Series on COVID Therapy Studies – Considering Licorice Root (Glycyrrhizin)
With the onslaught by COVID and its coinciding onslaught of self-proclaimed experts with every opinion under the sun, I choose to respond with a series of research study reports so you can choose for yourself. Each edition will bring a few studies describing possible therapies for COVID under investigation or reported in past research. As my recent Facebook Live video noted, we do not know enough about this virus to be definite at this time. I am not claiming any of these are the preventive or curative answer for you or your family’s safety. I just want you to be aware of these studies and have knowledge so that you can grow in wisdom rather than stumble about in panic.
One huge challenge in identifying effective therapies for COVID lies in the novelty of it all. Research requires time, something of which we have little in an emerging pandemic. We don’t have the luxury of studying 100 years of research or 10,000 past experiments. This battle requires a great deal of extrapolation. Extrapolation means that we take the little information we do have and attempt to use it in predicting what we don’t know. This process takes place every time an experiment proceeds in science, but the urgency in this case makes it more frustrating than usual. As we walk through a different possible therapy in each post, keep this paragraph in mind.
In looking at licorice root, a traditional natural therapy used for centuries in a variety of settings, we can only attempt to extrapolate what limited research has revealed but do not have definitive answers. We must discern the full puzzle picture from a limited number of puzzle pieces. Several references are given below. The quick answer… one of the active ingredients, Glycyrrhizin, has been tested for multiple other viruses including past coronaviruses (SARS). Punch line… it shows antiviral activity in test tubes. However, whether either oral or IV doses are sufficient to kill the virus inside a person remains unknown. More below.
Past research prior to COVID-19:
While coronaviruses are widespread in nature, usually causing colds and respiratory symptoms in animals and humans, occasionally a few have mutated and gained the ability to cause greater illness. One was called SARS many years ago and caused a good deal of concern before fizzling out. Cinatl et al published a 2003 study in Lancet on several possible antivirals for SARS: ribavirin, 6-azauridine, pyrazofurin, mycophenolic acid, and glycyrrhizin. The found glycyrrhizin to be the most effective in this study of SARS infected cells in laboratory petri dishes. This should obviously stimulate further study into whether an adequate human dose could be administered to inhibit the virus in an infected person. While the researchers offered theories of glycyrrhizin’s activity (casein kinase 2, nuclear factor KB, nitric oxide synthase, and others), research on its mechanism of action is needed.
Good research requires confirmation with more studies before it steps up for prime time use. Chen et al reported similar effectiveness in the Journal of Clinical Virology in 2005, but with a disappointing addition. Besides looking at whether glycyrrhizin slowed SARS, they looked at the concentrations necessary for this effect and compared it to the serum levels when the substance was given orally or IV. They concluded that the concentrations achievable by oral or even IV were not enough to be clinically beneficial to treat SARS in humans. This did not close the door on its use, but optimism lessened.
When at first you don’t succeed, try again. Hoever et al in a 2005 Journal of Medicinal Chemistry again confirmed activity of glycyrrhizin against SARS, but tried to modify it for greater effectiveness. Some modifications worked but increased side effects as well. Without going down a major rabbit trail, you can find further modifications and their applications to various bacterial and viral infections HERE. https://www.ncbi.nlm.nih.gov/pubmed?linkname=pubmed_pubmed_citedin&from_uid=15715493
You can look at another study by De Clercq in 2006 which examined many different potential therapies, but it did not add much to the pre COVID era. Crance et al also confirmed glycyrrhizin in vitro effectiveness in 2003 Antiviral Research.
Current COVID 19 research: NONE.
What’s the verdict? Licorice root and its active ingredient, glycyrrhizin, may end up in the arsenal against COVID or other future viral threats, but I don’t believe it is ready for prime time. At Sanctuary we use it for adrenal support and low blood pressure but will not recommend it for COVID. While generally safe, it may raise blood pressure or trigger fluid retention in salt sensitive patients. This would not be good for those with cardiovascular disease. We will keep reviewing other therapies, but good discernment would leave licorice root on the shelf until research sorts out how to apply it in COVID (or other viruses).
REFERENCES
Cinatl, J., et al. (2003). “Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus.” The Lancet 361(9374): 2045-2046.
Chen, F., et al. (2004). “In vitro susceptibility of 10 clinical isolates of SARS coronavirus to selected antiviral compounds.” J Clin Virol 31(1): 69-75.
De Clercq, E. (2006). “Potential antivirals and antiviral strategies against SARS coronavirus infections.” Expert Rev Anti Infect Ther 4(2): 291-302.
Crance, J. M., et al. (2003). “Interferon, ribavirin, 6-azauridine and glycyrrhizin: antiviral compounds active against pathogenic flaviviruses.” Antiviral Res 58(1): 73-79.
J Med Chem. 2005 Feb 24;48(4):1256-9. Antiviral activity of glycyrrhizic acid derivatives against SARS-coronavirus. Hoever G(1), Baltina L, Michaelis M, Kondratenko R, Baltina L, Tolstikov GA, Doerr HW, Cinatl J Jr.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
