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- Title
Grapefruit juice and licorice increase cortisol availability in patients with Addison's disease.
- Authors
Methlie, Paal; Husebye, Eystein E. S.; Hustad, Steinar; Lien, Ernst A.; Løva°s, Kristian
- Abstract
Objective: Failure to mirror the diurnal cortisol profile could contribute to the impaired subjective health status in Addison's disease (AD). Some patients report benefit from the use of various nutritional compounds. The objective of this study was to investigate the impact of licorice and grapefruit juice (GFJ) on the absorption and metabolism of cortisone acetate (CA). Design: Patients (n=17) with AD on stable CA replacement therapy were recruited from the outpatient clinic at Haukeland University Hospital, Norway. They were assessed on their ordinary CA medication and following two 3-day periods of co-administration of licorice or GFJ. Methods: Time series of glucocorticoids (GCs) in serum and salivawere obtained, and GCs in 24 h urine samples were determined. The main outcome measure was the area under the curve (AUC) for serum cortisol in the first 2.6 h after orally administered CA. Results: Compared with the ordinary treatment, the median AUC for serum cortisol increased with licorice (53 783 vs 50 882, P<0.05) and GFJ (60 661 vs 50 882, P<0.05). Median cortisol levels in serum were also elevated 2.6 h after tablet ingestion (licorice 223 vs 186 nmol/l, P<0.05; GFJ 337 vs 186 nmol/l, P<0.01). Licorice increased the median urinary cortisol/cortisone ratio (0.43 vs 0.21, P<0.00001), whereas GFJ increased the (allo-tetrahydrocortisolCtetrahydrocortisol)/tetrahydrocortisone ratio (0.55 vs 0.43, P<0.05). Conclusion: Licorice and in particular GFJ increased cortisol available to tissues in the hours following oral CA administration. Both patients and physicians should be aware of these interactions.
- Subjects
GRAPEFRUIT juice; LICORICE (Plant); HYDROCORTISONE; MEDICAL care; ADDISON'S disease; NUTRITION; TIME series analysis; THERAPEUTICS
- Publication
European Journal of Endocrinology, 2011, Vol 165, Issue 5, p761
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-11-0518