Arthritis is a common term used to describe 100 different disease condition.
A common thread involved in all these conditions is joint pain and inflammation.
Rheumatoid arthritis is a type of arthritic condition which involves pain and inflammation in joints of the fingers, wrist and feet. Gender, genetics and age are considered to be the prime causes of this disorder.
Rheumatoid arthritis is the autoimmune form of arthritis. In this body’s immune system starts attacking its own tissue and joints leading to degeneration of joints and inflammation.
Characteristic symptoms include pain, swelling, inflammation and stiffness. Chronic pain can lead to fatigue, sleeplessness and weight loss. Obesity, age and certain environmental factors pose a health risk for this disease.
The inflammation can spread to other parts of the body such as lungs and heart. Complications of rheumatoid arthritis include osteoporosis, carpel tunnel syndrome, rheumatoid nodules, dry eyes and mouth, heart and lung problems etc.
Treatment involves administration of painkillers, steroids, non steroidal anti-inflammatory drugs and anti-rheumatic drugs. Lifestyle changes, exercise and even alternative therapies are available in treatment of arthritis.
Grapefruit- the “Nature’s medicine”
Grapefruit is a citrus fruit related to orange, pomelo and lemon.
It is juicy, tangy and tart in taste and is known for its numerous health benefits. It is rich in antioxidants and various vitamins like Vitamin C, Vitamin A, Vitamin K, Vitamin D and Vitamin B complex.
Additionally it is an excellent source of dietary fibre, potassium, phosphorus, calcium, and copper. It contains phytochemicals including lycopene and liminoids .
Grapefruit can be called as one of the Nature’s medicine due to its tremendous health benefits. It is known to be beneficial for boosting the immune system.
The Vitamin C present in grapefruit helps in healing sore throats, and coughs. It also helps in improving the functioning of digestive system. In fact the fibre present in grapefruit relieves the disease symptoms in patients with constipation.
Again, grapefruit is known to assist in lowering the blood pressure, controlling blood sugar levels, alleviating fatigue and promoting weight loss.
A study performed by scientists at UCLA and Zhongshan University in China concluded that grapefruit contains a compound called Naringenin which helps in repairing DNA in prostate cancer cells in humans.
Grapefruit is also known for its beneficial effects in patients with rheumatoid arthritis. Daily consumption of grapefruit has been associated with lowering of inflammation caused due to inflammatory diseases .
Many studies have proved the beneficial effects of antioxidants in ameliorating disease symptoms in the case of rheumatoid arthritis.
4 Benefits Of Grapefruit In Rheumatoid Arthritis
Various phytonutrients present in grapefruit offer anti-inflammatory effect and also the antioxidants present in grapefruit benefit in rheumatoid arthritis.
1. It is a rich source of antioxidants
Antioxidant activities of plant derived flavonoids are found to be beneficial in arthritis treatment. Research shows that kaempferol, hesperitin and naringin- flavonoids present in grapefruit inhibit the activity of inflammatory enzyme COX-2 and hence can aid in treatment of rheumatoid arthritis.
Grapefruit is a rich source of Vitamin C. An observational study was conducted where the association of consumption of antioxidant vitamins and trace elements with rheumatoid arthritis.
Greater consumption of fruits and cruciferous vegetables was inversely associated with risk of arthritis.
Consumption of grapefruit juice was inversely associated with risk of arthritis. Consumption of β-cryptoxanthin, an antioxidant found in citrus fruits, was inversely associated with risk of arthritis.
A recent study investigated the role of antioxidant supplements on a group of 40 female patients suffering from Rheumatoid arthritis.
These patients were administered daily doses of Selenplus capsule (containing 50 micrograms of Selenium, 8 milligrams of zinc, 400 micrograms of Vitamin A, 125 milligrams of Vitamin C, and 40 milligrams of Vitamin E) for a period of 12 weeks.
The disease activity was tested before and after the drug intervention and results were analysed. This study eventually helped to conclude that antioxidants are helpful in controlling clinical outcome and oxidative stress in patients with rheumatoid arthritis.
While on one hand this study used artificial antioxidants as supplements, grapefruit can be a natural means to provide all the nutrients mentioned above. Thus future research with grapefruit juice as a means to provide antioxidants could ascertain the anti-oxidative properties of grapefruit .
Similarly research shows that high doses of Vitamin C could be beneficial in reducing inflammation and oxidative damage in patients suffering from inflammatory diseases.
In a recent study performed using arthritic rats as models it was found that iontophoresis with ascorbic acid (Vitamin C) helps in cartilage regeneration near damaged tissues.
In this study the rat models were divided into two groups- one receiving iontophoresis with ascorbic acid while the other left untreated.
On comparing the cartilage thickness and cellularity of both the groups, it was found that the group that the group that underwent Iontophoresis with ascorbic acid showed higher number of mean cartilage-forming cells and reduced thickness of calcified tissue.
This proves that ascorbic acid does play a significant role in cartilage regeneration and swelling reduction in arthritis. Grapefruit being a rich source of Vitamin C can thus be used as a good supplement for patients suffering from rheumatoid arthritis.
What does this mean?
Antioxidant consumption is associated with reduced risk of arthritis and grapefruit is a rich source of antioxidants.
2. Grapefruit active ingredients have anti-inflammatory effect
Grapefruit has a number of therapeutic compounds such as naringin, hesperidin and kaempferol that can benefit in arthritis treatment.
In an animal model of arthritis, naringin supplementation was found to reduce inflammation in joints. Significant reduction in damage to joints and migration of inflammatory cells to affected sites was observed.
Another study also proves this same point and results reveal that naringin reduces swelling and inflammation as effectively as steroid dexamethasone.
Tumor necrosis factor-alpha and nuclear factor kappa B are proteins that play a very important role in inflammation.
Naringin suppresses the activity of these proteins and protects stem cells from inflammation induced bone injury.
Rheumatoid arthritis is an autoimmune condition where the body’s own immune system attacks the tissues of the joints. Naringin is found to have an immunomodulating effect wherein it prevents activation of immune cells and prevents them from inducing inflammation in rheumatoid arthritis.
Kaempferol is a dietary flavonoid present in grapefruit. Synovial fibroblasts are type of cells present in the lubricating fluid between the joints that in rheumatoid arthritis start secrete inflammatory substances and destroy bones and cartilage.
Research shows that kaempferol inhibits the growth of synovial fibroblasts in rheumatoid arthritis, prevents them from releasing inflammatory chemicals like prostaglandins, COX enzyme and this in turn inhibits degradation and inflammation of joints and bone tissue.
Kaempferol can be a novel therapeutic agent in rheumatoid arthritis.
Hesperidin is another flavonoid found in grapefruit. It can help in reducing inflammation and inflammation related pain. It possess antioxidant and anti-inflammatory activity that benefits in treatment of rheumatoid arthritis.
Animal study demonstrates that hesperidin serves as an antioxidant and prevents activation of destructive inflammatory cells in rheumatoid arthritis.
A group of scientists demonstrated the suppressive effects of the Citrus flavone named Naringin on inflammatory responses in mice.
This study identified the healing properties of Naringin and showed experimentally that naringin could reduce the interchondral joint damage, and lower the infiltration of inflammatory factors in artificially-induced arthritic mice thus proving that naringin could be effective in treating symptoms of rheumatoid arthritis .
Naringin is a commonly found flavone in grapefruit and other citrus fruits. In recent years another study confirmed the anti-inflammatory role of naringin obtained from grapefruit in ameliorating disease symptoms of autoimmune arthritis.
This study tested the effect of naringin on inflammatory mediators like Th1/Th2 cytokines, CD4 (+) CD25 (+) Foxp3 (+) (Treg), CD4(+)GITR(+) expressing cells, etc. Results from this study proved that naringin possesses inhibitory effect of T-cells thus lowering the production of inflammatory mediators by the T-cells.
This eventually prevents the cellular infiltration into the joints thus preventing them against arthritic damage .
What does this mean?
Naringin is one of the most important active ingredients of grapefruit and it exerts anti-inflammatory and immunomodulating effect in rheumatoid arthritis. Kaempferol and hesperidin are the other compounds present in grapefruit that reduce inflammation and bone damage in rheumatoid arthritis.
3. Grapefruit potentiates effect of anti-inflammatory agents
The bark of herb Anacardium occidentale has anti-inflammatory effect, but its activity is 8-15 times lesser than that of painkiller diclofenac. A study reports that co-administration of grapefruit juice with the extract of this herb potentiates its anti-inflammatory effect.
Similarly co-administration of grapefruit juice and painkiller diclofenac is found to have a synergistic effect.
Grapefruit juice exerts anti-inflammatory effect and strengthens diclofenac’s ability to reduce swelling.
However this is animal study and needs to be validated in humans. It is generally recommended not to take grapefruit or grapefruit juice with any medication due to possibility of drug interaction.
What does this mean?
Co-administration of grapefruit juice with anti-inflammatory herb strengthens its therapeutic effect and exerts anti-inflammatory effect. However it is advisable not to take grapefruit juice in combination with anti-inflammatory drugs or any medications.
4. It is beneficial in treatment of obesity and metabolic syndrome
Obesity and metabolic syndrome serve as risk factors for development of rheumatoid arthritis.
Sinetrol X-Pur is a citrus polyphenolic extract derived from red orange, grapefruit and orange. A study was conducted where for 12 weeks overweight individuals were asked to take this extract twice a day with meals.
At the end of the study, a 5.71% decrease in waist, 4.71% decrease in hip and 9.73% decrease in abdominal fat was observed. Decrease in inflammation and oxidative stress was also observed.
Obesity can hamper metabolic health. Naringin reverses metabolic damage induced by high fat diet. It reduces glucose intolerance, prevents liver dysfunction, lowers cholesterol levels and improves heart health.
Other active ingredients of grapefruit such as hesperidin also protect from diet induced obesity and changes in metabolic health.
What does this mean?
Grapefruit can benefit in weight loss and improve metabolic health both of which serve as risk factors for development of rheumatoid arthritis.
It is important to mention here that there are many contradictory reports regarding the role of grapefruit in relieving arthritic symptoms on the internet.
There are numerous reports that claim that grapefruit juice interacts with the medications and thus have ill-effects on patients with rheumatoid arthritis.
Thus it is common for the patients to be confused and skeptical about the authenticity of both the claims. This section would thus try and clear the air for our readers.
These drugs include anti-rheumatic drugs like methotrexate, cyclosporine, beta-blockers like acebutol, and cancer drugs like etoposide, some anti-allergic, antibiotics, and HIV protease inhibitors .
However these reports just suggest to use grapefruit with caution and do not advice to avoid using grapefruit juice as a whole.
Grapefruit juice has many health benefits as stated in previous sections. It does possess effective anti-inflammatory properties.
However it interacts with some medications used for rheumatism and should not be consumed in combination with these drugs.
In ideal situation it is advised to consume the beverage about three to four hours after taking the medications. But still the gap could vary from one case to another.
Thus it is always better to consult your physician to be sure if your medications might interact with grapefruit and if they do what should be the optimum time gap to avoid such interaction .
If the above mentioned advice is followed you can simply benefit from the nutrients available in grapefruit without worrying about any ill-effects.
How can Grapefruit be included in the diet?
Grapefruit is highly preferred breakfast in many parts of the world. It could be consumed as a fruit, seed extract or juice by individuals.
There are grapefruit supplements also available in the market however the natural product cannot be replaced by any supplement. It is usually advised that patients with arthritis consume the fruit rather than taking supplements as that would have better results.
Due to lack of significant trials performed in humans, not much evidence is available to comment upon the dosing of this fruit. However if taken within the normal dietary limits, it would not have any side effects.
It has been found to be safe for consumption by children and pregnant as well as lactating women on the basis of observation. However no scientific data is available to support this view.
How to take grapefruit for Rheumatoid Arthritis?
Grapefruit is consumed on a regular basis as breakfast in different parts of the world. Grapefruit supplements are available but I would suggest consuming the fruit as a whole.
Half a grapefruit prior to meals helps in controlling appetite and reducing calorie intake. Additionally it would provide you with all nutrients and anti-inflammatory agents. You can also consume grapefruit juice; the one you make at home and not processed.
A glass of grapefruit juice daily should benefit in rheumatoid arthritis and overall health. You can also add grapefruit to salads.
Grapefruit is safe for consumption by humans.
One of the most important concerns about consuming grapefruit is that it may cause drug interactions. This is because certain nutrients in grapefruit inhibit the activity of drug metabolizing enzyme which may lead to high concentrations of the drug in the blood and cause adverse effects.
Additionally it may also block the absorption of certain drugs from the intestine. Few of the drugs it can interact with are cyclosporine, antiviral drugs, calcium channel blocker drugs, statin drugs, anti-rheumatic drugs, antibiotics etc.
It is best to avoid consuming grapefruit or grapefruit juice in combination with any medication. It is best to keep a gap of 3-4 hours between consumption of either to avoid any ill-effects.
If opting for grapefruit supplements, please consult a doctor.
It is important to note here that although grapefruit allergies are uncommon, but in case of any rare occurrence, use of grapefruit in any form must be avoided.
Grapefruit is one of the best foods that you can include in your diet if suffering from arthritis or any other metabolic condition. The nutrients in grapefruit are proven to exert anti-inflammatory effect in arthritis. Also consumption of grapefruit juice is inversely associated with occurrence of arthritis.
Avoid consuming any medications with grapefruit or grapefruit juice to eliminate possibility of drug interactions.