A rare case of black licorice addiction kills in Massachusetts

The universe will not have enough special ways to die in 2020 Severe reminder Eating too much licorice candy can be fatal.

A 54-year-old construction worker recently died in Massachusetts after overeating black licorice, which naturally contains a toxin called glycyrrhizin, also known as glycyrrhizic acid. Published doctor His addiction case study In this week’s New England Journal of Medicine.

According to a survey, the poor were in a fast food restaurant when they suddenly fell into cardiac arrest. He was “suddenly out of breath with a general tremor and loss of consciousness,” doctors report. Paramedics arrived within minutes and revived him with four shocks and CPR. However, when he was admitted to the hospital about 30 minutes later, doctors said he had multiple organ failure, “serious metabolic disorders”, dangerously low levels of potassium in his blood, and associated cardiac arrest. I noticed that. Ventricular fibrillationThis is when the lower chamber of the heart cramps irregularly without pumping blood. All of these conditions are consistent with licorice poisoning.

Through thorough medical investigation, he appears to have no previous history of heart disease, and doctors have fixed his condition to candy. Discussions with his family revealed that he had eaten 1-2 bags of licorice daily for about 3 weeks before his heart stopped. By the time he arrived at the hospital, too much damage had already been done. He died about 32 hours later with his family at his bedside.

Twisted history

Medical researchers have long known the complex and toxic effects of licorice on the human body. Licorice has a twisted history, renowned in Eastern and Western cultures, Dating back to the Babylonian and Egyptian empires. Hippocrates prescribed it for the treatment of asthma and dry cough. Traditional Chinese medicine uses licorice to treat symptoms, from tuberculosis to peptic ulcer.

However, these uses had side effects. In the 1950s, Dutch medical scientist FE Reverse One of the first systematic studies on the anti-ulcer effect of licorice extract The patient noted that he was suffering from swelling, “severe headache”, high blood pressure, chest pain and pressure.

In the decades that followed, researchers found that licorice glycyrrhizin was taken up by microorganisms in the intestine and converted to glycyrrhetinic acid (also known as glycyrrhetinic acid). This metabolized version is absorbed by the body. In the kidney, glycyrrhetinic acid derivatives block an important enzyme called 11β-hydroxysteroid dehydrogenase type 2 or 11βHSD2, which converts the steroid hormone cortisol to cortisone. Cortisol has many important functions, including being an important regulator of the balance of ions, salts, and water. This has a significant impact on blood volume, blood pressure, and overall cardiovascular function.

When 11βHSD2 is blocked by glycyrrhetinic acid, cortisol levels accumulate in the kidney. This leads to a chain of life-threatening problems in the body, including higher levels of sodium, water retention, spikes in potassium levels, and subsequent renal failure. Increased sodium and water retention leads to swelling and high blood pressure. Extremely low potassium levels (hypokalemia) Cardiac conduction system— A special group of cardiomyocytes that use electrical signals to contract the heart muscle and pump blood. Therefore, low potassium levels can lead to fatal, irregular heart rhythms such as ventricular fibrillation.

Scary but rare

To make matters worse, glycyrrhetinic acid also interferes with liver enzymes that affect aldosterone levels. This is another important steroid hormone that exacerbates all other health effects of toxins. The liver also recirculates glycyrrhetinic acid. This means that after frequent intake of licorice, high levels can accumulate and remain high for long periods of time. It may take several weeks for the symptoms of licorice poisoning to disappear.

For these reasons, medical researchers and institutions warn against eating large amounts of black licorice at once, or daily. In fact, the U.S. Food and Drug Administration usually I like to remind consumers of life-threatening risks before and after Halloween Every year (unfortunately this year is unnecessary).

In a past warning, the FDA said: “If you’re over 40, eating 2 ounces of black licorice a day for at least two weeks can lead to hospitalization for arrhythmias or arrhythmias.”

Still, gummy candies are not a threat to public health, as black licorice is not a terribly popular candy and few people enjoy enough toxic levels. (Also, not all “licorice” candies actually contain licorice plant extracts. Although they do contain many red licorice candies, Like a red twister.. ) Disease reports are rare, not to mention death. Some of the examples of harm include a reference to “black licorice lovers” from the FDA that they were “problematic” after eating candy in 2016. In 1977, the researchers The case of a 58-year-old woman eating 1.8 kilograms of black licorice a week I have a cardiac arrest. However, she survived cardiac arrest and recovered completely after quitting eating licorice.

The poor fellows of Massachusetts were not so lucky. The doctor was able to raise his potassium levels with large intravenous doses of potassium chloride, but his condition worsened. His blood pressure became unstable, his neurological prognosis was poor, and his kidneys were dysfunctional. He was transferred to comfort before he died peacefully with his family.