A builder has died after eating a bag and a half of liquorice every day for several weeks.
Liquorice contains glycyrrhizic acid which, if eaten in excess, can cause dangerously low potassium and imbalances in electrolytes.
Doctors found's the Massachusetts man's potassium levels to be low, after he collapsed at a fast food restaurant. Emergency responders did CPR and he revived, but died the next day.
"Even a small amount of liquorice you eat can increase your blood pressure a little bit,” said Dr Neel Butala, a cardiologist at Massachusetts General Hospital who described the case in the New England Journal of Medicine.
The US Food and Drug Administration (FDA) warns that eating as little as 76 grams of black liquorice a day for two weeks could cause a heart rhythm problem, especially for people over the age of 40.,
Many kinds of food and drink include liquorice extract, including some that may be unexpected.
"It could be jelly beans, liquorice teas, a lot of things over the counter. Even some beers, like Belgian beers, have this compound in it,” said Dr Robert Eckel, a University of Colorado cardiologist and former American Heart Association president.
The FDA says that up to 3.1 per cent of a food’s content can have glycyrrhizic acid – but many sweets and other liquorice products don’t reveal how much of it is contained per ounce or gram, Dr Butala said.
Doctors have reported the case to the FDA in hope of raising attention to the risk.
Jeff Beckman, a spokesman for the Hershey Company in the US, which makes the popular Twizzlers liquorice twists, said in an email that “all of our products are safe to eat and formulated in full compliance with FDA regulations,” and that all foods, including candy, “should be enjoyed in moderation.”
With additional reporting by the Associated Press
