Licorice Root: A Natural Solution for Adrenal Support and Hormonal Health

Licorice root, a traditional herb renowned for its multifaceted therapeutic properties, is currently in the spotlight for its potential to support adrenal function and hormonal health. Embraced for centuries by traditional medicinal practices, licorice root, or Glycyrrhiza glabra, contains adaptogenic and anti-inflammatory compounds like glycyrrhizin that have been studied for their capacity to modulate cortisol levels and adrenal function. As research progresses, licorice root's integration into evidence-based practices holds promise as a natural option for those navigating the intricate interplay of adrenal and hormonal dynamics.

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Understanding the Adrenal Glands and Hormonal Balance 

The adrenals are small, triangular glands that sit on top of each kidney. Each adrenal gland is made up of the cortex and medulla, each responsible for distinct functions. The adrenal cortex synthesizes essential hormones, including glucocorticoids (e.g., cortisol), mineralocorticoids (e.g., aldosterone), and androgens that regulate metabolism, electrolyte balance, reproduction, and the body's stress response. The adrenal medulla produces catecholamines, such as adrenaline and noradrenaline, crucial for the immediate "fight or flight" response. (18)

Adrenal dysfunction refers to an impairment in the normal functioning of the adrenal glands, encompassing both hyperactivity and hypoactivity. Hyperactivity, as seen in conditions like Cushing's syndrome, involves excessive production of hormones, particularly cortisol, which can lead to a range of health issues such as metabolic disturbances, immune suppression, and cardiovascular complications. On the other hand, hypoactivity, exemplified by Addison's disease, signifies inadequate production of hormones, resulting in symptoms like fatigue, weight loss, and electrolyte imbalances.

Adrenal dysfunction can significantly impact hormonal health. Cortisol, a primary hormone produced by the adrenal glands, influences blood sugar regulation, immune function, and the body's response to stress. Prolonged stress and subsequent cortisol dysregulation may contribute to insulin resistance, metabolic syndrome,  cardiovascular disease, immune suppression, disrupted circadian rhythms, osteoporosis, anxiety, and depression (44). Additionally, adrenal issues may influence sex hormone production, affecting conditions like polycystic ovary syndrome (PCOS) and fertility.

In the context of functional medicine, the term "adrenal dysfunction" is sometimes colloquially used to describe a condition often referred to as "adrenal fatigue" or "HPA axis dysfunction." This concept suggests that chronic stress can lead to dysregulation of the adrenal glands, resulting in symptoms like fatigue, difficulty concentrating, weight gain, temperature fluctuations, and sleep disturbances. While the conventional medical community does not universally recognize the term "adrenal fatigue," some practitioners in the field of functional medicine consider it in the context of addressing stress-related hormonal imbalances.

What Is Licorice Root?

Licorice root, derived from the Glycyrrhiza glabra plant, has a rich history and a prominent role in traditional herbal medicine practices across various cultures. Its use dates back thousands of years to ancient Chinese, Indian, Egyptian, and Greek civilizations for treating lung, liver, circulatory, and kidney diseases. Today, licorice is an herbal supplement used to manage digestive problems, menopausal symptoms, cough, infections, skin conditions, stress, and inflammation. Licorice's name is derived from the Greek words "glykos" (sweet) and "rhiza" (root), so it makes sense that it is also commonly used as a sweetening agent in foods and beverages. 

Around 400 bioactive compounds have been isolated from licorice, including various flavonoids, saponins, phytosterols, polysaccharides, coumarins, amino acids, gums, lignans, starches, and sugars. The root's triterpene saponin, glycyrrhizin, and its derivatives possess anti-asthmatic, antidiabetic, antimicrobial, antispasmodic, anti-inflammatory, and antioxidant properties. The polysaccharides contribute to the herb's demulcent effects, giving licorice its ability to protect irritated and inflamed tissues. (45)

Licorice Root in Adrenal Support

Licorice root has garnered attention in herbal medicine for its potential benefits on adrenal function, specifically its impact on cortisol metabolism and the stress response. The active compounds in licorice root, notably glycyrrhizin and flavonoids, contribute to its adaptogenic properties, making it a subject of interest in supporting the body's response to stress. Glycyrrhizin, glycyrrhizic acid, and glycyrrhetinic acid inhibit the enzyme 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2), which is responsible for breaking down cortisol into its inactive form. This enzymatic inhibition increases circulating cortisol and has prompted investigations into licorice root's potential role in treating conditions characterized by low cortisol levels. For example, patients with Addison's disease (or adrenal insufficiency, characterized by the insufficient production of cortisol and aldosterone by the adrenal glands) co-administered a licorice supplement with their cortisol replacement therapy have measurably increased cortisol availability (29).  

Licorice Root and Hormonal Health

Some evidence suggests that licorice root's impact on hormonal health extends beyond its influence on cortisol and the HPA axis. Licorice's flavonoids, isoflavonoids, and chalcones exhibit mild estrogenic activity, potentially impacting hormonal balance. This estrogenic effect might be relevant in managing symptoms associated with menopause, where declining estrogen levels contribute to various discomforts such as hot flashes, mood changes, and vaginal dryness. Licorice's estrogenic properties could theoretically provide a natural and supportive approach to alleviate these symptoms. One study has supported this notion, showing that daily administration of 330 mg of licorice extract reduced the frequency and severity of hot flashes in menopausal women.

In more recent years, licorice root has also been explored for its potential as an adjunct therapy to treating PCOS due to its anti-androgenic effects by blocking the enzymes 17-hydroxysteroid dehydrogenase and 17-20 lyase in the ovaries and adrenal glands. While human studies are needed to fully elucidate the benefits of licorice supplementation for patients with PCOS, preliminary studies do show promise in licorice's ability to reduce testosterone secretion, the number of ovarian cysts, and improve fertility in PCOS-induced animal models (35, 48).

Dosage and Administration of Licorice Root

Licorice supplements are available in various forms, including teas, tablets, capsules, lozenges, and liquid extracts. Many licorice supplements come in the form of deglycyrrhizinated licorice (DGL), in which a substantial amount of glycyrrhizin has been removed from the root for safer consumption (discussed in more detail below). (6) 

Licorice dosing will vary depending on the type of herbal preparation and desired health outcome. In general, the following doses are considered to be safe and effective:

• Dried root: 1-5 grams three times daily
• Tincture (1:5 strength): 2-5 mL three times daily
• Standardized extract (containing 20% glycyrrhizic acid) 250-300 mg three times daily 

Potential Interactions and Precautions

The safety concerns associated with licorice supplements primarily revolve around the presence of glycyrrhizin. The side effects of licorice are minimal when less than 10 mg of glycyrrhizic acid is taken daily, and chronic use is avoided. Long-term use, however, is associated with increased blood pressure, fluid retention, and low serum potassium (hypokalemia). The use of glycyrrhizin-containing preparations of licorice should be avoided in patients with high blood pressure, pre-existing hypokalemia, and those taking corticosteroid, diuretic, or monoamine oxidase-inhibiting medications. (20) 

Glycyrrhizin can also cross the placental barrier. Research has shown that maternal consumption of glycyrrhizin during pregnancy increases the risk of preterm labor and alters the hypothalamic-pituitary-adrenal (HPA) axis in their children, increasing their risk for adult diseases. 

Integrating Licorice Root With Other Natural Therapies

Combining licorice root with other natural therapies and lifestyle interventions forms a holistic approach to adrenal and hormonal support. This comprehensive strategy emphasizes individualized care, considering specific health profiles and needs. In conjunction with licorice root, adaptogenic herbs like ashwagandha and rhodiola can work synergistically to support the body's response to stress and promote adrenal health. A balanced, nutrient-diet diet, rich in vitamin C, B vitamins, zinc, magnesium, and omega-3 fatty acids, contributes to overall well-being, reduces inflammation, and prevents nutrient deficiencies that can quickly occur during prolonged stress. Additionally, mind-body practices like meditation, yoga, and deep breathing exercises play a crucial role in reducing stress and supporting adrenal health. (5) 

This holistic approach begins by collaborating with integrative and functional medical doctors trained in conducting comprehensive assessments, considering factors such as stress levels and triggers, dietary habits, sleep habits, exercise patterns, and coexisting medical conditions. They will then work with you to develop an individualized treatment plan that emphasizes healthy lifestyle modifications, balancing hormones, preventing blood sugar imbalances, and complementary supplements to promote optimal adrenal health and function. (10) 

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Licorice Root for Adrenal Support: Final Thoughts

Licorice root is a promising natural solution for adrenal support and hormonal health. Recognized for centuries in various traditional medicine practices, licorice is valued for its adaptogenic properties, with potential benefits in modulating cortisol levels and supporting the stress response. As with any herbal remedy, the benefits of licorice root for hormonal health should be approached with awareness and individual considerations. Seeking professional guidance is crucial to ensure a personalized approach that considers individual health circumstances, existing medical conditions, and potential drug interactions. A holistic strategy, incorporating licorice root alongside lifestyle modifications, balanced nutrition, and mindfulness practices, may offer a comprehensive and individualized approach to optimizing adrenal and hormonal health.