KUSA - 9NEWS' Dr. John Torres answers your health questions every Wednesday at 8 a.m.
ASK DR. JOHN A QUESTION
Question #1
Dear Dr. John,
I have gout and my Doctor, who I trust completely, has me on the medicine Colchicine. My questions is: why can't I have grapefruit with the Colchicine? Will it cause it to overact, under-act or attack my stomach? I haven't had any stomach issues with the Colchicine.
We received a half box of great Ruby Red Grapefruit for Christmas, I haven't had any but, I would really love to eat some, even a part of one.
Also, shellfish. I've been told that shellfish, shrimp, crab, clams, mussels etc., can cause a flair of my gout. Is this really a concern?
Thank you so much, I get a lot of information from your segments on 9NEWS.
Ruth Ann
Hi Ruth Ann -
This is a subject that is confusing to most of us at some time or another. Medicines can interact with other medicines, herbs and even certain foods. When it comes to foods, the biggest culprit is the simple grapefruit. Although it's a delicious fruit, the grapefruit also has the ability to modify a certain enzyme in our bodies called the Cytochrome P450.
This enzyme is used by our body to break down many medicines, including Colchicine. The problem is that grapefruit interacts with this enzyme and when it does it doesn't allow the medicine Colchicine to break down like it normally does. So if you are taking this medicine and eating a grapefruit, it can make the levels of this drug high, sometimes high enough to cause side effects.
These side effects include overall body weakness and muscle pain, vomiting and diarrhea, and lips tongue and hands can turn a gray color. Some deaths from combining grapefruit and Colchicine have been reported as well. Your best bet is to avoid the grapefruit.
You can also talk with your doctor to see if you can be placed on another medicine that will still help with your gout, but that won't stop you from eating this fruit. This interaction can occur even up to two weeks after eating a grapefruit, but you can still eat other citrus fruits, like oranges.
Question #2
Dr. Torres,
Hello! I am curious if you have any advice or further reading regarding Collagenous Sprue. My mother was diagnosed with Celiac a few years ago and has not shown improvement with gluten free diets or prednisone therapy.
This year she was told she has Collagenous Sprue and is currently being treated with oral Budesonide. It is not helping. No matter what she eats or drinks, it comes back up. There isn't much research out there about this issue. The only thing I have seen so far is Cyclosporine treatment for CS.
Do you have any advice?
Thank you for your time!
Kellie
Hi Kellie -
Many people understand the issues surrounding what's known as Celiac Sprue, also called gluten sensitivity. Nowadays, many restaurants and food manufacturers even supply gluten-free diets. Collagenous Sprue is a rarer and less understood condition that is similar in some ways to Celiac Sprue but different in others. Most patients that are eventually diagnosed with Collagenous Sprue are first told they have Celiac Sprue, but after gluten free diets don't help, then further testing is done and this more rare condition is diagnosed.
Unfortunately, Collagenous Sprue is difficult to treat and the standard treatment of avoiding gluten and taking high dose steroids doesn't always work. In cases like this, other medicines are tried. Budesonide is a medicine used for another intestinal disorder: Crohn's Disease.
Besides that, other medicines like Mesalamine have shown some success. Medicines used to treat certain leukemias, like Alemtuzumab, or medicines like Cladribine, have shown some success in small clinical trials. In some, a combination of meds and diets seems to help the most. Overall, this is a very difficult condition to treat, so going through multiple regimes to see what works might be needed.
Question #3
I am a 55-year-old female, overweight, with Type 2 Diabetes. I currently am taking medications for blood glucose, cholesterol, hypertension and depression. I have heard some interesting information about taking HCG for weight loss. I understand that this is a "pregnancy hormone" that boosts the metabolism, and along with a very strict 500 to 1,000 calorie diet, can result in big weight loss numbers.
When I called my doctor about using this I was told "No, it will increase your blood glucose levels." I don't understand why I can't try this method as long as I continue to take my medications and check my glucose levels more frequently.
Please explain why this would be a bad idea for me, so I can really understand the impact on my health.
Sincerely,
Shelley
Hi Shelley -
I am not a big proponent of the HCG diet for a couple of reasons. First off, it is a difficult diet to maintain and can be hard on the body, especially that of a diabetic.
Secondly, the only good way to lose weight is to lose weight and keep it off. This means a lifestyle change that you can sustain for years to come and not a quick-fix right now. The goal is to not only lose the weight but to keep it off as well.
As for HCG and diabetes, I agree with your doctor that it isn't a good combination. Although losing weight will help with your diabetes, going on the HCG diet could also mean that your sugar levels right now could bounce all over the place. Chasing these high or low sugar levels while trying to correct them on the spot is very difficult to do, and could affect your overall health.
On top of that, one of the side effects of HCG is the developments of blood clots, which also happen more often in Type 2 diabetics. The combination could increase your risk even more of developing such a clot - which could be risky and potentially even fatal.
(KUSA-TV © 2011 Multimedia Holdings Corporation)
You Might Be Interested In