Licorice, Digestion, & Hormones

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Let’s Take A Look At Licorice…

Licorice, as a confectionary, is mostly sugar and is useless for medicinal purposes.

Licorice (Glycyrrhiza sp., most often Glycyrrhiza glabra), in the form of either the root extract (which can be taken as a supplement, or used topically) or the whole root (which can be taken as a powder/capsule, or used to make tea), is a medicinal plant with a long history of use.

How well-evidenced is it for its popular uses?

Licorice for digestion

In this case, it is more accurate to say that it combats indigestion, including acid reflux and ulcerative colitis:

Systematic Review on Herbal Preparations for Controlling Visceral Hypersensitivity in Functional Gastrointestinal Disorders ← licorice was a top-tier performer in this review

Network pharmacology mechanisms and experimental verification of licorice in the treatment of ulcerative colitis ← looking at the mechanism of action; ultimately they concluded that “licorice improves ulcerative colitis, which may be related to the activation of the Nrf2/PINK1 signaling pathway that regulates autophagy.“

Licorice vs menopause symptoms

This one, while a popular use, isn’t so clear. Here’s a study that examines the compounds in licorice (in this case, Glycyrrhiza uralensis) that interact with estrogen receptors, notes that the bioavailability is poor, and proposes, tests, and recommends a way to make it more bioavailable:

Development of an Improved Menopausal Symptom-Alleviating Licorice (Glycyrrhiza uralensis) by Biotransformation Using Monascus albidulus

On the other hand, it is established that it will lower serum testosterone levels, which may make it beneficial for menopause and/or PCOS:

Polycystic ovaries and herbal remedies: A systematic review

Licorice for men

You may be wondering: what about for men? Well, the jury is out on whether it meaningfully reduces free testosterone levels:

Licorice consumption and serum testosterone in healthy men

See also:

Liquorice in moderate doses does not affect sex steroid hormones of biological importance although the effect differs between the genders

And finally, it may (notwithstanding its disputed effect on testosterone itself) be useful as a safer alternative to finasteride (an antiandrogen mostly commonly used to treat benign prostatic hyperplasia, also used to as a hair loss remedy), since it (like finasteride) modulates 5α-reductase activity (this enzyme converts testosterone to the more potent dihydrogen testosterone, DHT), without lowering sperm count:

Therapeutic role of Glycyrrhiza Uralensis fisher on benign prostatic hyperplasia through 5 alpha reductase regulation and apoptosis

Licorice for the skin

As well as its potentially estrogenic activity, its anti-inflammatory and antioxidant powers make it comparable to hydrocortisone cream for treating eczema, psoriasis, and other such skin conditions:

New Herbal Biomedicines for the Topical Treatment of Dermatological Disorders

Is it safe?

It is “generally recognized as safe”, as the classification goes.

However, consumed in excess it can cause/worsen hypertension, and other contraindications include if you’re on blood thinners, or have kidney problems.

As ever, this is a non-exhaustive list, so do speak with your doctor/pharmacist to be sure.

Want to try some?

We don’t sell it, but here for your convenience is an example product on Amazon

Enjoy!

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  • Pain Doesn’t Belong on a Scale of Zero to 10

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    Over the past two years, a simple but baffling request has preceded most of my encounters with medical professionals: “Rate your pain on a scale of zero to 10.”

    I trained as a physician and have asked patients the very same question thousands of times, so I think hard about how to quantify the sum of the sore hips, the prickly thighs, and the numbing, itchy pain near my left shoulder blade. I pause and then, mostly arbitrarily, choose a number. “Three or four?” I venture, knowing the real answer is long, complicated, and not measurable in this one-dimensional way.

    Pain is a squirrely thing. It’s sometimes burning, sometimes drilling, sometimes a deep-in-the-muscles clenching ache. Mine can depend on my mood or how much attention I afford it and can recede nearly entirely if I’m engrossed in a film or a task. Pain can also be disabling enough to cancel vacations, or so overwhelming that it leads people to opioid addiction. Even 10+ pain can be bearable when it’s endured for good reason, like giving birth to a child. But what’s the purpose of the pains I have now, the lingering effects of a head injury?

    The concept of reducing these shades of pain to a single number dates to the 1970s. But the zero-to-10 scale is ubiquitous today because of what was called a “pain revolution” in the ’90s, when intense new attention to addressing pain — primarily with opioids — was framed as progress. Doctors today have a fuller understanding of treating pain, as well as the terrible consequences of prescribing opioids so readily. What they are learning only now is how to better measure pain and treat its many forms.

    About 30 years ago, physicians who championed the use of opioids gave robust new life to what had been a niche specialty: pain management. They started pushing the idea that pain should be measured at every appointment as a “fifth vital sign.” The American Pain Society went as far as copyrighting the phrase. But unlike the other vital signs — blood pressure, temperature, heart rate, and breathing rate — pain had no objective scale. How to measure the unmeasurable? The society encouraged doctors and nurses to use the zero-to-10 rating system. Around that time, the FDA approved OxyContin, a slow-release opioid painkiller made by Purdue Pharma. The drugmaker itself encouraged doctors to routinely record and treat pain, and aggressively marketed opioids as an obvious solution.

    To be fair, in an era when pain was too often ignored or undertreated, the zero-to-10 rating system could be regarded as an advance. Morphine pumps were not available for those cancer patients I saw in the ’80s, even those in agonizing pain from cancer in their bones; doctors regarded pain as an inevitable part of disease. In the emergency room where I practiced in the early ’90s, prescribing even a few opioid pills was a hassle: It required asking the head nurse to unlock a special prescription pad and making a copy for the state agency that tracked prescribing patterns. Regulators (rightly) worried that handing out narcotics would lead to addiction. As a result, some patients in need of relief likely went without.

    After pain doctors and opioid manufacturers campaigned for broader use of opioids — claiming that newer forms were not addictive, or much less so than previous incarnations — prescribing the drugs became far easier and were promoted for all kinds of pain, whether from knee arthritis or back problems. As a young doctor joining the “pain revolution,” I probably asked patients thousands of times to rate their pain on a scale of zero to 10 and wrote many scripts each week for pain medication, as monitoring “the fifth vital sign” quickly became routine in the medical system. In time, a zero-to-10 pain measurement became a necessary box to fill in electronic medical records. The Joint Commission on the Accreditation of Healthcare Organizations made regularly assessing pain a prerequisite for medical centers receiving federal health care dollars. Medical groups added treatment of pain to their list of patient rights, and satisfaction with pain treatment became a component of post-visit patient surveys. (A poor showing could mean lower reimbursement from some insurers.)

    But this approach to pain management had clear drawbacks. Studies accumulated showing that measuring patients’ pain didn’t result in better pain control. Doctors showed little interest in or didn’t know how to respond to the recorded answer. And patients’ satisfaction with their doctors’ discussion of pain didn’t necessarily mean they got adequate treatment. At the same time, the drugs were fueling the growing opioid epidemic. Research showed that an estimated 3% to 19% of people who received a prescription for pain medication from a doctor developed an addiction.

    Doctors who wanted to treat pain had few other options, though. “We had a good sense that these drugs weren’t the only way to manage pain,” Linda Porter, director of the National Institutes of Health’s Office of Pain Policy and Planning, told me. “But we didn’t have a good understanding of the complexity or alternatives.” The enthusiasm for narcotics left many varietals of pain underexplored and undertreated for years. Only in 2018, a year when nearly 50,000 Americans died of an overdose, did Congress start funding a program — the Early Phase Pain Investigation Clinical Network, or EPPIC-Net — designed to explore types of pain and find better solutions. The network connects specialists at 12 academic specialized clinical centers and is meant to jump-start new research in the field and find bespoke solutions for different kinds of pain.

    A zero-to-10 scale may make sense in certain situations, such as when a nurse uses it to adjust a medication dose for a patient hospitalized after surgery or an accident. And researchers and pain specialists have tried to create better rating tools — dozens, in fact, none of which was adequate to capture pain’s complexity, a European panel of experts concluded. The Veterans Health Administration, for instance, created one that had supplemental questions and visual prompts: A rating of 5 correlated with a frown and a pain level that “interrupts some activities.” The survey took much longer to administer and produced results that were no better than the zero-to-10 system. By the 2010s, many medical organizations, including the American Medical Association and the American Academy of Family Physicians, were rejecting not just the zero-to-10 scale but the entire notion that pain could be meaningfully self-reported numerically by a patient.

    In the years that opioids had dominated pain remedies, a few drugs — such as gabapentin and pregabalin for neuropathy, and lidocaine patches and creams for musculoskeletal aches — had become available. “There was a growing awareness of the incredible complexity of pain — that you would have to find the right drugs for the right patients,” Rebecca Hommer, EPPIC-Net’s interim director, told me. Researchers are now looking for biomarkers associated with different kinds of pain so that drug studies can use more objective measures to assess the medications’ effect. A better understanding of the neural pathways and neurotransmitters that create different types of pain could also help researchers design drugs to interrupt and tame them.

    Any treatments that come out of this research are unlikely to be blockbusters like opioids; by design, they will be useful to fewer people. That also makes them less appealing prospects to drug companies. So EPPIC-Net is helping small drug companies, academics, and even individual doctors design and conduct early-stage trials to test the safety and efficacy of promising pain-taming molecules. That information will be handed over to drug manufacturers for late-stage trials, all with the aim of getting new drugs approved by the FDA more quickly.

    The first EPPIC-Net trials are just getting underway. Finding better treatments will be no easy task, because the nervous system is a largely unexplored universe of molecules, cells, and electronic connections that interact in countless ways. The 2021 Nobel Prize in Physiology or Medicine went to scientists who discovered the mechanisms that allow us to feel the most basic sensations: cold and hot. In comparison, pain is a hydra. A simple number might feel definitive. But it’s not helping anyone make the pain go away.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • Reverse Inflammation Naturally – by Dr. Michelle Honda

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This book is in some ways not as marketable as some; it doesn’t have lots of colorful healthy food on the cover; it doesn’t even have a “woman laughing alone with salad” (you know the stock photo trope), let alone someone looking glamorous in a labcoat with a stethoscope draped over their shoulder despite listening to hearts not being a regular part of their job as an immunologist or such.

    What it does have, instead, is a lot of very useful information, and much more than you’ll usually find in a book for laypeople.

    For example, you probably know that for fighting inflammation, a green salad is better than a cheeseburger, say, and a black coffee is better than a glass of wine.

    But do you know about the roles, for good or ill, of prostaglandins and linoleic fats vs dietary fats? How about delta-6-desaturase? Neu5Gc and arachidonic acid?

    Dr. Honda demystifies all of these and more, as well as talking about the impacts of very many foods and related habits on various different inflammation-based disease. And of course, almost all disease involves some kind of inflammation (making fighting inflammation one of the best things you can do for your overall disease-avoidance strategy!), but she singles out some of the most relevant, as per the list on the front cover.

    She also talks a lot of “pharmacy in your kitchen”, in other words, what herbs, spices, and plant extracts we can enjoy for (evidence-based!) benefits on top of our default healthy diet free (or at least mostly free, for surely none of us are perfect) from inflammatory agents.

    Not content with merely giving a huge amount of information, she also gives recipes and a meal plan, but honestly, it’s the informational chapters that are the real value of the book.

    Bottom line: if you’d like to reduce your body’s inflammation levels (and/or perhaps those of a loved one for whom you cook), then this book will be an invaluable resource.

    Click here to check out Reverse Inflammation Naturally, and reverse inflammation naturally!

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  • Basic Baked Tofu

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    One of the main criticisms of tofu is that it is tasteless. Well, so is flour, but you’re not supposed to eat it plain, and the same goes for tofu. It’s a blank canvas that you get to decide what to do with—not to mention, it’s a canvas that’s very high in protein, and is a complete protein too, containing all essential amino acids. Anyway, here’s a starter recipe that elevates tofu from “nutrition” to “nutritious tasty snack”!

    We were going to do a fancier recipe today, but considered that it might be judicious to cover this basic element first, that can be incorporated into a larger recipe later, a bit like we have done with recipes such as our Tasty Versatile Rice, and Plant-Based Healthy Cream Cheese (amongst others).

    You will need

    • 1 block of extra-firm tofu; these are quite standardized in size; it should be about 12oz; don’t worry if it’s a little more or less.
    • 2 tbsp arrowroot powder (or potato starch if you don’t have arrowroot)
    • 1½ tbsp extra virgin olive oil
    • 1 tbsp nutritional yeast
    • 1 tsp black pepper
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Optional: ½ tsp garlic powder
    • Optional: ½ tsp ground turmeric

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 425ºF / 220ºC.

    2) Press the tofu for about 15 minutes (to remove excess moisture), using a tofu press if you have one. If you don’t, then here is an example product on Amazon, or alternatively, you can go with the time-honored tradition of cutting the tofu lengthways into slabs, and wrapping it in a lint-free kitchen towel or muslin cloth, and pressing it with heavy books. We don’t recommend pressing for more than about 15 minutes, as you are going to bake the tofu so you don’t want it too dry going in.

    3) Cut the tofu into cubes. Size is up to you, but half-inch cubes are very respectable.

    4) Combine the tofu cubes in a big bowl with the oil and seasonings, including the nutritional yeast but not the arrowroot powder or potato starch yet. You will need to toss them gently (very gently; they are fragile!) to combine.

    5) Add the arrowroot powder or potato starch, and again toss gently to combine. We do this last, because it would stop the other things from sticking properly if we did it earlier.

    6) Arrange the tofu on a baking tray lined with baking paper, in a single layer so that the cubes don’t touch. Bake for 15 minutes, turn them over, and bake for a further 15 minutes on the other side. They should now be golden and crisp, but if they’re not, just give them a little more time.

    7) Serve as a snack, or set aside for whatever else you’re going to do with them in a larger more complex recipe.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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Related Posts

  • The Dopamine Precursor And More
  • Which Osteoporosis Medication, If Any, Is Right For You?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Which Osteoporosis Medication, If Any, Is Right For You?

    We’ve written about osteoporosis before, so here’s a quick recap first in case you missed these:

    All of those look and diet and/or exercise, with “diet” including supplementation. But what of medications?

    So many choices (not all of them right for everyone)

    The UK’s Royal Osteoporosis Society says of the very many osteoporosis meds available:

    ❝In terms of effectiveness, they all reduce your risk of broken bones by roughly the same amount.

    Which treatment is right for you will depend on a number of things.❞

    …before then going on to list a pageful of things it will depend on, and giving no specific information about what prescriptions or proscriptions may be made based on those factors.

    Source: Royal Osteoporosis Society | Which medication should I take?

    We’ll try to do better than that here, though we have less space. So let’s get down to it…

    First line drug offerings

    After diet/supplementation and (if applicable) hormones, the first line of actual drug offerings are generally biphosphates.

    Biphosphates work by slowing down your osteoclasts—the cells that break down your bones. They may sound like terrible things to have in the body at all, but remember, your body is always rebuilding itself and destruction is a necessary act to facilitate creation. However, sometimes things can get out of balance, and biphosphates help tip things back into balance.

    Common biphosphates include Alendronate/Fosamax, Risedronate/Actonel, Ibandronate/Boniva, and Zolendronic acid/Reclast.

    A common downside is that they aren’t absorbed well by the stomach (despite being mostly oral administration, though IV versions exist too) and can cause heartburn / general stomach upset.

    An uncommon downside is that messing with the body’s ability to break down bones can cause bones to be rebuilt-in-place slightly incorrectly, which can—paradoxically—cause fractures. But that’s rare and is more common if the drugs are taken in much higher doses (as for bone cancer rather than osteoporosis).

    Bone-builders

    If you already have low bone density (so you’re fighting to rebuild your bones, not just slow deterioration), then you may need more of a boost.

    Bone-building medications include Teriparatide/Forteo, Abaloparatide/Tymlos, and Romosozumab/Evenity.

    These are usually given by injection, usually for a course of one or two years.

    Once the bone has been built up, it’ll probably be recommended that you switch to a biphosphate or other bone-stabilizing medication.

    Estrogen-like effects, without estrogen

    If your osteoporosis (or osteoporosis risk) comes from being post-menopausal, estrogen is a very common (and effective!) prescription. However, some people may wish to avoid it, if for example you have a heightened breast cancer risk, which estrogen can exacerbate.

    So, medications that have estrogen-like effects post-menopause, but without actually increasing estrogen levels, include: Raloxifene/Evista, and also all the meds we mentioned in the bone-building category above.

    Raloxifene/Evista specifically mimics the action of estrogen on bones, while at the same time blocking the effect of estrogen on other tissues.

    Learn more…

    Want a more thorough grounding than we have room for here? You might find the following resource useful:

    List of 82 Osteoporosis Medications Compared (this has a big table which is sortable by various variables)

    Take care!

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  • Pink Himalayan Salt: Health Facts

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Q: Great article about the health risks of salt to organs other than the heart! Is pink Himalayan sea salt, the pink kind, healthier?

    Thank you! And, no, sorry. Any salt that is sodium chloride has the exact same effect because it’s chemically the same substance, even if impurities (however pretty) make it look different.

    If you want a lower-sodium salt, we recommend the kind that says “low sodium” or “reduced sodium” or similar. Check the ingredients, it’ll probably be sodium chloride cut with potassium chloride. Potassium chloride is not only not a source of sodium, but also, it’s a source of potassium, which (unlike sodium) most of us could stand to get a little more of.

    For your convenience: here’s an example on Amazon!

    Bonus: you can get a reduced sodium version of pink Himalayan salt too!

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  • Delay Ageing – by Dr. Colin Rose

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    Note: the title is spelled that way because it is British English. We generally write in US English here at 10almonds, but we’ll first quote directly from Dr. Rose as written:

    ❝I have written Delay Ageing because there is some very important recent University research on ageing and age related illness that deserves to be made accessible to a general audience.❞

    What is this research? Well, there’s quite a lot over its 300-odd pages (exact number depends on the edition and whether we count end matter), and most of it is tweaks and refinements on things with which you’ll probably be at least brushingly familiar if you’re a regular 10almonds reader.

    Dr. Rose addresses the nine hallmarks of aging, of which there are ten, ranging from such things as “telomeres get shorter” and “DNA accumulates damage”, to “stem cells become exhausted” and “cells fail to communicate properly”, and asks the question “what if we were to target all these things simultaneously?”.

    Rather than going for drugs on drugs on drugs (half of them to deal with undesired side effects of the previous ones), Dr. Cole leaves no stone unturned to find lifestyle interventions that will improve each of these, even if just a little. Because, all those “little” improvements add up and even compound, and on the flipside, mean that factors of aging aren’t adding up and compounding so much or so quickly anymore.

    The rather broad umbrella of “lifestyle interventions” obviously includes food under its auspices, and with it, nutraceuticals. So to give one example, if you’re taking a fisetin supplement (a natural senolytic agent), you’ll find science vindicating that here. And much more.

    The style is… Less pop-science and more “textbook written for laypersons”, and you may be thinking “isn’t that the same?” and the difference is that the textbook has a lot less polish and finesse, but often more precise information.

    Bottom line: if you’d like to combat aging on 10 different fronts with easily implementable lifestyle interventions, and know exactly what is doing what and how, then this is the book for you.

    Click here to check out Delay Ageing, and delay aging!

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