Is glycyrrhizin sensitivity increased in anorexia nervosa and should licorice be avoided? Case report and review of the literature

René K Støving; Linnéa E Lingqvist; Rasmus K Bonde; Alin Andries; Marianne H Hansen; Marianne Andersen; Kirsten Hørder

doi:10.1016/j.nut.2010.06.006

Is glycyrrhizin sensitivity increased in anorexia nervosa and should licorice be avoided? Case report and review of the literature

René K Støving, Linnéa E Lingqvist, Rasmus K Bonde, Alin Andries, Marianne H Hansen, Marianne Andersen, Kirsten Hørder

Research output: Contribution to journal › Journal article › Research › peer-review

Abstract

OBJECTIVE: Hypokalemia is a potentially life-threatening electrolyte disturbance in anorexia nervosa and is most frequently caused by purging behavior. We report a case of severe hypokalemia in anorexia nervosa induced by daily ingestion of approximately 20 g of licorice. METHODS: To confirm the diagnosis of licorice-induced pseudohyperaldosteronism, a re-exposure trial was performed. RESULTS: Cessation of the licorice intake normalized plasma potassium, renin, and aldosterone levels and the urine cortisol/cortisone ratio. Re-exposure confirmed the diagnosis. The pronounced response to a relatively low daily dose of licorice suggests high glycyrrhizin sensitivity. CONCLUSION: Patients with anorexia nervosa not only have decreased food intake but also selective and sometimes bizarre eating habits that, in association with increased sensitivity to glycyrrhizin, may cause severe hypokalemia.

Original language	English
Journal	Nutrition
Volume	27
Issue number	7-8
Pages (from-to)	855-858
Number of pages	4
ISSN	0899-9007
DOIs	https://doi.org/10.1016/j.nut.2010.06.006
Publication status	Published - 2011

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@article{324437a2e02d43999143da1ca453f9b5,

title = "Is glycyrrhizin sensitivity increased in anorexia nervosa and should licorice be avoided? Case report and review of the literature",

abstract = "OBJECTIVE: Hypokalemia is a potentially life-threatening electrolyte disturbance in anorexia nervosa and is most frequently caused by purging behavior. We report a case of severe hypokalemia in anorexia nervosa induced by daily ingestion of approximately 20 g of licorice. METHODS: To confirm the diagnosis of licorice-induced pseudohyperaldosteronism, a re-exposure trial was performed. RESULTS: Cessation of the licorice intake normalized plasma potassium, renin, and aldosterone levels and the urine cortisol/cortisone ratio. Re-exposure confirmed the diagnosis. The pronounced response to a relatively low daily dose of licorice suggests high glycyrrhizin sensitivity. CONCLUSION: Patients with anorexia nervosa not only have decreased food intake but also selective and sometimes bizarre eating habits that, in association with increased sensitivity to glycyrrhizin, may cause severe hypokalemia.",

author = "St{\o}ving, {Ren{\'e} K} and Lingqvist, {Linn{\'e}a E} and Bonde, {Rasmus K} and Alin Andries and Hansen, {Marianne H} and Marianne Andersen and Kirsten H{\o}rder",

year = "2011",

doi = "10.1016/j.nut.2010.06.006",

language = "English",

volume = "27",

pages = "855--858",

journal = "Nutrition",

issn = "0899-9007",

publisher = "Elsevier",

number = "7-8",

}

TY - JOUR

T1 - Is glycyrrhizin sensitivity increased in anorexia nervosa and should licorice be avoided? Case report and review of the literature

AU - Støving, René K

AU - Lingqvist, Linnéa E

AU - Bonde, Rasmus K

AU - Andries, Alin

AU - Hansen, Marianne H

AU - Andersen, Marianne

AU - Hørder, Kirsten

PY - 2011

Y1 - 2011

N2 - OBJECTIVE: Hypokalemia is a potentially life-threatening electrolyte disturbance in anorexia nervosa and is most frequently caused by purging behavior. We report a case of severe hypokalemia in anorexia nervosa induced by daily ingestion of approximately 20 g of licorice. METHODS: To confirm the diagnosis of licorice-induced pseudohyperaldosteronism, a re-exposure trial was performed. RESULTS: Cessation of the licorice intake normalized plasma potassium, renin, and aldosterone levels and the urine cortisol/cortisone ratio. Re-exposure confirmed the diagnosis. The pronounced response to a relatively low daily dose of licorice suggests high glycyrrhizin sensitivity. CONCLUSION: Patients with anorexia nervosa not only have decreased food intake but also selective and sometimes bizarre eating habits that, in association with increased sensitivity to glycyrrhizin, may cause severe hypokalemia.

AB - OBJECTIVE: Hypokalemia is a potentially life-threatening electrolyte disturbance in anorexia nervosa and is most frequently caused by purging behavior. We report a case of severe hypokalemia in anorexia nervosa induced by daily ingestion of approximately 20 g of licorice. METHODS: To confirm the diagnosis of licorice-induced pseudohyperaldosteronism, a re-exposure trial was performed. RESULTS: Cessation of the licorice intake normalized plasma potassium, renin, and aldosterone levels and the urine cortisol/cortisone ratio. Re-exposure confirmed the diagnosis. The pronounced response to a relatively low daily dose of licorice suggests high glycyrrhizin sensitivity. CONCLUSION: Patients with anorexia nervosa not only have decreased food intake but also selective and sometimes bizarre eating habits that, in association with increased sensitivity to glycyrrhizin, may cause severe hypokalemia.

U2 - 10.1016/j.nut.2010.06.006

DO - 10.1016/j.nut.2010.06.006

M3 - Journal article

C2 - 20739148

SN - 0899-9007

VL - 27

SP - 855

EP - 858

JO - Nutrition

JF - Nutrition

IS - 7-8

ER -

Is glycyrrhizin sensitivity increased in anorexia nervosa and should licorice be avoided? Case report and review of the literature

Abstract

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