Man dies from eating more than a bag of liquorice a day, for weeks

We know the dangers of sweet foods to our health, but in the case of liquorice, it turns out it may be worse for us than we ever thought, doctors say.

This is after one man’s love for the confectionery turned sour when he suffered cardiac arrest, according to a case published in the New England Journal of Medicine this month. 

Doctors wrote that the 54-year-old man, a construction worker in the US state of Massachusetts, ate about one-and-a-half bags of black liquorice every day for a couple of weeks. 

“The patient had been in a fast-food restaurant when he gasped suddenly and lost consciousness,” the report reads.

He was revived after emergency responders performed CPR, but reportedly died the next day.

How did this happen?

“Even a small amount of liquorice you eat can increase your blood pressure a little bit,” said Dr Neel Butala, a cardiologist at Massachusetts General Hospital who described the case in the New England Journal of Medicine.

In their paper, they explain that black liquorice contains a compound, known as glycyrrhizic acid, that can be toxic in large doses.

Dr Elazer Edelman, one of the authors of the paper, explained that studies have shown that glycyrrhizic acid could cause "hypertension, hypokalemia [dangerously low potassium levels], metabolic alkalosis, fatal arrhythmias, and renal failure" – all of which were seen in this patient.

Apart from this, the patient was also reported to have had a poor diet. 

The doctors also noted that the patient had recently changed the type of sweets he was consuming – a few weeks prior to his death, he switched from red fruit-flavoured twists to a different type made with black liquorice.

Another doctor, Dr Andrew Lundquist, also wrote that the liquorice was to blame: "Further investigation revealed a recent change to a liquorice-containing candy as the likely cause of his hypokalemia," Lundquist wrote.

According to The Guardian, Jeff Beckman, a spokesman for the Hershey Company which produces the Twizzlers liquorice twists, said that “all of our products are safe to eat and formulated in full compliance with FDA regulations”, and that all foods, including candy, “should be enjoyed in moderation”.

Previous case report also linked to liquorice

In a 2015 case study, published in the BMJ Case Reports, a 45-year-old woman was reported to have experienced hot flushes, sweating, and headaches for four months.

Tests revealed that she had been suffering from hypertension that was induced by liquorice tea. Doctors wrote that she had been drinking up to six cups of liquorice tea per day, and that once she stopped consuming the drink, her hypertension, and hypokalaemia entirely resolved.

Since the patient had chosen the tea as a substitute for caffeinated tea and fruit-based infusions, the doctors wrote that “clinicians need to be continually vigilant of the impact that dietary choices may have on patient health”. 

In 2017, the Food and Drug Administration (FDA) warned that eating two ounces (56g) of black liquorice per day for at least two weeks could lead to irregular heart rhythm (arrhythmia) in people 40 years and older.