My mother-in-law has been visiting with us for the past few weeks. She remarked one day while peeling a mango how she felt as if she had a kindred spirit with citrus fruit, but was quick to also mention how disappointed she was to learn that she is no longer able to eat grapefruit. When asked why, she simply replied, “I’m on cholesterol medication.”
That wonderful, thick skinned, tangy yet sweet fruit that is also known as the forbidden fruit of
Enzymes called cytochromes metabolize many drugs such as statins. Most of these enzymes are concentrated in the liver, but some of them are found else where in the body such as in the gut. One cytochrome in particular called CYP3A4 is quite predominant in the small intestine and significantly participates in the breakdown of statins. Grapefruit can inhibit the activity of this intestinal cytochrome thereby increasing the level of statins in the blood stream. More drug can therefore lead to a higher risk of side effects. As little as 8 oz. of grapefruit juice can have a significant effect on drug levels. And, the effect of eating a single serving of grapefruit may last as long as 24 hours.
Fortunately, all is not lost for my mother-in-law. Mangos, oranges, and orange juice do not effect statin levels. Although other citrus fruits such as limes and