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I've seen similar warnings about grapefruit before, but the article is the first time I've seen the specific mechanism discussed in this kind of depth. It's al

I've seen similar warnings about grapefruit before, but the article is the first time I've seen the specific mechanism discussed in this kind of depth. It's also the first time I've seen mention that all "bitter citrus" includes the problematic compounds, including lime and "sour orange" (is that the same as blood orange?). At least for me, it would be better if the headlines would cover this as the broader "bitter citrus", instead of grapefruit specifically. I can't stand grapefruit, so I never paid much attention to the warnings, but I love lime and blood orange, which means further investigation is warranted. TFA says it's "unlikely" anyone would consume enough lime to have an effect, but how much is "enough"?

pvaldes 6y ago
> "sour orange" (is that the same as blood orange?). Not. Sour orange is Citrus x aurantium whereas blood oranges are a type of cultivars of the common orange Citrus x sinensis sharing a red mutation. Both are hybrids but have different ancestors. Sour is inedible in fresh and must be processed, whereas the blood group are small but deliciously acid.
- smcameron 6y ago
  Sour orange pie is a thing though (tastes much like key lime pie).
- bserge 6y ago
  Citrus aurantium are used as a source of synephrine, a stimulant similar to ephedrine, which also interacts with various medication. According to OPs article, grapefruit works in a different way. This article also mentions grapefruit: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655712/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655712/
jrs235 6y ago
FWIW, I don't think "sour orange" referred to blood orange. I believe it refers to Bitter Orange/Seville Orange: https://en.m.wikipedia.org/wiki/Bitter_orange https://en.m.wikipedia.org/wiki/Bitter_orange I think blood oranges are sweet.
- cardy31 6y ago
  Blood oranges have very similar interactions to grapefruit, so it likely is referring to them.
sebmellen 6y ago
The NHS provides a very in-depth article on this (their health information is generally top notch). I would recommend giving it a read: https://www.nhs.uk/news/medication/prescription-drugs-and-grapefruit-a-deadly-mix/ https://www.nhs.uk/news/medication/prescription-drugs-and-gr.... In the article they state: > How much grapefruit is too much grapefruit? > The researchers report that furanocoumarins are present in all forms of grapefruit (freshly squeezed juice, frozen concentrate and whole fruit). > One whole grapefruit or 200ml of juice is sufficient to cause enough of an increase in the concentrations of active drugs to have an effect on the body, and therefore could cause side effects. I presume this would hold for other "bitter citrus" as well. ——————————————— The listed potential health effects are quite significant: > - Torsade de pointes (a form of abnormally rapid heartbeat that starts in the lower chambers of the heart, which can increase the risk of sudden death) > - Complete heart block (where there is no transmission of the electrical pulses between the upper and lower chambers of the heart that are needed to make it beat) > - Rhabdomyolysis (breakdown of muscle fibres that leads to the release of muscle fibre contents, including myoglobin which breaks down into substances that can damage the kidney) > - Nephrotoxicity (kidney damage) > - Myelotoxicity (damage to the bone marrow) > - Venous thrombosis (blood clot)
ycombinete 6y ago
> but how much is "enough" Indeed! My wife literally eats lemons like they were oranges. Probably something for us to look out for!
- pvaldes 6y ago
  > My wife literally eats lemons like they were oranges Those are probably Meyer lemons, that is a hybrid (lemon x tangerine if I remember correctly) so is sweeter than the true lemon (or maybe your wife is simply strange ;-)).
  - ycombinete 6y ago
    She is definiltely just strange. She loves anything sour, and will eat any lemon anywhere. She's had to stop recently after being shouted at by her dentist, for stripping away a lot of her enamel with all the citric acit in the lemons.
  - samatman 6y ago
    Especially in the Bay Area (the user name hints at that), this is a good guess. Most of the trees you'll find a few to a block are Meyer lemons. One of the things I miss about the Bay, along with the pervasive jasmine, and persimmon season.
  - pvaldes 6y ago
    Just was curious and checked it. It seems that there is not much lemon in Meyer lemons: (citron x (pomelo x mandarin)) I assume that, having a little pomelo blood could trigger the same chemical interactions shown in the article.
nkozyra 6y ago
I feel like people are more likely to consume a larger quantity of grapefruit than lime, though. People eat grapefruit by itself, or juice. Lime juice is typically a garnish or a flavor used in less quantity. Not to mention size of the fruit.
- samatman 6y ago
  Maybe, maybe not. A good cup of nimbu pani has at least two full limes squeezed into it, and there's no law saying you have to only drink one. Let me put it slightly differently: I don't hate grapefruit, but I don't especially care for it, and I really like lime. I'm pretty confident I consume more lime than grapefruit on a gram-for-gram basis.
  - nkozyra 6y ago
    It's not often consume in comparable amounts is my point. Even two limes is half a grapefruit.

pvaldes 6y ago

> "sour orange" (is that the same as blood orange?). Not. Sour orange is Citrus x aurantium whereas blood oranges are a type of cultivars of the common orange Citrus x sinensis sharing a red mutation. Both are hybrids but have different ancestors. Sour is inedible in fresh and must be processed, whereas the blood group are small but deliciously acid.

smcameron 6y ago
Sour orange pie is a thing though (tastes much like key lime pie).
bserge 6y ago
Citrus aurantium are used as a source of synephrine, a stimulant similar to ephedrine, which also interacts with various medication. According to OPs article, grapefruit works in a different way. This article also mentions grapefruit: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655712/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655712/

jrs235 6y ago

FWIW, I don't think "sour orange" referred to blood orange. I believe it refers to Bitter Orange/Seville Orange: https://en.m.wikipedia.org/wiki/Bitter_orange https://en.m.wikipedia.org/wiki/Bitter_orange I think blood oranges are sweet.

cardy31 6y ago
Blood oranges have very similar interactions to grapefruit, so it likely is referring to them.

sebmellen 6y ago

The NHS provides a very in-depth article on this (their health information is generally top notch). I would recommend giving it a read: https://www.nhs.uk/news/medication/prescription-drugs-and-grapefruit-a-deadly-mix/ https://www.nhs.uk/news/medication/prescription-drugs-and-gr.... In the article they state: > How much grapefruit is too much grapefruit? > The researchers report that furanocoumarins are present in all forms of grapefruit (freshly squeezed juice, frozen concentrate and whole fruit). > One whole grapefruit or 200ml of juice is sufficient to cause enough of an increase in the concentrations of active drugs to have an effect on the body, and therefore could cause side effects. I presume this would hold for other "bitter citrus" as well. ——————————————— The listed potential health effects are quite significant: > - Torsade de pointes (a form of abnormally rapid heartbeat that starts in the lower chambers of the heart, which can increase the risk of sudden death) > - Complete heart block (where there is no transmission of the electrical pulses between the upper and lower chambers of the heart that are needed to make it beat) > - Rhabdomyolysis (breakdown of muscle fibres that leads to the release of muscle fibre contents, including myoglobin which breaks down into substances that can damage the kidney) > - Nephrotoxicity (kidney damage) > - Myelotoxicity (damage to the bone marrow) > - Venous thrombosis (blood clot)

ycombinete 6y ago

> but how much is "enough" Indeed! My wife literally eats lemons like they were oranges. Probably something for us to look out for!

pvaldes 6y ago
> My wife literally eats lemons like they were oranges Those are probably Meyer lemons, that is a hybrid (lemon x tangerine if I remember correctly) so is sweeter than the true lemon (or maybe your wife is simply strange ;-)).
- ycombinete 6y ago
  She is definiltely just strange. She loves anything sour, and will eat any lemon anywhere. She's had to stop recently after being shouted at by her dentist, for stripping away a lot of her enamel with all the citric acit in the lemons.
- samatman 6y ago
  Especially in the Bay Area (the user name hints at that), this is a good guess. Most of the trees you'll find a few to a block are Meyer lemons. One of the things I miss about the Bay, along with the pervasive jasmine, and persimmon season.
- pvaldes 6y ago
  Just was curious and checked it. It seems that there is not much lemon in Meyer lemons: (citron x (pomelo x mandarin)) I assume that, having a little pomelo blood could trigger the same chemical interactions shown in the article.

nkozyra 6y ago

I feel like people are more likely to consume a larger quantity of grapefruit than lime, though. People eat grapefruit by itself, or juice. Lime juice is typically a garnish or a flavor used in less quantity. Not to mention size of the fruit.

samatman 6y ago
Maybe, maybe not. A good cup of nimbu pani has at least two full limes squeezed into it, and there's no law saying you have to only drink one. Let me put it slightly differently: I don't hate grapefruit, but I don't especially care for it, and I really like lime. I'm pretty confident I consume more lime than grapefruit on a gram-for-gram basis.
- nkozyra 6y ago
  It's not often consume in comparable amounts is my point. Even two limes is half a grapefruit.