Grapefruit juice interferes with breakdown of many drugs, requires careful monitoring

PEOPLE'S PHARMACY

Health & Fitness

September 19, 2004|By Joe Graedon and Teresa Graedon | Joe Graedon and Teresa Graedon,SPECIAL TO THE SUN

I noticed your comment on grapefruit juice raising blood levels of some medications. This is true, but as a medical doctor, I purposely use it to increase absorption of an expensive drug.

Grapefruit does not actually improve absorption of medications.

It does, however, interfere with the breakdown (metabolism) of dozens of drugs. In effect, that raises blood levels and increases the impact the drug has on the body.

Your strategy does require careful monitoring. The grapefruit effect is highly variable. Some people are very susceptible to it, while others are resistant. That makes it hard to predict how any individual patient will respond.

My mother has been taking thyroid hormone for 35 years and prefers Armour to Synthroid. Lately IM-Fve had a hard time convincing her doctors to prescribe Armour instead of the Synthroid.

They claim there is no difference. If not, and if it makes my mother feel better, why not go with her preference?

Are there any clinical differences between the two? IM-Fd like some evidence in case simple preference isnM-Ft a sufficient argument.

Actually, there are some differences between desiccated thyroid gland (Armour) and synthetic levothyroxine (Synthroid). Many doctors prefer to prescribe the synthetic because it is easier to control the dose. Most patients do well on a synthetic formulation, whether Synthroid, Levothroid or Levoxyl, although subtle differences between them make it unwise to shift back and forth frequently.

Other people tell us that they feel better on Armour thyroid. It contains small amounts of T3 hormone as well as T4 (levothyroxine), while Synthroid contains only T4. It is possible that some of these individuals arenM-Ft good at converting T4 to T3, which is the more active form.

Is there a remedy or solution to get rid of unwanted facial hair? Waxing is painful and expensive. Over-the-counter creams are not really the answer either.

Your dermatologist can prescribe a cream, called Vaniqa, to slow the growth of unwanted facial hair. It too is expensive, however, at $45 or $50 for a tube weighing just over an ounce.

Because his immune system was weakened by chemo treatments, my husband suffered a severe bout of herpes zoster (shingles) that left him with an unbearable itchy spot on his nose. Expensive antiviral creams and steroids did nothing to ease his misery.

When we read your article about Noxzema for itchy skin, we felt we had nothing to lose by trying it. Guess what? It works!

We are always pleased to learn that a simple, inexpensive product works for such a hard-to-treat problem. We suspect that the aromatic oils camphor, menthol and eucalyptol are responsible for the relief.

One of your readers was troubled with diarrhea. After gallbladder surgery, I had the same problem. My doctor prescribed Questran, saying the bile acid caused the problem. It works great.

Questran (cholestyramine) lowers cholesterol by binding to bile acids. Along with relieving your diarrhea, it keeps blood lipids under control.

What can people do who are allergic to aspirin and think they are having a heart attack?

Call 911 immediately if you think you are having a heart attack. The ambulance may carry a clotbusting drug that would be even more effective than aspirin.

Prior skin reactions (itchy hives), breathing difficulties or anaphylactic shock are the kinds of allergic reactions that would preclude use of aspirin even in an emergency. Stomach upset is not. An allergist can verify whether you are truly allergic. Desensitization is possible for those who must take aspirin.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or e-mail them via their Web site, www.peoplespharmacy.org.

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