ALLERGY, RESPIRATORY
Herbal Remedy Could Halt Peanut Allergy
Air Pollution May Raise Blood Pressure
Traffic, Dust Linked to Asthma in Kids
ALTERNATIVE MEDICINE
Acupuncture Cuts Dry Mouth in Cancer Patients
When Healing Becomes a Commodity
U.S. Spends Billions On Alternative Medicine
ANIMAL CARE
Animals Respond to Acupuncture's Healing Touch
'Comfort Dogs' Come to Emotional Rescue
Separation Anxiety, Canine-Style
BONES & JOINTS
Scientists ID New Genes Tied to Crohn's Disease
Extra Pounds in Mid-Life Affect Later Mobility
Soccer's a Winner for Building Bone Health in Girls
CANCER
Mineral May Reduce High-Risk Bladder Disease
Vitamin E, Selenium and Soy Won't Prevent Prostate Cancer
Multiple Screening Strategy Boosts Cervical Cancer Detection
CAREGIVING
ER Less Likely to Diagnose Stroke in Younger Folks
More Than 60,000 Patients Risked Hepatitis Infections
Late-Life Fatherhood May Lower Child's Intelligence
CIRCULATORY SYSTEM
Secondhand Smoke Quickly Affects Blood Vessels
Migraines in Pregnancy Boost Vascular Risks
An Apple a Day May Help Keep Heart Disease Away
COSMETIC
With Psoriasis, the Internet May Offer Hope
Gum Chewing May Cut Craving for Snacks
Get Sugared!.... Its a sweet choice for hair removal
DENTAL, ORAL
Holistic Dentistry-My View
Health Tip: At Risk for Gingivitis
Gum Disease Might Boost Cancer Risk
DIABETES
Doctors Urged to Screen Diabetics for Sleep Apnea
Whole Grains Take a Bite Out of Type 2 Diabetes Risk
Saliva Test Could Monitor Type 2 Diabetes
DIET, NUTRITION
Most Fast-Food French Fries Cooked in Unhealthiest Oil
Common Antioxidant Might Slow Parkinson's
'Organic' May Not Mean Healthier
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Global Warming May Bring More Respiratory Woes
Years of Exposure to Traffic Pollution Raises Blood Pressure
Gas Stove Emissions Boost Asthma in Inner-City Kids
EYE CARE, VISION
Gene-Transfer Proves Safe for Vision Problem
Certain Diabetes Drugs May Pose Eye Risk
When Corks Fly, Watch the Eyes
FITNESS
Walking Golf Course Affects Swing, Performance
Early Exercise Boosts Outcomes for ICU Patients
As Temperature Plummets, It's Still Safe to Exercise
GASTROINTESTINAL PROBLEMS
Bowel Prep Harder on Women Than Men
Intestinal Bacteria Trigger Immune Response
Olive Oil May Protect Against Bowel Disease
GENERAL HEALTH
'Cell Phone Elbow' -- A New Ill for the Wired Age
A Little Alcohol May Stave Off Alzheimer's
Heal Your Life® Tips for Living Well
HEAD & NECK
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
'Comfort Dogs' Come to Emotional Rescue
Magnet Therapy May Ease Hard-to-Treat Depression
Imaging Sheds Light on How Acupuncture Works
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Fish Oil Supplements Help With Heart Failure
Coffee Is Generally Heart-Friendly
Chinese Red Yeast Rice May Prevent Heart Attack
INFECTIOUS DISEASE
More Medicinal Uses for Pomegranate
Swine Flu Is Now a Pandemic Says W.H.O.
Hand Washing 10 Times a Day May Help Keep Flu Away
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Pool Chemicals Raise Kids Allergy, Asthma Risk
Many Children Will Outgrow Headaches
Treat Kids to a Safe Halloween
MEN'S HEALTH
More Vitamin C May Mean Less Chance of Gout
Physical Activity May Prolong Survival After Colon Cancer
Eating Fast Until Full Triples Overweight Risk
MENTAL HEALTH
The 3LS Wellness Program for Reversing Chronic Symptoms and Creating Lasting Health
Love Hormone May Ease Discussion of Painful Topics
Chocolate a Sweet Pick-Me-Up for the Depressed
PAIN
Tai Chi May Help Ease Fibromyalgia
Acupuncture, Real or Fake, Eases Back Pain
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Yoga's Benefits Outweigh Risks for Pregnant Women
Pregnant Women Exposed To Certain Pollutants Could Lower Childs IQ
Acupuncture May Ease Depression During Pregnancy
SENIORS
Eating Well And Keeping Active As You Grow Old Will Help You Stay Sharp
Exercise Benefits Even the Oldest Old
Could Your Cell Phone Help Shield You From Alzheimer's?
SEXUAL HEALTH
SLEEP DISORDERS
Pay Attention to Signs That Say You're Too Fatigued to Drive
Better Sleep, Grades Seem to Go Up
Lose Weight, Sleep Apnea May Improve
WOMEN'S HEALTH
Health Tip: Be More Comfortable During Childbirth
Iodine in Prenatal Vitamins Varies Widely
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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