Grapefruit, Pomegranate Juice Not a Good Mix With Statins

April 23, 2009— -- Recently, I talked about a study on "Good Morning America" showing that although statins effectively reduce low-density lipoprotein (LDL) cholesterol, they also appear to reduce patients' levels of energy and activity. I discussed five ways to deal with the problem of low energy or fatigue while on statins.

The response was tremendous, and I have learned what my own patients have been telling me for some time -- not all people tolerate statins without side effects. Complaints of memory problems, fatigue, low energy and muscle weakness were fairly common -- although with more than 13 million users, it is hard to know how many people suffer overall.

Yet, giving people the heads-up that side effects can occur while on statins is important. I believe many patients are led to think they are crazy when their doctors tell them that the symptoms aren't likely from statins, or the doctors wrongly attribute the symptoms to something else rather than try to stop the statins, lower the dose or switch to another brand.

So many doctors believe the statin drugs are so safe and effective that the "joke," or discussion, in the medical community is that perhaps most healthy adults would benefit from a low dose of statins just to prevent heart disease.

"Perhaps we should put statins in the drinking water," a few will suggest.

Back to the reason for this piece!! In the segment, I included the suggestion to try juices high in antioxidants such as pomegranate juice, a recommendation learned from my patients over the years. However, I also noted on the show that grapefruit juice should be avoided as it could interfere with metabolism of the statin medication and raise the drug level and potential side effects even more.

An astute viewer alerted me that there is a similar interaction of pomegranate juice with statins and that pomegranate juice should also be avoided. I did a little homework and found that a study performed on rats (which means we don't know if the effect will be the same in humans) in Japan and published in 2005 did find that pomegranate juice, like grapefruit juice, could potentially interfere with the metabolism of certain medications.

Fruits and many pure unsweetened fruit juices are great sources of antioxidants, vitamins, potassium and fiber and are an essential part of a heart-healthy diet. Yet, with so many people on statins to treat or prevent heart disease and stroke, it would seem that much more attention should be paid to the grapefruit and pomegranate fruit interaction with statins.

Perhaps these juices should add this potential interaction on their labels and include the information in their marketing campaigns. I know that I will do my part to spread the word to my patients and audiences that I speak to.

Many viewers asked about the origin of the study on statins and fatigue. The research was done by Dr. Beatrice Golomb and presented at the American Heart Association's 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention held March 10 to 14 in Palm Harbor, Fla.

According to Golomb, 1,016 adults who were free of diabetes or heart disease but had high LDL levels received either simvastatin, pravastatin or placebo for six months. The researchers found that although both statins effectively lowered LDL cholesterol, pravastatin was associated with a significantly higher proportion of patients who rated both their energy and activity levels as "much worse" and simvastatin was associated with a significantly higher proportion of patients who rated their energy level as "much worse."

What has been your experience with statins? Do you routinely avoid grapefruit or pomegranate juice while on statins? Have you tried coenzyme Q-10? What were the results?

As always, I welcome your questions and comments.

Dr. Savard is working on a new book. To learn more about her health management system, download free forms and a sample letter to your doctor, visit http://www.drsavard.com and click on "Learn how to take charge of your health."