FURTHER-STUDIES ON THE MECHANISM OF THE MINERALOCORTICOID ACTION OF LICORICE IN HUMANS

The pathogenesis of pseudohyperaldosteronism from licorice has been ev aluated in 6 male volunteers taking daily 7 g of a commercial preparat ion of licorice for 7 days, corresponding to an intake of 500 mg/day o f glycyrrhizic acid. Pseudohyperaldosteronism was evident during the t reatment (increase of body weight, suppression of plasma renin activit y and plasma aldosterone, reduction of serum potassium). The ratio (te trahydrocortisol+allo tetrahydrocortisol)/tetrahydrocortisone in urine increased in 5 cases after 3 days of treatment, without an increase o f plasma mineralocorticoid activity (PMA). In the 6th case the urinary ratio was unchanged and PMA increased from the pretreatment value. Af ter 7 days of therapy the ratio remained high and PMA was not measurab le in 3 cases, while in the other 3 cases the ratio returned to pretre atment and PMA was higher than pretreatment value. We conclude that th e pseudohyperaldosteronism from licorice is initially related to decre ased activity of 11 beta-hydroxysteroid-dehydrogenase and afterwards a lso a direct effect of licorice derivatives on mineralocorticoid recep tors becomes evident in some cases. In other cases however the effect on the enzyme is prevailing probably due to individual factors. (C) 19 96, Editrice Kurtis