![]() Citrus trees had been planted casually by Europeans all over the West Indies, with hybrids springing up all over the place, and very little documentation of who planted what, and which mixed with which. The early days of the grapefruit are plagued by mystery. In fact, the grapefruit was first found a world away, in Barbados, probably in the mid-1600s. Grapefruit is a mix between the pomelo-a base fruit-and a sweet orange, which itself is a hybrid of pomelo and mandarin.īecause those base fruits are all native to Asia, the vast majority of hybrid citrus fruits are also from Asia. It’s a little bit like blending and reblending primary colors. Cross that sour orange with a citron and you get a lemon. Mix certain pomelos and certain mandarins and you get a sour orange. With the exception of those weirdos like the finger lime, all other citrus fruits are derived from natural and, before long, artificial crossbreeding, and then crossbreeding the crossbreeds, and so on, of those three fruits. Several others scattered around Asia and the South Pacific, including the caviar-like Australian finger lime, but those three citrus species are by far the most important to our story. Three citrus fruits spread widely: the citron, the pomelo, and the mandarin. The current theory is that somewhere around five or six million years ago, one parent of all citrus varieties splintered into separate species, probably due to some change in climate. The citrus family of fruits is native to the warmer and more humid parts of Asia. Hell, even the name doesn’t make any sense. Its journey started in a place where it didn’t belong, and ended up in a lab in a place where it doesn’t grow. Right from the moment of its discovery, the grapefruit has been a true oddball. That food was grapefruit, a seemingly ordinary fruit that is, in truth, anything but ordinary. “A food had never been shown to produce a drug interaction like this, as large as this, ever.” “The hard part about it was that most people didn’t believe our data, because it was so unexpected,” he says. Follow-up testing confirmed his findings, and today there is not really any doubt that he was correct. (For a more complete list, check 1989, David Bailey, a researcher in the field of clinical pharmacology (the study of how drugs affect humans), accidentally stumbled on perhaps the biggest discovery of his career, in his lab in London, Ontario. For laypersons who read my blog, I'll add the names under which these compounds are marketed. Interestingly, they repeated the experiment with ingestion of the actual grapefruit, with no resultant change in concentration or blood pressure.įor now, there are enough data to support the recommendation for banning grapefruit and grapefruit juice altogether from the diets of those on certain cardiovascular medications. There was no change in plasma concentration of the amlodipine, but the nifedipine concentration increased significantly and resulted in "short-lived" hypotension. In 2010, in Clinical and Experimental Hypertension, a report was published in which a hypertensive male was given 7 oz of grapefruit juice with nifedipine and later with amlodipine. It is uncertain as to whether the same concerns hold for ingesting the actual fruit as they do for the juice of the grapefruit. The latest report suggests that the effects can range from complete nullification of a drug effect as in clopidogrel to boosting the effects of the drug simvastatin to as much as 330% in the human bloodstream. Does ingesting a grapefruit amount to the same interaction as drinking the juice? It seems that the juice would represent a more toxic cocktail of furanocoumarins, which are the nasty little compounds found in grapefruit as well as Seville oranges and limes, that inhibit the concentration of cytochrome p450 3A4. I wish I'd known 20 years ago what I know now, but questions still linger. The grapefruit-juice "effect" can last up to 72 hours. With the latest information on drug-grapefruit interactions, depending on which medications he was taking, this was really bad advice. As Shakespeare would have aptly put it, "His countenance fell," because he loved grapefruit and loudly lamented he'd "greatly miss it." I told him to at least wait a few hours after he took his morning meds to partake of any components of the fruit. ![]() "It is probably better to just avoid grapefruit juice altogether," I said. I told him truthfully that I'd heard of a few case reports and some theories that floated around from time to time. A few years ago, a patient asked me if I knew anything about grapefruit juice and drug interactions. ![]()
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