ALLERGY, RESPIRATORY
Childhood Food Allergies on the Rise
'Safe' Ozone Levels May Not Be for Some
Know Your Asthma Triggers
ALTERNATIVE MEDICINE
Holistic Treatment for Candida Infection
Naprapathy: A Hands-On Approach to Pain Management
Ginger Can Ease Nausea From Chemotherapy Treatments
ANIMAL CARE
Safe Toys for Dogs
Beware of Dog Bites
Separation Anxiety, Canine-Style
BONES & JOINTS
Hip Replacement Boosts Mobility at Any Age
Human Ancestors Put Best Foot Forward 1.5M Years Ago
Vitamin C Protects Some Elderly Men From Bone Loss
CANCER
Many Ignore Symptoms of Bladder Trouble
Omega-3 May Safely Treat Precancerous Bowel Polyps
Scams and Shams That Prey on Cancer Patients
CAREGIVING
Rapid Infant Weight Gain Linked to Childhood Obesity
What Moms Learned May Be Passed to Offspring
With Alzheimer's, Health-Care Costs Could Triple
CIRCULATORY SYSTEM
Salt Boosts Blood Pressure in High-Risk Patients
Migraines in Pregnancy Boost Vascular Risks
Drink a Little Wine, Live a Little Longer
COSMETIC
Contact Lenses Boost Kids' Self-Image
Wrinkle Fillers Need Better Label Warnings: FDA Panel
The Acne Drug Accutane More Than Doubles Depression Risk
DENTAL, ORAL
Hormones May Be to Blame for Women's Cavity Rates
Acupuncture May Ease Anxiety Over Dental Work
Obesity Boosts Gum Disease Risk
DIABETES
Patients' Photos Help Boost Radiologists' Accuracy
Findings Challenge Tight Glucose Control for Critically Ill Patients
Americans Consuming More Sugary Beverages
DIET, NUTRITION
The Food Irradiation Story
DASH Diet Has Extra Benefits for Women's Health
Compound in Berries May Lessen Sun Damage
DISABILITIES
Could Your Cell Phone Help Shield You From Alzheimer's?
Review Finds Marijuana May Help MS Patients
ENVIRONMENTAL HEALTH
Short-Term Air Pollution Exposure May Damage DNA
Chemical in Plastics May Cause Fertility Problems
Green Areas Lower Health Inequities Between Rich, Poor
EYE CARE, VISION
Kids Who Spend More Time Outdoors Have Better Vision
Drinking Green Tea May Protect Eyes
Too Much Sun, Too Few Antioxidants Spell Eye Trouble
FITNESS
Any Exercise Good After a Heart Attack
You Can Get Great Exercise In The Garden
Higher Fitness Levels Tied to Lower Heart, Death Risks
GASTROINTESTINAL PROBLEMS
Gum Chewing May Speed Colon Surgery Recovery
Japanese Herbals May Ease Gastro Woes
Traditional Nonsurgical GERD Treatments Not Impressive
GENERAL HEALTH
Adults Need To Get Thier Food Facts Straight
Lose Weight, Sleep Apnea May Improve
Want Sun Protection? Wear Red or Blue
HEAD & NECK
Ski Helmets Encouraged for All
Many Children Will Outgrow Headaches
Zen May Thicken Brain, Thwart Pain
HEALTH & TECHNOLOGY
E-Mailing Your Way to Healthier Habits
The Internet Is Becoming One-Stop Shopping for Health Help
Study Suggests Link Between Cell Phones and Brain Tumors
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Exercise May Blunt Salt's Effect on Hypertension
Quitting Smoking Doubles Survival in Early Stage Lung Cancer
Implanted Defibrillators Boost Long-Term Survival
INFECTIOUS DISEASE
Bacterial Infections May Succumb to Honey
Hand Washing 10 Times a Day May Help Keep Flu Away
Surgical Masks Could Prevent Flu, Maybe
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Combo Treatment Eases Wheezing in Babies
Don't Leave Your Kids In The Car !
St. John's Wort Doesn't Work for ADHD
MEN'S HEALTH
Exercise May Prevent Prostate Cancer: Study Shows
Whole Grains, Bran May Fight Hypertension in Men
Strenuous Daily Workout May Keep Cancer at Bay
MENTAL HEALTH
Keeping Mentally Active Seems To Keep The Brain Active
The Unmedicated Mind
Positive Brain Changes Seen After Body-Mind Meditation
PAIN
Acupuncture, Real or Fake, Eases Back Pain
'Cell Phone Elbow' -- A New Ill for the Wired Age
Tai Chi May Help Ease Fibromyalgia
PHYSICAL THERAPY
PREGNANCY
Obesity May Affect Fertility in Young Womene
Calcium Supplements Cut Blood Lead Levels During Pregnancy
Yoga's Benefits Outweigh Risks for Pregnant Women
SENIORS
Seniors Cope With Sleep Loss Better Than Young Adults
A Little Alcohol May Stave Off Alzheimer's
Memory Loss Help from Brain Supplement Prevagen
SEXUAL HEALTH
SLEEP DISORDERS
Moderate Aerobics May Ease Insomnia Symptoms
Exercising Throat Muscles May Relieve Sleep Apnea
Pay Attention to Signs That Say You're Too Fatigued to Drive
WOMEN'S HEALTH
Women Smokers Lose 14.5 Years Off Life Span
Varicose Veins May Mask Larger Problem
Spice Compounds May Stem Tumor Growth
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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