A Man Died After Eating a Bag of Black Licorice Every Day

He had no historical past of coronary heart issues. He walked his canine commonly and labored a bodily demanding job as a development employee, in line with his medical doctors.Then, in January 2019, he collapsed at a McDonald’s and died.The probably perpetrator? Black licorice, in line with the medical doctors who handled him and who this week revealed their findings concerning the uncommon case in The New England Journal of Medication.The report mentioned the person, an unidentified 54-year-old from Massachusetts, had consumed one to 2 giant baggage of black licorice a day for 3 weeks. That behavior prompted his potassium ranges to drop precipitously, prompting a cardiac arrest, in line with the examine. He by no means regained consciousness after his collapse and died about 24 hours after he arrived at Massachusetts Common Hospital.“We virtually didn’t consider it after we figured it out,” mentioned Dr. Jacqueline B. Henson, who handled the person whereas she was a resident on the hospital. “We have been all shocked and stunned.”Aspiring medical doctors are taught in medical faculty that black licorice comprises glycyrrhizic acid, a plant extract that’s typically used as a sweetener in candies and different meals and might result in dangerously low potassium ranges whether it is consumed in excessive sufficient doses. However it’s uncommon to see a case of somebody dying on account of ingesting an excessive amount of of the sweet, Dr. Henson mentioned.The person in Massachusetts had a poor weight loss plan and smoked a pack of cigarettes a day, in line with his family and friends, his medical doctors mentioned. But it surely was a swap from purple to black licorice three weeks earlier than his loss of life that medical doctors mentioned proved deadly.Dr. Henson mentioned she interviewed the person’s family and friends members, and medical doctors ran a number of laboratory checks that confirmed the person’s potassium ranges have been properly beneath regular.They studied his medical historical past, which included heroin use, although he had not used opiates for 3 years. There was no household historical past of cardiac illness or different situations that will have led to low potassium ranges, mentioned Dr. Henson, who’s now a fellow at Duke College Faculty of Medication in Durham, N.C.“We had no different clear trigger for why his potassium ranges have been so low,” she mentioned.The case “raises a public well being challenge that consuming giant quantities of licorice could be hazardous to your well being,” mentioned Dr. Neel M. Butala, one of many authors of the examine and a fellow on the interventional cardiology unit at Massachusetts Common Hospital.Dr. Butala mentioned shoppers wanted to learn by sweet and different meals producers concerning the ranges of glycyrrhizic acid of their merchandise.He additionally reported the case to the Meals and Drug Administration.In an announcement, the F.D.A. declined to remark particularly on the report, citing its coverage to not talk about particular person circumstances.“The F.D.A. is dedicated to defending public well being and guaranteeing the protection of our nation’s meals provide,” the company mentioned in an e-mail. “We’re conscious that the naturally occurring compound present in black licorice can have opposed well being results.”The F.D.A. warns people who find themselves 40 or older that consuming two ounces of black licorice a day for a minimum of two weeks could cause “coronary heart rhythm or arrhythmia.”The company warns shoppers on its web site concerning the risks of an overdose from black licorice. The compound glycyrrhizin, which is derived from licorice root, could cause potassium ranges within the physique to fall and result in irregular coronary heart rhythms, hypertension, edema, lethargy and congestive coronary heart failure, in line with the company’s warning.The findings by the medical doctors have been rigorously researched and will function a public well being warning, mentioned Dr. Keith C. Ferdinand, a heart specialist at Tulane College Faculty of Medication, who was not concerned within the case and browse the article in The New England Journal of Medication.Whereas it seemed to be “a really uncommon case,” it ought to function a warning to the general public “to remember that any substance that’s taken into the physique, particularly taken in extra, can have true physiological results,” mentioned Dr. Ferdinand, who can also be the Gerald S. Berenson Endowed Chair in Preventive Cardiology.“It’s all the time onerous to discover a trigger and impact when an individual has a sudden catastrophic occasion,” he mentioned.However the elements within the case — the low potassium, the affected person’s coronary heart arrhythmia, the truth that he had been doing properly till his collapse — sign that the licorice “was in all probability the supply” of his in the end deadly situation, Dr. Ferdinand mentioned.Different research have raised the alarm about ingesting an excessive amount of licorice. In 2012, medical doctors from Mercy Hospital and Medical Middle in Chicago revealed a examine titled “Licorice Abuse: Time to Ship a Warning Message.” It suggested medical doctors to warn sufferers about ingesting an excessive amount of licorice and known as on the F.D.A. to control the usage of it.“The every day consumption of licorice isn’t justified as a result of its advantages are minor in comparison with the opposed outcomes of power consumption,” the examine mentioned. It famous the case of a 35-year-old Egyptian man with no underlying well being issues who briefly misplaced management of his motor features after he drank a liter of licorice-flavored water throughout Ramadan.“There are quite a few licorice-containing merchandise which are available in our on a regular basis use and could be unintentionally consumed by the general public in liberal quantities, placing them liable to issues,” it famous.Dr. Henson mentioned individuals who prefer to eat the occasional piece of licorice shouldn’t be alarmed by the case in Massachusetts.Black licorice shouldn’t be a poison, she mentioned.“It’s effective taken in kind of small quantities, sometimes,” Dr. Henson mentioned. “However when taken frequently, it could result in these points.”

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