Can Liquorice Lower Potassium Levels in Dialysis Patients?

January 7, 2016 | By Stu | Filed in: Uncategorized.

As with any significant change to diet, talk with your nephrologist or renal dietician before trying to lower your potassium with liquorice. Consuming too much glycyrrhetinic acid can cause hypokalemia (dangerously low potassium levels), which can kill you.

Did you know that liquorice contains a compound that can lower the potassium levels of a dialysis patient?

So as a dialysis patient, I keep a pretty close eye on my bloods. Generally they’re not too bad (I could possibly be a bit better at taking my binders to keep my phosphate low), but the one my eyes are always drawn to first is potassium.

If you’re a dialysis patient, I don’t need to tell you why you need to keep your potassium low. You could die if you don’t! 

A trip to the emergency room with hyperkalemia taught me that lesson many years ago.

We all know which foods we should avoid to keep our potassium in the safe range; no big bags of nuts, no packet of chips, no tomato based sauces….

We’re constantly getting told what we can’t eat as dialysis patients, but what about things that will actually bring us benefits?

Recent studies have shown that licorice contains an active compound called glycyrrhetinic acid (GA), that actually helps lower the serum potassium levels in anuremic (no longer producing urine) dialysis patients.

According to the National Center for Biotechnology Information, U.S. National Library of Medicine, “glycyrrhetinic acid (GA), inhibits renal 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) and by that mechanism increases access of cortisol to the mineralocorticoid receptor that causes renal sodium retention and potassium loss.” (link)

What this effectively means is that eating a small amount of liquorice every day can stop your body absorbing some of the potassium in the food you eat.

How much does liquorice decrease my potassium? I hear you ask:

Well in a 6-month prospective, double-blind, placebo-controlled crossover study, researchers at the Department of Nephrology, Fremantle Hospital and School of Medicine and Pharmacology, University of Western Australia, Perth, Australia, 10 hemodialysis patients received cookies or bread rolls supplemented with either GA (500 mg/day) or placebo.

On GA, mean serum potassium level [K+] was on average 1 mmol/l lower than on placebo, and the frequency of hyperkalemia (dangerously high serum potassium levels of  greater than 6 mmol/l) was reduced from 9% to 0.6%

Whaaaaaaat?

That’s an average drop of 93% in the number of dialysis patients presenting with hyperkalemia!

In another study conducted at the Division of Nephrology and Hypertension, Inselspital, University of Berne, patients given 500mg of GA daily were found to have decreased potassium levels from a baseline average of 5.5 to 4.9 after one week and 4.5 after two weeks

That’s an average serum potassium level drop of 22% in just two weeks!

As with any good news, there’s also some bad news. Consumption of glycyrrhetinic acid via liquorice can also increase sodium levels and  blood pressure in a group of patients where hypertension is always an issue.

As stated above, ALWAYS talk to your doctor or renal dietician before embarking on any significant diet change.

What do you think? Do we need to see more research into the benefits of liquorice for dialysis patients?

References:

http://www.nature.com/ki/journal/v76/n8/full/ki2009282a.html

http://jasn.asnjournals.org/content/13/1/191.full

http://www.ncbi.nlm.nih.gov/pubmed/11752037


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