ALLERGY, RESPIRATORY
Air Pollution May Raise Blood Pressure
Obesity May Raise Kids' Allergy Risk
Overweight Moms More Likely to Have Asthmatic Kids
ALTERNATIVE MEDICINE
Acupuncture May Not Help Hot Flashes
Grapefruit Compound Inhibits Hepatitis C Virus
Indian Spice May Thwart Liver Damage
ANIMAL CARE
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
Separation Anxiety, Canine-Style
'Comfort Dogs' Come to Emotional Rescue
BONES & JOINTS
Winter Is Tough on Feet
Backpack Safety Should Be on Back-to-School Lists
Alcohol Abuse Can Damage Bones
CANCER
Antioxidants Pose No Melanoma Threat
Gene Studies Reveal Cancer's Secrets
Multiple Screening Strategy Boosts Cervical Cancer Detection
CAREGIVING
Coordination Has Led to Quicker Heart Treatment
Tiniest Babies Carry Biggest Costs
Caregivers Face Multiple Strains Tending Older Parents
CIRCULATORY SYSTEM
Tai Chi and Qigong Offer Many Health Benefits: Review
Varicose Veins May Mask Larger Problem
Health Tip: Are You Anemic?
COSMETIC
New Genetic Links to Baldness Discovered
With Psoriasis, the Internet May Offer Hope
Study Evaluates Laser Therapies for Hair Removal
DENTAL, ORAL
Dental Implants Need More Work Than Root Canals
Toothbrushing May Stave Off Heart Woes
An Oral Approach to Heart Disease
DIABETES
Poor Blood Sugar Control After Heart Surgery Impacts Outcomes
24 Million Americans Had Diabetes in 2007
Lifestyle Factors Tied to Older Adults' Diabetes Risk
DIET, NUTRITION
The 3LS Wellness Program for Reversing Chronic Symptoms and Creating Lasting Health
Eating in America Still Unhealthy
Atkins Diet Tougher on Heart After Weight Loss
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Chemical in Plastics May Cause Fertility Problems
Hypertension May Hit Black Males Earlier
Ozone-Depleting Inhalers Being Phased Out
EYE CARE, VISION
Autistic Children Make Limited Eye Contact
Statin Drugs Cause Eye Disorders
When Corks Fly, Watch the Eyes
FITNESS
Diet, Exercise May Slow Kidney Disease Progression
Fitness Fades Fast After 45
Be Healthy, Spend Less
GASTROINTESTINAL PROBLEMS
New Guidelines Issued for Management of IBS
Soothing Imagery May Help Rid Some Kids of Stomach Pain
Japanese Herbals May Ease Gastro Woes
GENERAL HEALTH
Smog Tougher on the Obese
A Honey of a Sinusitis Treatment
Swine Flu Loves a Crowd
HEAD & NECK
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
Using Light Therapy to Silence Harmful Brain Activity
'Comfort Dogs' Come to Emotional Rescue
Save Your Aging Brain, Try Surfing The Web
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Soy Protein Doesn't Lower Cholesterol
Relaxation Tapes or Mozart Lower Blood Pressure
Obese People Seem to Do Better With Heart Disease
INFECTIOUS DISEASE
Swine Flu Now Reported in All 50 States
Grapefruit Compound Inhibits Hepatitis C Virus
Swine Flu Loves a Crowd
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Folic Acid Reduces Infant Heart Defects
Fussy Babys Could Be Out Of Your Control
Plastics Chemical Tied to Aggression in Young Girls
MEN'S HEALTH
Could Chinese Herb Be a Natural Viagra?
Low Vitamin D Levels May Boost Men's Heart Attack Risk
Eating Fast Until Full Triples Overweight Risk
MENTAL HEALTH
Estrogen May Help Men's Hearts
Environmental Chemicals May Affect Male Reproduction
Using the Mind to Heal the Heart
PAIN
Are We Exercising Pain Away? Not So Much.
Acupuncture, Real or Fake, Eases Back Pain
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Woman in America Are Delaying Motherhood, Study Says
Music of Mozart Soothes the Preemie Baby
Yoga's Benefits Outweigh Risks for Pregnant Women
SENIORS
Tai Chi May Help Ward Off Knee Pain in Seniors
Common Antioxidant Might Slow Parkinson's
Seniors Cope With Sleep Loss Better Than Young Adults
SEXUAL HEALTH
SLEEP DISORDERS
Sleeping Could Help Women Lose The Baby Fat
Moderate Aerobics May Ease Insomnia Symptoms
Lose Weight, Sleep Apnea May Improve
WOMEN'S HEALTH
Most Women With Osteoporosis Unaware of Raised Fracture Risk
How Much Fish to Eat While Pregnant?
Sleeping Could Help Women Lose The Baby Fat
Add your Article

Grapefruit-Heavy Diet Helped Spur Dangerous Clot

THURSDAY, April 2 (HealthDay News) -- A rare set of interactions involving grapefruit juice, birth control pills and a genetic mutation almost cost a 42-year-old woman her leg, physicians report.

"It started when she was driving in the car one afternoon," said Dr. Lucinda Grande, a recent medical school graduate who is doing her residency in family medicine at the Providence Hospital of St. Peter Health Care in Olympia, the largest health-care provider in the state of Washington. "Her leg became extremely painful, from the lower back to the ankle. She didn't think much of it, but the next morning, it turned purple."

The woman was seen by Grande when she went to the hospital emergency room. She was also seen by Dr. Richard Krug, a surgeon who recognized a limb-threatening situation.

"He had an ultrasound done, which confirmed that she had a large blood clot in her leg," Grande said. "Dr. Evert-Jan Verschuyl, an interventional radiologist, did a procedure where he was able to bust up the clot."

Verschuyl injected the powerful clot-dissolving tissue plasminogen activator (tPA) into the leg, and then placed a stent to keep blood flowing through the reopened vein. It was a seemingly casual remark that the woman made as she was leaving the hospital that led to her story being published in this week's issue of The Lancet.

"She just happened to mention that she had started a diet that had her eating grapefruit for breakfast for three days," Grande said. "I wondered if that contributed to the blood clot, so I did a little bit of thinking and reading."

It's well known that grapefruit has interactions with a number of drugs, Grande said. A reference book she consulted showed that grapefruit juice magnifies the effects of the estrogen in the birth control pill the woman was taking; one effect of estrogen is to increase the likelihood of clotting. The patient was advised to stop taking the pill.

Dr. Raul Mendez, another physician involved in the case, recommended a series of follow-up tests. One of them showed that the woman had the factor V Leiden mutation, which also increases the risk of blood clots.

So it was the combination of grapefruit juice, the estrogen in the birth control pill, the clot-inducing mutation and just sitting in the car in a position that narrowed the blood vessel, that threatened amputation of the leg, Grande said.

This means there is no great lesson for people in general from the episode, she said. "Grapefruit juice is not a threat to society at large," she said. "It is very healthy in most cases. I believe this was a unique situation, and it should not discourage people from eating grapefruit."

Still, it's best for someone who intends to embark on an unusual diet, such as one that includes a lot of grapefruit, to consult a doctor about possible interactions with any medications that the person might be taking, Grande said.

"You should consult a physician about any major change in lifestyle," she said.

Its not fair to blame the grapefruit for the woman's problem, said Dr. Alan Blum, a professor of family medicine at the University of Alabama. The effects of the long auto trip she took and the oral contraceptive she was taking would be "far greater risks for a deep vein thrombosis than a total of three grapefruits over three days," Blum said.

"The bottom line is that grapefruit remains a healthful, I'd even call it essential, food for the vast majority of people," he said. "The scary message from this case report, if widely disseminated, will do far more harm than good to public health."

-Ed Edelson

More information

Interactions between grapefruit juice and medications are described by the University of Florida.



SOURCES: Lucinda Grande, M.D., resident, Providence St, Peter Hospital, Olympia, Wash.; April 2, 2009, The Lancet

Last Updated: April 03, 2009

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