Content Sources:
[1] Xue Jing. Don't eat grapefruit when taking hypolipidemic drugs[N].Health Times,2007-11-01(019).
[2] Luo Qin. Be vigilant about eating grapefruit to eat "muscle dissolution"[J].Family Medicine,2024,(01):39.)
[3] Hu Huajun. Nine types of common drugs react with food[J].Fortune World,2021,(05):72-73.)
The pomelo in autumn fruits is loved by people, but for patients taking hypolipidemic drugs, grapefruit has become a minefield that cannot be stepped on, why is this? It turns out that many lipid-lowering drugs in clinical practice belong to statins, and the principle of this class of drugs is mainly to prevent cardiovascular and cerebrovascular diseases by reducing the concentration of cholesterol in the blood.
However, the active ingredient in grapefruit can increase the concentration of statins in the blood, which naturally enhances the toxic side effects of the drug, which may cause dizziness, nausea, tachycardia and various adverse reactions of the body, and in severe cases, it may even lead to liver and kidney failure.
Liu Caidong, 47, who lives in Hainan, is the owner of a hotel. Every time the peak season comes, Liu Caidong is so busy that his feet don't touch the ground, and in order to save labor costs, he often sits at the front desk on duty. Liu Caidong doesn't have any bad habits, he likes to drink some wine on weekdays, play cards with friends, and order a few side dishes, and his life is full and nourishing.
On April 16, 2022, when Liu Caidong was cleaning up his room at home, he suddenly felt a little dizzy in his head and a little inexplicably flustered.
With the progress of time, Liu Caidong often feels some chest tightness, some insomnia and fatigue, and sometimes feels some numbness in his fingers.
On June 23, Liu Caidong was on duty at the front desk, and after he helped the guests register their information, he saw that people were still standing in front of him and did not leave. Liu Caidong couldn't help but be a little puzzled, but the guest reminded him of the "room card", and he realized that he forgot to give the card again. These days, he often suffers from this forgetfulness.
Liu Caidong raised his hand and pressed his temples, inexplicably felt very tired, he was just about to stand up and go to get a cup of warm water to drink, but just after walking two steps, suddenly a tingling sensation hit his chest, so painful that his face was wrinkled together, and he was covered in cold sweat, and almost fell to his knees directly. Only then did he realize that something was wrong with his body, so he hurriedly called his wife and asked her to take him to the hospital.
Soon, Liu Caidong came to the hospital for registration. After blood routine, biochemistry, electrocardiogram and other imaging examinations, the results showed that Liu Caidong's total cholesterol value was 9.80mmol/L, and the low-density lipoprotein value was 5.2mmol/L.
Knowing that he was diagnosed with heart disease and hyperlipidemia at once, Liu Caidong was stunned. He doesn't eat any big fish and meat on weekdays, he doesn't even smoke, he likes to drink some alcohol, how did he get this cardiovascular disease? After asking Liu Caidong about his daily eating habits, the doctor found that he loved to eat egg yolks, fish roe, crabs, shellfish and other foods.
However, these foods happen to contain higher levels of cholesterol, an egg yolk has about 200 mg of cholesterol, and 100 grams of fish roe contains about 400 mg of cholesterol, which is even higher than the content of animal offal such as pork liver.
After listening to the doctor's popular science, Liu Caidong suddenly realized that his hyperlipidemia was really eaten. The doctor prescribed him rosuvastatin and other drugs to lower blood lipids to control his condition, and told him to pay attention to a light, low-fat diet in the future. Before leaving, the doctor also made a point of emphasizing that statins should not be consumed with foods such as grapefruit.
Liu Caidong didn't understand a little, didn't he say a light diet, so wouldn't it be better for him to eat more fruits, why can't he eat grapefruit? The doctor patiently explained that taking statins and grapefruit together will cause an increase in the blood concentration in the body, which is equivalent to overdosing, which will cause various uncomfortable reactions in the body, and in severe cases, it will also produce toxic side effects such as muscle soreness and damage to kidney health.
Hearing this, Liu Caidong was startled, and then he realized that poisoning reactions would occur if the drug was not used properly. The doctor added that after drinking grapefruit juice, the effect on the blood concentration of the body will last for about 3~7 days, so he is advised not to eat grapefruit for 3 days before and for a period of time after taking the medicine. Liu Caidong nodded, indicating that he remembered.
After a period of taking medicine, Liu Caidong's physical discomfort has improved a lot, he carefully followed the doctor's instructions to take medicine on time, and he didn't dare to touch the fruit of grapefruit, and when he went back to the hospital for a follow-up, his blood lipids really dropped a lot. Liu Caidong was very happy in his heart, thinking that after a while, it was estimated that his blood lipids would almost recover.
However, the accident came quickly, on November 9, when Liu Caidong got up in the morning, he suddenly felt a little sore, and he was a little tired and weak, and he couldn't get up from bed for a long time. He thought that his body was cold because he had a cold last night, and he didn't think much about it, so he got up and washed up after eating breakfast, and planned to have breakfast for a while and go to the store to have a look.
As a result, when brushing his teeth at the washstand, Liu Caidong suddenly felt a tumult in his stomach, and spit out some yellow sour water, and his legs suddenly became weak, and he didn't even have the strength to stand. Seeing that his face was pale and his forehead was covered with cold sweat, his wife asked him to rest at home for a day today. Liu Caidong frowned, feeling that it was not a big deal, and just wanted to refuse, but as soon as he walked out of the toilet, he fell directly to the ground at once. The wife was startled, and hurriedly stepped forward to help, and quickly took a taxi to send someone to the hospital for examination.
The results showed that the creatine kinase (CK) value was 1520 U/L, which was significantly elevated, far exceeding the normal value, indicating muscle lysis. The hospital finally diagnosed Liu Caidong with rhabdomyolysis.
Typically, creatine kinase also increases in some amount after strenuous exercise, and the longer the exercise, the more pronounced the increase in creatine kinase becomes. However, Liu Caidong was unwell early in the morning and did not do strenuous exercise, and the doctor suspected that he was caused by improper medication, and after questioning, it was found that he was taking rosuvastatin.
The doctor asked Liu Caidong if he had eaten grapefruit, but Liu Caidong shook his head, saying that the doctor had told him that he could not take statins and grapefruit foods, and he did not dare to touch grapefruit and citrus, and he had quit smoking and drinking. The condition suddenly fell into a mystery, and the doctor knew that if the real cause of his muscle dissolution was not found out this time, he might have this critical situation next time.
In order to find out the truth of Liu Caidong's condition, the doctor carefully inquired about his eating habits, and finally solved the case! The doctor was shocked: "How can you step on the thunder so accurately?" Although your diet may seem healthy, the three foods you eat regularly are also 'natural enemies' of the statin audience. In fact, in addition to grapefruit, these 3 foods that most people love to eat bring far more serious side effects than grapefruit. Many patients who take lipid-lowering drugs only know that they can't eat grapefruit, but they don't know that these things should also be consumed less! ”
The first category of food is mangoes
Mango is a nutritious food, but it contains a certain amount of tannic acid, which will inhibit the absorption of the drug by the gastrointestinal tract, resulting in reduced efficacy, and some ingredients in mango may also cause skin itching, erythema, allergies and other reactions. Specific enzyme components in mango can interfere with the absorption of statins, affecting blood levels and efficacy. It is rich in vitamin K to promote blood clotting, statins have anti-platelet aggregation effect, when the two are used together, it may induce the occurrence of adverse drug reactions, lead to metabolic disorders in the body, and affect the lipid-lowering effect of statins.
The second category of food is red yeast rice products
Red yeast rice is a common Chinese herbal medicine, which has the effect of promoting blood circulation and removing blood stasis, dissolving turbidity and lowering lipids, strengthening the spleen and eliminating appetite, and is often used to treat dietary stagnation, abdominal distension and other conditions. And Liu Caidong heard that red yeast rice can regulate blood lipids, and eating it is good for the body, so he bought a large amount of red yeast rice to cook porridge, and also bought red yeast rice health products to eat.
However, red yeast rice itself also contains similar pharmacological effects to statins, and when used at the same time, it will cause patients to have a rapid decrease in blood lipids, increase the concentration of blood drugs in a short period of time, and interact with each other, resulting in a significant increase in the probability of adverse reactions such as muscle damage and headaches, and finally triggering the toxic side effects of drugs.
The third food group is avocados
Avocado, also known as avocado, is rich in unsaturated fatty acids, proteins and various trace elements, known as "forest cream", but the tyrosine and other ingredients in it will cause the human body to have increased blood pressure and headaches, and will also affect the absorption of statin drugs and the play of efficacy, which is not conducive to the control of the disease.
To sum up, in addition to paying attention to the above three foods in life, we also need to try to avoid excessive intake of high-fat and high-cholesterol foods, such as animal offal, fried chicken, French fries, etc., which will also affect the absorption of statin drugs and increase the burden and pressure on the body's cardiovascular system.
In addition, high-sugar foods can cause blood sugar fluctuations, which in turn will also affect the body's blood lipid levels, causing the body to accumulate excessive calories and aggravate the condition, such as cakes, milk tea, desserts, etc. Cold, spicy and irritating foods can irritate the mucosa of the gastrointestinal tract, resulting in poor drug efficacy, which also needs to be paid attention to. Eat a reasonable diet and eat scientifically.
(Note: "Knowledgeable doctors bluntly said: When taking statins, except for grapefruit, you can't eat these three foods" The names are pseudonyms, and some of the pictures are network pictures; Reprinting and plagiarism are prohibited in the article)