Political writer and commentator Ann Coulter is notorious for her extremely conservative statements, but could natural chemicals in grapefruit be a contributor to her behavior? It’s a fun hypothesis to consider.
In a 2009 interview with Patrick of the Web site FishbowlDC, Coulter was asked what she had for breakfast. She facetiously answered, “My usual: 6-egg omelette, pound of bacon, six pancakes, toast, gallon of orange juice — wait, that was Jerry Nadler’s breakfast. I had a grapefruit.”
Perhaps she was also jesting about the grapefruit. Or maybe she dines, or dined on, whole grapefruit on a regular basis. If the latter sentence was true and, like many people today, Coulter regularly uses prescription medication, there’s a good chance that a grapefruit-drug interaction could be one instigator behind Coulter’s radical statements.
Grapefruit or paradise citrus bears the scientific name Citrus paradise. It is a tropical or semitropical tree yielding a large, roundish, yellow-skinned, edible citrus fruit (with the same name) with a juicy, acidic pulp. The species originated in Barbados.
Although seemingly ordinary in many ways and with grapefruit juice occurring in such popular food products as the sparkling flavored soda brand Fresca (The Coca-Cola Company), grapefruit has documented interactions with various prescription drugs (Kay Seden et al).
The main type of interaction is a change to metabolism of a given drug, in which chemicals in grapefruit juice inhibit an enzymatic protein present in the human intestine, which is called cytochrome P450 3A4 or CYP3A4 (Kay Seden et al).
A cytochrome is a type of protein that contains iron and is a component of electron transport chains in the cellular organelles the mitochondrion and the chloroplast (Neil A. Campbell et al). In short, cytochromes are proteins involved with cellular respiration, the process that in humans converts food and oxygen to carbon dioxide, water, heat, and adenosine triphosphate, a molecule used for energy.
The bottom line is that particular chemicals in grapefruit juice can increase or decrease the bioavailability of a drug, that is, the proportion of the drug that reaches the systemic circulation intact after consumption. Systemic circulation in mammals and birds is the circulatory system excluding the pulmonary circulation, the circulation of blood from the heart to the lungs for oxygenation and back to the heart.
Normally, a drug that is a substrate that would be chemically changed by CYP3A4 is metabolized in the intestine and then further metabolized in the liver, decreasing the bioavailability of the drug (Kay Seden et al). However, when grapefruit-containing products are consumed around the same time as the drug, chemicals from grapefruit inhibit metabolism of the drug by the cytochrome, leaving more of the drug to pass on to the liver. Metabolism of the drug in the liver is unaffected by the consumed grapefruit, but, nonetheless, more of the drug remains to enter the circulatory system. That is, more of the drug is bioavailable.
By raising or lowering the bioavailability of a drug, grapefruit chemicals can increase or decrease the effect of the drug. Miscellaneous studies report possible interactions with such classes of medications as antihistamines, antipsychotics, anxiolytics (anti-anxiety agents), immunosuppressants, and others (Seden et al). Studies have also been done regarding interactions with over-the-counter drugs, such as caffeine and nicotine, although such studies cited by Seden et al do not show statistically significant data.
So, the possibility remains that Ann Coulter concurrently consumes, or has concurrently consumed in the past, grapefruit and a drug whose effect would be amplified or weakened by a grapefruit-drug interaction. An interaction with a psychotropic (mind-altering) drug could especially alter her behavior, contributing to the immoderate statements she has made.
Bibliography
Author: Neil A. Campbell, Jane B. Reece. Book: Biology. Edition: 7. Place of publication: San Francisco, California. Publisher: Benjamin Cummings. Date: 2005.
Author: Patrick. Web page: Ann Coulter: The FishbowlDC Interview. Web site: FishbowlDC. Date: January 12, 2009. Institution: WebMediaBrands Inc. Date of access: February 25, 2012. Web address: http://www.mediabistro.com/fishbowldc/ann-coulter-the-fishbowldc-interview_b14645.
Author: Kay Seden; Laura Dickinson; Saye Khoo; David Back. Article: Grapefruit-Drug Interactions. Periodical: Drugs. Volume: 70. Issue: 18. Date: December 2010. Pages: 2373-2407. Database: ProQuest. Library: Jean Burr Smith Library. Date of access: February 7, 2012. Web address: http://search.proquest.com/.
Author: The Coca-Cola Company. Web page: Fresca. Web site: Fresca. Date: 2007. Institution: The Coca-Cola Company. Date of access: February 25, 2012. Web address: http://www.fresca.com/. Path: Product.
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