Concerns With Taking Licorice With Metoprolol

Answer

Thank you for reaching out to us!

The concern you're hearing about is likely due to the potential interaction between metoprolol and licorice supplements. I'll disregard aloe from this conversation as there doesn't appear to be any evidence of a clinically significant interaction between it and metoprolol.

Licorice candy and supplements were a news item a number of years ago due to reports that they can worsen certain cardiovascular conditions, including increasing the risk of arrhythmia. You mentioned you had AFib in your question, and I imagine that is where your concern is coming from.

The FDA posted a warning back in 2017 about licorice (Consumer Updates > Black Licorice: Trick or Treat? (archive-it.org)) and they even posted a YouTube video about it (Black Licorice: Trick or Treat (youtube.com)). Additionally, news outlets also reported on its potential dangers (FDA Issues Warning About Black Licorice For Halloween (forbes.com)).

Why Licorice Is a Concern

Licorice contains a compound called glycyrrhizin, which can be problematic for the heart and blood pressure.

In large amounts, glycyrrhizin has been reported to cause serious issues like high blood pressure, low potassium levels, and irregular heartbeats. This happens because glycyrrhizin may increase the body's cortisol levels, which can lead to fluid retention and other complications.

People with atrial fibrillation (AFib), a condition where the heart beats irregularly, need to be especially careful with licorice. The effects of glycyrrhizin can worsen their condition, increasing the risk of severe heart problems.

Solutions

If you are set on using a licorice supplement, look for deglycyrrhizinated licorice (DGL) products, which have the glycyrrhizin removed and are safer for those with heart issues.

You mentioned DGL licorice in your question, so it seems you are already aware that it is the safer option versus licorice supplements that contain glycyrrhizin. DGL supplements may certainly be an option for you.

I highly recommend speaking with your doctor before taking any supplements, even DGL licorice. It is likely safer for you than other licorice supplements, but since your doctor knows your medical situation best, they are in the best position to provide appropriate advice to you.

Some other natural options (if your doctor doesn't want you to have licorice) include Indian Gooseberry (Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: a double-blind, randomized, placebo-controlled clinical trial - PubMed (nih.gov)) and quince.

Final Words

I wanted to thank you again for reaching out. Please do so again anytime.