Blog | Friday, July 22, 2011

Doc, can I use this natural supplement?

A little while back, I saw a patient in my reflux practice who had recently stopped her proton pump inhibitor and substituted licorice root to help keep her acid reflux symptoms under control. She told me that her symptoms were still under good control with the licorice root, and asked me if I was all right with her staying on it instead. Since she did not have any mucosal injury (esophagitis) or other complications from GERD, my main question that I had to answer was about the safety of licorice root .

Licorice by FotoosVanRobin via Flickr and a Creative Commons licenseSo I looked it up, just to be sure I was doing my due diligence. If you aren't aware of the possible side effects of licorice root, the major ones to be aware of are:
--edema/fluid retention
--high blood pressure
--potassium loss

Fortunately, these only tend to occur at large doses (more than 3 grams per day for several weeks) when the licorice root contains glycyrrhizin. In short, I thought it was fine for her since she was otherwise in good health, and the dose was not that large.

Nonetheless, there is an important reminder here: just because something is natural, doesn't mean it is completely without side effects. Even natural substances are still chemicals.

If you are a patient, please discuss all of your supplements with your physicians. In this case in particular, extreme use can actually cause rare life threatening problems. If you are a doctor or other health care professional, be sure to ask your patients about any herbs and supplements they might be taking.

Ryan Madanick, MD, is an ACP Member, a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain. This post originally appeared at his blog, Gut Check.