one type of candy they avoid like plague. But with Halloween on the way, those who love black licorice should know that eating too much can be dangerous.
Overindulging in black licorice can cause complications that are "acutely life-threatening," Dr. Christopher Newton-Cheh, a cardiologist at Massachusetts General Hospital in Boston, told U.S. News & World Report.
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Eaten in large amounts, black licorice can lower the body's potassium levels drastically. Potassium is important for heart and muscle health, and if levels plummet, it can lead to muscle weakness, abnormal heart rhythms and congestive heart failure. It also can cause the body to retain sodium, leading to elevated blood pressure.
High blood pressure and low potassium levels can be particularly dangerous for people with preexisting heart or kidney conditions. Rutgers University experts say that people with high blood pressure and heart or kidney conditions should avoid black licorice completely.
Though eating black licorice is not considered lethal, it appeared to be the root cause of one man's death in 2019. In a case report published by the New England Journal of Medicine, doctors noted that a man went into cardiac arrest and died from a brain injury sustained while the emergency responders tried to shock his heart back to a normal rhythm. Upon further investigation, the doctors learned that he had low potassium levels most likely caused by his poor diet, which included eating a bag or two of red licorice a day. Three weeks before he died, he had switched to black licorice.
Newton-Cheh was one of the doctors who had treated the man.
Other adverse health effects also are associated with high consumption of black licorice. In a 2009 study, pregnant women who ate a lot of it had children who later struggled with poor cognitive skills. According to the U.S. Food and Drug Administration and the American Heart Association, it can interfere with some medications, herbs and dietary supplements.
Overindulgence in black licorice also appeared to be to blame in a case of a 55-year-old woman who presented at a clinic with low potassium levels and high blood pressure. According to Healthline, she reported eating one to two packages of it daily for four years after she had quit smoking. After eliminating licorice from her diet and eating a potassium-rich diet, which included potassium supplements, her levels returned to normal.
So what makes black licorice so dangerous? Licorice, formally known as Glycyrrhiza glabra, is a type of legume that grows in southern Europe, the Middle East and Asia. Licorice root is what gives black licorice its pungent taste. The root is not used to make red licorice and some black licorice candies use artificial flavors instead. The chemical glycyrrhizin in the licorice root causes a person's potassium levels to drop.
It is important to remember that licorice root can be found in other products including jelly beans, root beer and some herbal teas and dietary supplements. Manufacturers must list licorice or glycyrrhizic acid in the ingredient list.
The FDA warns that black licorice only should be eaten in moderation. But that amount has never been clearly defined. The FDA says anyone 40 and older who eats 2 ounces of black licorice a day for two weeks could end up in the hospital with an irregular heart rhythm.
Some people tout licorice root as an alternative medicine to treat coughs, asthma, stomach pain, insomnia and even infections. Advocates say the licorice plant has anti-inflammatory, antioxidant and antimicrobial properties. There is not enough evidence to support these claims, though. According to a 2012 review, the daily consumption of licorice is never justified because its benefits are minor compared to the dangers of chronic consumption.
With Halloween just days away, parents may wonder whether they should get rid of all the black licorice candies that their kids will bring home. Health experts say children can eat a few pieces, but they should not overindulge.