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Dr. Gourmet Newsletter: September 15, 2008

Dr. Tim Says....

Timothy S. Harlan, M.D.I have written before about the interaction with certain medications and grapefruit. It wasn't until about 2 years ago that scientists identified the exact substance in grapefruit that causes the problem. We now know that furanocoumarins (naturally-occurring substances found in grapefruit's juice) are the culprit.

The issue is how those furanocoumarins interact with the CYP3A4 enzyme made in the liver. The problem arises because of the way this enzyme acts on certain medications. Drinking grapefruit juice affects this enzyme and interferes with how they are broken down. We don't know exactly how long after eating grapefruit or drinking the juice the effect wears off, however. Consequently the ongoing presence of the grapefruit in the body continues to have an effect on the system.

Interestingly, there are also CYP3A4 enzyme produced in the intestine that can interfere with the availability of drugs being absorbed into the bloodstream. As a result you should be aware that there may not be a safe time to take some medications when eating grapefruit or drinking grapefruit juice.

One of the questions that I have received after writing on this topic is just which drugs can be a problem. Grapefruit Interactions

Featured Recipe

Trout with Tarragon Mustard Sauce

Fresh TarragonI like serving trout in filets because I am not all that fond of fighting with my food when I am ready to eat it. Most trout filets have been boned before you buy them, but check carefully before cooking. The key to cooking is a pan that's quite hot but not so hot as to scorch the fish. Place the filets in skin side down to sear and then reduce the heat. The skin will crisp up nicely and the fish will cook easily.

This recipe is Coumadin® (warfarin) safe and gluten free provided that the ingredients used to make it are gluten free. Those who are lactose intolerant or have GERD / Acid Reflux should avoid it.

Taste Buds

There are five types of receptors on the tongue that sense all of the flavors that we taste. They are salt, sweet, bitter, sour and one called umami. Umami is a taste receptor that was identified only about six years ago and is best described as savory.


Each of these flavors acts on their own, but how they interact with each other is key to making recipes taste fantastic. Activation of any one taste will enhance another taste bud.

Sour tastes come from acidic foods. Because of the properties of acidic foods and how fast they react on the sour taste buds, these flavors can quickly brighten an otherwise dull dish.

The properties of salt react with acids and soften the bitterness of dishes. In doing so, sweetness is enhanced. Taste Buds

Eat well, eat healthy, enjoy life!

Timothy S. Harlan, M.D.
Dr. Gourmet

eatTHISdiet for Coumadin Users:
The Book

Many of our readers have written to ask about a book on Coumadin use, and we're pleased to announce that eatTHISdiet for Coumadin Users is now available for purchase in both spiral-bound paperback and PDF format!

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Try My eatTHISdiet!

My eatTHISdiet is Dr. Gourmet's newest version of his popular diet plan. This free and easy to use meal planner can help you create two-week meal plans for your entire family. It'll even make use of the leftovers!

Use it to lose weight or just eat healthier with Dr. Gourmet's delicious and healthy recipes. On Coumadin®? Lactose intolerant or gluten sensitive? Have GERD / acid reflux? My eatTHISdiet will create a plan for you, too! Get started on My eatTHISdiet.

Also available: My eatTHISdiet - The Comfort Food Diet. Eat the foods you love and still eat healthy!

Hand on Heart

Hand on Heart

Dr. Harlan's latest cookbook, Hand on Heart, includes several of the recipes from, plus a few that were developed specifically for the book, like Banoffee Pie! More on what's inside.

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