Yashtimadhu (Mulethi)

What it is

Yashtimadhu (mulethi, licorice) is the root of Glycyrrhiza glabra, an Ayurvedic herb whose glycyrrhizin can raise blood pressure and lower potassium. In Ayurveda, Yashtimadhu is traditionally used for soothing the throat, supporting digestion, and as a component of formulations for cough, gastritis, and ulcer-like symptoms. In modern herbal and food use, licorice appears in teas, lozenges, powders, extracts, and flavoring agents.

A key safety fact is that regular intake of glycyrrhizin-containing licorice can cause a syndrome called pseudoaldosteronism, with hypertension, fluid retention, and hypokalemia. This matters because many people assume herbal products are harmless, yet licorice is one of the better-known herbs with clinically important adverse effects and drug interactions.

In India, mulethi is widely sold as a crude herb, powder, and ingredient in classical and proprietary Ayurvedic products. Product strength can vary, and labels may not always clearly state whether the preparation contains whole licorice, standardized extract, or deglycyrrhizinated licorice (DGL), which has much less glycyrrhizin.

Form	What it means	Main point
Whole root/powder	Traditional herb form	Contains glycyrrhizin unless specially processed
Standardized extract	Concentrated herbal extract	Potency varies by product
DGL	Deglycyrrhizinated licorice	Lower risk of blood pressure and potassium effects, but evidence is still limited for many uses
Candy/flavoring	Food use	Some products contain real licorice; others use anise flavor instead

How it works

Licorice contains several bioactive compounds, especially glycyrrhizin and its metabolite glycyrrhetinic acid, plus flavonoids and other phytochemicals. Glycyrrhetinic acid inhibits the enzyme 11-beta-hydroxysteroid dehydrogenase type 2. This enzyme normally helps protect mineralocorticoid receptors from cortisol. When it is inhibited, cortisol can act more like aldosterone, leading to sodium retention, potassium loss, edema, and elevated blood pressure.

This mechanism explains why licorice can produce pseudoaldosteronism even though it is not a steroid medicine. The effect is dose-related but can vary a lot between people depending on the product used, duration, age, kidney function, and other medicines.

Traditional uses for throat irritation and cough may relate to demulcent and anti-inflammatory effects. Laboratory and animal studies also suggest antimicrobial, anti-inflammatory, and mucosal effects, but these findings do not automatically prove meaningful benefit in humans.

Evidence and uses

In Ayurveda, Yashtimadhu has a long history of use for sore throat, hoarseness, cough, dyspepsia, and gastric irritation. Modern evidence is mixed and depends on the indication and the exact preparation.

1. Sore throat and cough: Licorice is commonly used in lozenges, teas, and gargles. Some small clinical studies suggest symptomatic relief, including perioperative sore throat in certain settings, but evidence is not strong enough to treat it as a proven stand-alone therapy for infections.
2. Peptic symptoms and gastritis: DGL has been marketed for dyspepsia and ulcer-related symptoms because removing glycyrrhizin may reduce major safety concerns. However, high-quality modern evidence is limited, and it should not replace evaluation for H. pylori, ulcers, bleeding, or persistent reflux symptoms.
3. Oral mucositis and mouth/throat irritation: Some studies have examined licorice-containing preparations for mucositis symptom relief, especially in cancer care settings. Results are promising in some trials, but protocols differ and evidence is still emerging.
4. Other proposed uses: Licorice has been studied for menopausal symptoms, viral illnesses, fatty liver, and skin conditions. Evidence in humans is limited, inconsistent, or insufficient for routine recommendation.

For readers comparing traditional and modern views, the main point is that Yashtimadhu has plausible pharmacologic activity and some supportive small studies, but the best-established modern fact is its safety risk from glycyrrhizin rather than a clearly proven broad therapeutic benefit.

Safety and interactions

Licorice is not risk-free. Glycyrrhizin-containing products can raise blood pressure, lower potassium, cause swelling, trigger headaches, and in severe cases contribute to abnormal heart rhythms or muscle weakness. Risk increases with larger amounts, prolonged use, older age, heart disease, kidney disease, and use of interacting medicines.

People who should be especially cautious include those with hypertension, chronic kidney disease, heart failure, liver disease, low potassium, pregnancy, or a history of arrhythmia. Many professional sources advise avoiding medicinal licorice in pregnancy because of safety concerns.

Important interactions include:

Medicine or situation	Why it matters
Diuretics such as furosemide or hydrochlorothiazide	Can worsen potassium loss
Digoxin	Low potassium can increase toxicity risk
Corticosteroids	May increase steroid-like adverse effects
Antihypertensives	Licorice may counter blood pressure control
Warfarin and other medicines	Herbal products may alter effects or adherence; discuss with a pharmacist

DGL may have a lower risk of pseudoaldosteronism because much of the glycyrrhizin is removed, but that does not make it universally safe. Product quality, contamination, and labeling accuracy can vary in supplements and traditional products. If you use mulethi regularly, especially as an extract or in multiple products, tell your clinician or pharmacist.

When to see a clinician

Seek medical advice before using Yashtimadhu if you have high blood pressure, kidney disease, heart disease, are pregnant, or take prescription medicines. Also ask before giving herbal preparations to children, because dosing and safety data are limited.

Get prompt care if you develop leg swelling, rising blood pressure, palpitations, severe weakness, muscle cramps, or confusion while using licorice products. These can be signs of low potassium or fluid retention.

If you are using mulethi for persistent sore throat, chronic cough, black stools, vomiting blood, weight loss, trouble swallowing, or ongoing stomach pain, do not rely on self-treatment. Those symptoms need proper medical evaluation.

Limitations and open questions

A major limitation in licorice research is heterogeneity. Studies use different species, extracts, doses, and formulations, so results are hard to compare. Traditional use does not always map neatly onto standardized modern products.

Evidence in humans is limited for many claimed benefits, and some positive studies are small or short-term. Better trials are needed to clarify which preparations, if any, help specific conditions and at what risk.

Another open question is real-world exposure. Consumers may not know whether a tea, candy, powder, or Ayurvedic formula contains clinically meaningful glycyrrhizin. Until labeling and standardization improve, safety depends partly on careful product selection and clinician awareness.