Yashtimadhu (Glycyrrhiza glabra), commonly called licorice or mulethi, is described in the Ayurvedic Pharmacopoeia of India as the dried, unpeeled root and stolon of the plant. Modern products are not interchangeable: whole-root powders and extracts retain glycyrrhizin, while deglycyrrhizinated licorice (DGL) is processed to remove most of it. This distinction is central to both gastric use and safety. Licorice has a long history in digestive care, but current human data do not justify treating it as a replacement for established therapy for peptic ulcer disease, gastro-oesophageal reflux disease (GERD), or Helicobacter pylori infection.

Carbenoxolone and the Modern Ulcer Story

Interest in licorice for peptic ulcers led to the development of carbenoxolone, a semisynthetic derivative of glycyrrhetinic acid. Controlled studies published during the 1960s and 1970s reported faster healing of gastric ulcers with carbenoxolone. A 1968 paper in Gut, for example, examined carbenoxolone treatment and the antagonistic effect of spironolactone. These trials helped establish that a licorice-derived compound could influence ulcer healing, but carbenoxolone was a specific pharmaceutical agent rather than ordinary Yashtimadhu powder or DGL.

Carbenoxolone also produced mineralocorticoid-like adverse effects, including sodium and fluid retention, potassium loss, hypertension, and oedema. Its history therefore illustrates both the pharmacological activity of licorice constituents and the danger of assuming that a natural source guarantees gentle action. It does not provide direct proof that contemporary whole-root supplements or DGL reliably heal ulcers.

DGL vs. Whole Root: A Necessary Distinction

Glycyrrhizin-containing licorice and DGL should be evaluated as different preparations. Glycyrrhizin is converted to glycyrrhetinic acid, which can inhibit 11-beta-hydroxysteroid dehydrogenase type 2. This permits cortisol to exert stronger mineralocorticoid effects and may cause sodium retention, potassium depletion, raised blood pressure, oedema, muscle weakness, and cardiac rhythm disturbances. Individual susceptibility varies, and serious reactions have occurred at lower intakes in vulnerable people.

DGL is processed specifically to reduce this risk. Health Canada’s current monograph requires a finished DGL product to contain no more than 3% of the glycyrrhizic acid originally present in the source material. It recognizes chewable DGL as a demulcent for minor gastrointestinal inflammation and for abdominal pain or burning in the stomach. This regulatory indication should not be interpreted as approval for healing peptic ulcers, eradicating H. pylori, or treating complicated reflux disease.

Parameter Whole Root or Glycyrrhizin-Containing Extract DGL
Glycyrrhizin Retained; quantity varies by material and extract Greatly reduced; qualifying products contain no more than 3% of the original amount
Principal clinical concern Hypokalaemia, hypertension, fluid retention, oedema, and arrhythmia Lower glycyrrhizin-related risk, although product quality and other ingredients still matter
Digestive role Traditional short-term use for burning and dyspeptic symptoms Demulcent relief of minor gastrointestinal irritation and stomach burning
Ulcer treatment Not equivalent to carbenoxolone and not a substitute for standard ulcer care Not an established treatment for gastric or duodenal ulcer healing
Form Powder, decoction, or standardized extract under professional guidance Usually a chewable preparation intended to mix with saliva

The European Medicines Agency’s assessment of oral DGL trials did not support a well-established medicinal use for gastric or duodenal ulcer treatment. DGL may still provide short-term soothing relief in selected people with minor burning or dyspeptic discomfort, but persistent, recurrent, nocturnal, bleeding-associated, or unexplained symptoms require medical assessment.

Yashtimadhu and H. pylori

H. pylori is an important cause of peptic ulcer disease and requires a validated eradication regimen followed by confirmation that the infection has cleared. Licorice constituents have demonstrated activity against the organism in laboratory investigations, and one randomized Iranian trial published in 2016 enrolled 120 patients and compared clarithromycin-based triple therapy with the same regimen plus licorice. Reported eradication was 83.3% in the licorice group and 62.5% in the control group.

That trial supports further evaluation of licorice as an adjunct, not as stand-alone treatment. It used a clarithromycin-based regimen that should not now be selected empirically where susceptibility is unknown. The 2024 American College of Gastroenterology guideline recommends 14-day optimized bismuth quadruple therapy as a preferred regimen for many treatment-naive patients and advises against PPI-clarithromycin triple therapy unless clarithromycin sensitivity has been demonstrated. Eradication should be confirmed after treatment with an appropriate breath, stool, or biopsy-based test.

Yashtimadhu, PPIs, and Standard Gastric Care

Proton pump inhibitors remain established medicines for acid suppression in peptic ulcer disease, erosive oesophagitis, and other defined acid-related disorders. They act differently from licorice preparations, and the two should not be presented as direct substitutes. Management also depends on the diagnosis: an H. pylori-positive ulcer requires eradication therapy, a medicine-induced ulcer requires review of the offending medicine, and alarm symptoms may require endoscopy or other investigation.

Yashtimadhu or DGL may be considered only as complementary symptom support when a qualified clinician judges it appropriate. They should not delay investigation of black stools, vomiting blood, progressive difficulty swallowing, persistent vomiting, anaemia, unintended weight loss, severe abdominal pain, or recurrent symptoms. Prescribed PPIs should not be stopped or stepped down solely because an herbal product has been started.

Dosage, Duration, and Safety Limits

The Ayurvedic Pharmacopoeia of India gives 2–4 g of Yashti powder as the pharmacopoeial dose. This is a monograph dose, not a universal self-treatment instruction: glycyrrhizin content varies, the patient’s constitution and diagnosis matter, and risk rises with prolonged or excessive exposure. The European Medicines Agency treats glycyrrhizin-containing licorice as a short-term preparation and notes important cardiovascular and electrolyte hazards with chronic use.

DGL dosing

Health Canada’s oral DGL monograph lists an adult single dose of 380–1520 mg, taken three times daily, with the product chewed between meals or about 20 minutes before meals. Commercial extracts differ in concentration and excipients, so the labelled amount and glycyrrhizic-acid specification should be checked rather than transferring a dose from one product to another. Symptoms that persist or worsen should be assessed by a healthcare professional.

People who should avoid whole-root licorice

Glycyrrhizin-containing Yashtimadhu is unsuitable for several groups because it can disturb blood pressure, fluid balance, and potassium. Medicinal use should be avoided during pregnancy and lactation and in children unless specifically directed by a suitably qualified clinician.

  • People with hypertension, hypokalaemia, kidney disease, cardiovascular disease, heart failure, or significant oedema
  • People with liver disease, especially when fluid retention or electrolyte disturbance is present
  • People taking thiazide or loop diuretics, cardiac glycosides such as digoxin, corticosteroids, stimulant laxatives, or medicines that can worsen potassium loss
  • People taking antihypertensive treatment, because licorice may oppose blood-pressure control

DGL has a lower glycyrrhizin-related risk, but “deglycyrrhizinated” should not be treated as a guarantee that every product is identical or interaction-free. Anyone using prescription medicines, particularly for the heart, kidneys, blood pressure, or fluid balance, should show the exact product label to a physician or pharmacist.

The Ayurvedic Pharmacological Profile

The Ayurvedic Pharmacopoeia of India records a clear dravyaguna profile for Yashti. These attributes describe the drug within Ayurvedic pharmacology and should be applied through assessment of dosha, agni, tissue state, disease stage, associated symptoms, and the chosen anupana.

  • Rasa (taste): Madhura
  • Guna (qualities): Guru and Snigdha
  • Virya (potency): Shita
  • Vipaka (post-digestive effect): Madhura
  • Karma: Balya, Chakshushya, Vrishya, Varnya, Vatapittajit, and Raktaprasadana

The same monograph lists Kasa, Kshaya, Svarabheda, Vatarakta, and Vrana among its therapeutic uses, and names preparations including Eladi Gutika, Yashtimadhuka Taila, and Madhuyashtyadi Taila. Its explicit designation as Vatapittajit, together with Madhura rasa, Snigdha guna, and Shita virya, explains why Ayurvedic physicians may select it when soothing, nourishing, or Pitta-moderating actions are desired. It should nevertheless be prescribed according to the complete clinical picture rather than equated mechanically with an antacid or PPI.

Yashtimadhu may appear in individualized digestive prescriptions with other herbs, but no single pairing or milk-based recipe is universally appropriate for hyperacidity. Formula choice, processing, dose, and vehicle depend on diagnosis and tolerance. Broader dietary and constitutional context is discussed in our Pitta management article, while our Triphala guide describes a different classical approach to bowel and digestive support.

A Practical Summary

Yashtimadhu is a pharmacologically active Ayurvedic drug, not merely a sweet soothing tea. Whole-root preparations retain glycyrrhizin and therefore carry meaningful risks involving potassium, blood pressure, fluid retention, and cardiac rhythm. DGL reduces this particular hazard and has a recognized demulcent role for minor gastrointestinal irritation and burning, but it is not an established ulcer-healing medicine.

For peptic ulcers, significant GERD, or suspected H. pylori, diagnosis and standard treatment remain primary. Licorice should not replace eradication antibiotics, prescribed acid suppression, endoscopic evaluation, or investigation of alarm symptoms. Its most defensible place is carefully selected, short-term complementary use with attention to the exact preparation, dose, medical history, and concurrent medicines. For another evidence-focused herbal profile, see our Ashwagandha research review.

This article is educational and is not medical advice. Do not stop or alter prescribed gastric medicines without consulting a gastroenterologist or other qualified healthcare provider. Whole-root Yashtimadhu has clinically important contraindications and interactions; DGL should also be reviewed with a healthcare professional when symptoms persist, pregnancy is possible, or prescription medicines are being used.

References

  1. Ayurvedic Pharmacopoeia of India
  2. Treatment of gastric ulcer with carbenoxolone: antagonistic effect of spironolactone (1968), PubMed
  3. Carbenoxolone: a review of its pharmacological properties and therapeutic efficacy in peptic ulcer disease (1976), PubMed
  4. Ema (ema.europa.eu)
  5. NCCIH
  6. Webprod (webprod.hc-sc.gc.ca)
  7. To evaluate of the effect of adding licorice to the standard treatment regimen of Helicobacter pylori (2016), PubMed
  8. American College of Gastroenterology
  9. Ema (ema.europa.eu)