Grapefruit juice found to give cancer treatment a boost

[Celebration]

http://www.physorg.com/news169152201.html

This spring, at the American Association for Cancer Research's 100th annual meeting in Denver, Cohen presented early results finding that drug levels in patients taking rapamycin once a week and drinking 8 ounces of grapefruit juice every day were similar to the levels that would be expected from taking the drug daily without juice.

snip.........

However, not just any grapefruit juice will work. The grocery-store grapefruit juice Cohen initially used did not cause an increase of the rapamycin levels in the blood. "We were scratching our heads trying to figure out what was wrong," he said.

By a stroke of luck the Florida Department of Citrus saw a report about Cohen's work on television. The department contacted Cohen and told him the key chemicals in grapefruit juice have a short shelf-life and can break down during the time it takes to process and sell the juice.

[dixiegrrrrl]

1. Goes to show fresh vs, procesed fruit is lmuch better for you.

Pomegranate is very similar to grapefruit juice, I read. And people on beta blockers have the same issues with it as with grapefruit juice.

[supernova]

2. pasturized juice

sits in containers for up to a year before being packaged for sale and shipped to a grocery store where you can buy it.

I'm not surprised that fresh-squeezed gives the benefit and prepackaged does not.

[boris the spider]

7. That's not it! The enzymes are killed when you heat juice to such a high temp!

It's a mind-blower that the researcher said they were 'scratching their heads' about it, trying to figure out what had changed in the juice when it was boiled.

One...two...three...DUH!!!!!!!!!!!!!!!!:rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :rofl: :woohoo: :woohoo: :woohoo:

(And silly little me, not working at U of Chicago and all...:eyes: :eyes: :eyes: :eyes: )

[Davis_X_Machina]

3. Pity the poor people taking statins...

...who can't drink grapefruit juice.

[trotsky]

4. Same effect is responsible.

In some cases (such as this), it helps. In others, it definitely harms.

[Celebration]

5. why not try the same thing with statins?

Take statins once a week, eat fresh grapefruit juice the other six days. See what happens. Might cut into some drug profits if it works.

[trotsky]

6. Because grapefruit juice isn't an ALTERNATIVE to statins (or cancer treatment).

It affects the absorption of medicine. In the case of the cancer treatment in your OP, this is a good thing. In the case of statins, it's bad.

http://cholesterol.about.com/od/statindrugs/a/grapefruitstat.htm

[Celebration]

9. Ummm

They whole reason it works with cancer treatment is that there is greater absorption when grapefruit juice is ingested.

Same principle!

It would probably be deadly to take grapefruit with cancer drugs, too, except the dosage is dramatically reduced.

The same principle could be tried with statin drugs--lower statin drugs, but increase absorption by taking grapefruit juice.

It may or may not work, but if it worked for cancer drugs, it would seem it could at least be tried.

[trotsky]

10. Read my link.

It should help you understand the specific difference in this case.

[Celebration]

11. I did

per the article

"Grapefruit contains the compound bergamottin, which interacts with certain enzyme systems in the body, such as cytochrome P-450 and P-glycoprotein. These enzyme systems are responsible for breaking down statins, as well as other drugs, into more usable chemicals and transporting them in the body.

When grapefruit juice is consumed at or around the time you take your statin, the components in grapefruit prevent these enzyme systems from breaking down the drug, causing the drug to accumulate in high amounts in the body. This can be very dangerous and can cause a variety of health problems, such as liver damage or a rare condition called rhabdomyolysis (severe muscle and kidney damage)."

The drug accumulates in high amounts when you eat grapefruit. Thus it would seem possible to use fresh grapefruit and take a smaller dose of medication. It isn't proven of course, but would be worth exploring the possibility......

[trotsky]

12. Yep, you read it, but you obviously don't understand it.

Oh well. Good luck with your grapefruit juice.

[Celebration]

13. LOL, you should read THIS

http://drugs.about.com/od/medicationabcs/a/gjuice_drugs.htm

The way grapefruit can affect over 50 different medications is essentially the same mechanism, whether it is a cancer drug or an asthma drug.

How Does Grapefruit Juice Affect Medications?
The cells that line your small intestine contain an enzyme called CYP3A4. This enzyme helps break down dozens of medications. Certain substances in grapefruit juice inhibit CYP3A4 and hence allow more of a medication to enter your blood stream.

Now that it has been shown that the dosage of a cancer drug can be dramatically reduced by using fresh grapefruit juice, it is time to see if other drugs affected by the same mechanism in grapefruit juice can also be reduced to a once a week dosage.

Now that would be a health care plan!!

Most medications do not interact with grapefruit juice. However, grapefruit juice does have an effect on more than 50 drugs, including some medications for the treatment of:

Abnormal heart rhythm
Allergies
Anxiety
Asthma and COPD
Blood clots
BPH (enlarged prostate)

Cancer

Cough
Depression
Epilepsy
Erectile dysfunction
Heart disease
High blood pressure

High cholesterol

HIV/AIDS
Hormonal conditions
Infection-viral, bacterial and fungal
Pain

[trotsky]

14. Good grief, I was hoping you'd get it by now.

But I suppose I have to spell it out.

Yes, the mechanism is the same. The chemical in grapefruit juice prevents the digestive system from breaking down as much of the drug, meaning more enters the bloodstream.

In the case of the anti-cancer drug, this is a good thing and does not appear to be harmful because higher levels of the drug are tolerated by the body and "spaced out" over the course of a week.

In the case of statins, this is a BAD thing because the body cannot tolerate the high initial level of the drug to start with.

Your experiment would result in people suffering severe liver damage.

Do you understand now?

[Celebration]

15. Heh, there is a company looking to capitalize on all this

The truth is that we don't know how this would affect each and every drug at this time. "My experiment" is non existent. I would not advocate people experimenting with this on their own--only as part of a controlled experiment.

http://scienceblogs.com/terrasig/2007/11/grapefruit_juice_as_a_drug_boo.php

Even this cautionary science blog person feels that there should be well designed experiments with this approach.

It looks like the first controlled experiment with this approach worked fine. I think it is time for some more.

[trotsky]

16. Your original quote: "why not try the same thing with statins?"

Simple answer: because in the specific case of statins, we know it causes liver damage.

You have spent this entire subthread obfuscating, backing off, and changing the subject - your usual SOP when you're caught making a ridiculous assertion. At least you realize your error.

And your link to the "cautionary science blog person" includes this important caveat:

And this is where I am most concerned. Some CYP3A4 substrates have a very narrow window between their therapeutic concentrations and their toxic concentrations. Fiddling with CYP3A4 may lead to unpredictable increases in drug concentrations to a point that mimics getting an overdose of drug.

Which is what happens with statins.

[Celebration]

17. sure, but in reference to STUDIES

Good grief, the OP is about a controlled scientific study. So, why not try it with other drugs? Of course!! They should!!! "It" was a controlled scientific study, as was referenced in the OP!! I even said "same thing", which of course would be the same thing as in the OP using other drugs and this technique.

SAME THING!!!

You notice that people did NOT try manipulating their cancer drugs by themselves.

[trotsky]

18. Because we've already studied this effect with statins.

We know that drinking grapefruit juice with statins causes harm.

Your original question then - "why not try the same thing with statins?" - is answered with "We have, and it has been found to cause serious damage and injury."

I'll repeat: You have spent this entire subthread obfuscating, backing off, and changing the subject - your usual SOP when you're caught making a ridiculous assertion. I'm enjoying laughing at you, if you want to continue. Otherwise you might want to just let it go - unless you'd like to humiliate yourself even more, 'cause I'm game.

[Celebration]

19. so, what studies have been done

Which give the subjects fresh grapefruit juice every day, with only one dose per week of a statin drug?

Obviously, we know that it is dangerous to give the full, usual amount of a statin drug with fresh grapefruit juice.

And, no, I have not been obfuscating at all-- it seems like a good idea to try the same approach as outlined in the OP, with other drugs that interact with grapefruit juice. As it happens there is a company trying to capitalize on that, so obviously some scientific type people agree that it is worth trying. Whether it works in the case of one particular type of drug or not is not known until it is tried.

But perhaps you know of a study regarding using 1/7 the usual amount of statin drug plus grapefruit juice. If so, and it was harmful, then we can cross that one off the list and try it with other drugs. But I would love to see the results of the trial, if you have them.

[trotsky]

20. What part of this don't you understand?

Some CYP3A4 substrates have a very narrow window between their therapeutic concentrations and their toxic concentrations. Fiddling with CYP3A4 may lead to unpredictable increases in drug concentrations to a point that mimics getting an overdose of drug.

Statins would be one of those drugs with a very narrow window. I am sorry you do not understand the science behind this, instead believing that the shotgun approach is the best way to run experiments. People would suffer in your experiment.

[Celebration]

21. I asked a simple question

You are unable to cite a study.

Why wouldn't a cancer drug have that same "narrow window"? And since when would temporarily cutting the dosage of a drug like a statin to 1/7 of the normal dosage be dangerous, given that blood levels could be done as often as necessary in a study?

You stated that there had already been such a study showing that this would be dangerous. The statement you quoted is speculative, as admitted by the author, who actually called for more studies!

Unfortunately you have not provided any information requested, leading me to believe that you are relying on studies showing that grapefruit juice is dangerous with a REGULARLY PRESCRIBED amount of statins, not a very reduced amount of statins.

[trotsky]

23. You asked a question that's already been answered.

There is a much finer line between a "safe dose" of statins and an OVERDOSE of statins. Drugs differ in their toxicity levels, how much the body can tolerate at one time. DO YOU UNDERSTAND THIS? I refuse to go any more until you answer in the affirmative.

[Celebration]

24. So what?

All that means is that statins have to be prescribed very carefully. Are they? Does that same thing apply to cancer drugs? ANSWER ME. Doesn't everything have to be prescribed carefully? ANSWER ME. Do you understand this? I refuse to go any further until you answer in the affirmative.

Sure, statins have a narrow window (affirmative). But, that means they have to be prescribed very carefully. Also, that means that grapefruit plus statins has to be prescribed very carefully.

I like careful.

Most likely cancer drugs have to be prescribed carefully as well. I certainly hope you agree.

[trotsky]

25. Well, since you refused to answer my question, I guess that's it.

Thanks for playing along and humiliating yourself once again! It's been fun!

[Celebration]

26. yeah right (sarcasm)

"Sure, statins have a narrow window (affirmative). But, that means they have to be prescribed very carefully. Also, that means that grapefruit plus statins has to be prescribed very carefully."

[unc70]

27. You are you being so deliberately "dense". Are you trying to get someone killed?

The problems with grapefruit have been known for some years, widely discussed by the Graedons at The Peoples Pharmacy and by others. One of the problems with what you are promoting (for example, stretching Liptor with the help of grapefruit juice)is very difficult to regulate because of inconsistency of "dosage" from one glass of juice to the next. The downside risk could be death.

Recent studies indicate a nearly-identical effect from pomogranites.

[Celebration]

28. All I am advocating

Is a controlled study, as was done with the cancer drug. Why would these same inconsistencies not have affected the cancer drug?

I assume, from the point of view of consistency, that you would have opposed the study on the cancer drug as well, which, of course, turned out very favorably.

[trotsky]

29. Because the cancer drug has a different metabolic and toxicologic profile than statins!

You really don't understand, that's what's sad here.

[unc70]

30. There may be no ethical way to do that clinical trial with human subjects

As Trotsky tried to explain, we already know a lot about these drugs, how much and how quickly they pass from digestive to blood and other organs, how long they remain in the body. Most statins have relatively small dosage levels where they are both safe and effective while maintaining an adequate safety margins to compensate for variability among patients and to tolerate errors where a dose was missed or doubled.

For most statins, the grapefruit effect is many times greater than the already tight safety margins.

We already have the data on absorption rates and such for approved drugs and considerable data on the grapefruit effect on various statins. The risks are at unacceptable levels to even consider for a clinical trial of this type.

Remember that patients taking statins almost always are taking medications for other conditions. We know a lot about drug interactions when used in combination (and which should not be used together). Suppose you were on you Lipitor+grapefruit dosing and now needed medication for another condition. Not only are those also grapefruit sensitive not allowed, you really don't know how this might affect interactions with the statins.

The ethics of a long-term clinical trial with significant risk of increased side effects, even death, with outcomes no better than current treatment, with the only "benefit" being reduction in drug costs (probably offset by treating side effects) preclude even considering things like this.

A better strategy would be to ensure that generic versions of Lipitor are available when the current patent expires, and that they are rigorously tested because it is very important to maintain strict equivalency and high quality manufacturing.

I hope that this adequately explains why no further study is needed. While you might personally decide to take this risk, a doctor's active participation borders on malpractice.

Please don't take this risk.

[Celebration]

31. if grapefruit affects statins so MUCH

that even a controlled trial with safety standards is too dangerous to undertake, I wonder if the statins themselves might be considered to be too dangerous to take, as it may be likely, or at least possible, that people would encounter the grapefruit type substances inadvertently in their diets, putting them at severe risk.

It sounds like you are giving a good reason to avoid the drugs in the first place, and maybe try other methods to lower cholesterol, if needed.

[iverglas]

8. one caveat

Patients receiving radiation therapy are advised to abstain from acidic foods (and sugar). Mouth sores and infection are a risk.

So if anyone this could benefit is getting radiation at some stage as well, they would have to be careful to follow different regimes. ;)

[lovecanada56035]

22. I guess it's time to stock up

Though I don't really care for grapefruit juice myself.