Since 2020 does not provide extraordinary ways to die, the universe offers a terrifying reminder that eating too much licorice candy can be fatal.
A 54-year-old black construction worker in Massachusetts recently died after consuming an excessive amount of black licorice, a naturally occurring toxin called glycerizine, aka glycyrrhizic acid. Doctors published a case study of his poisoning in the New England Journal of Medicine this week.
According to the study, the poor fellow was in a fast-food restaurant when he suddenly went into cardiac arrest. He “experienced sudden hisses, full body tremors and loss of consciousness,” doctors report. The paramedics arrived within minutes and resuscitated him with four shocks and CPR. But when he was admitted to the hospital about 50 minutes later, doctors discovered he had multi-organ failure, “profound metabolic degeneration”, dangerously low levels of potassium in his blood, and cardiac arrest associated with ventricular fibrillation. The chambers of the heart glow irregularly without pumping blood. All of these conditions are compatible with licorice poisoning.
A thorough medical examination noted that he had no previous history of heart problems and doctors pinned his condition on Candy. Discussions with his family revealed that he ate one to two “large” bags of black lychees every day for about three weeks before his heart stopped beating. By the time he reached the hospital there was a lot of damage. He died about 32 hours later on his bedside with his family.
Twisted history
Medical researchers have long known about the complex and toxic effects of the Lyris plant on the human body. Lacoris has a rich history in Eastern and Western cultures, extending to the Babylonian and Egyptian empires. Hippocrates suggested it in the treatment of asthma and dry cough. Chinese traditional medicine has used licorice to treat conditions ranging from tuberculosis to peptic ulcer.
But these uses were not without side effects. In the 1950s, Dutch-medical scientist FE Reverse conducted the first systematic study of the anti-ulcer effects of licorice extract and noted that patients suffered from swelling, “violent headaches,” high blood pressure, and chest pain and pressure.
In the decades that followed, researchers found that the glycerizine in licorice was absorbed by intestinal microorganisms and converted to glycyrrhizinic acid (aka glycyrrhizic acid). This is absorbed by the body after metabolism. In the kidney, glycyrrhizinic acid derivatives inhibit an important enzyme called 11β-hydroxysteroid dehydrogenase type 2, or 11βHSD2, which converts the steroid hormone cortisol into cortisone. Cortisol has many important functions, including being a critical regulator of ion, salt and water balance. As a result, blood volume, blood pressure and the overall functioning of the cardiovascular system are significantly affected.
With 11βHSD2 blocked by glycyrrhizinic acid, cortisol levels build up inside the kidneys. This leads to a cascade of life-threatening problems in the body, including high levels of sodium, water retention, drowning in potassium levels and subsequent kidney failure. Increased sodium and water retention leads to inflammation and high blood pressure. An extreme drop in potassium levels (hypokalemia), which throws up the ionic balance, is serious for the cardiac conduction system – a special group of heart muscle cells that use electrical signals to contract the heart muscle and pump around the blood. As such, a decrease in potassium levels can lead to fatal irregular heart rhythms, such as ventricular fibrillation.
Scary, but rare
To make matters worse, glycyrrhizinic acid also interferes with enzymes in the liver that affect aldosterone levels, another complex steroid hormone – which enhances all other health effects of toxins. The liver also replicates glycyrrhizinic acid, meaning that high levels may accumulate after repeated consumption of licorice and remain high for a long time. Symptoms of lyresis poisoning can take weeks to go away.
For this reason, medical researchers and health agencies warn against eating too many black licorice – at the same time and / or on a daily basis. In fact, the U.S. The Food and Drug Administration usually reminds consumers of the deadly dangers surrounding Halloween each year (although, unfortunately, this year is unnecessary).
In past warnings, the FDA notes: “If you’re 40 or older, eating 2 ounces of black licorice a day for at least two weeks can lead to hospitalization with irregular heart rhythms or arrhythmias.”
However, since black licorice is not a very popular candy and few people are busy consuming enough toxic amounts, greasy sweets are not dangerous to public health. (Also, not all “licorice” candies contain lycopene plant extracts, such as red lizards like red candies, red tweezers.) Reports of illnesses are rare, let alone death. Some examples of the harmful include the FDA’s reference to “black licorice ion ficionado,” which caused a “problem” after eating candy in 2016. In 1977, researchers reported the case of a 58-year-old woman who ate just 1.8 kilograms (about 63.5 ounces) of black licorice per week and went into cardiac arrest. But, she survived cardiac arrest and she recovered completely after she stopped eating lysis.
The poor fellow from Massachusetts was not so lucky. However, doctors were able to increase her potassium levels with large, intravenous doses of potassium chloride, but her condition worsened. His blood pressure became unstable, his neurological prognosis was weak, and his kidneys failed. He was moved to comfort her before she died peacefully with her family.
