[tabi] seasonal foods and your medicines

  • From: "Chip Orange" <Corange@xxxxxxxxxxxxxxx>
  • To: <tabi@xxxxxxxxxxxxx>
  • Date: Wed, 17 Nov 2010 09:35:08 -0500



Don't Let Holiday Foods Derail Your Medications

Here is an "unintended consequence" to holiday eating that you may not have 
considered before... eating certain traditional or festive foods can deactivate 
your medications or -- even worse -- bring on a potentially toxic reaction. 

At this time of year, people eat foods and drink beverages they don’t normally 
consume, and that can spell trouble, says Leo Galland, MD, an internist and 
founder of Pill Advised (http://PillAdvised.com <http://pilladvised.com/>  
<http://edhn.bottomlinesecrets.com/a/hBM4ixmB74VNIB8VudaNFNORvAG/dhn3> > ), an 
online resource for information about medications and supplements. "When people 
start changing their diet patterns over the holidays, there’s an opportunity 
for interaction with drugs that few are aware of," he notes. "It’s important to 
know how food can alter the effects of drugs."


Why foods and drugs clash


Dr. Galland explains that food can affect the level of a drug in your body 
through absorption, metabolism or excretion. Certain foods can either increase 
or, more commonly, decrease absorption of specific drugs into the bloodstream 
from the gastrointestinal tract.

Calcium in dairy products -- such as eggnog and cheese -- prevents certain 
drugs from being fully absorbed. Other foods alter the way some drugs are 
metabolized, especially in the liver, and this may either raise or lower the 
drug’s level. A prime example is the way the juice of grapefruits, popular at 
holiday brunch, causes high blood levels of a number of drugs by interfering 
with their breakdown.

Food also can impact the rate at which a drug is excreted by the kidneys, he 
notes. For instance, drinking alcohol initially decreases the absorption of the 
blood pressure drug propranolol (Inderal). This may reduce the blood level of 
the drug, interfering with its effect. And then continued intake of alcohol 
actually increases the blood level of propranolol and may intensify its effect 
in reducing blood pressure, potentially bringing it down too low. 


Common interactions


Dr. Galland ran through a list of foods and beverages that you’re likely to 
encounter during the holidays and talked about ways that they can interfere 
with medications. Here are the most common interactions...

Chocolate. The flavonoids in chocolate are good for you, but another substance 
in chocolate, theobromine, is a stimulant and a mild diuretic. Theobromine may 
interact with other stimulants, such as pseudoephedrine used in cold remedies, 
increasing their effect. Theobromine also has the potential to boost the effect 
of heart and blood pressure medications, and it can decrease the effect of 
sedatives, such as zolpidem (Ambien). The darker the chocolate, the more 
intense this effect, Dr. Galland said, noting that as little as one tablespoon 
of cocoa powder can cause stimulant effects. 

Cranberries. Some studies show that cranberry juice or cranberry sauce in large 
quantities can increase the effect of the anticlotting drug warfarin 
(Coumadin), causing a hemorrhage. If you’re on Coumadin, take it easy on the 

Cream sauces, dips and other dairy foods and drinks. Be wary of cheese dips, 
eggnog, ice cream cake and other dairy-rich foods if you’re taking an 
antibiotic, thyroid hormone or carbidopa/levodopa (Sinemet), a drug for 
Parkinson’s disease. The calcium in dairy products can interfere with 
absorption of these drugs. If you are going to eat a calcium-laden food, 
consume it at least two hours away from the time that you take any of these 


Seasonal Drinking Dangers


We’ve talked about this before, of course, but it’s important enough to repeat 
now that the season of toasting and partying is here -- alcohol in any form can 
interact with many drugs, and the effect will vary from one person to the next 
and from one drug to another. For instance...

* Alcohol and antacids are not a good mix. If you develop heartburn from 
overindulging at a holiday buffet, do not take cimetidine (Tagamet), famotidine 
(Pepcid), nizatidine (Axid) or ranitidine (Zantac). These antacid medications 
block alcohol metabolism, increasing inebriation and elevating your risk for 
alcohol poisoning.

* Alcohol increases the effect of sedatives, pain medications and 
antihistamines, and it may increase side effects of some antidepressants such 
as trazodone (Desyrel) and amitriptyline (Elavil), impairing mental and motor 

* With blood pressure medications, alcohol may increase the effect initially, 
but then when it wears off, it causes fluid retention and may counteract their 

* Combining large amounts of alcohol with products containing acetaminophen, 
such as Tylenol, Midol and some cough and cold products, can cause liver 

* If you’re taking aspirin or another nonsteroidal anti-inflammatory drug 
(NSAID), like ibuprofen (Advil, Motrin) or naproxen (Aleve), drinking will 
increase your risk for gastrointestinal bleeding.

* People with diabetes, especially, should use caution because many of the 
drugs used to reduce blood sugar (such as metformin) interact adversely with 
alcohol (such as by affecting heart rhythm). 


What to Watch Out For


Even armed with all of the above information, it’s possible that sometime this 
season you may inadvertently challenge your body with a bad food-drug 
interaction. Symptoms can take many forms, though Dr. Galland suggested that 
any of the following should arouse your suspicion: A noticeable change in 
mental sharpness, memory, mood or sleep... abdominal pain... dizziness... 
fatigue... muscle pain. If you think you’ve had an interaction, call your 
doctor and be sure to tell him/her about any changes in your medications and 
your diet. 



Leo Galland, MD, is an internist, author and internationally recognized leader 
in integrated medicine based in New York City. For more information about 
supplements and drugs and free access to Dr. Galland’s Web application visit 
www.PillAdvised.com <outbind://13/www.PillAdvised.com>  
<http://edhn.bottomlinesecrets.com/a/hBM4ixmB74VNIB8VudaNFNORvAG/dhn4> > .

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