2 Glycyrrhizin inhibits the conversion of the precur- sor cortisol to cortisone by inhibiting the enzyme 11- betahydroxysteroid dehydrogenase [4]. Hydrolysis of slowly absorbing glycyrrhizin into the more rapidly absorbed glycyrrhetenic acid is performed by intestinal microbiota. Consequently antibiotics aﬀecting gut ﬂora, adversely aﬀects absorption of liquorice. Liquorice boosts cellular formation of endogenous interferon, and has a positive long-term healing eﬀect on Hepatitis-C-infected patients [5–9]. 3.4. Posology and Dosage. Liquorice is marketed in various forms, and because its often sold as the natural grown product, concentrations in the plant varies. Solid extract 250–500 mg, three times daily, is suggested for medicinal purposes. Dried root is dispensed at 1–4 g, three times daily to a maximum of 12 g [2]. At 75 mg daily glycyrrhetenic acid (derived from 50 G/day liquorice), a raising eﬀect on blood pressure is noted after 2 weeks. More than this, daily dose increases blood pressure proportional to increased liquorice intake [2, 4]. 3.5. Liquorice Toxicity. This on its own is rare, yet not infrequent when encountered clinically and usually occurs in diuretic medicated patients unwittingly combining con- sumption of commercial products containing high amounts of liquorice extract like chewing tobacco, laxatives, or confections with concentrated liquorice extracts [9–11]. Consumption of glycyrrhizin is considered safe at 200 mg per day, a dose accepted as recommendation to Japanese. The accepted daily intake (ADI) for glycyrrhizin at 0.2 mg/kg/day is deemed safe; up to 1200 mg/day liquorice ﬂavonoid oil shows no clinical noteworthy change of hematological or related biochemical parameters [12–14]. In the United States of America, glycyrrhizin is classiﬁed “as generally recognised as safe” as a ﬂavouring agent, although not as a sweetener [2]. Commercially liquorice ﬂavoured sweets rarely have any serious medicinal side eﬀects, especially if consumed irregularly, in moderate amounts, of less than 25 g of liquorice per day. 4. Medical Impact Liquorice has many positive and negative health modulating physiological eﬀects which explain a variety of its medical eﬀects. The most widely renowned negative action derives from liquorice’s association with hypertension. Because of the inhibition of 11-beta hydroxysteroid dehydrogenase, by liquorice, cortisol levels are high within the collecting duct of the kidney, and potassium is excreted while sodium is retained [4]. Cortisol has high mineralo-corticoid properties, that is, it acts like aldosterone and increases sodium re- absorption from the glomerular ﬁltration in the proximal tubules of the kidney in ENaC channels [3, 4]. Sodium retention leads to higher osmotic intravascular pressure, which in turn retains more water, which increases circulating blood volume with consequent increased blood pressure leading to hypertension [4, 15]. Case Reports in Medicine Figure 1: Ubiquitous Liquorice all sorts. A mainly carbohydrate and liquorice confection (by Maynards-Bassetts. Cadbury Adams, Toronto Ont.) These sweets are marketed freely to the public. Liquorice has a variety of positive healthy eﬀects on the body. For example, it is known that Liquorice has antiviral properties and has some inhibitory eﬀects on HIV, encephalitis, and SARS-corona viruses [11, 16, 17]. Also Glycyrrhetenic acid itself has a retardant eﬀect on peptic ulcers, possibly due to the fact that it has antibacterial properties and retards the growth of Helicobacter pylori [18]. Other medicinal claims are that liquorice is anti- ulcer (peptic, duodenal, and aspirin) [19, 20]. Liquorice- induced hypokalemic myopathy may explain why GIT spasms relax, and also why liquorice containing alcohols are said not to induce emesis [21]. With gastric smooth muscle paralysis, the irritating eﬀect of ethanol is reduced and gastric contraction is temporarily weakened. Liquorice among others is claimed to also be anti-inﬂammatory, an immune-stimulant, a demulcent, an expectorant, anti- catarrhal, hepato-protective, a GIT spasmolytic, a mild laxative, and an antioxidant [20–24]. 4.1. Consumption Products. Liquorice used as a ﬂavorant in candies adds much gustatory joy to the variety of living pleasures. The ﬂavour is so positive and pleasant, it is also used for ﬂavouring other foods like ice-cream, biscuits, cakes, and drinks. It is a very popular ﬂavour for sweet treats as “Liquorice All Sorts” (see Figures 1 and 2), and also in Salty Liquorice in Holland. Liquorice is added to baked confectionery, toﬀees, chocolates, chewing-gum, and sucking sweets. Black and Red Liquorice varieties are made using food dyes which can discolour the tongue. (Figure 3). Liquorice is also part of spice mixes constituting curry, and liquorice is also used in breath fresheners. It is also used in medications, in many syrups, lozenges, capsules, laxatives, cough-lozenges, and mixtures to mask bitterness and foul-ﬂavours of other drugs. Liquorice is included in commercial over-the-counter tobacco products like pipe and chewing tobacco and snuﬀs. Liqourice can stain the tongue and teeth (see Figures 3, 4, 5 and 6). Liquorice concentrate-ﬂavour is popular in alcoholic drinks too like Absinthe (thujole containing) and Pernod in France, Anise in Europe, and Ouzo in Greece.