- ALLERGY, RESPIRATORY
- Air Quality Better in Northeast, Midwest
- Folic Acid Might Offer Allergy Relief
- Obesity May Raise Kids' Allergy Risk
- ALTERNATIVE MEDICINE
- New Insights Show Ginseng Fights Inflammation
- Licorice May Block Absorption of Organ Transplant Drug
- Quit Smoking the Holistic Way
- ANIMAL CARE
- Separation Anxiety, Canine-Style
- Animals Respond to Acupuncture's Healing Touch
- 'Comfort Dogs' Come to Emotional Rescue
- BONES & JOINTS
- Alcohol Abuse Can Damage Bones
- Tai Chi May Help Ease Fibromyalgia
- Put Your Best Foot Forward Next Year
- CANCER
- Vitamin D May Improve Melanoma Survival
- Breast Self-Exam Rates Go Up With Counseling
- Quitting Smoking Doubles Survival in Early Stage Lung Cancer
- CAREGIVING
- UV Lights, Fans May Curb TB Spread in Hospitals
- MRSA Infections Spreading to Kids in Community
- Preventing Shaken Baby Syndrome
- CIRCULATORY SYSTEM
- Bad Marriages Harder on Women's Health
- Anemia Rates Down for U.S. Women and Children
- Exercise Extends Life of Kidney Patients
- COSMETIC
- Science May Banish Bad Hair Days
- Wrinkle Fillers Need Better Label Warnings: FDA Panel
- Mouse Study Finds Molecule That Tells Hair to Grow
- DENTAL, ORAL
- A Sweet Way to Shield Baby's Teeth
- Mom's Vitamin D Levels Affect Baby's Dental Health
- Sports Drinks May Be Tough on Teeth
- DIABETES
- Chamomile Tea May Ward Off Diabetes Damage
- Lifestyle Factors Tied to Older Adults' Diabetes Risk
- Americans Consuming More Sugary Beverages
- DIET, NUTRITION
- B Vitamins Might Lower Stroke Risk
- Purple Tomato Extended Lives of Cancer-Prone Mice
- Adding Garlic Might Cut Cancer Risk
- DISABILITIES
- Review Finds Marijuana May Help MS Patients
- Could Your Cell Phone Help Shield You From Alzheimer's?
- ENVIRONMENTAL HEALTH
- Lead Exposure in Childhood Linked to Criminal Behavior Later
- Accumulated Lead May Affect Older Women's Brains
- Global Warming Biggest Health Threat of 21st Century, Experts Say
- EYE CARE, VISION
- Clues Found to Brain Mechanism Behind Migraines
- Eye Problems, Hearing Loss May Be Linked
- Blood Sugar Control Helps Diabetics Preserve Sight
- FITNESS
- Vigorous Treadmill Workout Curbs Appetite Hormones
- Maximize Your Run
- Early Exercise Boosts Outcomes for ICU Patients
- GASTROINTESTINAL PROBLEMS
- HRT Use Raises Risk of Stomach Trouble
- New Guidelines Issued for Management of IBS
- Bowel Prep Harder on Women Than Men
- GENERAL HEALTH
- The Yearly Flu Shot Debate
- Parents Influence Sex Decisions, Hispanic Teens Say
- 'Cell Phone Elbow' -- A New Ill for the Wired Age
- HEAD & NECK
- Ski Helmets Encouraged for All
- Many Children Will Outgrow Headaches
- Zen May Thicken Brain, Thwart Pain
- HEALTH & TECHNOLOGY
- Using Light Therapy to Silence Harmful Brain Activity
- The Internet Is Becoming One-Stop Shopping for Health Help
- Combating Myths About Seasonal Allergies
- HEART & CARDIOVASCULAR
- Research Shows Genetic Activity of Antioxidants
- Review Confirms Links Between Diet, Heart Health
- Fatty Fish May Cut Heart Failure Risk in Men
- INFECTIOUS DISEASE
- Surgical Masks Could Prevent Flu, Maybe
- Grapefruit Compound Inhibits Hepatitis C Virus
- Hand Washing 10 Times a Day May Help Keep Flu Away
- KID'S HEALTH
- Working Intensely Early on May Help Autistic Kids
- Scary Toxins Make Halloween Face Paints Questionable
- More Calcium And Dairy Products in Childhood Could Mean Longer Life
- MEN'S HEALTH
- Could Chinese Herb Be a Natural Viagra?
- Lots of Sex May Prevent Erectile Dysfunction
- Countdown to Hair Loss
- MENTAL HEALTH
- Fear Response May Stem From Protein in Brain
- The 3LS Wellness Program for Reversing Chronic Symptoms and Creating Lasting Health
- Breast-Fed Baby May Mean Better Behaved Child
- PAIN
- Alleviating Rheumatoid Arthritis
- Acupuncture, Real or Fake, Eases Back Pain
- 'Cell Phone Elbow' -- A New Ill for the Wired Age
- PREGNANCY
- Pre-Pregnancy Weight Linked to Babies' Heart Problems
- Calcium Supplements Cut Blood Lead Levels During Pregnancy
- Mom's Extra Pregnancy Pounds May Raise Child's Heart Risks
- SENIORS
- Memory Loss Help from Brain Supplement Prevagen
- Life Expectancy in U.S. Hits New High
- Seniors Who Volunteer May Live Longer
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Grapefruit-Heavy Diet Helped Spur Dangerous Clot
By eHolistic.com Published: 04/02/2009
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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