Grapefruit as one part of a healthy eating plan can be very nutritious. Grapefruit is a rich source of many health-promoting nutrients such as beta-carotene, vitamin C, potassium, fiber, water, pectin, lycopene and folic acid. In addition to that, it is very low in sodium, saturated fat and calories. So, where is the problem? Grapefruit is also chock full of naturally existing plant chemicals known as furanocoumarins; the most well-known being bergamottin/bergamot. If you take medications on a daily basis, you need to know that furanocoumarins can possibly lead to a toxic build up of drugs in your bloodstream.
Most drugs follow these steps – First the drugs are broken down in the intestines and absorbed into the blood. Next the drugs go to the liver, which breaks them down further for use. Finally, the usable parts of the drug are then sent out into the body and delivered to the appropriate locations. When your PCP prescribes a medication and dosage, it is with the knowledge that only a portion of that drug will be broken down, absorbed and transported in the body.
So, what is the problem? If you have grapefruit juice (which contains furanocoumarins) it stops the enzymes in the intestines from working, meaning you will absorb a lot more than expected. That sounds good at first, but think about this – the liver is supposed to further process the medications that you just absorbed, but the furanocoumarins stop that as well. Additionally, furanocoumarins also interfere with transportation of medications. All of this leads to a lot more of the drug circulating in your blood. The amount could be toxic – such high levels that you could have life-threatening complications.
There are over 85 medications that can have serious consequences from grapefruit juice, including drugs for:
• Allergies
• Antibiotics for infections (e.g. urinary tract infection)
• Breathing (e.g. asthma, cough, emphysema)
• Cancer
• Central nervous system (e.g. pain, epilepsy)
• Heart disease (e.g. arrhythmia, blood clots, heart attack, high cholesterol, high blood pressure, stroke)
• Immune system (e.g. HIV)
• Male reproductive health (e.g. enlarged prostate, erectile dysfunction)
• Mental health issues (e.g. anxiety, depression)
• Nausea
The signs that you may have a problem with grapefruit juice and your medications can be quite obvious, scary and dangerous. You may experience an irregular heartbeat, heart blockages, kidney damage, blood clots and bone marrow damage.
So does one glass of grapefruit juice really make a difference? The answer is yes, and the impact can last up to four days after your drink it. Check your prescription bottle, and you will see a sticker on it that will warn you if grapefruit juice is a problem. Removing grapefruit juice from the menu is the obvious action to take if you see that warning label. Grapefruit juice is not the only source of Furanocoumarins. So, it is important to take note of other foods and drinks to be avoided such as:
Food Rich in Grapefruit & Furanocoumarin (to be avoided)*
Candy: Anything made with bitter orange oil or sour orange peel or bergamot orange/peel or Seville orange peel- found in candy, gum
Cocktails/Liqueur (check with the bartender; some examples include Blue Cosmopolitan, Hurricane, Sea Breeze, Siberian Sunrise)
Citrus Drinks/Sodas: Fanta, Fresca, Canada Dry Citrus Blend, Crush Fuze, Full Throttle Citrus, 7 Up, Sierra Mist, Squirt, Sundrop
Fruit: Bergamot Oranges/Peel, Bitter Orange Oil, Grapefruit/grapefruit juice (fresh, frozen, concentrate, extract), Minneolas, Pummelos, Seville or Sour Oranges, Tangelos
Jam/Jelly: Orange Marmalade
Teas: Lipton Diet Citrus Green Tea, Nestea Citrus Green Tea, Snapple, Earl Grey
Waters: Powerade Citrus, Prope Citrus, Vitamin Water Tropical Citrus
Medications are a vital key in the treatment of many health conditions. To make sure the right dosage is being delivered to your body, make it a priority to find out if you need to avoid furanocoumarins (in all foods/drinks). Your PCP, pharmacist and registered dietitian are invaluable in this endeavor – review your medication list with each of them to determine the potential risk of interference by Furanocoumarins; your life may depend upon it!
Jennifer Giffune, R.D., L.D.N. is a freelance author, professional speaker and nutrition counselor. On the last Wednesday of each month, Jennifer can be heard on 89.5 WSKB radio on the “Wake up Wednesday Morning” Show. To make an appointment with Jennifer at Mercy Medical Group, call 786-1500.
* List made from multiple sources
