Ingredient Guide
Licorice Root: Benefits, Dosage, and What the Research Says
Ancient botanical, modern evidence: what clinical research actually shows about Glycyrrhiza glabra.
Written by Jessica Medson
Licorice root (Glycyrrhiza glabra) is one of the most extensively documented botanical medicines in the world, used for thousands of years across Ayurvedic, Traditional Chinese, and Middle Eastern medical traditions. Its primary active compound, glycyrrhizin, has been studied in human clinical trials for digestive support, H. pylori eradication, liver enzyme normalization, menopausal symptom relief, and oral mucosal healing. Research suggests the addition of licorice to standard H. pylori antibiotic therapy raised eradication rates from 62.5% to 83.3% in one randomized trial -- though the evidence base overall consists primarily of small trials, and larger multi-center studies are needed to confirm findings across populations.
What Is Licorice Root?
Licorice root is the dried root and rhizome of Glycyrrhiza glabra, a perennial legume native to southern Europe and western Asia. The genus name comes from the Greek glykys (sweet) and rhiza (root), reflecting the characteristic sweetness that makes it instantly recognizable. Historically documented in Egyptian papyri, ancient Chinese pharmacopeias, and Roman medical texts, licorice holds one of the longest unbroken records of medicinal use of any plant in the world.
The root's sweetness -- roughly 50 times more intense than sucrose -- comes from glycyrrhizin (also called glycyrrhizic acid), a triterpenoid saponin that also drives most of licorice's pharmacological activity. Glycyrrhizin typically constitutes 2-25% of the root by dry weight, varying by species, soil, and climate.1
Two primary commercial forms are in common use:
- Whole-root or standardized licorice root extract: Retains glycyrrhizin and delivers the full phytochemical profile. Used at lower doses for its anti-inflammatory, hepatoprotective, and mucosal properties.
- Deglycyrrhizinated licorice (DGL): Processed to remove most glycyrrhizin, substantially reducing its mineralocorticoid effects on blood pressure and potassium. Preferred for longer-term digestive support in people who need to limit cardiovascular exposure.
Licorice root is sold as chewable tablets, capsules, liquid extracts, teas, lozenges, and topical preparations. The FDA recognizes licorice as generally recognized as safe (GRAS) as a food-grade flavoring, but therapeutic supplement doses require more caution (see the Safety section).8
How Does It Work?
Licorice root exerts its effects through several well-characterized mechanisms, primarily driven by glycyrrhizin and its primary metabolite, glycyrrhetic acid (18-beta-glycyrrhetinic acid).1
11-beta-HSD inhibition and cortisol modulation
After oral ingestion, intestinal bacteria hydrolyze glycyrrhizin into glycyrrhetic acid, which is a potent inhibitor of 11-beta hydroxysteroid dehydrogenase (11-HSD) -- the enzyme responsible for converting the active stress hormone cortisol into inactive cortisone. By slowing this conversion in tissues, glycyrrhetic acid allows cortisol to act longer and more broadly, producing corticosteroid-like anti-inflammatory and mucosal-soothing effects. This same mechanism is also responsible for licorice's most significant side effect: at high doses, inhibiting the renal form of this enzyme causes sodium retention and potassium loss (see Safety).1
HMGB1 binding (preclinical)
Laboratory research has demonstrated that glycyrrhizin binds directly to High-Mobility Group Box 1 protein (HMGB1), a late-phase inflammatory mediator implicated in sepsis, arthritis, and organ damage.11 By physically binding HMGB1, glycyrrhizin inhibits its ability to recruit immune cells and promote cytokine activity. This is a well-established mechanism at the biochemical level, though controlled human clinical trials specifically targeting this pathway have not been published. This evidence should be regarded as Tier C: preclinical data suggest a plausible mechanism; human evidence has not been established.
Mucosal protection and prostaglandin support
Licorice-derived compounds appear to stimulate mucus secretion and cell turnover in the gastrointestinal lining, and may support prostaglandin synthesis -- a class of lipid mediators that help maintain the protective mucosal barrier in the stomach and esophagus.3
Phytoestrogenic activity
Several isoflavonoids and chalcones in licorice root -- including liquiritigenin and isoliquiritigenin -- interact with estrogen receptors, which may partly explain observed effects on menopausal vasomotor symptoms.9 These compounds appear to bind estrogen receptors with lower potency than endogenous estrogen, producing a modulating rather than a fully estrogenic effect.
Digestive Health and Gastric Support
Licorice root has the most substantial human trial evidence in gastroenterology among all its studied applications. Clinical research has examined it for functional dyspepsia, Helicobacter pylori eradication, and mucosal comfort.
What the research shows: functional dyspepsia
A randomized, double-blind, placebo-controlled trial enrolled 50 patients with confirmed functional dyspepsia and assigned them to receive GutGard (a standardized Glycyrrhiza glabra extract, 75 mg twice daily) or placebo for 30 days. The licorice group showed a significant decrease in total dyspepsia symptom scores on days 15 and 30 (p ≤ .05 vs. placebo), and 56% of patients in the licorice group achieved marked improvement compared with 0% in the placebo group. Nepean Dyspepsia Index quality-of-life scores also improved significantly. No treatment-related adverse effects were reported.3
What the research shows: H. pylori eradication
Two randomized controlled trials suggest licorice may support Helicobacter pylori eradication as an adjunct to antibiotic regimens. A 2014 trial in 60 patients with peptic ulcer disease found that licorice substituted for bismuth subsalicylate in a four-drug regimen produced comparable eradication rates (67% licorice group vs. 57% bismuth group), supporting licorice as a viable alternative when bismuth is contraindicated.4 A larger 2016 trial of 120 patients found that adding licorice to a standard clarithromycin-based triple therapy regimen for two weeks raised eradication success from 62.5% in controls to 83.3% in the licorice-supplemented group -- a statistically significant difference.5
A note on DGL and gastric ulcer healing
An older double-blind crossover trial testing deglycyrrhizinated licorice (760 mg three times daily) in 96 patients with chronic gastric ulcer found no significant healing advantage over placebo when assessed by gastroscopy at four weeks.12 Most contemporary research interest has shifted toward licorice as an H. pylori adjunct rather than a standalone ulcer-healing therapy. Patients with peptic ulcers should work with a physician and not substitute supplemental licorice for evidence-based medical treatment.
Liver Health: Hepatoprotective Effects
Licorice root extract has been studied as a hepatoprotective agent, with the most clinically relevant human trial evidence coming from non-alcoholic fatty liver disease (NAFLD), a condition characterized by lipid accumulation and hepatocellular inflammation.
What the research shows
A randomized controlled trial enrolled 66 patients with confirmed NAFLD and assigned them to receive either 2 g of aqueous licorice root extract daily or a matched control for two months. Patients receiving licorice demonstrated statistically significant reductions in both markers of liver inflammation:
- Alanine aminotransferase (ALT): decreased from 64.09 to 51.27 IU/mL (p < 0.001)
- Aspartate aminotransferase (AST): decreased from 58.18 to 49.45 IU/mL (p < 0.001)
The control group showed no statistically significant change in either enzyme. Body mass index did not differ meaningfully between groups, suggesting the liver enzyme changes were not simply a consequence of weight loss.2
The authors appropriately noted that studies incorporating liver biopsy (histological) data are needed to confirm clinical benefit at the tissue level. A broader pharmacological review confirmed that glycyrrhizin preparations demonstrate hepatoprotective activity across multiple liver diseases in clinical research, including viral hepatitis, though intravenous glycyrrhizin formulations used in Japan represent a different delivery context from oral supplements.1
Research in this area is encouraging, though the evidence base remains limited in size and duration. Individuals with liver disease should discuss any supplementation with their gastroenterologist before use.
Menopausal Symptom Support
Licorice root is increasingly studied as a phytoestrogen-containing botanical that may help women manage vasomotor symptoms -- particularly hot flashes -- during the menopausal transition.
What the research shows
A double-blind controlled trial assigned 90 menopausal women to licorice root extract (330 mg/day) or a starch placebo for eight weeks, with a four-week washout follow-up. The licorice group showed a significant reduction in both the frequency and severity of hot flashes throughout the intervention period compared with the placebo group. Benefits persisted for approximately two weeks post-treatment before returning toward baseline, while the placebo group's minor initial improvement disappeared after the first week (interpreted by the researchers as a psychological placebo response that was not sustained).9
A second randomized trial directly compared licorice (1,140 mg/day) to hormone replacement therapy (HRT) in 60 menopausal women over 90 days. Investigators found that licorice was not significantly different from hormones in reducing the number and duration of hot flashes, though HRT proved superior for reducing severity.10 This is an intriguing finding but should be interpreted cautiously given the small sample size and the limitations of comparing one study's outcomes to the established evidence base for HRT.
The proposed mechanism centers on phytoestrogenic isoflavonoids and chalcones in the root that bind estrogen receptors at low affinity, helping to maintain normal receptor signaling during periods of declining endogenous estrogen. Research suggests licorice may help support menopausal comfort, though women with hormone-sensitive conditions should consult their physician before use.
Oral Health: Aphthous Ulcer Relief
Topical and locally applied licorice preparations have been evaluated specifically for recurrent aphthous stomatitis (RAS) -- commonly known as canker sores -- one of the most prevalent oral mucosal conditions, estimated to affect 15-25% of the general population.
What the research shows
A controlled trial assigned subjects with recurrent aphthous ulcers to one of three conditions: a dissolving oral patch containing Glycyrrhiza glabra extract, a placebo patch, or no treatment (n=23 per group). By day four, 81% of the active treatment group reported no pre-stimulus pain, compared with 63% in the placebo group and 40% in the untreated group (p < 0.01). By day eight, ulcer size was significantly smaller in the treated group (p < 0.05), while ulcers in the untreated group had actually grown 13% from baseline.6
A 2023 systematic review synthesized six clinical trials involving 314 total subjects testing licorice in various formulations -- paste, adhesive patch, and mouthwash at 1% or 5% concentrations. Across studies, licorice demonstrated significant effects on RAS pain reduction, ulcer size, and healing time, with typical healing occurring within 4-8 days. No adverse effects were reported in any of the active treatment groups.7
Proposed mechanisms include anti-inflammatory activity at the mucosal site, antioxidant effects, upregulation of epidermal growth factor (which supports epithelial repair), and demonstrated antibacterial activity against oral pathogens.7 Notably, topical application largely avoids systemic glycyrrhizin absorption, making this one of the safer contexts for licorice use.
Safety, Side Effects, and Drug Interactions
Licorice root has a well-documented, dose-dependent safety concern that sets it apart from most botanical supplements: its primary active compound, glycyrrhizin, can cause meaningful changes in blood pressure and potassium at doses achievable through supplementation or heavy candy consumption. Understanding this risk is critical before use.
Pseudoaldosteronism: the core mechanism of harm
Glycyrrhetic acid (the gut-metabolized form of glycyrrhizin) inhibits the renal enzyme 11-HSD type 2, which normally inactivates cortisol in the kidney. When this enzyme is blocked, cortisol accumulates and binds mineralocorticoid receptors in the kidney tubules, triggering sodium retention and potassium loss -- a syndrome called pseudoaldosteronism. Clinical consequences can include hypertension, hypokalemia (low blood potassium), metabolic alkalosis, and in severe cases, cardiac arrhythmias including QT interval prolongation that can progress to life-threatening rhythm disturbances.18
Dose and duration thresholds
A comprehensive regulatory toxicology review proposed an acceptable daily intake of 0.015-0.229 mg glycyrrhizin per kg body weight per day (approximately 1-16 mg for a 70 kg adult).8 European and US food safety authorities have noted that consuming roughly 100 mg of glycyrrhizin or more per day -- present in approximately 50 g of confectionery licorice candy -- for extended periods poses meaningful cardiovascular risk, particularly in older adults. Individual sensitivity varies; some people develop pseudoaldosteronism at lower intakes.
Populations who should avoid high-dose whole-root licorice
- People with hypertension: Licorice may worsen blood pressure control and antagonize antihypertensive medications.
- People with heart disease, heart failure, or arrhythmias: Hypokalemia increases sensitivity to digoxin and the risk of rhythm disturbances.
- People with kidney disease or chronic edema: Sodium retention may worsen fluid balance.
- Pregnancy: High-dose licorice use is associated with adverse fetal outcomes in observational studies; therapeutic supplemental doses should be avoided during pregnancy.
- Breastfeeding: Glycyrrhizin is detectable in breastmilk. There is insufficient safety data for therapeutic use while nursing. Evidence does not support the use of licorice as a galactogogue (to increase milk supply) -- it may in fact reduce prolactin levels.1
Drug interactions
- Antihypertensives and diuretics: May reduce efficacy of blood pressure medications; potassium-sparing diuretics may interact unpredictably with licorice's potassium-lowering effect.
- Digoxin and cardiac glycosides: Licorice-induced hypokalemia can dramatically increase toxicity risk.
- Corticosteroids: Additive anti-inflammatory effect via shared 11-HSD inhibition; may amplify steroid side effects.
- Hormonal contraceptives or hormone replacement therapy: Potential for additive or opposing estrogenic effects via phytoestrogenic compounds.
- CYP3A4-metabolized medications: Some licorice constituents may modulate hepatic cytochrome P450 enzyme activity, altering drug clearance.
DGL as a lower-risk option
Deglycyrrhizinated licorice (DGL), with glycyrrhizin content reduced to below 3%, largely avoids mineralocorticoid concerns and is the preferred form for people who wish to use licorice for ongoing digestive support. Always consult a qualified healthcare provider before starting licorice root if you take any prescription medications, are pregnant or breastfeeding, or have cardiovascular, renal, hepatic, or hormonal conditions.
Licorice Root: Study-Based Dose Reference
Doses below are drawn from the clinical trials cited in this article. They are not a prescription or a recommendation for any individual. Consult a healthcare provider before use, especially for whole-root products containing glycyrrhizin.
| Goal | Typical Dose | Timing | Notes |
|---|---|---|---|
| Functional dyspepsia symptom support | 75 mg standardized Glycyrrhiza glabra extract (GutGard-type) twice daily | With meals | RCT used this dose for 30 days; significant improvement vs. placebo. DGL preferred for long-term use to limit glycyrrhizin exposure. |
| Adjunct H. pylori eradication support | Not yet standardized; used alongside prescribed antibiotic triple therapy | Per prescriber guidance | Trial showing 83.3% eradication added licorice to clarithromycin-based triple therapy for 2 weeks. Never self-treat H. pylori infection. |
| Menopausal hot flash support | 330-1,140 mg/day licorice root extract (divided doses) | Daily in 2-3 divided doses | RCTs ranged 8-90 days. Monitor blood pressure periodically with whole-root products. Consider DGL if prolonged use is planned. |
| Oral mucosal comfort (aphthous ulcers) | Topical adhesive patch, paste, or 1-5% mouthwash applied locally | Multiple applications daily, as needed | Topical use avoids systemic glycyrrhizin absorption. Healing typically observed within 4-8 days in trials. |
| Liver enzyme support (NAFLD, under medical supervision) | 2 g aqueous licorice root extract daily | With meals | RCT duration was 2 months. Monitor blood pressure and liver enzymes. Use only under the guidance of a physician who is aware of your full medication list. |
These doses reflect what was studied in cited clinical trials; they are not universal recommendations. Glycyrrhizin content varies widely between products. Always read supplement labels and consult a healthcare professional.
Licorice Root: Evidence at a Glance
A summary of key clinical findings across studied applications. Tier A = human RCT or meta-analysis; Tier B = human observational; Tier C = animal or in vitro only.
| Outcome | Study Design | Key Finding | Evidence Tier |
|---|---|---|---|
| Functional dyspepsia symptoms | RCT, n=50, 30 days (GutGard 75 mg twice daily vs. placebo) | 56% of licorice group achieved marked improvement vs. 0% placebo (p ≤ .05); significant symptom score reductions on days 15 and 30 | Tier A |
| H. pylori eradication (added to triple therapy) | RCT, n=120, 2 weeks (licorice + clarithromycin triple therapy vs. triple therapy alone) | Eradication rate 83.3% (licorice group) vs. 62.5% (control) -- statistically significant | Tier A |
| H. pylori eradication (vs. bismuth) | RCT, n=60 (licorice vs. bismuth in 4-drug regimen) | Eradication 67% (licorice) vs. 57% (bismuth); comparable efficacy | Tier A |
| Menopausal hot flash frequency and severity | RCT, n=90, 8 weeks (330 mg/day vs. placebo) | Significant reduction in hot flash frequency and severity vs. placebo; effect persisted ~2 weeks post-treatment | Tier A |
| Menopausal hot flashes vs. HRT | RCT, n=60, 90 days (1,140 mg/day vs. hormone replacement therapy) | Licorice not significantly different from HRT in reducing number and duration of hot flashes; HRT superior for severity | Tier A |
| Aphthous ulcer pain and healing | Systematic review of 6 RCTs, n=314 (various topical formulations) | Significant improvements in pain reduction, ulcer size, and healing time (4-8 days); no adverse effects reported | Tier A |
| Liver enzymes in NAFLD (ALT, AST) | RCT, n=66, 2 months (2 g/day vs. control) | ALT: 64.09 to 51.27 IU/mL; AST: 58.18 to 49.45 IU/mL (p < 0.001); no significant change in controls | Tier A |
| Gastric ulcer healing (DGL, standalone use) | RCT crossover, n=96 (DGL 760 mg 3x/day vs. placebo) | No significant advantage over placebo in gastric ulcer healing at 4 weeks | Tier A (negative finding) |
| Anti-inflammatory mechanism (HMGB1) | In vitro binding assay (no human trial) | Glycyrrhizin directly binds HMGB1 and inhibits its cytokine activities; mechanism plausible, human evidence not established | Tier C |
All Tier A findings come from relatively small trials, many from a single region. Results should be interpreted as promising but in need of larger, multi-center replication before definitive conclusions can be drawn.
Frequently Asked Questions
What is licorice root good for?
Clinical research suggests licorice root may support digestive comfort (especially in functional dyspepsia), help improve H. pylori eradication rates when added to antibiotic therapy, reduce menopausal hot flash frequency, support liver enzyme normalization in NAFLD, and relieve aphthous (canker) sore pain and healing. Evidence is promising but based on small trials that need larger replication.
What is the difference between licorice root and DGL?
DGL (deglycyrrhizinated licorice) has had most of its glycyrrhizin removed during processing. Glycyrrhizin is both the primary active anti-inflammatory compound and the cause of licorice's blood pressure and potassium side effects. DGL retains mucous membrane-soothing properties with substantially less cardiovascular risk, making it the preferred form for daily digestive use.
How much licorice root should I take?
Clinical trials have used 75-150 mg of standardized extract (twice daily) for dyspepsia, 330-1,140 mg/day for menopausal hot flashes, and 2 g/day aqueous extract for liver enzyme support. There is no single universal dose. Product glycyrrhizin content varies widely -- always read the label and consult a healthcare provider, especially for whole-root products.
Is licorice root safe to take every day?
Short-term use at moderate doses is generally well tolerated in healthy adults. Long-term daily use of whole-root licorice containing significant glycyrrhizin (above roughly 100 mg/day) raises blood pressure and lowers potassium for many people. DGL is a safer choice for ongoing daily use. People with hypertension, heart disease, or kidney disease should avoid supplemental licorice entirely without medical supervision.
Does licorice root help with H. pylori infection?
Two randomized trials suggest it may. In one study, adding licorice to clarithromycin-based triple antibiotic therapy raised H. pylori eradication rates from 62.5% to 83.3%. A separate trial found licorice comparable to bismuth in a four-drug regimen (67% vs. 57% eradication). Do not self-treat H. pylori; always use licorice as an adjunct under medical supervision.
Can licorice root raise blood pressure?
Yes -- this is a well-documented effect of glycyrrhizin (found in whole-root products). Glycyrrhetic acid, the active metabolite, inhibits a kidney enzyme that normally inactivates cortisol, causing sodium retention and potassium loss. This raises blood pressure in a dose- and duration-dependent manner. DGL does not carry the same risk. People with hypertension should avoid whole-root licorice.
Does licorice root help with menopause symptoms?
Research suggests it may help maintain hot flash frequency and severity within a more comfortable range. A double-blind trial of 90 menopausal women found 330 mg/day significantly reduced hot flash frequency and severity versus placebo over 8 weeks. A separate trial found licorice comparable to hormone replacement therapy for reducing hot flash number and duration, though HRT was superior for severity reduction.
Is licorice root safe during pregnancy?
High-dose therapeutic licorice root is not recommended during pregnancy. Observational research has linked heavy licorice consumption to adverse fetal and developmental outcomes. The FDA and food safety authorities in multiple countries advise pregnant women to limit licorice intake. Consult your OB-GYN or midwife before using any licorice supplement during pregnancy.
Does licorice root interact with medications?
Yes -- licorice root has clinically significant interactions with several drug classes. It may reduce the effectiveness of blood pressure medications, increase digoxin toxicity risk via potassium lowering, amplify corticosteroid effects, and potentially alter the metabolism of drugs processed by liver CYP3A4 enzymes. Always disclose licorice use to your prescribing physician.
How long does it take for licorice root to work?
This depends on the application. For aphthous ulcers, topical licorice patches show pain relief by day 4 and significant size reduction by day 8. For functional dyspepsia, significant symptom improvement appeared at the 15-day mark in clinical trials. For menopausal hot flashes, meaningful changes were seen over the full 8-week study period. Liver enzyme benefits required a full two-month course.
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Scientific References
- 1.Kwon YJ, Son DH, Chung TH, Lee YJ A Review of the Pharmacological Efficacy and Safety of Licorice Root from Corroborative Clinical Trial Findings. Journal of Medicinal Food. 2020. PubMed: 31874059Human observational
- 2.Hajiaghamohammadi AA, Ziaee A, Samimi R The efficacy of licorice root extract in decreasing transaminase activities in non-alcoholic fatty liver disease: a randomized controlled clinical trial. Phytotherapy Research. 2012. PubMed: 22308054Clinical (RCT / meta-analysis)
- 3.Raveendra KR, Jayachandra, Srinivasa V, Sushma KR, Allan JJ, Goudar KS, Shivaprasad HN, Venkateshwarlu K, Geetharani P, Sushma G, Agarwal A An Extract of Glycyrrhiza glabra (GutGard) Alleviates Symptoms of Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study. Evidence-based Complementary and Alternative Medicine. 2012. PubMed: 21747893Clinical (RCT / meta-analysis)
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- 5.Hajiaghamohammadi AA, Zargar A, Oveisi S, Samimi R, Reisian S To evaluate of the effect of adding licorice to the standard treatment regimen of Helicobacter pylori. Brazilian Journal of Infectious Diseases. 2016. PubMed: 27614124Clinical (RCT / meta-analysis)
- 6.Martin MD, Sherman J, van der Ven P, Burgess J A controlled trial of a dissolving oral patch concerning glycyrrhiza (licorice) herbal extract for the treatment of aphthous ulcers. General Dentistry. 2008. PubMed: 18348383Clinical (RCT / meta-analysis)
- 7.Dorsareh F, Vahid-Dastjerdi G, Bouyahya A, Zarshenas MM, Rezaie M, Yang WM, Amiri-Ardekani E Topical Licorice for Aphthous: A Systematic Review of Clinical Trials. Iranian Journal of Medical Sciences. 2023. PubMed: 37786470Clinical (RCT / meta-analysis)
- 8.Isbrucker RA, Burdock GA Risk and safety assessment on the consumption of Licorice root (Glycyrrhiza sp.), its extract and powder as a food ingredient, with emphasis on the pharmacology and toxicology of glycyrrhizin. Regulatory Toxicology and Pharmacology. 2006. PubMed: 16884839Human observational
- 9.Nahidi F, Zare E, Mojab F, Alavi-Majd H Effects of licorice on relief and recurrence of menopausal hot flashes. Iranian Journal of Pharmaceutical Research. 2012. PubMed: 24250477Clinical (RCT / meta-analysis)
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- 11.Mollica L, De Marchis F, Spitaleri A, Dallacosta C, Pennacchini D, Zamai M, Agresti A, Trisciuoglio L, Musco G, Bianchi ME Glycyrrhizin binds to high-mobility group box 1 protein and inhibits its cytokine activities. Chemistry and Biology. 2007. PubMed: 17462578Preclinical (animal / cell)
- 12.Engqvist A, von Feilitzen F, Pyk E, Reichard H Double-blind trial of deglycyrrhizinated liquorice in gastric ulcer. Gut. 1973. PubMed: 4584640Clinical (RCT / meta-analysis)