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tantanman

Help! Patty

tantanman
9 years ago

After seven decades I have developed a slight case of high blood pressure. Dr. put me on lisinopril, which she said was a mild medication. The only caution I have found about citrus and these ACE inhibitors, other than grapefruit, referred to tangelos and Seville's. It will be bad to give up my Golden GF, and Wikewas, but if it includes tan-tangelos, I would indeed suffer greatly. I have three Page and four different Clementine -Orlando's in the ground.

I might add Na, K, near center of normal with cholesterol=I54. Any info you may have on this would be helpful.

Comments (13)

  • hoosierquilt USDA 10A Sunset 23 Vista CA
    9 years ago

    Okay, more cardio. Much, much more cardio. And, if your weight is not within normal limits, get it there. More importantly, get your body fat ratio where it needs to be (I really could care less about anyone's total weight, it is your body composition that is critical - for a man, 11-20% body fat. See if you can get yourself off the stupid medication. I just hate seeing someone healthy have to become a slave to lifestyle-induced medications. That's my first recommendation. Now, if you're fit, your body composition is where it needs to be, and the doc still feels you need to be on blood pressure-lowering medications, have a talk with him about having citrus fruits that have only partial grapefruit parentage. It's interesting - had a chat with Dr. Kahn about this last time I was at the UC Riverside Citrus Variety Collection, asking her if anyone had really done a good search on the levels of furanocourins in the various grapefruits, pummelos and hybrids of these. The answer - no, and they all vary so much, depending on where grown, how grown, age of tree, etc., that any values obtained could not be very consistently reported. Bottom line - the hybrids probably have less. And, timing of your meds and ingestion of the fruits make a difference. Lastly, your doctor can decide if you can have citrus, and perhaps check your therapeutic blood levels of your lisinopril to make sure you are clearing it adequately, and the metabolism of that drug is not being significantly interfered with by ingesting citrus with grapefruit and/or pummelo heritage.

    As to the rest of your labs - I would expect your electrolytes to always be WNL (Na, K), because we human beings have a VERY narrow range for normal. And your cholesterol is admirable. Wish mine were that low. I would ask the doc what's causing the elevation in your BP. Could just be arteries and the aging process (they become less elastic as we age, along with many other things, lol!) But, I betcha if you can increase your cardiovascular exercise and make sure your weight and body fat composition are optimal, you may see a drop in your BP.

    All that being said, my hubby had slightly elevated cholesterol, but low HDL levels, so our internal med doc put him on a low dose of Lipitor. My husband said, "my wife said I can't take that because I eat grapefruit EVERY morning, and to prescribe something else if you need to." (See doc's eybrows lift). Our (wonderful) doc said not to worry, dosage was so low that it wouldn't interfere, and to take it at night. All should be conversations you have with YOUR doc ;-) As, I'm just a nurse.

    Patty S.

  • tantanman
    Original Author
    9 years ago

    Patty,
    Very good info. The message Dr Kahn had was exactly as I suspected, and very helpful. As far as my Dr., I had him for over 40 years and bring him citrus. He may think he can get more if I can't eat any. Just kidding. I have heard of doctors telling the same as your husband's and some just saying "no".

    Thanks a lot.

    Larry

  • tantanman
    Original Author
    9 years ago

    Patty,
    I really only got see my Dr.'s assistant, his daughter. The talk will come later.

  • hoosierquilt USDA 10A Sunset 23 Vista CA
    9 years ago

    Okay, have that discussion with the doc. Not sure what the doc's assistant's qualifications are (is she an RN, a NP, a PA??) Have that frank talk with your doc. And, see about your overall general health, and have the doc suggest a diet and exercise plan to make sure you're fit and body fat composition is in check. If so, you may find you don't need blood pressure lowering medication. And THAT is a great thing.

    Patty S.

  • poncirusguy6b452xx
    9 years ago

    My doctor put me on pravastatin, no need to watch what I eat. I also talked with my pharmacist to be sure. talk to both

    I refrain from signing my name. I don't want anyone to know who this 5+ decade'r is that needs meds.

  • hoosierquilt USDA 10A Sunset 23 Vista CA
    9 years ago

    Steve, pravastatin is a statin - a cholesterol-lowering medication for hyperchoesteremia. Not an ACE inhibitor prescribed for hypertension. Completely different diagnoses, completely different drug categories that do entirely different things. There are actually quite a few different drugs whose metabolism is interfered with by the furanocoumarin found in grapefruits, pummelos and their respective hybrids (to lesser degrees). I believe about 75 or thereabouts.

    And, many folks in the 5th (or even 4th) decade struggle with hypercholeteremia (eleveated cholesterol levels). Some of it is genetic, most of it is lifestyle-induced. If you can reduce your body fat, and bring it into normal ranges, and increase your cardiovascular exercise (under the guidance and direction of your doctor), you may find that you can bring your cholesterol levels back WNL.

    Patty S.

  • greenman28 NorCal 7b/8a
    9 years ago

    That's odd because I, too, take Lisinopril and have read that grapefruit is not a problem. That was one of the first things I asked my doctor.

    Josh

  • johnmerr
    9 years ago

    Josh,

    I think we would all feel better about the medical profession, if they didn't call it "practice"... LOL

  • keithdphan
    9 years ago

    grapefruit is a natural diuretic. therefore when taken with medication results in unbalance/over dosing of that drug.

    This post was edited by keithdphan on Mon, May 26, 14 at 17:23

  • poncirusguy6b452xx
    9 years ago

    I apologize I pulled up the wrong med. I am on paroxetine HCL.

    I am surprised you knew who I was. I left off my kname so kno one would know who I was. Must of recognized my writing style. You are so sharp.

    Me

  • hoosierquilt USDA 10A Sunset 23 Vista CA
    9 years ago

    Steve, you post your name with some of your other forum posts, we know who you are :-)

    Josh, I am not aware that there is an issue with Lisinopril, I have not heard that, but your pharmacist will know for sure. They all have databases that will display drug to drug and drug to food interactions, so it's a pretty easy look up for your pharmacist :-)

    http://www.drugs.com/pro/lisinopril.html#LINK_1754ea7e-5d5f-4c74-84a3-505cf7c41015

    Keith, it has absolutely nothing to do with diruresis (grapefruits do not illicite diuresis, this is an old wive's tale). It has to do with a chemical called furanocoumarin (or bergmottin), which is found in grapefruits and pummelos, and to some lesser degree, their respective hybrids. This chemical blocks the enzyme cytochrome P450 3A4, used to metabolize many drugs. If the enzyme is blocked, the drug can quickly reach toxic levels in the blood stream.

    Here is a list of some of the more commonly prescribed medications that can be affected by furanocoumarin, but this is not an EXHAUSTIVE LIST. Please check with your pharmacist and your doctor, to make sure you're not taking a drug that has an interaction with ANY food (including milk, licorice, and kale for example), they are always in the best position to be able to advice you. These are SOME the drugs that have a known issue with furanocoumarin:

    A-C
    Alfentanil (oral)
    Amiodarone
    Apixaban
    Atorvastatin
    Buspirone
    Clopidogrel
    Crizotinib
    Cyclosporine

    D-F
    Darifenacin
    Dasatinib
    Dextromethorphan
    Domperidone
    Dronedarone
    Eplerenone
    Erlotinib
    Erythromycin
    Everolimus
    Felodipine
    Fentanyl (oral)
    Fesoterodine

    H-P
    Halofantrine
    Ketamine (oral)
    Latatinib
    Lovastatin
    Lurasidone
    Maraviroc
    Nifedipine
    Nilotinib
    Oxycodone

    P-Z
    Pazopanib
    Pimozide
    Primaquine
    Quinine
    Quetiapine
    Quinidine
    Rilpivirine
    Rivaroxaban
    Silodosin
    Simvastatin
    Sirolimus
    Solifenacin
    Sunitinib
    Tacrolimus
    Tamsulosin
    Ticagrelor
    Triazolam
    Vandetanib
    Venurafenib

    Verapamil
    Ziprasidone

    Again - bottom line - talk with your doctor and your pharmacist about whether or not your medications you take interact with grapefruits, pummelos or their hybrids, OR any other foods, just to be safe.

    Patty S.

  • tantanman
    Original Author
    9 years ago

    Patty,

    Celery and ginger also. They have the grape fruit effect with ACE inhibitors.

  • hoosierquilt USDA 10A Sunset 23 Vista CA
    9 years ago

    See? Not exhaustive. Your best bet - your doctor and your pharmacist will give you the lowdown on any drug - food interaction or drug - drug interactions.

    Patty S.