Low doses of liquorice can induce hypertension encephalopathy

Am J Nephrol. 2000 Mar-Apr;20(2):145-8. doi: 10.1159/000013572.


Prolonged ingestion of liquorice is a well-known cause of hypertension due to hypermineralocorticoidism. We describe 2 cases of hypertension encephalopathy (in addition to the classical symptoms of hypertension, hypokalemia and suppression of the renin-aldosterone system) which resulted in pseudohyperaldosteronism syndrome due to the regular daily intake of low doses of liquorice. Glycyrrhizic acid, a component of liquorice, produces both hypermineralocorticism and the onset of encephalopathy through the inhibition of 11beta-hydroxysteroid dehydrogenase. Hypertension encephalopathy due to the daily intake of low doses of liquorice, however, has not been previously documented. It is proposed that some people could be susceptible to low doses of glycyrrhizic acid because of a 11beta-hydroxysteroid dehydrogenase deficiency.

Publication types

  • Case Reports

MeSH terms

  • 11-beta-Hydroxysteroid Dehydrogenase Type 1
  • Adult
  • Blood Pressure / drug effects
  • Glycyrrhiza / adverse effects*
  • Humans
  • Hydrocortisone / blood
  • Hydroxysteroid Dehydrogenases / antagonists & inhibitors
  • Hydroxysteroid Dehydrogenases / deficiency
  • Hyperaldosteronism / blood
  • Hyperaldosteronism / chemically induced
  • Hypertensive Encephalopathy / blood
  • Hypertensive Encephalopathy / chemically induced*
  • Hypertensive Encephalopathy / physiopathology
  • Hypokalemia / blood
  • Hypokalemia / chemically induced
  • Male
  • Middle Aged
  • Plants, Medicinal*


  • Hydroxysteroid Dehydrogenases
  • 11-beta-Hydroxysteroid Dehydrogenase Type 1
  • HSD11B1 protein, human
  • Hydrocortisone