What's a gralefrit?

Asked a hapless customer in Fawlty Towers one morning at breakfast;

“grapefruit”, was Polly’s retort, clearly used to Basil’s typing of the menu.

This was appropriate really, for his cursory and flippant rapport with his guests was almost as acidic as the juice of this most majestic of citric fruits.

And just like some breakfasts, I would like to start this entry with a grapefruit.

Not just one but a host of enormous plump ripe fruit, all ready for picking, in fact so heavy that the fall from the boughs like drunk squirrels.

For at the bottom of our new garden stands an impressive fruit tree, thick with heavy juicy grapefruit, a marmalade makers delight…

But alas not for yours truly. The joys of the gralefrit are now off limits for good, and not just for reasons of bad taste.

My main immunosuppressant tablet is the drug Tacrolimus, which needs to be ingested at a steady dose at the same time intervals so as not to build up an excess in the system. Too much Tacrolimus is dangerous and can cause organ rejection, just as much as not taking the drug. A finely balanced existence then, one which the grapefruit does it’s best to upset.

And now the science part:

The juice of the fruit reacts with the ketoconazole present in the blood which affects drastically the levels of an enzyme that interact with the Tacrolimus. Studies therefore have shown that the Tac can both increase and decrease, which has a seriously detrimental effect on the use of Tac as an immune suppressant.

So this time honoured breakfast staple is off limits for good.

Which is ironic, given that we are abundant with the malicious fruit.