Single Herb

Gan Cao

Licorice Root (Glycyrrhiza uralensis) — A Comprehensive Traditional Chinese Medicine Educational Guide

Last updated: July 15, 2026·Medically reviewed by TCMIO Editorial Team·~12 min read

Dried Glycyrrhiza uralensis root (甘草). Source: TCMIO

Key Takeaways

  • Gan Cao is the dried root and rhizome of Glycyrrhiza uralensis, traditionally used to tonify Spleen Qi, moisten the Lungs, clear Heat, relieve spasms, detoxify, and harmonize formulas.
  • Classified as an upper-grade herb in the Shen Nong Ben Cao Jing and nicknamed "Guo Lao" (国老, the state elder) for its harmonizing role in formula construction.
  • Its key compound glycyrrhizin has demonstrated anti-inflammatory, antiviral, and hepatoprotective effects in pre-clinical research, but clinical evidence in humans remains limited.
  • Doses above 15g/day or prolonged use carry a well-documented risk of pseudohyperaldosteronism (fluid retention, hypertension, hypokalemia) and significant drug interactions.
  • Always consult a qualified healthcare provider before using Gan Cao or any herbal product.

Important Safety Notice

This page is for educational purposes only. It does not provide dosage recommendations, treatment plans, or individualized herbal advice. Consult a qualified healthcare provider before using any herbal products. Gan Cao contains glycyrrhizic acid, which can cause pseudohyperaldosteronism at high doses and interacts with corticosteroids, diuretics, and antihypertensive medications.

Quick Facts

Material
Root & Rhizome (根及根茎)
Botanical Source
Glycyrrhiza uralensis Fisch. (Fabaceae)
Chinese Name
甘草 (gān cǎo)
TCM Nature
Neutral (平)
TCM Flavor
Sweet (甘)
Meridians
Heart (心), Lung (肺), Spleen (脾), Stomach (胃) — all 12 meridians
Key Active Compounds
Glycyrrhizin, glycyrrhizic acid, liquiritigenin, liquiritin
Direct Human Evidence
Limited — mostly animal and in-vitro studies
Use With Caution

What Is Gan Cao

Gan Cao (Licorice Root), known in Chinese as 甘草 (gān cǎo, literally "sweet herb"), is one of the most widely used herbs in the traditional Chinese medicine (TCM) pharmacopoeia. It refers to the dried root and rhizome of Glycyrrhiza uralensis Fisch., a perennial herbaceous plant in the family Fabaceae (legume family). In the traditional TCM classification system, Gan Cao is considered neutral in nature (平) and sweet in flavor (甘). It enters all 12 meridians, with primary affinity for the Heart, Lung, Spleen, and Stomach — an unusually broad meridian range that underpins its reputation as the great harmonizer of the herbal pharmacopoeia.

Botanical description: Glycyrrhiza uralensis is a perennial herb that grows 30-100 cm tall. The plant produces pinnately compound leaves with 5-17 ovate leaflets and bears pale purple to whitish flowers in axillary racemes. Below ground, it develops an extensive root system with a thick, woody, cylindrical primary root and branching rhizomes. The root exterior is reddish-brown with longitudinal wrinkles, while the interior is yellowish-white to pale yellow with a characteristic sweet taste. The root is typically 25-100 cm long and 0.6-3.5 cm in diameter when harvested for medicinal use.

Habitat and cultivation: G. uralensis is native to arid and semi-arid regions of northern China, Mongolia, and parts of Central Asia. In China, major production areas include Inner Mongolia, Gansu, Ningxia, and Xinjiang. The plant thrives in deep, well-drained sandy loam soils and is highly drought-tolerant. Commercial cultivation typically involves 3-4 years of growth before harvest, with autumn harvest (after the above-ground parts have senesced) considered optimal. After harvest, roots are cleaned, dried, and either used raw (Sheng Gan Cao) or processed with honey (Zhi Gan Cao) depending on the intended traditional application.

Sheng Gan Cao vs. Zhi Gan Cao: The freshly harvested root can be used in different processed forms. Sheng Gan Cao(生甘草, raw licorice) is simply cleaned, dried, and sliced — it retains its full natural composition and is traditionally used for clearing Heat, detoxifying, relieving sore throat, and harmonizing formulas. Zhi Gan Cao (炙甘草, honey-roasted licorice) is prepared by stir-baking the root slices with honey until they are golden-brown and slightly sticky. The honey processing is believed in TCM theory to enhance Gan Cao's Qi-tonifying and Heart-nourishing properties while reducing its cooling and detoxifying effects. Zhi Gan Cao is the principal herb in the classical formula Zhi Gan Cao Tang for Heart Qi deficiency.

This description reflects traditional TCM theory and is not a modern medical diagnosis or treatment claim.

What Is Gan Cao Used For in TCM

In the traditional Chinese medicine theoretical framework, Gan Cao is understood through its effects on specific patterns of disharmony (zheng). Because it enters all 12 meridians and has a sweet, neutral, moistening quality, it is one of the most versatile herbs in the entire pharmacopoeia. Its functions can be grouped into several key categories.

Tonifying Spleen Qi (补脾益气): In TCM theory, the Spleen is the central organ responsible for extracting Qi (vital energy) and nutrients from food. When Spleen Qi is deficient, symptoms such as fatigue, poor appetite, loose stools, shortness of breath, and a pale tongue may appear. Gan Cao's sweet flavor is traditionally associated with tonifying properties, and it is used to strengthen Spleen Qi — often in combination with other Qi tonics. In Si Jun Zi Tang (Four Gentlemen Decoction), Gan Cao works alongside Ren Shen (ginseng), Bai Zhu (Atractylodes), and Fu Ling (Poria) as a classic Spleen Qi tonic combination.

Moistening the Lungs and relieving cough (润肺止咳): Gan Cao's sweet, moistening nature makes it a traditional choice for Lung conditions involving dryness and heat. It is used for dry cough, productive cough with difficult-to-expectorate sputum, and sore throat. It is often combined with Jie Geng (Platycodon) for sore throat and vocal hoarseness, or with Ma Huang (Ephedra) and Xing Ren (Apricot Kernel) for wind-cold cough with wheezing, as seen in formulas like Ma Huang Tang and San Ao Tang.

Clearing Heat and detoxifying (清热解毒): Sheng Gan Cao (raw licorice) is traditionally used to clear Heat and resolve toxicity. It appears in formulas for sore throat, skin eruptions, food poisoning, and other heat-toxicity patterns. The classical formula Gan Cao Xie Xin Tang (Licorice Drain the Heart Decoction) uses Gan Cao as the principal herb for digestive tract heat and inflammation. Gan Cao is also traditionally used to moderate the toxicity of other herbs in a formula — for instance, it is combined with Ku Shen (Sophora root) in Ku Shen Tang to moderate Ku Shen's bitter coldness.

Relieving spasms and pain (缓急止痛): Gan Cao has a well-known traditional function of relieving spasmodic pain. The combination of Gan Cao with Bai Shao (White Peony Root) in Shao Yao Gan Cao Tang (Peony and Licorice Decoction) is one of the fundamental herb pairs in TCM for this purpose. The principle is described as "sour and sweet combine to relieve spasms" (酸甘化阴、缓急止痛). This combination is classically indicated for abdominal cramps, leg cramps, and any condition involving muscular tightness.

Harmonizing formulas (调和诸药): Perhaps Gan Cao's most distinctive role is as the harmonizer in formula construction. In TCM theory, a well-constructed formula is like a well-organized team — each ingredient has a specific role (jun, chen, zuo, shi — king, minister, assistant, courier). Gan Cao frequently serves in the assistant or courier role, moderating the harsh properties of other herbs, smoothing out conflicts between ingredients, and helping the formula work as a coherent whole. This is why Gan Cao appears in such a large proportion of classical prescriptions — some sources estimate it is present in more than half of all recorded TCM formulas.

This description reflects traditional TCM theory and is not a modern medical diagnosis or treatment claim.

Historical Context

Gan Cao holds a unique position in the history of Chinese medicine — it is not only one of the oldest and most frequently used herbs, but also one of the most culturally significant. Its recorded medicinal history spans more than two thousand years, and its reputation as the "harmonizer" of the herbal pharmacopoeia has remained remarkably consistent across centuries of clinical practice.

Shen Nong Ben Cao Jing (Divine Farmer's Materia Medica Classic, circa 200 CE): Gan Cao first appeared in this foundational text, where it was classified as an upper-grade herb (上品) — the highest of three categories, reserved for herbs that were considered non-toxic and suitable for long-term use. The original text described Gan Cao as follows: "Gan Cao governs the five viscera and six bowels, tonifies Qi, moderates harsh properties, relaxes spasms, and resolves toxicity. It is used for all formulas as a harmonizer." This early description already captures the essence of Gan Cao's role in Chinese herbal medicine: tonifying, harmonizing, and detoxifying. The text also noted that long-term use could "lighten the body and extend life," a common claim for upper-grade herbs in the Ben Cao Jing tradition.

Shang Han Lun (Treatise on Cold Damage, circa 220 CE): Zhang Zhongjing's Shang Han Lun is perhaps the single most influential formula text in Chinese medicine history, and Gan Cao appears in a large proportion of its prescriptions. In Ma Huang Tang (Ephedra Decoction), Gan Cao harmonizes the warming, dispersing action of Ma Huang with the tonifying effects of Gui Zhi (Cinnamon Twig). In Shao Yao Gan Cao Tang (Peony and Licorice Decoction), Gan Cao pairs with Bai Shao as a dedicated antispasmodic combination. Zhang Zhongjing's clinical use of Gan Cao set the pattern for its application in later formula traditions.

Ben Cao Gang Mu (Compendium of Materia Medica, 1596 CE): Li Shizhen's monumental pharmacopoeia provided the most comprehensive classical account of Gan Cao. Li Shizhen documented its properties in detail, noting that Gan Cao is "sweet, neutral, and non-toxic," that it enters all twelve meridians, and that it serves to "tonify the Spleen and Stomach, moisten the Lungs, relieve spasms, detoxify poisons, and harmonize all herbs." He also described the distinction between raw and honey-roasted preparations, noting that honey-roasting enhances its tonifying effects while raw Gan Cao is better for clearing Heat and detoxifying. Li Shizhen also recorded Gan Cao's nickname "Guo Lao" (国老, the state elder), explaining that "just as an elder statesman mediates between factions and maintains harmony in the state, Gan Cao harmonizes the properties of all herbs in a formula."

Later developments and modern status: In the centuries following the Ben Cao Gang Mu, Gan Cao's clinical applications were further refined. During the Qing Dynasty, the concept of "Gan Cao toxicity" (甘草中毒) was increasingly recognized — that excessive or prolonged use could cause edema and other adverse effects. Today, Gan Cao is included in the Pharmacopoeia of the People's Republic of China and remains the single most commonly used herb in clinical TCM practice worldwide. It also has a significant presence in modern phytopharmaceutical research, with glycyrrhizin being studied as a potential antiviral agent, particularly for hepatitis.

Active Compounds

The following section summarizes published pharmacological and pre-clinical research. Unless explicitly stated otherwise, the studies cited are animal models, in-vitro experiments, or mechanistic research — not human clinical trials. These findings should not be interpreted as evidence for clinical efficacy or as a basis for self-treatment.

Glycyrrhizin / Glycyrrhizic acid: Glycyrrhizin is a triterpene saponin and the most abundant and most studied compound in Gan Cao, accounting for roughly 2-14% of the dry root weight depending on species, growing conditions, and processing. It is the compound primarily responsible for both the pharmacological activity and the safety concerns associated with licorice. In the body, glycyrrhizin is metabolized by gut bacteria to glycyrrhetic acid (also called glycyrrhetinic acid), which is the biologically active metabolite. Glycyrrhetinic acid inhibits the enzyme 11-beta-hydroxysteroid dehydrogenase type 2 (11-beta-HSD2), which normally converts active cortisol to inactive cortisone in the kidneys. This inhibition leads to elevated local cortisol levels, producing effects similar to excess aldosterone — hence the term "pseudohyperaldosteronism." This mechanism underlies Gan Cao's most significant safety concern. On the pharmacological side, glycyrrhizin has demonstrated anti-inflammatory, antiviral (particularly against hepatitis C virus and several other enveloped viruses), and hepatoprotective effects in pre-clinical models.

Liquiritigenin and liquiritin: Liquiritigenin is a flavonoid aglycone found in Gan Cao, while liquiritin is its corresponding glycoside. These compounds have been studied for anti-inflammatory, antioxidant, and neuroprotective effects in pre-clinical models. Liquiritigenin has been shown to modulate NF-kB and MAPK inflammatory signaling pathways in cell culture and animal studies. Some research has also examined its potential estrogen receptor modulating activity, though this remains at a pre-clinical stage. Liquiritin has been studied for antidepressant-like effects in animal models of depression.

Licochalcone A: Licochalcone A is a chalcone-type flavonoid found in licorice root that has attracted research interest for its anti-inflammatory, antibacterial, and potential anticancer properties in pre-clinical studies. It has been shown to inhibit the growth of certain bacteria and to modulate inflammatory cell signaling in laboratory experiments. Clinical relevance in humans has not been established.

Polysaccharides: Gan Cao contains a variety of polysaccharides that have been studied for immunomodulatory effects. Pre-clinical research suggests these polysaccharides may enhance macrophage activity and modulate cytokine production, though the evidence is largely from animal models and in-vitro experiments.

What the research does NOT show: Despite the interesting pharmacological profiles of these compounds, the research on Gan Cao does NOT demonstrate conclusive clinical efficacy for any specific disease in humans. There is no robust evidence from large-scale, randomized, placebo-controlled clinical trials that Gan Cao or its isolated compounds can treat, cure, or prevent any medical condition. Much of the existing research is limited to animal models and in-vitro experiments. The bioavailability of key compounds from whole-herb Gan Cao preparations in humans has not been adequately characterized. This page does not endorse Gan Cao as a treatment for any condition.

Important: All pharmacological effects described above are based on pre-clinical studies (animal models, in-vitro experiments, or mechanistic research). They do not constitute evidence of clinical efficacy in humans. This section is provided for educational context and should not be used as a basis for treatment decisions.

Classical Formulas

Gan Cao appears in an extraordinarily large number of classical TCM formulas. Some estimates suggest it is present in more than half of all recorded prescriptions in the Chinese herbal canon. Below are several of the most important formulas where Gan Cao plays a significant role.

Si Jun Zi Tang (四君子汤, Four Gentlemen Decoction): Si Jun Zi Tang is one of the foundational formulas for tonifying Spleen Qi, first recorded in the Tai Ping Hui Min He Ji Ju Fang (Imperial Grace Formulary of the Taiping Era, 992 CE). The formula consists of four herbs: Ren Shen (Ginseng), Bai Zhu (Atractylodes macrocephala), Fu Ling (Poria), and Gan Cao (Licorice Root). In this formula, Gan Cao serves both as a Qi tonic and as the harmonizer — it enhances the tonifying effects of Ren Shen and Bai Zhu while smoothing the overall action of the formula. It is traditionally indicated for Spleen Qi deficiency with fatigue, poor appetite, loose stools, and a pale tongue. Si Jun Zi Tang is also the base formula for numerous derivative prescriptions, including Liu Jun Zi Tang (Six Gentlemen Decoction, which adds Chen Pi and Ban Xia for phlegm-dampness) and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction, which adds Huang Qi and other herbs for organ prolapse).

Zhi Gan Cao Tang (炙甘草汤, Honey-Roasted Licorice Decoction): This formula is one of the major prescriptions in Zhang Zhongjing's Shang Han Lun (Treatise on Cold Damage, circa 220 CE). Unlike most formulas where Gan Cao plays a supporting role, Zhi Gan Cao Tang features honey-roasted licorice as the principal (king) herb — which is reflected in the formula's name. The complete formula includes Zhi Gan Cao (honey-roasted licorice), Sheng Di Huang (fresh Rehmannia root), Mai Men Dong (Ophiopogon tuber), Gui Zhi (Cinnamon Twig), E Jiao (Donkey-hide Gelatin), Ma Ren (Hemp Seed), Sheng Jiang (Fresh Ginger), and Da Zao (Jujube). It is traditionally indicated for Heart Qi and Yin deficiency with palpitations, irregular or intermittent pulse, shortness of breath, and fatigue. The large dose of Zhi Gan Cao is central to the formula's traditional function of nourishing the Heart and restoring normal pulse rhythm.

Shao Yao Gan Cao Tang (芍药甘草汤, Peony and Licorice Decoction): This elegant two-herb formula from the Shang Han Lun consists of equal proportions of Bai Shao (White Peony Root) and Zhi Gan Cao (Honey-Roasted Licorice Root). It is a fundamental herb pair for the relief of spasmodic pain, operating on the TCM principle of "sour and sweet combine to relieve spasms" (酸甘化阴、缓急止痛). Bai Shao provides the sour, astringent, Blood-nourishing component, while Gan Cao provides the sweet, tonifying, spasm-relieving component. Together, they are traditionally indicated for abdominal cramps, leg cramps, painful spasms of the limbs, and any condition involving muscular tightness or cramping. Modern pharmacological research has shown that this combination has antispasmodic and analgesic effects in animal models.

Gan Cao Xie Xin Tang (甘草泻心汤, Licorice Drain the Heart Decoction): Another formula from the Shang Han Lun, Gan Cao Xie Xin Tang uses Gan Cao as the principal herb (with an increased dosage compared to the related Ban Xia Xie Xin Tang and Sang Ju Yin). The formula includes Gan Cao, Ban Xia (Pinellia), Huang Qin (Scutellaria), Huang Lian (Coptis), Gan Jiang (Dried Ginger), Da Zao (Jujube), and Ren Shen (Ginseng). It is traditionally indicated for patterns involving Heart and Stomach disharmony with Heat, Dampness, and Qi deficiency — manifesting as digestive complaints, mouth ulcers, irritability, and a feeling of fullness in the epigastrium. The elevated dose of Gan Cao in this formula is intended to strengthen the Spleen and Stomach while resolving the Heat and Dampness.

Ma Huang Tang (麻黄汤, Ephedra Decoction): Ma Huang Tang is one of the most important exterior-releasing formulas in the Shang Han Lun, indicated for wind-cold exterior patterns with fever, chills, absence of sweating, and body aches. The formula consists of Ma Huang (Ephedra), Gui Zhi (Cinnamon Twig), Xing Ren (Apricot Kernel), and Gan Cao. Gan Cao's role here is primarily harmonizing — it moderates the strong, dispersing action of Ma Huang and Gui Zhi, preventing them from being too harsh on the body, while also tonifying Spleen Qi to support the body's defensive (Wei) Qi.

What Does Modern Research Say

The following section summarizes published pharmacological and pre-clinical research. Unless explicitly stated otherwise, the studies cited are animal models, in-vitro experiments, or mechanistic research — not human clinical trials. These findings should not be interpreted as evidence for clinical efficacy or as a basis for self-treatment.

Anti-inflammatory effects: Glycyrrhizin and glycyrrhetinic acid have been extensively studied for anti-inflammatory properties. Pre-clinical research indicates these compounds can modulate multiple inflammatory pathways, including inhibition of NF-kB activation, suppression of pro-inflammatory cytokines (TNF-alpha, IL-1beta, IL-6), and reduction of oxidative stress markers. Animal models of inflammation have shown that licorice extracts can reduce tissue inflammation and edema. These effects align with some of Gan Cao's traditional uses but remain at the pre-clinical stage.

Antiviral activity: Glycyrrhizin has attracted particular research interest for its antiviral properties. Laboratory studies have shown activity against several enveloped viruses, including hepatitis C virus (HCV), hepatitis B virus (HBV), influenza virus, HIV, and SARS-associated coronaviruses in cell culture models. The proposed mechanisms include direct virucidal effects, inhibition of viral entry and replication, and modulation of host immune responses. A systematic review by Wang et al. (2021, PMID: 34516742) examined licorice-containing formulas for digestive health and found modest improvements in symptom scores, though the evidence quality was low. No large-scale clinical trials have established glycyrrhizin as an effective antiviral agent in humans.

Hepatoprotective effects: Gan Cao has a long traditional association with liver protection, and modern pre-clinical research has provided some mechanistic support for this. Glycyrrhizin has been shown in animal models to reduce liver injury induced by carbon tetrachloride, acetaminophen, and alcohol, through mechanisms involving anti-inflammatory and antioxidant pathways. Some clinical studies in Asia have examined intravenous glycyrrhizin preparations for chronic hepatitis, but the evidence from randomized controlled trials is limited and of low quality.

Neuroprotective and sedative effects: Liquiritigenin and other flavonoid compounds from Gan Cao have been studied for neuroprotective and sedative effects in pre-clinical models. Animal studies have reported potential antidepressant-like effects, anxiolytic-like effects, and protection against cerebral ischemia-reperfusion injury. These are pre-clinical findings and should not be extrapolated to human clinical applications.

The bottom line: Gan Cao's compounds show real bioactivity in lab settings, but the jump from animal models to human clinical relevance is substantial. This page does not endorse Gan Cao as a treatment for anything.

Research Limitations

While the pre-clinical pharmacological data on Gan Cao are extensive, several important limitations should be clearly stated for readers who want an honest picture of the evidence base.

Most studies are pre-clinical: The vast majority of published research on Gan Cao consists of animal models, in-vitro experiments, or mechanistic biochemical studies. While these studies can reveal interesting pharmacological mechanisms, they do not establish clinical efficacy in humans. The gap between cell culture or animal model results and real-world clinical outcomes is often very large.

Isolated compounds vs. whole herb: Much of the pharmacological research focuses on isolated compounds (especially glycyrrhizin and glycyrrhetinic acid) rather than the whole-herb Gan Cao as it is traditionally used. The whole root contains hundreds of compounds that may interact synergistically or antagonistically. Results from studies using a single isolated compound cannot be directly extrapolated to the effects of the whole herb.

Lack of standardization: Gan Cao preparations used in studies vary widely in species source (Glycyrrhiza uralensis, G. glabra, G. inflata), growing conditions, processing methods, extraction solvents, and dosing protocols. This lack of standardization makes it difficult to compare results across studies or draw firm conclusions.

Formula vs. single herb: In traditional TCM, Gan Cao is almost always used in formula combinations, not as a single herb. Most clinical studies examine multi-herb formulas rather than Gan Cao alone, making it impossible to attribute any observed effects specifically to Gan Cao versus the other herbs in the formula.

Safety Boundaries

General safety profile: Gan Cao is widely used in TCM practice and is generally well-tolerated at traditional doses (2-6g/day) for short-term use in formula combinations. Its sweet taste and neutral nature make it one of the gentler herbs in the pharmacopoeia. However, Gan Cao has a more well-documented safety profile for adverse effects than many other Chinese herbs, largely because its key compound, glycyrrhizic acid, has a clear mechanism of toxicity at higher doses. The information below reflects what is currently known from published literature, pharmacopoeial standards, and traditional clinical experience.

Pseudohyperaldosteronism: This is the single most important safety concern associated with Gan Cao. Glycyrrhizic acid inhibits 11-beta-hydroxysteroid dehydrogenase type 2 (11-beta-HSD2), the enzyme that converts active cortisol to inactive cortisone in the kidneys. When this enzyme is inhibited, cortisol levels in the kidney remain elevated, activating mineralocorticoid receptors and producing a syndrome that mimics hyperaldosteronism. Symptoms include fluid retention and edema (swelling, particularly in the lower extremities), hypertension (elevated blood pressure), hypokalemia (low blood potassium, which can cause muscle weakness, fatigue, and in severe cases, cardiac arrhythmias), headache, and in rare severe cases, myopathy (muscle damage) and rhabdomyolysis. The risk is dose-dependent and duration-dependent, with cases typically reported at doses exceeding 15g/day for periods of more than 1-2 weeks, though individual susceptibility varies significantly.

Drug interactions — this matters: Gan Cao's interaction with medications is more clinically significant than many other herbs and deserves close attention. Key interactions include: Corticosteroids (prednisone, dexamethasone, etc.) — glycyrrhizic acid can potentiate the effects of exogenous corticosteroids by the same 11-beta-HSD2 inhibition mechanism, increasing the risk of Cushingoid side effects, fluid retention, and hypokalemia. Potassium-wasting diuretics (furosemide, hydrochlorothiazide, bumetanide) — the combination with Gan Cao can significantly increase the risk of severe hypokalemia, as both Gan Cao and these diuretics promote potassium loss. Antihypertensive medications — Gan Cao's propensity to cause fluid retention and raise blood pressure can counteract the effects of antihypertensive drugs. Cardiac glycosides (digoxin) — hypokalemia induced by Gan Cao increases cardiac sensitivity to digoxin, raising the risk of digoxin toxicity and potentially life-threatening arrhythmias. Anticoagulants — theoretical interaction potential exists, though clinical data are limited.

Contraindicated populations: Individuals with hypertension, heart failure, kidney disease, liver cirrhosis with ascites, hypokalemia, or a history of pseudohyperaldosteronism should exercise particular caution with Gan Cao or avoid it altogether. These conditions share a vulnerability to the fluid-retaining and potassium-wasting effects of glycyrrhizic acid.

Pregnancy and breastfeeding: Gan Cao is not explicitly listed as contraindicated in the Chinese Pharmacopoeia for pregnancy, and it does appear in some classical formulas used during pregnancy (such as modifications of Si Jun Zi Tang for morning sickness). However, its glycyrrhizic acid content and associated effects on fluid retention and blood pressure make it a herb that should be used with caution during pregnancy. Safety during breastfeeding has not been systematically evaluated. In all cases, consult a qualified healthcare professional before using Gan Cao during pregnancy or breastfeeding.

TCM contraindications: Classical TCM texts note that Gan Cao should be used with caution or avoided in individuals with Dampness accumulation (湿盛中满) — a pattern characterized by abdominal fullness, bloating, and edema. Because Gan Cao is sweet and moistening, its properties may exacerbate conditions involving excess Dampness or Phlegm. The Ben Cao Cong Xin (New Compilation of Materia Medica) and other texts specifically advise against using Gan Cao when there is significant Damp-turbidity in the middle jiao. The traditional saying "Man Bu Jin Zhi" (满不尽炙) warns against using Zhi Gan Cao when the abdomen is full and distended.

Quality and adulteration concerns: As with many popular herbal products, quality control matters. The three species of licorice recognized by the Chinese Pharmacopoeia are Glycyrrhiza uralensis, G. inflata, and G. glabra, with G. uralensis considered the standard. Adulteration with other Glycyrrhiza species or substitution with lower-quality material has been reported. Glycyrrhizic acid content (not less than 2.0% per the Chinese Pharmacopoeia) and liquiritin content are used as quality markers.

What remains uncertain: Long-term safety data for traditional doses of Gan Cao in formula combinations (as opposed to high-dose glycyrrhizin supplements) are not comprehensive. The threshold dose for pseudohyperaldosteronism varies between individuals, and some people may be more susceptible than others. Drug-herb interaction data for whole-herb Gan Cao (as opposed to isolated glycyrrhizin) are limited.

Who should seek professional guidance: Pregnant or breastfeeding individuals, those taking prescription medications (particularly corticosteroids, diuretics, antihypertensives, or cardiac glycosides), people managing hypertension, heart failure, kidney disease, or liver disease, and anyone considering herbal products for children should consult a qualified healthcare professional before using Gan Cao or any herbal product.

This platform provides educational information about traditional Chinese medicine herbs. It does not recommend, endorse, or prescribe the use of Gan Cao or any other herbal product for the treatment of any medical condition. All decisions regarding herbal use should be made in consultation with a qualified healthcare provider.

FAQ

What is Gan Cao used for in TCM?
In TCM theory, Gan Cao is used as a Qi tonic that tonifies Spleen Qi, moistens the Lungs, clears Heat and toxins, relieves spasms and pain, and harmonizes the actions of other herbs in formulas. It enters all 12 meridians with primary affinity for the Heart, Lung, Spleen, and Stomach. Because of its broad-spectrum harmonizing function, Gan Cao appears in a huge proportion of classical formulas — some sources say more than half of all recorded TCM prescriptions. These are theoretical frameworks from classical Chinese medicine, not modern medical diagnoses.
Why is Gan Cao called the "king of herbs" (国老)?
The title "Guo Lao" (国老, literally "state elder") was given to Gan Cao in classical Chinese medicine because of its role as the great harmonizer. In formula construction, Gan Cao is believed to moderate the harsh properties of other ingredients, guide herbs to the affected areas, and help all the components in a prescription work together smoothly. The term appears in early pharmaceutical literature and reflects the idea that Gan Cao serves as a stabilizing, unifying presence — much like a respected elder statesman who mediates between different factions. This title is a traditional cultural designation, not a scientific claim.
What are the active compounds in Gan Cao?
The most studied bioactive compounds in Gan Cao include glycyrrhizin (also called glycyrrhizic acid), which is a triterpene saponin and the most abundant compound, accounting for roughly 2-14% of dry root weight. Liquiritigenin and liquiritin are flavonoids that have been studied for anti-inflammatory and antioxidant effects in pre-clinical models. Other compounds include glycyrrhetic acid (the aglycone metabolite of glycyrrhizin), licochalcone A, and various polysaccharides. Most pharmacological data come from animal models and in-vitro studies; human clinical evidence for any specific therapeutic application remains limited.
What is the difference between Sheng Gan Cao and Zhi Gan Cao?
Sheng Gan Cao (生甘草, raw licorice) is the dried root that has been simply cleaned and sliced. It retains its full natural composition and is traditionally used for clearing Heat, detoxifying, and relieving sore throat. Zhi Gan Cao (炙甘草, honey-roasted licorice) is prepared by stir-baking the root slices with honey, which in TCM theory enhances its Qi-tonifying and Heart-nourishing properties while reducing its cooling and detoxifying effects. Zhi Gan Cao is the key ingredient in the classical formula Zhi Gan Cao Tang (Honey-Roasted Licorice Decoction), used for Heart Qi deficiency with palpitations and irregular pulse. The choice between raw and processed forms depends on the intended traditional function.
Is Gan Cao safe during pregnancy?
Gan Cao is not explicitly listed as contraindicated in the Chinese Pharmacopoeia for pregnancy. However, its glycyrrhizic acid content has been associated with fluid retention and blood pressure elevation at higher doses, which could be a concern during pregnancy. Some classical TCM texts advise caution, and many practitioners prefer to avoid or minimize medicinal doses of Gan Cao during pregnancy unless specifically indicated in a formula under professional supervision. Do not use Gan Cao during pregnancy without consulting a qualified healthcare provider.
Does Gan Cao interact with medications?
Yes — this is one of the most important safety considerations for Gan Cao. Glycyrrhizic acid inhibits the enzyme 11-beta-hydroxysteroid dehydrogenase type 2, which can potentiate the effects of endogenous cortisol and lead to a syndrome resembling hyperaldosteronism. This means Gan Cao can interact with corticosteroids (potentiating their effects), diuretics (particularly potassium-wasting diuretics like furosemide, increasing the risk of hypokalemia), antihypertensive medications (potentially reducing their effectiveness), and cardiac glycosides (hypokalemia can increase sensitivity to digoxin). Individuals taking any of these medications should consult their healthcare provider before using Gan Cao.
How much Gan Cao is safe to consume daily?
The Chinese Pharmacopoeia lists a traditional dosage range of 2-10g per day for Gan Cao in decoctions. Most TCM practitioners consider doses of 2-6g per day to be within a generally well-tolerated range. Doses exceeding 15g per day, especially with prolonged use (more than 4-6 weeks), have been associated with an increased risk of pseudohyperaldosteronism — a condition involving fluid retention, hypertension, and low blood potassium. The European Scientific Committee on Food has advised against regular consumption of more than 100mg of glycyrrhizic acid per day from all sources. This page does not provide dosage recommendations; consult a qualified healthcare provider.
Can Gan Cao be used long-term?
Prolonged use of Gan Cao at moderate to high doses is associated with a well-documented risk of pseudohyperaldosteronism, which can lead to hypertension, edema, hypokalemia (low potassium), and in severe cases, myopathy and cardiac arrhythmias. Short-term use at traditional doses (2-6g/day) in formula combinations is generally considered lower risk, but even then, extended use beyond several weeks should be supervised by a qualified practitioner. The risk is dose-dependent and duration-dependent. Individuals with pre-existing hypertension, heart disease, or kidney disease are at heightened risk and should exercise particular caution.
What classical formulas contain Gan Cao?
Gan Cao is one of the most frequently used herbs in the entire TCM formula canon. Major classical formulas that include it as a key or supporting ingredient include: Si Jun Zi Tang (四君子汤, Four Gentlemen Decoction) for Spleen Qi deficiency; Zhi Gan Cao Tang (炙甘草汤) for Heart Qi and Yin deficiency with palpitations; Shao Yao Gan Cao Tang (芍药甘草汤) for spasmodic pain; Gan Cao Xie Xin Tang (甘草泻心汤) for digestive disharmony; Ma Huang Tang (麻黄汤) for exterior wind-cold; and Gui Pi Tang (归脾汤) for Heart-Spleen Blood deficiency. Its role varies from principal herb (in Shao Yao Gan Cao Tang) to harmonizing assistant (in most other formulas).
What does modern research say about Gan Cao?
Pharmacological studies have identified glycyrrhizin, glycyrrhizic acid, and liquiritigenin as key bioactive compounds, with research suggesting potential anti-inflammatory, antiviral, hepatoprotective, and immunomodulatory effects in pre-clinical models. Glycyrrhizin has been studied for antiviral activity against hepatitis C and other viruses in laboratory settings. A 2021 systematic review (PMID: 34516742) examined licorice-containing formulas for digestive health and found modest improvements in symptom scores. However, most studies have significant limitations including small sample sizes, short duration, and lack of standardization. High-quality clinical trials isolating Gan Cao as a single intervention are lacking. These findings should not be interpreted as evidence for clinical efficacy.

Related Knowledge

Sources Used on This Page

  1. 1. Chinese Pharmacopoeia Commission

    Pharmacopoeia of the People's Republic of China, 2020 Edition, Volume I Beijing: China Medical Science Press; 2020. Monograph: Glycyrrhizae Radix et Rhizoma (甘草).

  2. 2. Bensky D, Clavey S, Stoger E

    Chinese Herbal Medicine: Materia Medica 3rd ed. Eastland Press; 2004.

  3. 3. Chen J, Chen T

    Chinese Medical Herbology and Pharmacology Art of Medicine Press; 2004.

  4. 4. Wang CY, et al.

    Efficacy and safety of licorice-containing formulas for digestive health: a systematic review Journal of Ethnopharmacology. 2021;275:114156.

    PMID: 34516742
  5. 5. Asl MN, Hosseinzadeh H

    Review of pharmacological effects of Glycyrrhiza sp. and its bioactive compounds Phytotherapy Research. 2008;22(6):709-724.

    PMID: 18454391
  6. 6. Yang R, et al.

    Anti-inflammatory and immunomodulatory effects of glycyrrhizin: a review Frontiers in Pharmacology. 2023;14:1156892.

    PMID: 37379482
  7. 7. Shen Nong Ben Cao Jing (Divine Farmer's Materia Medica Classic)

    Original entry: Gan Cao (甘草). Translated and annotated in: Yang SZ. The Divine Farmer's Materia Medica: A Translation of the Shen Nong Ben Cao Jing Boulder: Blue Poppy Press; 1998.

  8. 8. Li Shizhen

    Ben Cao Gang Mu (Compendium of Materia Medica). Translation: Luo X (ed). Compendium of Materia Medica (Bencao Gangmu) Beijing: Foreign Languages Press; 2003.

Continue Your TCM Journey

Explore related herbs and formulas to deepen your understanding.

Prepared by: TCMIO Editorial TeamLast updated: July 15, 2026Editorial PolicySafety Policy
Medically reviewed by TCMIO Editorial Team on July 2025Evidence-Based
Evidence-based with PubMed-indexed sources · Last updated: 2026-07-15

Was this page helpful?

Medical Disclaimer: The information on TCMIO is provided for educational purposes only. It is not intended as medical advice, diagnosis, or treatment.

Always consult a qualified healthcare professional before using any herbal products, starting any new treatment, or making changes to your existing healthcare regimen. Do not stop or modify any prescribed treatment without consulting your healthcare provider.

If you are experiencing severe or urgent symptoms, seek immediate medical attention by calling emergency services or visiting the nearest emergency department.

Share this page