Gan Cao

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Glycyrrhiza uralensis Fisch.

Family: Fabaceae Genus: Glycyrrhiza Species: uralensis Pinyin: Gan Cao

Synonyms: Glycyrrhiza uralensis Fisch. ex DC., Liquiritia uralensis (Fisch.) Moench

American LicoriceWild LicoriceLicorice RootGan Cao甘草
Gan Cao

☯ TCM Properties

Category: tonifying
Temperature: neutral
Taste: sweet
Meridians: heart, lung, spleen, stomach
Functions:

Tonifies the Spleen and augments Qi; Moistens the Lungs, resolves Phlegm and stops coughing; Moderates spasms and alleviates pain; Clears Heat and relieves Fire toxicity; Moderates and harmonizes the harsh properties of other herbs

Traditional Chinese Uses

Gan Cao (licorice root) is the most widely used herb in all of Chinese medicine — its mild, sweet flavor and neutral character make it an ideal harmonizer that both strengthens Spleen and Lung Qi and mediates the interactions between other herbs in a formula. It stops cough, clears Heat toxin for sore throats and abscesses, relieves spasmodic pain in the extremities and abdomen, and modifies the harsh or toxic properties of other herbs. Honey-frying enhances its tonic action. It is the standard formula-harmonizing herb in TCM.

Western Herbalism Properties

Actions:
anti-inflammatorydemulcentexpectorantadaptogenantispasmodic

Used In Formulas (25)

Ba Zhen Tang
八珍汤 · Ba Zhen Tang
Rui Zhu Tang Jing Yan Fang
Envoy (Shi) 6g
Ba Zheng San
八正散 · Ba Zheng San
Tai Ping Hui Min He Ji Ju Fang
Envoy (Shi) 6g
Bai Hu Tang
白虎汤 · Bai Hu Tang
Shang Han Lun
Envoy (Shi) 3g
Ban Xia Bai Zhu Tian Ma Tang
半夏白术天麻汤 · Ban Xia Bai Zhu Tian Ma Tang
Yi Xue Xin Wu
Envoy (Shi) 3g
Bu Zhong Yi Qi Tang
补中益气汤 · Bu Zhong Yi Qi Tang
Pi Wei Lun
Deputy (Chen) 9g
Dan Zhi Xiao Yao San
丹栀逍遥散 · Dan Zhi Xiao Yao San
Jing Yue Quan Shu (Complete Works of Jing-Yue)
Envoy (Shi) 4.5g
Dang Gui Si Ni Tang
当归四逆汤 · Dang Gui Si Ni Tang
Shang Han Lun
Envoy (Shi) 6g
Er Chen Tang
二陈汤 · Er Chen Tang
Tai Ping Hui Min He Ji Ju Fang
Envoy (Shi) 3g
Gui Pi Tang
归脾汤 · Gui Pi Tang
Ji Sheng Fang (Formulas for Rescuing Lives)
Envoy (Shi) 3g
Gui Zhi Tang
桂枝汤 · Gui Zhi Tang
Shang Han Lun
Envoy (Shi) 6g
Huo Xiang Zheng Qi San
藿香正气散 · Huo Xiang Zheng Qi San
Tai Ping Hui Min He Ji Ju Fang
Envoy (Shi) 3g
Long Dan Xie Gan Tang
龙胆泻肝汤 · Long Dan Xie Gan Tang
Yi Fang Ji Jie (Collected Explanations of Medical Formulas)
Envoy (Shi) 6g
Ma Huang Tang
麻黄汤 · Ma Huang Tang
Shang Han Lun
Envoy (Shi) 3g
Ping Wei San
平胃散 · Ping Wei San
Tai Ping Hui Min He Ji Ju Fang
Envoy (Shi) 4.5g
Sang Ju Yin
桑菊饮 · Sang Ju Yin
Wen Bing Tiao Bian
Envoy (Shi) 2.5g
Si Jun Zi Tang
四君子汤 · Si Jun Zi Tang
Tai Ping Hui Min He Ji Ju Fang
Envoy (Shi) 6g
Suan Zao Ren Tang
酸枣仁汤 · Suan Zao Ren Tang
Jin Gui Yao Lue
Envoy (Shi) 3g
Wen Dan Tang
温胆汤 · Wen Dan Tang
San Yin Ji Yi Bing Zheng Fang Lun
Envoy (Shi) 3g
Wen Jing Tang
温经汤 · Wen Jing Tang
Jin Gui Yao Lue
Envoy (Shi) 6g
Xiao Chai Hu Tang
小柴胡汤 · Xiao Chai Hu Tang
Shang Han Lun
Assistant (Zuo) 9g
Xiao Yao San
逍遥散 · Xiao Yao San
Tai Ping Hui Min He Ji Ju Fang
Envoy (Shi) 6g
Xue Fu Zhu Yu Tang
血府逐瘀汤 · Xue Fu Zhu Yu Tang
Yi Lin Gai Cuo
Envoy (Shi) 6g
Yin Qiao San
银翘散 · Yin Qiao San
Wen Bing Tiao Bian
Envoy (Shi) 5g
Zhen Gan Xi Feng Tang
镇肝熄风汤 · Zhen Gan Xi Feng Tang
Yi Xue Zhong Zhong Can Xi Lu (Records of Heart-Felt Experiences in Medicine)
Envoy (Shi) 4.5g
Zhu Ye Shi Gao Tang
竹叶石膏汤 · Zhu Ye Shi Gao Tang
Shang Han Lun
Envoy (Shi) 3g

Botanical Description

Glycyrrhiza uralensis is a perennial herb in the pea family (Fabaceae), growing from a stout, woody, deep-reaching taproot and spreading rhizomes. Erect, branched or unbranched stems reach 30–70 cm, occasionally to 120 cm, and are glandular and finely downy. The leaves are alternate and pinnately compound with 7–17 oval to lance-shaped leaflets. Small pale purple to violet pea-like flowers are borne in dense axillary spikes in mid to late summer, followed by oblong, curved, glandular-hairy pods. The medicinal part is the dried root and rhizome — cylindrical, 10–30 cm long and 1–2 cm thick, brownish-grey and longitudinally wrinkled outside, pale yellow and fibrous within — which is rich in glycyrrhizin and provides the herb Gan Cao.

Habitat:

Dry, sunny grasslands, sandy plains, and hillsides across the temperate steppe of northern China, Mongolia, and Central Asia.

Native Region: China, Mongolia, Russia, Kazakhstan, Kyrgyzstan, Xinjiang, Inner Mongolia, Gansu, Ningxia, Shaanxi, Shanxi, Qinghai, Heilongjiang
Conservation Notes:

Glycyrrhiza uralensis is widely distributed across the temperate steppe of northern China, Mongolia and Central Asia. Heavy wild harvesting for medicine has led to local depletion and desertification concerns in parts of its range, and it is increasingly cultivated to reduce pressure on wild stands.

Active Constituents

Glycyrrhizin (glycyrrhizic acid)

Triterpenoid saponin

Concentration: ~2–9% of dried root

The principal sweet-tasting saponin (roughly 50× sweeter than sucrose) and the pharmacopoeial marker compound. Anti-inflammatory, antiviral and hepatoprotective. Hydrolysed in the gut to 18β-glycyrrhetinic acid, its active metabolite.

18β-Glycyrrhetinic acid

Triterpenoid aglycone

Concentration: Metabolite of glycyrrhizin

Active metabolite responsible for much of licorice's activity. Inhibits 11β-hydroxysteroid dehydrogenase type 2, slowing cortisol breakdown — the mechanism behind licorice's corticosteroid-like effects and, in excess, pseudoaldosteronism.

Liquiritin / liquiritigenin

Flavanone glycoside / aglycone

Concentration: Major flavonoids

Flavonoids credited with antitussive, expectorant, antispasmodic and antioxidant actions. Liquiritin is a pharmacopoeial quality marker alongside glycyrrhizin.

Isoliquiritigenin

Chalcone

Concentration: Minor

Antioxidant and antispasmodic chalcone; studied for oestrogenic and anti-tumour activity in vitro.

Licochalcone A

Chalcone

Concentration: Characteristic of G. inflata

Antimicrobial and anti-inflammatory chalcone; a chemotaxonomic marker distinguishing G. inflata from other licorice species.

Glabridin

Isoflavan

Concentration: Characteristic of G. glabra

Antioxidant isoflavan and tyrosinase inhibitor (skin-lightening interest). Found mainly in G. glabra rather than G. uralensis.

⚠ Drug Interactions

Digoxin / cardiac glycosides

Major Evidence: Moderate

Glycyrrhizin-induced potassium loss (pseudoaldosteronism) sensitises the myocardium to cardiac glycosides.

Clinical note: Hypokalaemia can precipitate serious, potentially fatal arrhythmias. Avoid concurrent use, or monitor serum potassium and digoxin closely.

Loop & thiazide diuretics

Major Evidence: Moderate

Additive potassium depletion — both licorice and these diuretics lower serum potassium.

Clinical note: Risk of significant hypokalaemia (muscle weakness, cramps, arrhythmia). Avoid or monitor electrolytes.

Corticosteroids

Moderate Evidence: Moderate

Glycyrrhetinic acid inhibits 11β-HSD2, slowing cortisol inactivation and potentiating corticosteroid effects.

Clinical note: May intensify sodium/water retention, hypertension and hypokalaemia. Use cautiously with systemic steroids.

Antihypertensives

Moderate Evidence: Moderate

Licorice raises blood pressure through pseudoaldosteronism, opposing antihypertensive therapy.

Clinical note: Can reduce the efficacy of blood-pressure medication and worsen control. Avoid in uncontrolled hypertension.

Warfarin

Minor Evidence: Limited

Some evidence that licorice increases warfarin clearance, potentially lowering INR.

Clinical note: Limited data. Monitor INR if licorice is started or stopped.

Dosage

FormAmount Frequency Duration Population Notes
Decoction (raw Gan Cao) 3–10 g Daily, in divided doses Adult

Standard daily range. The Chinese Pharmacopoeia (2020) gives 2–10 g; Bensky's Materia Medica gives 1.5–9 g. When Gan Cao is used only to harmonize a formula, 1–2 g is sufficient.

Decoction (high dose, short-term) 15–30 g Daily Short courses only Adult

Larger doses are used for clearing Fire toxicity (e.g. sore throat, drug/food toxicity) or acute spasmodic pain. Prolonged high-dose use risks pseudoaldosteronism (hypertension, hypokalaemia, oedema) and should be monitored.

Honey-fried (Zhi Gan Cao) 3–9 g Daily Adult

The honey-fried form is warmer and more tonifying; it is the form used to tonify Spleen and Heart Qi and to restore the pulse (e.g. in Zhi Gan Cao Tang / Regulate the Middle Decoction).

Preparation Methods

Raw Gan Cao decoction

Parts: root, rhizome

Dried, unprocessed root and rhizome sliced and decocted with the other formula ingredients. Favoured for clearing Heat, resolving toxicity and moistening the Lung.

Honey-fried (Zhi Gan Cao)

Parts: root, rhizome

Sliced root stir-fried with honey until golden and no longer sticky. Processing warms the herb and enhances its Qi- and Blood-tonifying, pulse-restoring action.

Powder / granule

Parts: root, rhizome

Milled to powder or prepared as a concentrated granule for direct dosing where decoction is impractical.

Clinical Studies

Chemical analysis of the Chinese herbal medicine licorice (Gan-Cao): An update review

Shang Z, Liu C, Qiao X, Ye M (2022) Journal of Ethnopharmacology Review

Comprehensive 2009–2022 review of licorice chemistry, quality evaluation, drug metabolism and pharmacokinetics; catalogues the triterpenoid saponins and flavonoids underlying its activity.

An Extract of Glycyrrhiza glabra (GutGard) Alleviates Symptoms of Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study

Raveendra KR, et al. (2012) Evidence-Based Complementary and Alternative Medicine Randomized controlled trial

A standardised low-glycyrrhizin licorice extract significantly reduced functional-dyspepsia symptom scores versus placebo over 30 days, with good tolerability.

References

  1. Bensky D, Clavey S, Stöger E. Chinese Herbal Medicine: Materia Medica . 3rd ed. Seattle: Eastland Press (2004)
  2. Chinese Pharmacopoeia Commission. Glycyrrhizae Radix et Rhizoma . Pharmacopoeia of the People's Republic of China, Vol. I (2020)
  3. Shang Z, Liu C, Qiao X, Ye M. Chemical analysis of the Chinese herbal medicine licorice (Gan-Cao): An update review . Journal of Ethnopharmacology 299:115686 (2022) [DOI]
  4. Raveendra KR, et al.. An Extract of Glycyrrhiza glabra (GutGard) Alleviates Symptoms of Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study . Evidence-Based Complementary and Alternative Medicine 2012:216970 (2012) [DOI]

This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.

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