Grapefruit: Good for You or A Deadly Delight?

I love grapefruit. I eat several a week and would probably eat more if I could. But I just read this article about grapefruits and how they can be toxic for people on medications. It was actually pretty scary how many drugs are affected by grapefruit. The article really focused on the negative effects of how grapefruit can cause overdose and potentially fatal side effects but I think they missed out on the more important issue: why not use grapefruits to supplement for lower dosages of the drugs? 

First a little on how it works.
Supposedly grapefruit contain a chemical called furanocoumarins. It is produced by the grapefruit as a defense mechanism against predators. The furanocoumarins, itself isn't toxic but it interferes with a an enzyme in our intestines called cytochrome P450 3A4 which I will just call the enzyme. 

This enzyme is in the lining of our intestines and helps metabolize many drugs by controlling the amount that enters the bloodstream. Drug companies know about this and purposely increase the dosage of some tablets to compensate for the action of the enzyme.

However, if furanocoumarins are present in the intestine, they stop the enzyme from working.  Therefore, more of the drug gets into the bloodstream and thus the risk of overdose.

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A single helping of grapefruit can have an effect, even if consumed hours before the patient takes their medicine. Researchers have shown that taking some drugs with a 200ml glass of grapefruit juice every day for three days nearly tripled the drugs' concentration in the blood.

Can't this be used to our advantage? 

Wouldn't it be great if, since it seems researchers are well aware of this interaction, that people could lower their drug dosages(and probably some of the other side effects of them) by supplementing with grapefruit? It's been nearly ten years since I took pharmacology in college so I definitely don't pretend to know enough about it to know whether there would then be other side effects, but it's such a shame that, likely due to financial reasons, this is unlikely to occur. 

Be Aware 

There really are a lot of medications out there that seem to be impacted to some degree by consuming grapefruit. Now some time in the future, we may be encouraged to eat grapefruit with our medications, for the time being, we need to be cognizant of the potential for a negative drug reaction. Therefore if you're adamant about eating grapefruit it would be worth talking with your doctor if you're taking any drugs. 

Below is a list(probably not comprehensive) of drugs that interact with grapefruit:

• Dasatinib (leukaemia)
• Erlotinib (lung cancer and pancreatic cancer)
• Everolimus (kidney cancer)
• Lapatinib (breast cancer)
• Nilotinib  (leukaemia)
• Pazopanib (kidney cancer)
• Sunitinib (kidney/gastrointestinal cancer)
• Vandetanib (thyroid cancer)
• Venurafenib (skin cancer)
• Erythromycin (antibiotic)
• Halofantrine (malaria)
• Maraviroc (HIV)
• Primaquine (malaria)
• Quinine (malaria)
• Rilpivirine (HIV)
• Atorvastatin(cholesterol)
• Lovastatin(cholesterol)
• Simvastatin(cholesterol)
• Amiodarone (heart rhythm disorders)
• Apixaban (anti-clotting)
• Dronedarone (heart rhythm disorders)
• Eplerenone (heart failure)
• Felodipine (high blood pressure/angina)
• Nifedipine (high blood pressure/angina)
• Quinidine  (heart rhythm disorder)
• Rivaroxaban (anti-blood clotting)
• Ticagrelor (anti-blood clotting after heart attack)
• Oral Alfentanil (painkiller)
• Oral fentanyl (painkiller)
• Oral ketamine (painkiller, sedative)
• Lurasidone (schizophrenia/mental health problems)
• Oxycodone (painkiller)
• Pimozide (schizophrenia/other mental health problems)
• Ziprasidone (schizophrenia, mania, bipolar disorder)
• Domperidone (anti-nausea)
• Cyclosporine (post organ transplant, rheumatoid arthritis, psoriasis)
• Sirolimus (post organ transplant)
• Tacrolimus (post organ transplant)
• Solifenacin (urinary frequency/incontinence)
• Silodosin (enlarged prostate)
• Tamsulosin (enlarged prostate)

As you can see the list is fairly long. As there are several malaria drugs on the list, I am definitely going to talk with my doctor before I start eating grapefruit while in Guyana.

Hope you all have explored better ways to spend your down time than reading this blog. If not, check out some suggestions. 

A dose of positivity

I'm sure by now you've heard about the dentist that shot a lion in Zimbabwe. If, like me, you're first response was anger, you would not be in the minority. It seems that this made so many people irate that he had to shut down his business' website and even had Sharon Osbourne say: ""I hope that [he] loses his home, his practice & his money, [as h]e has already lost his soul."

While my first response was anger, it quickly turned to sadness and pity for this guy. I know, I know, I've probably lost several of you already. I don't condone what he did but at the same time is ruining his life going to bring back the lion? Unlikely. I see this so often where we see something that we feel outraged about and we practice "justifiable rage" and actively pursue ruining someone else's life. How many times do we rally against some injustice only to create more suffering and hurt? It seems that we, as a detacted internet community with minimal human interaction to each other, have developed into a world police team that goes around defending injustices. And that's great to a degree. No other time in history is it so hard to be a bad guy. There is bound to be a camera or a blogger who caught it on tape(wow-dating myself).

 At the same time though why is it that we thinking we can be judge, jury and executioner to someone else's life and try to actively ruin it?   I get that we need accountability but it's totally unneccessary to jump on the pig pile and kick someone when he's down. Yeah, he's likely going to get extradited for what he did and probably have to pay some huge fines, but again, it's not going to bring the lion back. AND most likely will not deter people from big game hunting in the future.  It'd be great if we could bring some of this passion and donating to a cause the protects these animals from the poachers. Rather than focus on the negative let's do something positive. Instead of wishing a guy lose his livelihood, why not create some livelihoods in that country so poaching isn't so appealing?

Let's stay positive. Okay and on that note: Positive News!

It was recently announced that Ironman Lake Placid will field a female pro race in 2016. That means that Amber will be back defending her title. And I am positive she'll be there kicking some butt.

Get The Most Out of Your Down Time

Rainy day and nothing good to read? Downtime at work?  Maybe you're not as self-absorbed as I am and subsequently you don't think other people like reading your boring ultra-running blog ;) What can you do to stay healthy or fit?

 I've already talked about the need to get off your keesters(did you know that the singular of keesters is keister? Weird) while at work. Those exercises, which also can be done at home, help your body but what about your mind? Instead of watching another Cat Fancy video, maybe try to do something that actively engages your mind. Learn a new language, take a free class or just do some puzzles that exercise your mind.

I've listed a few websites that might help keep that brain healthy and active which you can pick up at your leisure (I wonder if the plural is leesures, yee' sures).

Learn Just About Anything:
Coursera: Coursera partners with colleges and offers online courses on pretty much any subject for free. I've taken a nutrition class from University of Pittsburgh, Global Health from University of Copenhagen, and an exercise physiology course from University of Melbourne. It's not just for health professions either. There's a huge variety of classes on so many different topics. The classes combine video lecture, reading assignments, and graded quizzes. You get a certificate of completion if you get above a set grade for the class. For that it's free but if you want a verified one, I think it's something like $39. But you can learn for free.


Learn a Foreign Language
Duolingo: A great site to learn a foreign language. It's a great place for very beginner learners to start to recognize words visually as well as auditorily and can be done at your own pace. As far as I'm aware, it is totally free and has almost 20 languages to choose from. It certainly hasn't helped my horrible pronunciation of words but has helped me recognize and understand a little more.


Play a Game
I used to really like Lumosity but it seems that they have started to charge a fee to use it. For $6,70/month it's probably still worth it, but I bet you can find many of the puzzles online for free. While I haven't explored it much, Knowledge Adventure seems to have some similar games(but not created specifically for you) The nice thing about this is that it diversifies the challenges with many different game options. The problem with most games is that there becomes a time where they're no longer novel and your mind can do them on auto-pilot. It's no longer stimulating it to improve and develop new neural pathways. "If you don't use it, you lose it". Keep on changing the types of games and you should be good.

Watch a Video
I know, I know. I made fun of your kitten viewing problem earlier in this page, but some videos are good. Look up how to tie a bowline, play guitar, or maybe just use it for some guided meditation with Jon Kabat-Zinn.  Or you could go to TED talks, where you will find a plethora of interesting topics to pique your interest.
Or you could watch the funny part of Ted, when Mark Wahlberg is listing all the trashy girls' names... Luckily that's only a minute or so, so you'll still have time for other things ;)

Inch a Little Further Down the Rabbit Hole
Okay, so everyone has been on wikipedia. Here's the hyperlink challenge: Type in anything you're somewhat interested in. Now read about said topic. Come across something you haven't heard of? Click on the hyperlink. Repeat. Continue until you develop a decubitus ulcer or until you have come to a page that you know everything on it already.



Alright, have fun!

Iceland? More like Waterfall Land!

If Alaska and Ireland had a love-child and then sent him off to boarding school, Iceland would be him.

A mix between icebergs and glaciers of Alaska and the green fields and cliffs of Ireland, Iceland has it all. And if you live on the East Coast, it's actually a shorter flight than to California. It also can be inexpensive. However, with that being said there are some things that you need to do to keep from becoming a penurious old tourist.

Here are some tips: 

Fly Wow. Wow Airlines flies from Boston to Iceland direct for less money than to get to California. Don't expect any frills but it is better than what some people described as a flying bus. However, bring snacks and a water bottle because otherwise you'll be paying for it. 

This airline is made for mom's

Don't take the car insurance. Man! I have had the hard sell before from car insurance companies but nothing like Iceland. They try to get you to get windshield insurance, ash insurance, roadside assistance insurance, excess insurance etc. I feel like if I'd asked for it they'd have sold me life insurance. If you are planning on going into the Highlands you may want to reconsider this but if you are just driving the ring road, you definitely do not need all this. Saves you about $40/day.

Camp.  On Wow Airlines(where they nickel and dime you for everything), it costs $48 for each bag you check. Stuff one full with a tent and sleeping bags and it will buy itself back immediately. There are campgrounds in almost every town and almost all of them are near the local pool which is heated by a hot spring. Also, you can pull off anywhere along the road and pitch a tent which was amazing. I cannot tell you how awesome(probably one of the few times awesome is actually describing the awe inspiring moment) it is to wake up to a view of a glacier.  Be aware though: there are many places along the road that are so narrow that it makes pulling off to park nearly impossible. Be patient and you will find a gem. 

Bonus is a Bonus! Bonus is the local grocery store(think Aldi) that has low prices and a fairly good selection. This is probably the best way to cut costs as restaurant prices are astronomical(think $20 bagels). I had read many blogs talking about getting the roadside hotdogs, and I tried one and can tell you that it is definitely worth going to the grocery store. 

Don't buy the beer from grocery stores. While you may think it wise to buy the beer from the grocery store, it is not a good idea because it is only 2.25 abv. Go to a state run liquor store for the real deal. 

Buy the beer from grocery stores. With a legal driving limit of 0.05, and with severe penalties for exceeding that limit(plus sheep everywhere on the road), it doesn't make sense to risk it. Stick with the low alcohol content beer if there is even a chance you will have to drive after. 

Go to Happy Hour. With beer and food prices around double that of the US, it is crucial to make it to happy hour where the prices come down to about normal. The nice thing is that in Reykjavik the hours are staggered so you can make it to several bars in one evening. 

That's a $10 beer and the thing to the left is dried fish and butter to dip it in. Smelled like Fish food. No joke.

Don't skimp on the mineral baths. Whether it's Myvatan or Blue Lagoon, you need to spend the $45 to go to one. You will not be disappointed. BUT also go to the Hot Spring pools in the towns because they are also amazing. The one in Reykjavik is $5 and has seven hot tubs of various temperatures, a water-slide and an Olympic sized pool. 

We found this hot spring off a dirt road. Only even knew it was there from the steam rising from it.

Get off the beaten path. The ring road is pretty amazing in itself but there are so many things that you will miss if you don't take some detours. While F roads are off-limits to 2WD vehicles, there are still plenty of dirt roads that you can drive on. That's how we found a hidden gem of a hot spring.

Skip the Golden Circle. Depending on your schedule and how much time you have, you can drive as much or as little as you want. The Golden Circle, while nice, is so crowded with tourists and the sights are somewhat underwhelming when compared to some of the other places we saw along the way. Skip it and either head North to Snaefellsjokull peninsula or south to Skogar. They are both only a few hours away and offer so much better waterfalls, glacier views and picturesque towns.  And they offer some really cool hikes runs. We did a trail run along the coast in Snaefellsjokull that linked up the towns of Hellna and Arastapi which afforded us some awesome ocean views as well as a cave to explore. Meanwhile down in Skogar there is a 15 mile hike to Thormork(if you look on the map the TH looks like a weird D but it's pronounced with a th sound). We weren't able to do the whole thing(that'd have been a 30 mile hike), but what we did do was amazing as we passed 22 waterfalls! 

Oh yeah the waterfalls. I get that with 8% of Iceland covered by an icecap, it is fairly appropriate to call it Iceland, but I have never seen so many waterfalls in my life. It was spectacular. 

A few last things to consider: 

Bring CDs. Out of the city there is minimal radio coverage so it is definitely worth packing a few of your favorites. Especially if you do what we did, and covered over 1,400 miles. 

Gas is very expensive(about $8/gallon). I'd get the smallest car you can comfortably have to save on gas. The Chevy Spark worked perfectly for us. If your credit card doesn't have a PIN, you will also need to buy a gas card at an N1 station. This is crucial, especially late at night, because you otherwise won't be able to use an automated gas station. 

As I arrived home, Amber is in her final preparations for her own trip to Iceland. She will be racing in a 55 kilometer trail race in a couple weeks. I hope she has as wonderful a time as we did.