Grapefruit diet almost cost woman her leg
 

http://ca.news.yahoo.com/s/afp/09040...efruit_offbeat

Thu Apr 2, 7:16 PM

PARIS (AFP) - A woman who ate a grapefruit each day almost had to have
her leg amputated because of a dangerous blood clot, according to an
unusual case study reported in the Lancet.

Emergency doctors in Olympia, in the US Pacific coast state of
Washington, treated the 42-year-old woman in November 2008 after she
was admitted with shortness of breath, dizziness and difficulty
walking.
An ultrasound scan found she had a large clot blocking the veins of
her left leg.

She was in imminent danger of losing the limb to gangrene, but doctors
administered a clot-busting drug directly into the blockage and safely
dissolved it.

The physicians found she had taken a relatively long car journey, of
about an hour and a half, the day before; took a daily dose of
oestrogen oral contraceptives; and had a genetic variant, called the
factor V Leiden mutation, which is linked to a blood-clot disorder.

All are well-established factors for causing deep vein thrombosis
(DVT), as these dangerous events are called.
But what "may well have tipped the balance" is that she had been
eating a grapefruit every morning under a weight-loss diet begun three
days earlier, the report said.

Grapefruit juice is known to block the action of an enzyme called
CYP3A4 which breaks down the contraceptive hormone oestrogen.

This in turn boosts levels of coagulability -- the tendency of blood
to clot.

Grapefruit juice is broken down only very slowly, which means that it
has a cumulative effect if taken daily. Thus, on the third day of her
diet, the patient's oestrogen levels would have been many times above
normal, helping the clot to form.

DVT has been popularly termed "economy-class syndrome," as it is
associated with passengers hunched up on cramped seats in long-haul
flights.

But experts say DVT can be inflicted by any kind of immobility -- in
cars, the office or at home -- that causes the leg to be bent for long
periods and prevents blood from flowing. The clotting risk is
amplified by oral contraceptives and heritability.