From The “Life Competence” Files: Death By Licorice

The current issue of the New England Journal of Medicine describes the odd case of  a middle-aged construction worker who died from eating one or two large bags of black licorice daily over a three week period. A naturally occurring compound, glycyrrhizic acid, found in black licorice can have adverse health effects if you gorge on it: in 2017, the FDA warned on its website, “If you’re 40 or older, eating 2 ounces of black licorice a day for at least two weeks could land you in the hospital with an irregular heart rhythm or arrhythmia.” If you have muscle weakness or an irregular heartbeat, you should stop eating it and call your doctor, who should also advise you possible  about interactions it may have with your other medications.

The construction worker’s sudden addiction to the candy  caused his heart to stop, and he collapsed at mid-day at a fast-food restaurant. Emergency responders performed  CPR and revived him,  but he died the next day. Dr. Neel Butala, a cardiologist at Massachusetts General Hospital who was one of the authors of the case study, pronounced the lesson of the episode:

“The key message here for the general public is that food containing licorice can potentially be hazardous to your health if eaten in large quantities. I don’t think people realize it. It’s not labeled that way.”

It shouldn’t have to be labelled, should it? What isn’t potentially deadly in asbsurdly large quantities? Water can kill you. Of course candy can kill you. It’s interesting to know why, and that  licorice root extract can cause dangerously low potassium and imbalances in bodily electrolytes, but honestly: who wouldn’t do a little checking if they suddenly started eating huge amounts of something that normal people only consume occasionally, if at all?

This guy, obviously. Watch his family score a large cash settlement from whatever licorice-maker the late Mr. Licorice favored.

The tragedy might have been averted if the victim had been a bit more literate. There are few virtues that have spawned more cautionary quotes than moderation, such as,

“Moderation is the key of lasting enjoyment.” Hosea Ballou

“Practice moderation in all things except love.” Gary Zukav

“In moderating, not in satisfying desires, lies peace.” Reginald Heber

“Moderation is the inseparable companion of wisdom.” Charles Caleb Colton

“Moderation in all things.” Terence

“Everything in moderation, and there’s a perfect balance in this life if we can find it.Ryan Robbins

“Out of moderation a pure happiness springs.” Johann Wolfgang von Goethe

“Never go to excess, but let moderation be your guide. Marcus Tullius Cicero

“Moderation is the secret of survival.Manly Hall

“The boundary of man is moderation. When once we pass that pale our guardian angel quits his charge of us.” Owen Feltham

“Be moderate in order to taste the joys of life in abundance.” Epicurus

“Moderation is the silken string running through the pearl-chain of all virtues.” Joseph Hall

“Fortify yourself with moderation; for this is an impregnable fortress.” Epictetus

Of course, the only quote the construction worker really needed was,

“Don’t eat so damn much licorice!Anonymous.

36 thoughts on “From The “Life Competence” Files: Death By Licorice

  1. Man, I feel for the guy. I love black licorice. Two oz is not a lot, and would hardly be considered an excessive amount (a container of yogurt is 6 oz). Many sites tout the potential health effects of licorice and it has been used as a folk remedy for a long time. A large bag/day…well…I could see it. I mean, if you ate some at lunch, some at dinner, and some later as a snack. I have eaten a bag in a day when I got some that was really good (I didn’t say I SHOULD have). A bag a day for a week…that is something else, but people get addicted to eating laundry booster and Tums. As addictions go, this one isn’t that odd.

    • Yeah, Trader Joe’s sells an 8 ounce bag. Apparently, the government’s advisory of 2017 cautioned against two ounces per day for two weeks. I’ve certainly polished off a bag in 24 hours.

      Speaking of incompetence, I’ve looked at five different news websites, and all of them seem to regard a “large bag” as a standard unit of measurement. If they don’t know the number, they should just say so, instead of repeating “two large bags.”

      • I read the NEJM article hoping to discover exactly which brand of candy and how much he was eating. The brand was not mentioned and the article described his consumption only as “one or two large packages of soft candy daily”. From a scientific standpoint, I think it would have been pertinent to specify the candy, bag size, and the glycyrrhizic acid, active ingredient of licorice root, content to provide an idea of the dose he consumed.

  2. As an anesthetist, I was once called to intubate an unconscious individual with an unstable heart rhythm who not only had eaten 2 lbs of black licorice but he washed it down with a half-gallon of vodka. This was circa 1973!

  3. Most “locrice” available in the US won’t do that. The common licorice is made with starch, sugar, anise seed extract and dye.
    Licorice seed contains a naturally sweet compound and that’s what is deadly.

    • Thanks for the recipe, Matthew B. As far as breakdown goes, anything thought of as “candy” in this country is mostly sugar

      The warnings about licorice were around when I was a child but, I don’t think that’s what stopped me from eating “too much” of it. The flavor was so strong that a few pieces (usually Twizzlers, shared) were sufficient; the heavy-duty Australian licorice was overpowering and I think the caveats were attached to the latter. At any rate, when considering flavors, licorice was not one that came quickly to mind,

      In terms of ‘moderation,” though, i am “fully on or fully off.” In between doesn’t work for me, especially not in diet. I checked with my doctor and he agreed that it wouldn’t be easy to die of a surfeit of romaine lettuce.

      \

  4. One would think that the fact that black licorice is one of the most vile, nasty flavors in all of biochemistry would naturally limit its intake…

    What’s the over/under on how long before we see warning labels on the stuff? My guess is two years, max.

  5. The sugar-free Gummy Bears scare from a few years back should have alerted folks to candy dangers, although those did spur numerous grotesquely humorous online reviews and personal anecdotes:
    LIKE THESE

  6. “Everything in excess! To enjoy the flavor of life, take big bites. Moderation is for monks.”
    Excerpt from the notebooks of Lazarus Long, from Robert Heinlein’s “Time Enough for Love”

  7. I question anyone eating any amount of licorice.

    I know they have no sense of taste.

    And I wonder if they are mentally imbalanced.

    I would send someone to the doctor for eating even 1/8 ounce let alone however much this person ate.

  8. Surely one major political party will make hay out of this incident of immoderate licorice consumption and fix the blame for it on Donald John Trump.

    Hey: If every Supreme Court justice gets to be called by THREE names, then it is only ethical to call the President by at least that many, too – like George Eighch Dubya Bush.

  9. David Goldberg sued Hershey the maker of Twizzlers in 2018 claiming that eating a standard size bag of black Twizzlers a week for years resulted in him developing atrial fibrillation.

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