First, here is some positive
information about grapefruit. It’s delicious when broiled with a
bit of brown sugar. It’s packed with vitamin C, dietary fiber, and
potassium. It’s good for the immune system, skeletal system, and
the cardiovascular system!
Yes, grapefruit has some good points
and is generally healthy for you. However, grapefruit has a bad side
and many people fall victim to the worse side of grapefruit.
Grapefruit has earned the ire of some for its potential to cause
harmful drug interactions and is known as the grapefruit effect. But,
why is it specifically grapefruit and grapefruit juice that’s
singled out?
Even though the harmful drug
interactions have been known for several decades, many doctors still
do not warn patients when they prescribe a drug known to be on the
list. To begin with, the chemical in grapefruit that we’re going
to talk about is called furanocoumarin. It’s a toxic chemical
found in many plants that functions as a line of defense against
would be eaters through a bitter flavor and by causing potential
stomach issues.
It’s that exact line of defense that
causes the drug interaction. Furanocoumarin is also found in most
other citrus; but sour oranges, some mandarins, and tangelos have
higher concentrations, though not as high as grapefruit.
The chemical doesn’t interact
directly with medications, but instead binds itself to an enzyme
found in the liver and intestinal tract. The enzyme in question is
known as CYP3A4. This enzyme helps regulate how much of a drug may
enter your bloodstream.
Essentially, furanocoumarin puts CYP3A4
into a headlock; as a result, it can’t do its job, so a medication
seeps into your bloodstream at an increased rate. Certain drugs show
different effects. Men taking Viagra may see the drug hit harder and
faster, which may sound good but likely, this may come along with
headaches, dizziness or even vomiting. None of which will help
sexify the mood.
The FDA notes that cholesterol lowering
drugs known as statins often have harmful interactions with
grapefruit juice. These can include dizziness, harm to the liver and
kidneys, and muscle breakdown. In one Mayo Clinic study, some people
even showed signs of memory loss.
Some psychiatric and anxiety
medications have also displayed signs of the grapefruit effect,
including upset stomach, digestive issues, and exhaustion.
If you’re unsure of what drugs
interact with grapefruit juice you can see a partial list here. I
have more in this blog and this blog.
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