Liquorice

Moegi Tanaka et al. (2021) · PloS one

This randomized controlled trial with 77 analyzed women explored whether Yokukansan, a traditional Japanese Kampo herbal formula, can reduce anxiety around breast cancer surgery. Kampo is the Japanese adaptation of traditional herbal medicine, and Yokukansan combines seven herbal extracts that are traditionally prescribed for irritability, restlessness, and insomnia. Perioperative anxiety (anxiety in the period around an operation) matters because the authors link it to faster heart rate, higher blood pressure, longer postoperative pain, and a higher risk of postoperative delirium. Common anxiety medicines such as benzodiazepines can cause sedation, which is why a short-course herbal option was tested. Women aged 20 to 60 undergoing partial or total mastectomy at two Niigata hospitals in Japan were randomly assigned to a Yokukansan group or a control group. The Yokukansan group took two 2.5 g doses of a standardized extract granule, one at bedtime the night before surgery and one 2 hours before anesthesia; the control group received water. Anxiety was measured objectively with salivary alpha-amylase (an enzyme that rises with stress) and subjectively with two questionnaires, the Hospital Anxiety and Depression Scale and the State-Trait Anxiety Inventory. Pain was rated on a 100-mm scale the day after surgery. Salivary alpha-amylase just before surgery was lower in the Yokukansan group than in controls (0.88 versus 1.14 on a log scale, p = 0.03), meaning a smaller physiological stress signal at that moment. HADS-Anxiety scores dropped by 2.77 points with Yokukansan and 1.43 points in controls (both significant, though the difference between groups did not reach significance, p = 0.083), and the authors suggest part of the drop may reflect reassurance once surgery was complete. Trait anxiety on the STAI fell by 4.23 points with Yokukansan and did not change in controls (p = 0.92), with a significant group-by-time interaction (p = 0.009). On both questionnaires higher scores mean more anxiety, so falling scores indicate improvement. Pain scores were nearly identical (1.4 versus 1.36, p = 0.70), and no adverse events were observed. The authors suggest two preoperative doses may reduce perioperative anxiety and that further research is justified. Several limitations apply. Patients knew which group they were in because no matching placebo exists for Kampo medicines, so reassurance may explain some of the effect. Salivary alpha-amylase measures stress generally, and the analyzed groups fell short of the planned size, leaving statistical power at 0.708. Pain was low in both groups, so any pain effect remains untested. Larger double-blind, placebo-controlled trials, including more invasive surgeries, are called for.

Hadis Hooshmandi et al. (2024) · Journal of ovarian research

This 8-week randomized, double-blind, placebo-controlled trial with 66 women explored whether licorice (Glycyrrhiza glabra) root extract could ease some of the metabolic burden of polycystic ovary syndrome (PCOS), a hormonal condition marked by irregular ovulation, elevated androgen levels, and polycystic ovaries on ultrasound. PCOS frequently occurs alongside obesity and insulin resistance, the body's reduced response to insulin, which raises blood sugar and makes weight loss harder to achieve. The trial paired licorice extract with a calorie-restricted diet to test whether the herb added benefit beyond diet alone. Seventy-two overweight or obese women with PCOS, ages 18 to 45, at a clinic in Yazd, Iran, were randomly assigned to 1,500 mg of standardized licorice extract daily, taken as three capsules before meals, or a matching placebo, both alongside the same reduced-calorie diet, for 8 weeks. Sixty-six women completed the study. Body composition was measured with a bioelectrical impedance analyzer, and blood tests tracked fasting glucose, insulin, and cholesterol levels before and after treatment. Women taking licorice lost more weight than those on diet alone (82.60 kg versus 86.09 kg, a statistically significant difference at p<0.001) and showed larger drops in body mass index and body fat percentage. Their fasting blood sugar (74.0 versus 94.0 mg/dl), insulin (6.68 versus 11.06 µIU/ml), and an insulin-resistance score called HOMA-IR (1.23 versus 2.55) all improved significantly more than in the placebo group (p<0.001), as did triglycerides and total and LDL cholesterol (all lower with licorice) and HDL cholesterol (higher, the more favorable direction) (p between <0.001 and 0.01). A separate measure of insulin-producing capacity, HOMA-B, improved within the licorice group and looked better than placebo before statistical adjustment, but that edge disappeared once the analysis accounted for baseline differences and other factors, a reminder that not every raw difference holds up under closer scrutiny. Diet and activity levels were identical between the two groups throughout the study, and the low-calorie diet alone produced no measurable change in any of these markers over the 8 weeks. The authors propose that licorice's compounds act on fat metabolism, insulin signaling, and cholesterol handling through several biological pathways, though those pathways were not directly measured in this trial. The study ran for only 8 weeks, did not test licorice without the accompanying diet, and relied on 24-hour dietary recall, a self-reported method that can be imprecise. Longer trials isolating licorice's own effect and testing its proposed mechanisms, in more diverse populations than this single-center Iranian cohort, are needed to confirm these results.

Bowen Xu et al. (2026) · Frontiers in endocrinology

This open-label randomized trial at Shanghai East Hospital compared two approaches to primary dysmenorrhea (menstrual cramping without an underlying pelvic disease) in 80 women aged 15 to 46: a Traditional Chinese Medicine protocol called Cai's Gynecology Cyclical Therapy, paired with a specific formula called the Stasis-Clearing and Meridian-Warming Method, versus standard ibuprofen. The TCM approach is built on a century-old idea from a Shanghai medical lineage: that treatment should change across the four phases of the menstrual cycle rather than staying the same throughout. Forty women received ibuprofen (a common anti-inflammatory pain reliever) for two days during each period, while the other forty received herbal decoctions -- different formulas depending on the cycle phase -- for three full menstrual cycles. Researchers tracked pain on a 0-to-10 visual pain scale and a symptom-severity score, and checked whether pain returned in the month after treatment ended. People collecting the follow-up data did not know which treatment each woman had received. Both treatments worked well overall (97.5% of women improved in each group), but the pattern of improvement differed. Ibuprofen relieved pain faster in the first month, as expected for a direct pain reliever. The herbal treatment started more slowly but kept improving month after month, and by the third month the two treatments were statistically equivalent on both pain and symptom scores. The most striking difference came after treatment stopped: only about 13% of the herbal-treatment group had their pain return the following month, compared to about 90% of the ibuprofen group. No side effects were reported in either group throughout the study. The researchers suggest this gap in relapse rates may reflect a real difference in how the two approaches work -- ibuprofen blocks pain-causing chemicals only while it is being taken, whereas the herbal protocol may produce a more lasting change. However, because patients and treating doctors could not be kept unaware of which treatment they were giving or receiving (an inherent challenge when comparing herbal decoctions to a standard pill), and because the study involved one hospital and a single follow-up cycle, the authors call for larger, multi-site studies with longer follow-up to confirm these findings.

Janmejaya Samal (2015) · Journal of intercultural ethnopharmacology

This systematic review pooled published research on using Ayurveda, India's traditional medical system, alongside standard drugs for pulmonary tuberculosis (PTB) — a bacterial lung infection that remains one of India's leading causes of death. The review searched PubMed through April 2015 and found six studies worth including: four human trials testing Ayurvedic herbal formulas as add-ons to standard anti-TB drugs (ATDs), and two lab studies testing plant extracts directly against the TB bacterium. In Ayurveda, PTB is traditionally understood as Rajayakshma, a wasting condition tied to depleted bodily tissues (dhatu) and vital reserve (ojas) — explaining why many of the formulas studied are rejuvenative "Rasayana" tonics rather than antibiotics. The four clinical trials enrolled 30 to 133 PTB patients each, all in India, and ran from 28 days to 6-8 months. Participants took Ayurvedic formulas — a nine-herb Rasayana capsule, a liquid tonic called Bhringarajasava, Ashwagandha with Chyawanprash, or a hepatoprotective blend called Liv-600 — alongside their prescribed drug regimen (DOTS). Researchers tracked symptoms like cough and fever, body weight, X-ray changes, drug blood levels, and liver enzymes. The two lab studies tested leaf and plant extracts against TB bacteria in culture, measuring the lowest concentration that stopped bacterial growth. Across the trials, Ayurvedic add-ons consistently eased symptoms and supported weight gain more than standard treatment alone (p<0.001 in the largest trial). One striking finding: Ashwagandha plus Chyawanprash raised blood levels of two key TB drugs, isoniazid and pyrazinamide, by 7-10% (meaning the body absorbed more of the medicine that actually kills the bacteria) — potentially valuable given rising drug resistance. The hepatoprotective blend showed no harmful rise in liver enzymes, suggesting it may guard against the liver damage these drugs can cause. In the lab, extracts from four of five tested legumes completely stopped bacterial growth at a low concentration (50 micrograms per milliliter), and extracts from five other plants inhibited even drug-resistant TB strains by up to 95%. These findings position Ayurvedic formulas as promising supportive care — easing symptoms, protecting the liver, and possibly boosting drug absorption — rather than replacements for standard TB treatment, which no study tested. The evidence base is thin: only six studies total, all small, mostly from India, with just one describing blinding and none pooling results statistically. The authors call for properly designed clinical trials of the lab-active plants, especially against multidrug-resistant TB. The evidence reviewed concerns Ayurvedic preparations as adjuncts to prescribed drug therapy; none of it addresses their use instead of it.

Aliasghar Manouchehri et al. (2023) · JBRA assisted reproduction

Polycystic ovary syndrome (PCOS) is one of the most common hormone-related conditions affecting women of reproductive age, estimated to affect 4-25% of women depending on how it is diagnosed (14.6% in Iran). Beyond irregular periods and fertility struggles, PCOS often comes with insulin resistance, weight gain, acne, excess hair growth, and long-term metabolic risk. Because standard medications can carry side effects, researchers have looked to medicinal plants as gentler options. This review pulls together what is known about nine herbs -- from aloe vera to flax -- and how each is thought to act on the hormonal and metabolic disruptions behind PCOS. Unlike a systematic review with a registered search protocol, this is a narrative synthesis: the authors describe the proposed mechanism of each of nine plants -- aloe vera, chamomile, chaste tree, cinnamon, ginseng, stachys, fennel, liquorice, and flax -- based mainly on animal and laboratory studies rather than human clinical trials. Each plant's key active compound and hypothesized mechanism of action are summarized in a comparison table, covering effects on hormone levels, ovarian tissue, insulin sensitivity, and inflammation. Each herb is proposed to work differently. Cinnamon appears to improve insulin sensitivity and lower blood sugar and lipids by affecting insulin-receptor signaling. Chaste tree and fennel are proposed to shift the balance of reproductive hormones (chaste tree lowering testosterone, fennel raising progesterone and thickening the uterine lining). Flax's lignans are linked to lower androgen levels and less excess hair growth (hirsutism), while stachys is proposed to ease abnormal uterine bleeding by damping estrogen receptor activity. Chamomile and aloe vera are described as supportive of ovarian tissue and follicle development, and ginseng and liquorice are framed around broader immune and metabolic support. Importantly, the review does not report clinical trial results, statistics, or human outcome data for any of these plants -- the mechanisms described come mainly from animal models and lab studies, not from testing in women with PCOS. The authors see herbal medicine as a promising, low-side-effect complement to PCOS care, working mainly through immune support and cycle regulation rather than direct hormone replacement -- but they are careful to say more research time is needed. Because this is a synthesis of mostly preclinical and mechanistic findings, none of these nine plants can be considered proven PCOS treatments; each is better read as a lead for future controlled human trials than as an established remedy to try in place of medical care.