Mineralocorticoid activity of liquorice: 11-beta-hydroxysteroid dehydrogenase deficiency comes of age

Lancet. 1987 Oct 10;2(8563):821-4. doi: 10.1016/s0140-6736(87)91014-2.


The sodium retention associated with liquorice ingestion has been thought to be due to a direct mineralocorticoid effect, despite the fact that it does not seem to occur in patients or animals with severe adrenal insufficiency. This study in seven normal subjects given liquorice showed that sodium retention is associated with a significant change in cortisol metabolism indicating inhibition of 11-beta-hydroxysteroid dehydrogenase (11 beta-OHSD). Congenital deficiency of this enzyme produces a syndrome of apparent mineralocorticoid excess. It is suggested that in both conditions there is a defect in the renal conversion of cortisol to cortisone by 11 beta-OHSD which results in high intrarenal cortisol levels, acting on type 1 mineralocorticoid receptors to cause sodium retention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 11-beta-Hydroxysteroid Dehydrogenases
  • Adult
  • Glycyrrhetinic Acid / blood
  • Glycyrrhiza*
  • Humans
  • Hydrocortisone / metabolism
  • Hydroxysteroid Dehydrogenases / antagonists & inhibitors*
  • Hydroxysteroid Dehydrogenases / deficiency
  • Kidney / metabolism
  • Male
  • Mineralocorticoids / metabolism*
  • Plants, Medicinal*
  • Potassium / metabolism
  • Renin-Angiotensin System / drug effects
  • Sodium / metabolism


  • Mineralocorticoids
  • Sodium
  • Hydroxysteroid Dehydrogenases
  • 11-beta-Hydroxysteroid Dehydrogenases
  • Glycyrrhetinic Acid
  • Potassium
  • Hydrocortisone