Last week, a 54-year old construction worker from Massachusetts suffered a cardiac arrest at a local fast-food restaurant.
Not long after he tragically passed the following day, his death was revealed to be due to excessive consumption of black licorice candy.
According to the operating physicians, the patient had been consuming bags of the confection daily for some time.
Unfortunately, glycyrrhizic acid, or glycyrrhizin, is a compound derived from licorice root, that results in high blood pressure, swelling, abnormal heart rhythms, and even heart failure if consumed in large enough quantities.
A more detailed analysis of the strange circumstance surrounding the patient’s death can be found in a paper published Wednesday in the New England Journal of Medicine.
“The patient had been in his usual state of health until midday on the day of admission, when he was in a fast-food restaurant and gasped suddenly, with full-body shaking and loss of consciousness. The shaking movements ceased quickly, but he remained unresponsive. Emergency medical services personnel arrived after approximately 4 minutes, and cardiopulmonary resuscitation (CPR) was initiated,” Dr. Jacqueline B.Henson wrote in the report. “The heart rhythm was identified as ventricular fibrillation; four shocks were delivered, and the patient received intravenous naloxone, amiodarone, and a bolus of epinephrine followed by a continuous infusion. A slow, wide-complex heart rhythm with a rate of 40 beats per minute was noted, reportedly with concurrent return of mental status, but CPR had to be resumed after pulselessness recurred.”
The findings identified dangerously low potassium levels (induced by black licorice consumption) to be the primary cause of the patient’s death.
The authors went on to write that muscle weakness and or abnormal heart rhythms are the key warning signs to watch out for on this front.
On balance, a healthy adult should try to consume 3,500–4,700 mg of potassium daily from foods.
While it’s true that a high intake of black licorice resulted in a fatal drop in potassium levels for the patient examined in the new risk assessment, there are several influencing factors that should be noted.
Having said that, the medical events below are meant to demonstrate that none share a strong correlation with the sudden cardiac arrest experienced by the patient.
In fact, aside from these, the patient was determined to be active and of generally good health. He did not consume alcohol nor did he have a family history of metabolic or cardiac diseases.
Test results did indicate that he previously struggled with heroin abuse (a struggle he overcame roughly three years ago) and contracted hepatitis C. It was additionally revealed that he smoked one pack of cigarettes a day for the last 36 years.
All of these can be linked to cardiac incidence but not necessarily in the manner or subject in which it occurred.
All relevant parameters contributed to the following diagnosis: Pseudohyperaldosteronism suggestive of excessive licorice consumption complicated by cardiac arrest associated with ventricular fibrillation.
Potassium is integral to the regulation of sleep, muscle contractions, and neurological functions.
Via various processes, a rich potassium diet reduces one’s risk of developing high blood pressure, strokes, osteoporosis, kidney stones, and cardiac events.
The authors note that one can restore healthy potassium levels by curbing black licorice consumption (assuming that this is the source of the deficiency) as well as cautioning those with a history of heart disease against consuming black licorice at all.
“While black licorice is safe in small quantities, it can be dangerous when consumed in large amounts or even in more moderate amounts on a regular basis,” Dr. Jacqueline Boykin Henson, who is the gastroenterology fellow at Duke University who treated the patient at Massachusetts General Hospital, explained in a press release.