There are many supplements I frequently recommend to my patients in my integrative medicine clinic in San Jose, Calif. One of my all-time favorites is deglycyrrhizinated licorice, or DGL. The reason I love this supplement is that it addresses many health issues, and I am a big fan of addressing many issues with one stone, so to speak.
Licorice has been used in many forms throughout the centuries by many cultures. Traditionally, the licorice root is used for hormonal issues, gut and throat issues, respiratory issues, and fatigue issues. We know now that the glycyrrhizin in licorice root can cause issues with hypertension, edema, and possibly effect a hormonal component of our renal regulation called aldosterone regulation. So, there is definitely a concern for long-term use in regards to licorice root.
But the deglycyrrhizinated licorice version has the substantial parts of glycyrrhizin removed, therefore is a safer option for long-term use if needed.
One main reason I use DGL in my patients is for gastrointestinal issues. In my clinical experience, patients who have heartburn, peptic ulcer disease, or gastritis find great relief from DGL. There was a study published in the British Medical Journal comparing an over-the-counter medication for peptic ulcer disease and DGL for 82 patients who had endoscopically healed peptic ulcer. Patients were given two tablets of DGL twice daily compared to a regular dosage of the over-the-counter medication for peptic ulcer disease. After two years on this regimen, the recurrence rate for gastric ulcers for the two groups was relatively similar. However, after both groups went off the medication or DGL, the recurrence of peptic ulcers occurred.
This study demonstrates DGL as an effective potential alternative to taking over-the-counter stomach ulcer medications if you have any concerns about these medications.
The general dosage to use of DGL is about one to three tablets of DGL at a dosage of 380-400 mg per tablet. You would take it about 30 minutes before each meal to help your stomach upset issues. On the bottle, you should make sure that there is less than 1 to 2 percent glycyrrhizin in the tablet to make sure that majority of the concerning component is out of the tablets so that you can more safely use this long-term.
For many of my patients, they find that DGL also helps with fatigue because it has traditionally been used for adrenal support as well. Some of the more important takeaway points are that even though most of the glycyrrhizin is out of the DGL, you should still check your blood pressure daily at the start of using this supplement. Once you have been using the DGL for a while and are being monitored by a doctor for the long-term usage of this, you should still check your blood pressure once or twice every week to make sure that your blood pressure remains in your normal range.
Some other key factors to keep in mind are that you should also have your kidney and liver function checked regularly. Although there are generally minimal concerns with usage of DGL, in regard to your liver and kidney function -- as you would with any other medication you use long-term -- I caution all of my patients to treat supplements like a medication in that they should not be cavalier about using supplements, either. If you are on any supplements or medications on a daily basis, you should always have regular blood work done to monitor your liver and kidney functioning.
If you think that you are having any issues, whether it is hypertension or swelling in ankles, you may want to consider coming off the DGL and see if the symptoms improve. You should also see your doctor for a full physical evaluation and discussion about your supplement and medication regimen if you should at any point have any concerns about new or worsening symptoms.
It's safe to say that I am a huge fan of supplements as alternative options for medications when the safety profile is more favorable. So when you do have an ailment such as fatigue or stomach upset, DGL is a great option. But as with anything you ingest on a daily basis, natural, common-sense precautions should be taken. So make sure you are checking your blood pressure and blood work regularly, and make sure to keep your doctor in the loop about any new supplements or medications you are taking.
In my clinic, I teach my patients to use common sense with their health more so than anything else. In the end, being overly cautious is always better than not being cautious enough. While the safety profile and effectiveness of DGL in treating stomach ulcers, heartburn or gastritis is similar -- if not better -- than over-the-counter strong medications (and it is one of my favorites to use in my patients with no major issues in usage), continue to use common sense when starting a new supplement, whether it be DGL or something else.
 Morgan AG, Pacsoo C, McAdam WA (June 1985). "Maintenance therapy: a two year comparison between Caved-S and cimetidine treatment in the prevention of symptomatic gastric ulcer recurrence." Gut 26 (6): 599-602.
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