Q: I have arthritis and was told years ago that eating grapefruit would cause more stiffness and aches so I stopped eating grapefruit… then I heard a different story that grapefruit is supposed to be good for people with arthritis. Please tell me which story is correct.
A: From what I have been able to find it is not grapefruit by itself that causes problems but its interaction with certain medications can cause problems. Grapefruit juice can cause some medications to be too strong and I found that it can also have the opposite effect.
Dr. Adegbenga Bankole with Virginia Tech Carilion School of Medicine's Department of Internal Medicine specializes in Rheumatology and gave WSLS some perspective on the concerns over grapefruits and medications.
Dr. Bankole says, "Grapefruit does not have a direct effect on osteoarthritis or the stiffness associated with osteoarthritis. However, it does have some indirect effects in the production of cartilage, which is damaged in osteoarthritis. Grapefruits are a rich source of Vitamin C along with all citrus fruits such as oranges and lemons. The acidity of these fruits can reduce the absorption of some painkillers and it may be better to have a space of a few hours before between the grapefruits and your arthritis medicine. I would encourage you to eat as many fruits as you can."
In addition to Dr. Bankole's information, an “Arthritis Today” publication from the Arthritis Foundation highlights research from David G. Bailey, PhD, clinical professor of pharmacology at the University of Western Ontario in Canada.
Regarding grapefruit, apple and orange juice the research finds, “They block the pills’ absorption, so you get less or even no benefit from taking them,” says Bailey. “This might cause someone to think that they need to switch to a ‘better’ medication – when in fact changing what they eat, or when, would make the drug effective.”
Getting less benefit from a pain reliever that is expected to treat arthritis would explain thinking that the grapefruit or fruit’s juice was making arthritis “worse.”
Here is a listing of potential food blockers from the article titled “Some Foods Block the Effects of Meds”
FOOD: Milk and yogurt
BLOCKS:Iron supplements; many antibiotics, including fluoroquinolone, cipro floxacin and “cycline” antibiotics like tetracycline; thyroid hormone; and penicillamine (Cuprimine, Depen), a disease-modifying antirheumatic drug
FOOD: Apple, orange and grapefruit juice
BLOCKS:Disease modifying anti-rheumatic drugs, including methotrexate (Theumatrex, Trexall); cyclosporine (Gengraf, Neoral, Sandimmune), a drug used for severe psoriasis and rheumatoid arthritis; beta blockers like acebutol (Sectral); cancer drugs like etoposide (Etopophos, Vepesid); alendronate (Fosamax), an osteoporosis drug; the allergy medicine fexofenadine (Allegra); some antibiotics including ciprofloxine (Cipro) and levofloxacin (Levaquin)
BLOCKS:Alendronate; the antibiotic penicillin
FOOD: Foods rich in vitamin K, including leafy green vegetables and liver
BLOCKS:Blood thinners like warfarin (Coumadin)
BLOCKS: Antidepressants, especially monoamine oxidase inhibitors (MAOIs) like tranylcypromine (Parnate) – although people taking SSRIs like fluoxetine (Prozac) should avoid drinking more than moderate amounts of alcohol as well, as it counteracts their benefits.
Talk to your pharmacist if you have any questions about possible prescription medication interactions.