Is Throat Coat tea safe during pregnancy?

What does the evidence say about throat coat tea during pregnancy?

1. NCCIH states that consuming oral licorice extract in large amounts, about 250 grams of licorice per week, during pregnancy is unsafe and can increase the risk of delivery before a gestational age of 38 weeks. 1
2. Licorice contains glycyrrhizin, or glycyrrhizic acid, which can cause serious adverse effects such as irregular heartbeat and cardiac arrest. Even small amounts have been linked to severe adverse effects in people who consume a lot of salt, people with hypertension, and people with heart or kidney conditions. 1
3. Finnish studies graded glycyrrhizin intake as low under 250 mg a week, moderate 250 to 499 mg a week, and heavy 500 mg or more a week. Heavy consumption was associated with more than a twofold increased risk of preterm delivery before 37 weeks, and an odds ratio of 3.07 (95 percent CI 1.17 to 8.05) for delivery before 34 weeks. The reviewers concluded there is insufficient information to state categorically whether licorice may be used safely in pregnancy. 2
4. Slippery elm, the other signature ingredient, works differently. Its effects appear to be due to stimulation of mucus and saliva, which may relieve a sore or dry throat and coat irritated esophageal or gastric lining. It is not approved as therapy for any condition, and preparations are generally recognized as safe with no published cases of liver injury. 3
5. Herbal blends sit outside normal drug oversight: FDA regulates dietary supplements in a different way than prescription or over-the-counter drugs, which is the reason to read the full ingredient panel on a tea rather than assuming the box name describes it. 4

Is throat coat tea safe in each trimester?

• First trimester. Cold season and early pregnancy overlap, and this is the tea people reach for. The slippery elm and marshmallow side of the blend works by stimulating mucus and saliva, which is a coating effect rather than a drug effect. The licorice side is the part that needs a decision.
• Second trimester. If you are drinking it regularly, the amount is what matters. The Finnish studies that produced the preterm signal graded glycyrrhizin intake as low under 250 mg a week, moderate 250 to 499 mg, and heavy 500 mg or more a week.
• Third trimester. The preterm question is most relevant now. Heavy consumption was associated with more than a twofold increased risk of delivery before 37 weeks, and an odds ratio of 3.07 for delivery before 34 weeks. A plain demulcent tea without licorice sidesteps the whole issue.