Review Article

Licorice (Glycyrrhiza sp.) in Health and Disease: A Minireview of Traditional Uses and Therapeutic Activities

Abstract

Throughout history, human beings have utilized animals, minerals and plants for various purposes including use of them as foods and remedies.  The distribution of plants, animals and minerals varies across different regions of the world; however, we can find same species or closely related varieties in different geographical areas. Based on distinct different historical and cultural circumstances, there plants exhibit diverse therapeutic applications. Licorice (Glycyrrhiza spp.) as an ancient plant with long history of therapeutic uses is noticeable among traditional medicine of various cultures. Respectively, licorice is found in traditional medicines of Iran, India, Thailand and Korea and is recommended to respiratory, gastrointestinal, cardiovascular, and musculoskeletal problems. In modern medicine diverse beneficial effects of licorice has been shown by researches. Licorice effects on oral complications, dyspepsia, dental and gingival problems, non-alcoholic fatty liver disease, and polycystic ovarian syndrome are examples of its positive role on human health. Considering the inhibitory effect of licorice on 11-β-hydroxysteroid dehydrogenase enzyme type 2, pseudohyperaldosteronism may occur in case of long-term use of high doses and therefore, should be used with cautioun in susceptible patients. In spite of all the researches on licorice, it seems more clinical trials are needed to further confirm the therapeutic effects on this medicinal plant based on the traditional applications.

Hantemirova E, Belyaev AY, Korchagina O, Laletina I. Genetic differentiation and phylogenetic relationships of Glycyrrhiza glabra L., G. uralensis Fisch., and G. korshinskyi Grig. inferred from chloroplast DNA variation. Russ. J. Genet 2020;56:810-821.

Khan N. Khazainul Advia. IIIrd ed. New Delhi: Idara Kitab al Shifa 2011.

Ding Y, Brand E, Wang W, Zhao Z. Licorice: resources, applications in ancient and modern times. J Ethnopharmacol 2022;298:115594.

Pastorino G, Cornara L, Soares S, Rodrigues F, Oliveira MBP. Liquorice (Glycyrrhiza glabra): a phytochemical and pharmacological review. Phytother Res 2018;32:2323-2339.

Cho S, Park J-H, Pae AN, Han D, Kim D, et al. Hypnotic effects and GABAergic mechanism of licorice (Glycyrrhiza glabra) ethanol extract and its major flavonoid constituent glabrol. Bioorg Med Chem 2012;20:3493-3501.

Fukai T, Marumo A, Kaitou K, Kanda T, Terada S, et al. Anti-Helicobacter pylori flavonoids from licorice extract. Life Sci 2002;71:1449-1463.

Damle M. Glycyrrhiza glabra (Liquorice)-a potent medicinal herb. Int J Herb Med 2014;2:132-136.

Avicenna H. The Canon of Medicine (Qanoon-fil-Tib)ah 1025.

Memariani Z, Moeini R. Glycyrrhiza glabra L. therapeutic medicinal plants in traditional Persian medicine: CRC Press 2024:107-16.

Shirazi AK. Makhzan Aladviyeh1771.

CSIR. The Wealth of India, New Delhi. Council of Scientific and Industrial Research. New Delhi 1956.

Tariq N. Tajul Mufradat. Idara Kitab al Shifa. New Delh 2010.

Sala A. Indian Medicinal Plants. Hyderabad: Orient Longman; YNM.

Hussain S. Afzalul Mufradat. Idara Kitabul Shifa. New Delhi 2021.

Rastogi RPMB. Compendium of Indian Medicinal Plants. Lucknow: Central Drug Research Institute 2006.

Khan M. Muhit-e-Azam(Urdu translation): Central Council for Research in Unani Medicine 2012.

Baytar I. Al Jami al Advia wal Aghziya(Urdu translation): Central Council for Research in Unani Medicine 1999.

Kabiruddin. Makhzan al Mufradat. Deoband(India): Faisal Publications; YNM.

Chayan P, Manmas C, Wichian J. A description of King Narai’s medicinal formula. 2rd ed.

Amarin printing and publishing. Bangkok 1999.

Laohapand T, Jaturatamrong U. Thai Traditional Medicine in the Faculty of Medicine Siriraj

Hospital. Ayurved Thamrong School, Center of Applied Thai Traditional Medicine, Faculty of Medicine

Siriraj Hospital, Mahidol University. Supavanich Press. Bangkok 2009.

Foundation of Restoration and Promotion of Thai Traditional Medicine Ayuravej Vidhyalaya

(Jivaka Kormarpaj). Tamra Karn Phat Thai Derm (Phat Sart Songkhroa) Chabab Anurak. 1st ed.

Bangkok: Sam Charoen Phanit printing 1992.

Sa-ngiam P. Mai Thet MueangThai: Properties of Foreign and Thai medicine. Bangkok

Kasembannakij 1979.

Herbal Product Division, Food and Drug Administration. National List of Essential

Medicines for Herbal Medicines 2566 B.E. 1st ed: Minnie Group CO., LTD 2023.

Heo, J. (1613). Donguibogam: principles and practice of eastern medicine: UNESCO's world documentary heritage. Part 3-4, miscellaneous disorders. Seoul, Ministry of Health & Welfare. translated by Namil Kim, Changhyun Jeong, Wungseok Cha 2013.

Complied by Jiphyeonjeon of the Joseon Dynasty, Principles and Practice of Classified Collection of Medical Formulas (醫方類聚,EuiBangYooChui). Seoul, Geumyoung publishing co. 1977-1978.

Cheongwon-Gun. The Korean pharmacopoeia. 10th ed. Ministry of Food and Drug Safety 2013.

Lee Kyung-Lock. The Indigenization of licorice and its meaning during the early days of the Joseon dynasty. Korean J Med Hist 2015:24:423-455.

Guk YB. A study on the application of the prescription containing Shaoyao and Gancao in Donguibogam. J Korean Soc Herb Med 2010;18:1-14.

AlDehlawi H, Jazzar A, editors. The power of licorice (Radix glycyrrhizae) to improve oral health: a comprehensive review of Its pharmacological properties and clinical implications. Healthcare 2023.

Yu I-C, Tsai Y-F, Fang J-T, Yeh M-M, Fang J-Y, et al. Effects of mouthwash interventions on xerostomia and unstimulated whole saliva flow rate among hemodialysis patients: a randomized controlled study. Int J Nurs Stud 2016;63:9-17.

Ghalayani P, Emami H, Pakravan F, Nasr Isfahani M. Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy‐induced oral mucositis: a randomized double‐blinded clinical trial. Asia Pac J Clin Oncol 2017;13:e48-e56.

Pakravan F, Salehabad NH, Karimi F, Isfahani MN. Comparative study of the effect of licorice muco-adhesive film on radiotherapy induced oral mucositis, a randomized controlled clinical trial. Gulf J Oncolog 2021;1:42-47.

Dorsareh F, Vahid-Dastjerdi G, Bouyahya A, Zarshenas MM, Rezaie M, et al. Topical licorice for aphthous: a systematic review of clinical trials. Iran J Med Sci 2023;48:437.

Almaz ME, Sönmez IŞ, Ökte Z, Oba AA. Efficacy of a sugar-free herbal lollipop for reducing salivary Streptococcus mutans levels: a randomized controlled trial. Clin Oral Investig 2017;21:839-845.

Goultschin J, Palmon S, Shapira L, Brayer L, Gedalia I. Effect of glycyrrhizin‐containing toothpaste on dental plaque reduction and gingival health in humans: a pilot study. J Clin Periodontol 1991;18:210-212.

Kim Y-R, Nam S-H. A randomized, double-blind, placebo-controlled clinical trial of a mouthwash containing Glycyrrhiza uralensis extract for preventing dental caries. Int J Environ Res Public Health 2021;19:242.

Valkenburg C, Rosema NM, Hennequin‐Hoenderdos NL, Versteeg PA, Slot DE, et al. Do natural ingredients in a dentifrice contribute to prevention of plaque and gingivitis? Int J Dent Hyg 2021;19:429-439.

Pasupuleti MK, Nagate RR, Alqahtani SM, Penmetsa GS, Gottumukkala SN, et al. Role of medicinal herbs in periodontal therapy: a systematic review. J Int Soc Prev Community Dent 2023;1:9-16.

Tharakan AP, Pawar M, Kale S. Effectiveness of licorice in preventing dental caries in children: a systematic review. J Indian Soc Pedod Prev Dent 2020;38:325-331.

Saeedi M, Morteza‐Semnani K, Ghoreishi MR. The treatment of atopic dermatitis with licorice gel. J Dermatolog Treat 2003;14:153-157.

Hou DD, Wang XX, Li SJ, Wang DC, Niu Y, et al. Glycyrrhizic acid suppresses atopic dermatitis‐like symptoms by regulating the immune balance. J Cosmet Dermatol 2022;21:7090-7099.

Xie Y, Huang J, Liu J, Zhang Q. Efficacy of diammonium glycyrrhizinate in the treatment of rosacea with papules and pustules: a randomized, double‐blind, placebo‐controlled study. Dermatol Ther 2022;35:e15905.

Cassano N, Mantegazza R, Battaglini S, Apruzzi D, Loconsole F, et al. Adjuvant role of a new emollient cream in patients with palmar and/or plantar psoriasis: a pilot randomized open-label study. G Ital Dermatol Venereol 2010;145:789-792.

Guo D, Wang Q, Li A, Li S, Wang B, et al. Liquiritin targeting Th17 cells differentiation and abnormal proliferation of keratinocytes alleviates psoriasis via NF‐κB and AP‐1 pathway. Phytother Res 2024;38:174-186.

Zabihi M, Hatefi B, Ardakani ME, Ranjbar AM, Mohammadi F. Impact of licorice root on the burn healing process: a double-blinded randomized controlled clinical trial. Complement Ther Med 2023;73:102941.

Hollinger JC, Angra K, Halder RM. Are natural ingredients effective in the management of hyperpigmentation? a systematic review. J Clin Aesthet Dermatol 2018;11:28.

Rakhmini A, Ilyas FS, Muchtar SV, Patellongi IJ, Djawad K, et al. Comparison of 10%, 20% and 40% licorice extract cream as skin lightening agent. Int J Med Rev Case Rep 2018;2.

Chang G-H, Lin Y-S, Hsu K-H, Cheng Y-C, Yang P-R, et al. Nasal irrigation with Glycyrrhiza glabra extract for treatment of allergic rhinitis–a study of in vitro, in vivo and clinical trial. J Ethnopharmacol 2021;275:114116.

Ameri A, Farashahinejad M, Davoodian P, Safa O, Kusha A, et al. Efficacy and safety of licorice (Glycyrrhiza glabra) in moderately ill patients with COVID-19: a randomized controlled trial. Inflammopharmacology 2023;31:3037-3045.

Zendejas-Hernandez U, Alcántara-Martínez N, Vivar DT, Valenzuela F, Sosa Espinoza A, et al. Nebulized glycyrrhizin/enoxolone drug modulates IL-17A in COVID-19 patients: a randomized clinical trial. Front Immunol 2024;14:1282280.

Soleiman-Meigooni S, Yekta NH, Sheikhan HR, Aminianfar M, Hamidi-Farahani R, et al. Efficacy of a standardized herbal formulation from Glycyrrhiza glabra L. as an adjuvant treatment in hospitalized patients with COVID-19: a Randomized controlled trial. J Ayurveda Integr Med 2022;13:100670.

Ghaemi H, Masoompour SM, Afsharypuor S, Mosaffa-Jahromi M, Pasalar M, et al. The effectiveness of a traditional Persian medicine preparation in the treatment of chronic cough: a randomized, double-blinded, placebo-controlled clinical trial. Complement Ther Med 2020;49:102324.

Gupta D, Agrawal S, Sharma JP. Effect of preoperative licorice lozenges on incidence of postextubation cough and sore throat in smokers undergoing general anesthesia and endotracheal intubation. Middle East J Anaesthesiol 2013;22:173-178.

Agarwal A, Gupta D, Yadav G, Goyal P, Singh PK, et al. An evaluation of the efficacy of licorice gargle for attenuating postoperative sore throat: a prospective, randomized, single-blind study. Anesth Analg 2009;109:77-81.

Kuriyama A, Maeda H. Topical application of licorice for prevention of postoperative sore throat in adults: a systematic review and meta-analysis. J Clin Anesth 2019;54:25-32.

Raveendra KR, Jayachandra, Srinivasa V, Sushma KR, Allan JJ, et al. An extract of Glycyrrhiza glabra (GutGard) alleviates symptoms of functional dyspepsia: a randomized, double‐blind, placebo‐controlled study. Evid Based Complement Alternat Med 2012;2012:216970.

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. Braz J Infect Dis 2016;20:534-538.

Yoon JY, Cha JM, Hong SS, Kim HK, Kwak MS, et al. Fermented milk containing Lactobacillus paracasei and Glycyrrhiza glabra has a beneficial effect in patients with Helicobacter pylori infection: a randomized, double-blind, placebo-controlled study. Medicine 2019;98:e16601.

Momeni A, Rahimian G, Kiasi A, Amiri M, Kheiri S. Effect of licorice versus bismuth on eradication of Helicobacter pylori in patients with peptic ulcer disease. Pharmacogn Res 2014;6:341.

Rahnama M, Mehrabani D, Japoni S, Edjtehadi M, Firoozi MS. The healing effect of licorice (Glycyrrhiza glabra) on Helicobacter pylori infected peptic ulcers. J Res Med Sci 2013;18:532.

Lu P-D, Yuan M-C, Quan X-P, Chen J-F, Zhao Y-H. Preclinical studies of licorice in ulcerative colitis: a systematic review with meta-analysis and network pharmacology. J Ethnopharmacol 2022;296:115444.

Pouwels S, Sakran N, Graham Y, Leal A, Pintar T, et al. Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss. BMC Endocr Disord 2022;22:63.

Rostamizadeh P, Asl SMKH, Far ZG, Ahmadijoo P, Mahmudiono T, et al. Effects of licorice root supplementation on liver enzymes, hepatic steatosis, metabolic and oxidative stress parameters in women with nonalcoholic fatty liver disease: a randomized double‐blind clinical trial. Phytother Res 2022;36:3949-3956.

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. Phytother Res 2012;26:1381-1384.

Chigurupati H, Auddy B, Biyani M, Stohs SJ. Hepatoprotective effects of a proprietary glycyrrhizin product during alcohol consumption: a randomized, double‐blind, placebo‐controlled, crossover study. Phytother Res 2016;30:1943-1953.

Liang S-B, Hou W-B, Zheng R-X, Liang C-H, Yan L-J, et al. Compound glycyrrhizin injection for improving liver function in children with acute icteric hepatitis: a systematic review and meta-analysis. Integr. Med Res 2022;11:100772.

Carmeli E, Fogelman Y. Antioxidant effect of polyphenolic glabridin on LDL oxidation. Toxicol Ind Health 2009;25:321-324.

Tong Yan Qing TY, Sun Min SM, Hu Chun Jie HC, Zhao Dong Kai ZD. Changes of QT dispersion in hemodialysis patients after administrating Zhigancao decoction. Chin J Integr Med 2018;24:627-631.

Petramfar P, Hajari F, Yousefi G, Azadi S, Hamedi A. Efficacy of oral administration of licorice as an adjunct therapy on improving the symptoms of patients with Parkinson's disease, a randomized double blinded clinical trial. J Ethnopharmacol 2020;247:112226.

Man SC, Li X-B, Wang H-H, Yuan H-N, Wang H-N, et al. Peony-glycyrrhiza decoction for antipsychotic-related hyperprolactinemia in women with schizophrenia: a randomized controlled trial. J Clin Psychopharmacol 2016;36:572-759.

Menati L, Khaleghinezhad K, Tadayon M, Siahpoosh A. Evaluation of contextual and demographic factors on licorice effects on reducing hot flashes in postmenopause women. Health Care Women Int 2014;35:87-99.

Armanini D, Castello R, Scaroni C, Bonanni G, Faccini G, et al. Treatment of polycystic ovary syndrome with spironolactone plus licorice. Eur J Obstet Gynecol Reprod Biol 2007;131:61-67.

Shamsi M, Nejati V, Najafi G, Pour SK. Protective effects of licorice extract on ovarian morphology, oocyte maturation, and embryo development in PCOS-induced mice: an experimental study. IJRM 2020;18:865.

Amirhoseiny ES, Ganji A, Mosayebi G, Shamsi M, Ghazavi A. Improves immunological and histological alterations associated with polycystic ovarian syndrome in DHEA-induced mice by licorice extract. Comp Clin Path 2023;32:827-835.

Luís Â, Domingues F, Pereira L. Metabolic changes after licorice consumption: a systematic review with meta-analysis and trial sequential analysis of clinical trials. Phytomedicine 2018;39:17-24.

Tominaga Y, Nakagawa K, Mae T, Kitano M, Yokota S, et al. Licorice flavonoid oil reduces total body fat and visceral fat in overweight subjects: a randomized, double-blind, placebo-controlled study. Obes Res Clin Pract 2009;3:169-178.

Nazari S, Rameshrad M, Hosseinzadeh H. Toxicological effects of Glycyrrhiza glabra (licorice): a review. Phytother Res 2017;31:1635-1650.

Blanpain J-S. A licorice-flavored edema: a case report of glycyrrhizic acid toxicity from chronic licorice root consumption. Cureus 2023;15.

Vallejo-Garcia V, Barrio-Rodriguez A, Heras-Benito M. Infarto agudo de miocardio e hipopotasemia severa por consumo de regaliz durante el confinamiento por COVID-19. Hipertens Riesgo Vasc 2021;38:e10-e2.

Af Geijerstam P, Joelsson A, Rådholm K, Nyström FH. A low dose of daily licorice intake affects renin, aldosterone, and home blood pressure in a randomized crossover trial. Am J Clin Nutr 2024;119:682-691.

Penninkilampi R, Eslick E, Eslick G. The association between consistent licorice ingestion, hypertension and hypokalaemia: a systematic review and meta-analysis. J Hum Hypertens 2017;31:699-707.

Haron MH, Avula B, Ali Z, Chittiboyina AG, Khan IA, et al. Assessment of herb-drug interaction potential of five common species of licorice and their phytochemical constituents. J Diet Suppl 2023;20:582-601.

Tsai H-H, Lin H-W, Lu Y-H, Chen Y-L, Mahady GB. A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines. PloS One 2013;8:e64255.

Isbrucker R, Burdock G. 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. Regul Toxicol Pharmacol 2006;46:167-192.

Sabbadin C, Graziani A, Bavaresco A, Mazzeo P, Tizianel I, et al. Pseudohyperaldosteronism due to licorice: A practice-based learning from a case series. Int J Mol Sci 2024;25:7454.

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IssueVol 10, No 3, 2025 QRcode
SectionReview Article(s)
DOI https://doi.org/10.18502/tim.v10i3.19765
Keywords
Liquorice Complementary and alternative medicine Persian Medicine Thai traditional medicine Unani medicine

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1.
Mohammadkhanloo E, Zaidi SMA, Zarei A, Limsuvan S, Akarasereenont P, Oveissi V, Bahramsoltani R. Licorice (Glycyrrhiza sp.) in Health and Disease: A Minireview of Traditional Uses and Therapeutic Activities. Trad Integr Med. 2025;10(3):340-349.