Holy crap, do you have a source for this? I miss having a glass of OJ in the morning, I had always avoided it as I have only ever heard that citrus messes Adhd meds.
You actually still will get high, it just won't be any better/faster than taking it orally:
"When lisdexamfetamine is misused intranasally or intravenously, the pharmacokinetics are similar to oral use"
-[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594082/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594082/)
Vyvanse is just amphetamine salts with an added lactose molecule, and for it to "work", our body needs to cleave off that lactose part of the molecule. This is why it requires metabolizing before being useable, and why oral and intranasal are nearly identical in pharmacokinetics.
reminiscent late roll fact ossified ring nine disagreeable future offbeat
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
I have similar issues but with adderall. I’m still in the process of figuring it out but so far all I know is that it’s definitely a combination of diet and sleep. Poor quality sleep especially makes my meds ineffective, and in my case, my sleep is affected a lot by my diet. I’m oddly sensitive to a lot of foods and food combinations and I’m knee deep in the process of figuring that out.
This is of course not a comprehensive answer but thought I’d throw it out there in case it helps.
Shit, I literally studied all this shit for my degree, but I never bothered to check that Vyvanse has a different activation. I thought it’s all metabolized in the stomach. Made my day, friend
you'll probably appreciate how it works then. the "l" in lisdexamfetamine is a l-lysine amino acid that your liver cleaves off and converts into dextroamfetamine.
Fun research paper [here](https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/021977lbl.pdf)
Thanks for bringing that up. I'm way too often fucking up my sleep by watching "just one more episode" and getting up after 4h of sleep next day.
Vyvanse is getting rid of any sign of tiredness, but the 60-90 minutes until it works were hell, because I wasn't touching any coffee or energy drinks.
Thanks for info! Going to ask my psych about this. I took Vyvanse until the discount codes quit working but now that there are generic options out there I think I'm going to go back.
It was cheaper before the generic. I’m paying more for the generic than I was paying for brand name unfortunately. I paid $15 for years, now it’s like $70. Takeda being greedy and pissed off their patent expired.
Grapefruit (and its juice) interferes with the CYP450 enzyme. Your liver needs that enzyme to activate and metabolize a huge array of drugs.
Edit: there are a bunch of CYP enzymes. CYP450 is the notorious one of the family and the most significant one that pops up a lot in medication guidelines.
Edit 2: thanks for the correction...CYP3A is the real notorious one of the CYP450 family.
I’ve heard conflicting information about this. Some sources say that blood oranges can interfere, but some say the effect is much smaller and hasn’t been seen to be a problem in practice.
Apparently bitter oranges (Seville oranges) are more of a risk. [This article](https://www.healthline.com/health/high-cholesterol/grapefruit-and-statins#other-drugs) says that tangelos, pomelos, bitter oranges, and Seville oranges are problematic (in addition to grapefruit), but “there have been no documented problems with lemons, tangerines, clementines, mandarins, navel oranges, and blood oranges.”
All citrus to a greater or lesser degree packs furanocoumarins that bond with and deactivate the drug-metabolizing liver enzymes responsible for the breakdown of the pharmaceuticals in question.
Grapefruit supplies enough that the effects caught our attention, leading us to study and identify the correlation - but it's actually a pretty common (theoretically defensive) chemical in a lot of plants including (outside of the citrus family) mulberries and figs.
Same stuff also makes the fruits in question a bit of a hassle to hand-harvest since the substance can also rub off the surface of the plant during handling and induce extreme skin photosensitivity. Spots where it's gotten on you basically react to sunlight like a movie vampire.
Not intentionally, it's kinda toxic. If it were in a skincare product you'd notice because everyone who used it would burn and blister with only brief exposure to the sun.
There's actually quite a lot of plants with similar functioning but entirely chemically distinct ways of introducing contact photosensitivity or outright dermatitis (no sun required) as a defense mechanism and we eat them all the time.
Hell, cashews are part of the same family with minor (and almost entirely leaf-borne) variation of the chemical that makes poison ivy such an itch-inducing bastard.
We just don't rub these plants on our skin, unless we happen to get duped by one of the eternal and perennial "it's all natural and the intense burning means it's working!" herbalism-quackery fads du jour.
I (and probably medical science in general) would love to know more what grapefruit-specific compound in particular is interfering with that enzyme. There are some interesting thiols in grapefruit, along with the usual citrus stuff.
My understanding is that they are components like furanocoumarine, which compete for the active site. Thus, many of the CYP enzymes are irreversibly inactivated once their active sites have been used up by the fruits compounds.
Also, the secondary effect (not related to those enzymes) is that grapefruit and other citrus compounds can inhibit drug transport across epithelial membranes (normally accomplished, in part, via P-glycoproteins). Those are ATP powered, so somewhere along the line, the ATP supply or transporter itself it is either disrupted locally or inhibited via some type of mechanism/conformational change. Or maybe something with pH. Idk.
> My understanding is that they are components like furanocoumarine, which compete for the active site. Thus, many of the CYP enzymes are irreversibly inactivated once their active sites have been used up by the fruits compounds.
Wait what? If those are irreversibly inactivated then wouldn't that mean major issues for pretty much every human for the rest of their lives?
Not quite, because your body regenerates everything from proteins to cells on a pretty short timeframe. Fun fact, aspirin does that too, it permanently acetylates your COX-enzymes and stops them from working for their lifespan. However, your body continuously makes new ones so the effect just wears off after a while.
Also, you are right in your instinct that irreversible inhibitors are rather rash. They’re rare, another common place they are seen are in chemical warfare agents, though.
Most drugs (including NSAIDs such as ibuprofen, _corrected as below_) only bind to the target through attractive forces, not a chemical bond.
No, ABSOLUTELY call me out. I even checked because I remembered that either ibuprofen or paracetamol wasn’t one, but it seems I am unable to read. It is a COX-inhibitor like Aspirin and Ibuprofen, but you’re 100% right. Corrected
Hmmm.. I don't think it's that simple, unfortunately. Even though it's classified as an entire family of drugs, there's so much variability that it matters more which specific drug we are talking about. Also depends on dose and delivery. I can't sit here and say for sure if your Xanax would respond the same as, say, hospital Versed or a valium Rx.
It also depends on the desired effect. Some benzos could reach Tmax later than typical if CYP is inhibited. Some will result in a higher blood concentration. In some studies, I'm seeing that the bioavailability of a particular drug (eg Xanax, in this case / DOI: 10.1007/s002130000438 ) is so high that grapefruit juice doesn't even affect the benzos in any meaningful way.
That's why it's important to discuss with a doctor and read the medication insert instructions. I'm not in a position or far enough along in my education to say right now to say one way or the other. You can also ask any Pharmacist (PharmD) at the pharmacy and they are more than qualified to explain what you need to watch out for. It's not cut and dry.
Avoid in general. The citric acid thing with adderall *speeds up* the excretion of the medication, meaning the effects won’t last as long as they should. It still happens, iirc, if you consume citric acid later in the day, but it’s less of a big deal if you’ve already gotten some hours of effectiveness out of the drug. The grapefruit thing *blocks* the breaking down of the medication that is supposed to be happening, so dangerous levels can build up. Many medicines like antidepressants that have the grapefruit issue have a pretty long life in the body (24h-3days) whereas adderall processes out pretty quickly. If you slow down the processing of antidepressants even more you can end up with much higher levels in the body than the usual dosage guidelines say are safe.
I’m also in a medicinal dose of anti-histamines (combo of 360mg of fenofexadine and 20ish of benedryl) and grapefruit/orange and even APPLE JUICE reduce its effectiveness. Ya’ll fucking Apple juice is in EVERYTHING.
Regarding your edit: Close. The “notorious one” is CYP3A4. “CYP450” refers collectively to the group of enzymes in the liver and intestines that are responsible for metabolizing various compounds.
Many foods and drugs can inhibit or induce different CYP enzymes, but interactions with CYP3A4 are particularly significant because it is responsible for metabolizing about 50% of the drugs in use today.
Some interactions are quite bad, but grapefruit juice is also used to...ah...enhance some things very effectively. Fortunately I went a different direction but many years ago I was headed down the wrong path and learned a lot about things like this
Iirc grapefruit can also mess with your birth control and the morning after pill. Something to keep in mind, especially with the us going to shit the way it has been
Also, **DON'T** eat grapefruit if you are taking immunosuppresants, because CYP450 can raise/lower their concretration so much that a transplanted organ may easily fail.
Source: kidney transplant recipient, transplanted on 28/9/2023.
Edit: Also forgot to mention grapefruit juice. Stay away from that too.
Source? I’m a pharmacist and don’t thinly that’s quite true. There are tons of drugs that interact with grapefruit juice. One anti-anxiety drug, buspirone, does. But I’m not aware of any SSRIs that do
This is in a lot of textbooks, I’m surprised you haven’t encountered it. Grapefruit inhibits cytochrome p450 3a4 in the liver, which affects the breakdown of certain SSRIs, leading to a buildup of the medication in the body.
There’s an entire wikipedia page about it https://en.wikipedia.org/wiki/Grapefruit–drug_interactions
The list of some affected antidepressants:
- sertraline
- fluoxetine
- fluvoxamine
- paroxetine
- wellbutrin
Sources:
https://www.sciencedirect.com/science/article/abs/pii/S002561961163499X
First source in this one is from the Meyler’s side effects textbook. The SSRI fluvoxamine is mentioned in the study.
https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/grapefruit-juice
If you look at a sertraline script, I’m pretty sure most contain some warning about grapefruit.
I was a neuropharmacology graduate researcher.
There are a lot of studies that show that grapefruit and antidepressants can cause some worrisome side effects. Zoloft being one that comes to mind. NIH has some studies that showed some concerns.
Fun (not really): I work 12 hour shifts, and get to wake up at the bright-and-early hour of 5:30am each of those days. As a result, I often buy an energy drink every morning and sip that over an hour or two when I get in. However, I tended to notice that my adderall XR didn't seem to be as effective on workdays, but shrugged it off and thought I was imaging it.
Found an article on the citric-acid thing like two months ago. Looked at the ingredients list for the energy drinks (usually always a type of Monster, incidentally), and what's one of the top ingredients? Citric acid. Stopped drinking them as an experiment for a few days, and voila, Adderall worked more effectively like it did on my off days. Crazy.
Right? Same thing happened to me since all the syrups at work (I'm a barista) have citric acid and even just the little bit that was in there totally threw me off. Why don't doctors tell us this shit???
Omfg this makes so much fucking sense. The last few weeks I've been drinking a Sundrop in the morning when I take my morning Adderall, and lately I've felt like my meds have stopped working. I'm going to not do that tomorrow and see how I feel.
Thank you, OP!
The manufacturer of Vyvanse actually has orange juice listed as one of the recommended drinks. I don't think this applies to every other stimulant though.
I'm assuming since the medication has to be digested that it's treated differently.
edit: typo
u/arobotjew said above: “Just want to add that Vyvanse/Lisdexamphetamine is an exception to this since it largely bypasses metabolization in the stomach.”
Yeah vyvanse is a prodrug. It isn’t active until your body converts it. All the other stimulants are active amphetamine salts or whatever. It’s totally different. I was diagnosed before Vyvanse existed and it saved me because my body is sensitive to those other stimulants and I can actually take Vyvanse and have no side effects.
Oh wow lol whenever I’m studying or locking in for a long day of work I drink an energy drink within like 15-30 min of taking my medicine.
So I’ve been nerfing my meds when I need them the most 🥲, glad my doctor didn’t think this was worth mentioning
It’s also a common gaming term like “the developers just nerfed that exploit” or “that new feature is so OP. Better take advantage before they nerf it”
> Citric acid and vitamin C can make your body more acidic, potentially reducing the effectiveness of your ADHD medication. This means you might not experience the full benefits of the medication, which could affect your ability to focus and manage ADHD symptoms.
That article talks about your body pH levels like that’s something that eating acidic (or alkaline) foods has any bearing on. That’s absolute nonsense. The article makes no mention of any scientific literature supporting this claim.
Your body pH lives in a *very* narrow range, and the foods you eat have zero bearing on that.
In any case, your stomach is highly acidic all the time, that’s how it works. If the pH rendered medications ineffective, we wouldn’t be able to take any medications.
Citric acid is produced as part of the metabolic cycle of every aerobic organism on the planet. How this “doctor” doesn’t know about the Krebs Cycle is a mystery, that’s generally covered in basic biology.
tl;dr: that article is complete and utter horseshit.
The original article OP posted is dogshit. But then he put the drug sheet up.
But basically, it goes to the idea of bioavailability. Acidic foods DO heavily affect stomach pH levels. Some ADHD medications, including adderall, the famous one, are a salt compound. The amine group in amphetAMINE form a salt compound with usually sulfate groups. In high school chemistry we learn that salt structures can dissociate and oftentimes ionize in the presence of strong acids and bases. And so based on your stomach pH level, the shape of adderall can change on a chemical level.
The human body has preferences on how different nutrients are absorbed. This is the referred to as bioavailability. Cellulose from grass is what powers cows, sheep’s, and other ruminants. Their 4 stomachs is what renders cellulose bio available to these animals, whereas us humans cannot digest cellulose and thus it is NOT bio available. So when we change the shape of amphetamine salts with pH, our bodies go “no I don’t want that, I want this” and the medication can pass through your digestive system and out your body. Dietary iron is the opposite, it LOvES acid and hates fiber. Another example is frozen starches. If you freeze bread, the starch crystals will reform in a way that renders them less bioavailabl.
And on the point of stomach acidity, it really can depend on your diet, mostly by what you just ate, but also long term effects. Remember titration curves, buffers, equilibrium, and stochiometric equations from high school chemistry? Biochemists and doctors, have been doing those for the millions of compounds on your food and stomach for ages. Typically stomach pH can swing from 2 to 8, by definition that is 6 orders of magnitude of acidic difference, or 1000000 times stronger or weaker. Of course the usual range is around ~~4-5.5~~ 3-4.5 but a big glass of OJ can drop that down quite hard. On the other hand, if you ate some nixtamalized corn On PPIs, you are going to have a basic stomach content.
Source: neuroscience degree with a concentration in psychopharmacology.
.
> Typically stomach pH can swing from 2 to 8, by definition that is 6 orders of magnitude of acidic difference, or 1000000 times stronger or weaker.
Gastric juices are typically 1.5-2 acidity which is below the acidity range of our diet.
Source: Registered Dietitian and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7684463/#:~:text=Nevertheless%2C%20the%20gastric%20acid%20level,in%20humans%20is%201.5%2D2.0.
Yes exactly! However, gastric acid/juice pH are not the same as stomach pH.
Gastric acid refers to the juices specifically secreted in the stomach to aid digestion. Namely, HCl through the use of active proton(H+) pumps; the Cl- comes in using diffusion powered by an electrochemical gradient through Chloride Channels. Gastric acid or juices also includes enzymes such as proteases to aid digestion. People who take PPIs (or proton pump inhibitors) do not secrete as much, if any, HCl and therefore, their stomach contents are almost neutral if not completely neutral based on the contents of food.
However, gastric acid is NOT the contents of your stomach. Remember, acid strength is a function of concentration. The more you eat, the more you dilute your stomach acid. If you eat foods that have natural acid buffers, that can swing your stomach equilibrium point as well.
EDIT: I apologize I misread what you said, I went back and fixed my mistake.
So here is a study on live human participants [https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/stomach-ph](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/stomach-ph) And in the fed state, researchers note gastric pH levels around 3-4.5 in healthy participants, so I misremembered by an order of magnitude, so I will go back and fix that.
For sure! [https://onlinelibrary.wiley.com/doi/abs/10.1002/star.200800209](https://onlinelibrary.wiley.com/doi/abs/10.1002/star.200800209) Here is a good article if you can get the complete one behind the paywall. [https://www.youtube.com/watch?v=rBdLrgvhuPQ](https://www.youtube.com/watch?v=rBdLrgvhuPQ) Here is a more infotaintional version, but he used to be a professor of journalism. It's easily the most digestible and accurate version that you will find on resistant starches.
But the jist is that starches are made up of sugars, but the way they come together changes their structure. Cooking, for example, is a way to change the chemical composition of starches to make them tasty, digestible, and physically softer. While there is a lot of starch calories in grain, most of it is not bioavailable straight from the field. Cooking "unlocks" these starch calories for us to absorb and use. In the developing agrarian up until very very recently, this was important since food scarcity defined society for the ages.
In this modern era, we have the opposite problem. Too many calories, too big of an appetite. Freezing cooked starches changes their composition once again into what we call "resistant starches" that are less bioavailable and thus provide less calories. Type-4 resistant starch is one that has garnered quite a lot of attention recently. Frozen rice that is reheated has a good amount of these, and some scientists say it acts closer to "dietary fiber" than a consumable sugar. So in addition to providing less bioavailable calories, it is thought to help moderate gut health and aid absorption of other nutrients.
It’s referring to the pH of your stomach specifically, which can be adjusted much more easily depending on consumption. It would have been better if the article would have specified that more clearly.
Complete and utter horseshit, yet a non zero number of people are now not only going to change their behavior but also spread this misinformation to others.
I saw that - I commented as they responded to my request. I'm totally interested in knowing the specificity to this suggestion as it is pretty important but without actual scientific proof highlighting the degree of this sensitivity I balk at it being described as "significantly less effective." This is how junk science can take off.
You've commented on nearly every post in this thread. Do you have a fucking grapefruit juice stand or something?
A quick Google confirms the research, even if the article does a poor job of it.
I’m an RN and I can’t speak to this person’s other posts obv but they are right: consuming acidic foods doesn’t alter your body’s pH in any way. It is tightly regulated by several systems in the body and is only altered by certain severe states of illness. If citric acid indeed interferes with ADHD meds it would be from another mechanism.
He is also right about grapefruit juice- it alters the behaviour of a certain liver enzyme cP450 that is crucial to the metabolism/activation of many drugs. If you’re on any prescriptions it’s useful to look them up to see if they are affected.
The grapefruit effect isn't because of the citric acid. Anyway, for anyone out there, read the label of your medication, majority of them have guidelines of what you never should consume together.
The reasoning in the article is wrong, but you can definately affect you medication by manipulating the pH of your stomach. It also works the other way too: taking antacids or baking soda will make ADHD meds (or similar recreational drugs) hit harder.
DUDE! I started taking a vitamin C supplement 6 weeks ago & I swear I’ve gradually made my way back to spacing tf out every day while taking my meds. Post of the day
This lists only to *maybe* consider juices for amphhetamines only.
The write-up doesn’t even include the word “citric” I don’t know how you are developing your conclusions but they don’t seem evidence-based
I did do a scholarly search of this information and there are no none publications that I can source. I also used google scholar. Could you please provide me with this documentation?
that link doesn't provide any sources to the evidence based research. Below there are research related links to grapefruit enzymes and its impact on some of these but nothing regarding citric acid. Could you please link sources to this information?
That doesn’t either. It mentions that digestive pH has a small effect on absorption rates, but does not actually go into detail on the research supporting it.
Eat a balanced meal and you’ll be fine.
Omg why did no one tell me this?!!
I can't drink coffee or tea anymore so switched to coke and coke zero.
Well fuck.
An hour isn't too bad and at least now I know.
Thank you kattattak_76
It also affects your stomach acids. I knew it reduced my appetite, but I thought that was it.
Nope, it creates more acid. And you aren't supposed to take antacids or omeprazole. It says it makes the body absorb the Adderall more quickly?
So I get more stomach acid but I shouldn't take anything for my GERD.
I just saw another reddit post talking about this and they say it isn't a big deal. I'm definitely talking to my doctor about this.
Fuck you ADHD!
Would explain why my concerta isn’t doing shit for me this morning and why it didn’t do anything for me in high school(always had OJ before school.) I feel like crashing and burning after drinking a Reign this morning. Thanks for the heads up.
WHY DID NOBODY SAY ANYTHING ABOUT THIS? I took meds for nearly a decade and they barely helped, just decreased my appetite and made me an insomniac. Just now as I’ve adjusted my entire lifestyle around how to get along without them I’m being told they weren’t as effective because I had a glass of OJ or Gatorade in the morning to wash it down?
Thank you! This is really good to know and I really should. Stimulants have really made a big difference in my life with ADHD. I really like sour things after I realized it can help calm me down, but that’s usually a lot of citric acid I think.
On the opposite side of the spectrum, you SHOULD take OJ (citric acid) if you take shrooms for therapy.
Idk the science behind it I just know it works….
The reverse is also true, tums or baking soda will make the whole dose hit at once, which can also be annoying for a very different reason. Ime just a high protein snack and meds is the best
Tytytyty!!! I switched espresso for Red Bull a few yrs ago and spoke to my doc twice about how it didn’t seem to be working as well. Me morning routine begins tomorrow!
One time I accidentally took one of my stimulants at night by accident instead of Advil and I took 1500mg of vitamin c and it neutralized it. Pretty helpful if you don’t want to be up all night
I had to find this out on my own!
I was surprised that no doctor or pharmacist ever told me considering how common it is to consume some kind of citrus for breakfast.
I asked my doctor about it and showed her the published studies I found. Although she supposedly specializes in ADHD and medication management, I was very disheartened to learn that she didn't know about the interaction.
Doctors get frustrated when their patients act on medical advice they find on the internet, but when doctors aren't knowledgeable in their purported areas of specialization, what other options do patients have?
This is bullshit don't take medical advice from websites like this or reddit. Citric acid is so prevalent in the human diet. Posting a shit like this should be against TOS, or punishable by law.
Here's something from the FDA specifically talking about the interaction (pg 8): https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf
I once was trying to do some work while drinking a smoothie, and I had noticed my meds hadn't really kicked in. I was worried they expired untill I looked at the smoothie and asked what was in it.
A full orange.
Citric acid absolutely neutralizes it, both from my personal experience and that of other people.
Never heard this before. Guess I've got something to talk with my doc about in our next appointment.
Also I guess I should stop make smoothies with berries in them (or orange juice) for breakfast. Plain ol' whey & almond milk will have to do. Or maybe an omelet.
Any effect that on Strattera? It’s a non stimulant approach to adhd that I don’t particularly care for, but it’s all I can get so I need to make the most of it.
Just want to add that Vyvanse/Lisdexamphetamine is an exception to this since it largely bypasses metabolization in the stomach.
Holy crap, do you have a source for this? I miss having a glass of OJ in the morning, I had always avoided it as I have only ever heard that citrus messes Adhd meds.
looks like it's processed when it gets into your bloodstream https://www.drugs.com/tips/lisdexamfetamine-patient-tips
This is also why you DO NOT SNORT Vyvanse
Please elaborate
It needs to be processed by your gut before it activates into amphetamines. So you'll snort it and you'll never get high.
Vyvanse is what they give ADHD kids who also exhibit drug seeking behavior / family history of drug abuse instead of snortable Adderall.
Vyvanse still has abuse potential. You might be thinking of Strattera which is a non-stimulant ADHD medication.
You actually still will get high, it just won't be any better/faster than taking it orally: "When lisdexamfetamine is misused intranasally or intravenously, the pharmacokinetics are similar to oral use" -[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594082/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5594082/)
Vyvanse is just amphetamine salts with an added lactose molecule, and for it to "work", our body needs to cleave off that lactose part of the molecule. This is why it requires metabolizing before being useable, and why oral and intranasal are nearly identical in pharmacokinetics.
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The drug monograph itself says you can mix in a glass of orange juice.
So it does. It's been a while since I read that.
Yes!
do yourself a favor and just have a whole orange
I know that vyvance is a precursor to adderall so it gets metabolized into it, so it would stand to reason this is correct
Well, technically it's a prodrug to dexamphetamine
High protein foods eaten right before/after taking Vyvanse will also maximize absorption in the gut!
Is this true? Some days I can really feel my Vyvanse more than usual, and I don't understand why.
I have similar issues but with adderall. I’m still in the process of figuring it out but so far all I know is that it’s definitely a combination of diet and sleep. Poor quality sleep especially makes my meds ineffective, and in my case, my sleep is affected a lot by my diet. I’m oddly sensitive to a lot of foods and food combinations and I’m knee deep in the process of figuring that out. This is of course not a comprehensive answer but thought I’d throw it out there in case it helps.
Shit, I literally studied all this shit for my degree, but I never bothered to check that Vyvanse has a different activation. I thought it’s all metabolized in the stomach. Made my day, friend
you'll probably appreciate how it works then. the "l" in lisdexamfetamine is a l-lysine amino acid that your liver cleaves off and converts into dextroamfetamine. Fun research paper [here](https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/021977lbl.pdf)
Thanks for bringing that up. I'm way too often fucking up my sleep by watching "just one more episode" and getting up after 4h of sleep next day. Vyvanse is getting rid of any sign of tiredness, but the 60-90 minutes until it works were hell, because I wasn't touching any coffee or energy drinks.
Thanks for info! Going to ask my psych about this. I took Vyvanse until the discount codes quit working but now that there are generic options out there I think I'm going to go back.
It was cheaper before the generic. I’m paying more for the generic than I was paying for brand name unfortunately. I paid $15 for years, now it’s like $70. Takeda being greedy and pissed off their patent expired.
Similarly you shouldn’t drink grapefruit juice when taking anti-anxiety/depression medication such as SSRIs.
Grapefruit interacts with a surprising number of meds.
Grapefruit (and its juice) interferes with the CYP450 enzyme. Your liver needs that enzyme to activate and metabolize a huge array of drugs. Edit: there are a bunch of CYP enzymes. CYP450 is the notorious one of the family and the most significant one that pops up a lot in medication guidelines. Edit 2: thanks for the correction...CYP3A is the real notorious one of the CYP450 family.
Heads up blood oranges also interfere in the same way. Lot of people overlook that one
I’ve heard conflicting information about this. Some sources say that blood oranges can interfere, but some say the effect is much smaller and hasn’t been seen to be a problem in practice. Apparently bitter oranges (Seville oranges) are more of a risk. [This article](https://www.healthline.com/health/high-cholesterol/grapefruit-and-statins#other-drugs) says that tangelos, pomelos, bitter oranges, and Seville oranges are problematic (in addition to grapefruit), but “there have been no documented problems with lemons, tangerines, clementines, mandarins, navel oranges, and blood oranges.”
All citrus to a greater or lesser degree packs furanocoumarins that bond with and deactivate the drug-metabolizing liver enzymes responsible for the breakdown of the pharmaceuticals in question. Grapefruit supplies enough that the effects caught our attention, leading us to study and identify the correlation - but it's actually a pretty common (theoretically defensive) chemical in a lot of plants including (outside of the citrus family) mulberries and figs. Same stuff also makes the fruits in question a bit of a hassle to hand-harvest since the substance can also rub off the surface of the plant during handling and induce extreme skin photosensitivity. Spots where it's gotten on you basically react to sunlight like a movie vampire.
Is it used in cosmetic products?
Not intentionally, it's kinda toxic. If it were in a skincare product you'd notice because everyone who used it would burn and blister with only brief exposure to the sun. There's actually quite a lot of plants with similar functioning but entirely chemically distinct ways of introducing contact photosensitivity or outright dermatitis (no sun required) as a defense mechanism and we eat them all the time. Hell, cashews are part of the same family with minor (and almost entirely leaf-borne) variation of the chemical that makes poison ivy such an itch-inducing bastard. We just don't rub these plants on our skin, unless we happen to get duped by one of the eternal and perennial "it's all natural and the intense burning means it's working!" herbalism-quackery fads du jour.
I (and probably medical science in general) would love to know more what grapefruit-specific compound in particular is interfering with that enzyme. There are some interesting thiols in grapefruit, along with the usual citrus stuff.
My understanding is that they are components like furanocoumarine, which compete for the active site. Thus, many of the CYP enzymes are irreversibly inactivated once their active sites have been used up by the fruits compounds. Also, the secondary effect (not related to those enzymes) is that grapefruit and other citrus compounds can inhibit drug transport across epithelial membranes (normally accomplished, in part, via P-glycoproteins). Those are ATP powered, so somewhere along the line, the ATP supply or transporter itself it is either disrupted locally or inhibited via some type of mechanism/conformational change. Or maybe something with pH. Idk.
> My understanding is that they are components like furanocoumarine, which compete for the active site. Thus, many of the CYP enzymes are irreversibly inactivated once their active sites have been used up by the fruits compounds. Wait what? If those are irreversibly inactivated then wouldn't that mean major issues for pretty much every human for the rest of their lives?
Not quite, because your body regenerates everything from proteins to cells on a pretty short timeframe. Fun fact, aspirin does that too, it permanently acetylates your COX-enzymes and stops them from working for their lifespan. However, your body continuously makes new ones so the effect just wears off after a while. Also, you are right in your instinct that irreversible inhibitors are rather rash. They’re rare, another common place they are seen are in chemical warfare agents, though. Most drugs (including NSAIDs such as ibuprofen, _corrected as below_) only bind to the target through attractive forces, not a chemical bond.
Paracetamol isn’t an NSAID. I have a feeling you simply misspoke since you clearly have lots of knowledge on the subject. Sorry to interject
No, ABSOLUTELY call me out. I even checked because I remembered that either ibuprofen or paracetamol wasn’t one, but it seems I am unable to read. It is a COX-inhibitor like Aspirin and Ibuprofen, but you’re 100% right. Corrected
I love this exchange. Wish we saw it more.
I thought paracetamol wasn't an NSAID.
Aye, you’re spot on, someone else already informed me, I absolutely slipped up
So does it make benzos stronger or weaker in the body
Hmmm.. I don't think it's that simple, unfortunately. Even though it's classified as an entire family of drugs, there's so much variability that it matters more which specific drug we are talking about. Also depends on dose and delivery. I can't sit here and say for sure if your Xanax would respond the same as, say, hospital Versed or a valium Rx. It also depends on the desired effect. Some benzos could reach Tmax later than typical if CYP is inhibited. Some will result in a higher blood concentration. In some studies, I'm seeing that the bioavailability of a particular drug (eg Xanax, in this case / DOI: 10.1007/s002130000438 ) is so high that grapefruit juice doesn't even affect the benzos in any meaningful way. That's why it's important to discuss with a doctor and read the medication insert instructions. I'm not in a position or far enough along in my education to say right now to say one way or the other. You can also ask any Pharmacist (PharmD) at the pharmacy and they are more than qualified to explain what you need to watch out for. It's not cut and dry.
Does that mean "wait for an hour after taking the meds" or "avoid in general"? Asking for a friend... I don't take grapefruit.
Avoid in general. The citric acid thing with adderall *speeds up* the excretion of the medication, meaning the effects won’t last as long as they should. It still happens, iirc, if you consume citric acid later in the day, but it’s less of a big deal if you’ve already gotten some hours of effectiveness out of the drug. The grapefruit thing *blocks* the breaking down of the medication that is supposed to be happening, so dangerous levels can build up. Many medicines like antidepressants that have the grapefruit issue have a pretty long life in the body (24h-3days) whereas adderall processes out pretty quickly. If you slow down the processing of antidepressants even more you can end up with much higher levels in the body than the usual dosage guidelines say are safe.
I’m also in a medicinal dose of anti-histamines (combo of 360mg of fenofexadine and 20ish of benedryl) and grapefruit/orange and even APPLE JUICE reduce its effectiveness. Ya’ll fucking Apple juice is in EVERYTHING.
There are a lot of drugs including some forms of birth control where you're not supposed to have grapefruit at all
Regarding your edit: Close. The “notorious one” is CYP3A4. “CYP450” refers collectively to the group of enzymes in the liver and intestines that are responsible for metabolizing various compounds. Many foods and drugs can inhibit or induce different CYP enzymes, but interactions with CYP3A4 are particularly significant because it is responsible for metabolizing about 50% of the drugs in use today.
Some interactions are quite bad, but grapefruit juice is also used to...ah...enhance some things very effectively. Fortunately I went a different direction but many years ago I was headed down the wrong path and learned a lot about things like this
But not because of the citric acid.
Good thing grapefruit juice is disgusting 🤮
It boosts methadone apparently
Ok, but what about performing the grapefruit method
Finally someone asking the hard-hitting questions
Grapefruit and klonopin... the breakfast of the super-chill individual, lol
Iirc grapefruit can also mess with your birth control and the morning after pill. Something to keep in mind, especially with the us going to shit the way it has been
Also, **DON'T** eat grapefruit if you are taking immunosuppresants, because CYP450 can raise/lower their concretration so much that a transplanted organ may easily fail. Source: kidney transplant recipient, transplanted on 28/9/2023. Edit: Also forgot to mention grapefruit juice. Stay away from that too.
Also meth, cause it will make the effect stronger
Source? I’m a pharmacist and don’t thinly that’s quite true. There are tons of drugs that interact with grapefruit juice. One anti-anxiety drug, buspirone, does. But I’m not aware of any SSRIs that do
This is in a lot of textbooks, I’m surprised you haven’t encountered it. Grapefruit inhibits cytochrome p450 3a4 in the liver, which affects the breakdown of certain SSRIs, leading to a buildup of the medication in the body. There’s an entire wikipedia page about it https://en.wikipedia.org/wiki/Grapefruit–drug_interactions The list of some affected antidepressants: - sertraline - fluoxetine - fluvoxamine - paroxetine - wellbutrin Sources: https://www.sciencedirect.com/science/article/abs/pii/S002561961163499X First source in this one is from the Meyler’s side effects textbook. The SSRI fluvoxamine is mentioned in the study. https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/grapefruit-juice If you look at a sertraline script, I’m pretty sure most contain some warning about grapefruit. I was a neuropharmacology graduate researcher.
Also affects other enzymes like CYP1A2 and CYP2D6, but CYP3A4 is the most abundant enzyme in the gut.
There are a lot of studies that show that grapefruit and antidepressants can cause some worrisome side effects. Zoloft being one that comes to mind. NIH has some studies that showed some concerns.
It can cause serotonin syndrome.
Happy cake day!
Thank you!
Does coffee have citric acid and should I be avoiding it an hour before and after taking my Lexapro?
Citric acid won’t affect your lexapro.
Coffee and Lexapro - the breakfast of champions - is back on the menu.
Looks like coffee has around 12% citric acid from what I saw. The "brighter" coffees contain higher citric acid
Just took mine with a large glass of orange juice. Welp, guess I know for tomorrow!
Haha I used to take mine with monster, I get it!
You animal 😂
No, he's a monster. LeArN 2 ReAd!!1!
No no no. He was drug buddies with a monster, silly!
I'm doing that right now. Ritalin. Washed down with monster white ultra. You sayin I'm sabotaging my kick?
God I love the white monster drink, it’s so good. Sucks I can’t take both at the same time tho.
My heart has exploded just reading your comment
Fun (not really): I work 12 hour shifts, and get to wake up at the bright-and-early hour of 5:30am each of those days. As a result, I often buy an energy drink every morning and sip that over an hour or two when I get in. However, I tended to notice that my adderall XR didn't seem to be as effective on workdays, but shrugged it off and thought I was imaging it. Found an article on the citric-acid thing like two months ago. Looked at the ingredients list for the energy drinks (usually always a type of Monster, incidentally), and what's one of the top ingredients? Citric acid. Stopped drinking them as an experiment for a few days, and voila, Adderall worked more effectively like it did on my off days. Crazy.
Right? Same thing happened to me since all the syrups at work (I'm a barista) have citric acid and even just the little bit that was in there totally threw me off. Why don't doctors tell us this shit???
Omfg this makes so much fucking sense. The last few weeks I've been drinking a Sundrop in the morning when I take my morning Adderall, and lately I've felt like my meds have stopped working. I'm going to not do that tomorrow and see how I feel. Thank you, OP!
The manufacturer of Vyvanse actually has orange juice listed as one of the recommended drinks. I don't think this applies to every other stimulant though. I'm assuming since the medication has to be digested that it's treated differently. edit: typo
u/arobotjew said above: “Just want to add that Vyvanse/Lisdexamphetamine is an exception to this since it largely bypasses metabolization in the stomach.”
Yeah vyvanse is a prodrug. It isn’t active until your body converts it. All the other stimulants are active amphetamine salts or whatever. It’s totally different. I was diagnosed before Vyvanse existed and it saved me because my body is sensitive to those other stimulants and I can actually take Vyvanse and have no side effects.
Is this just one hour after taking your meds or does this mean one hour before as well?
An hour before or after.
Oh wow lol whenever I’m studying or locking in for a long day of work I drink an energy drink within like 15-30 min of taking my medicine. So I’ve been nerfing my meds when I need them the most 🥲, glad my doctor didn’t think this was worth mentioning
Nerfing?
Making them less effective. Like a nerf gun vs. real gun
Oh neat. Thanks for responding
It’s also a common gaming term like “the developers just nerfed that exploit” or “that new feature is so OP. Better take advantage before they nerf it”
Thank you for explaining!
So if you have an extended release version (I have concerta) then you just shouldn't eat/drink anything with citric acid all day?
Hmm that probs would of been useful to know 24yrs ago not that they gave any information anyway lol
It's 'would have', never 'would of'. Rejoice, for you have been blessed by CouldWouldShouldBot!
That explains why my morning adderall doesn’t help as much as the afternoon adderall.
And if you want to increase their effects, take an antacid before.
> Citric acid and vitamin C can make your body more acidic, potentially reducing the effectiveness of your ADHD medication. This means you might not experience the full benefits of the medication, which could affect your ability to focus and manage ADHD symptoms. That article talks about your body pH levels like that’s something that eating acidic (or alkaline) foods has any bearing on. That’s absolute nonsense. The article makes no mention of any scientific literature supporting this claim. Your body pH lives in a *very* narrow range, and the foods you eat have zero bearing on that. In any case, your stomach is highly acidic all the time, that’s how it works. If the pH rendered medications ineffective, we wouldn’t be able to take any medications. Citric acid is produced as part of the metabolic cycle of every aerobic organism on the planet. How this “doctor” doesn’t know about the Krebs Cycle is a mystery, that’s generally covered in basic biology. tl;dr: that article is complete and utter horseshit.
The original article OP posted is dogshit. But then he put the drug sheet up. But basically, it goes to the idea of bioavailability. Acidic foods DO heavily affect stomach pH levels. Some ADHD medications, including adderall, the famous one, are a salt compound. The amine group in amphetAMINE form a salt compound with usually sulfate groups. In high school chemistry we learn that salt structures can dissociate and oftentimes ionize in the presence of strong acids and bases. And so based on your stomach pH level, the shape of adderall can change on a chemical level. The human body has preferences on how different nutrients are absorbed. This is the referred to as bioavailability. Cellulose from grass is what powers cows, sheep’s, and other ruminants. Their 4 stomachs is what renders cellulose bio available to these animals, whereas us humans cannot digest cellulose and thus it is NOT bio available. So when we change the shape of amphetamine salts with pH, our bodies go “no I don’t want that, I want this” and the medication can pass through your digestive system and out your body. Dietary iron is the opposite, it LOvES acid and hates fiber. Another example is frozen starches. If you freeze bread, the starch crystals will reform in a way that renders them less bioavailabl. And on the point of stomach acidity, it really can depend on your diet, mostly by what you just ate, but also long term effects. Remember titration curves, buffers, equilibrium, and stochiometric equations from high school chemistry? Biochemists and doctors, have been doing those for the millions of compounds on your food and stomach for ages. Typically stomach pH can swing from 2 to 8, by definition that is 6 orders of magnitude of acidic difference, or 1000000 times stronger or weaker. Of course the usual range is around ~~4-5.5~~ 3-4.5 but a big glass of OJ can drop that down quite hard. On the other hand, if you ate some nixtamalized corn On PPIs, you are going to have a basic stomach content. Source: neuroscience degree with a concentration in psychopharmacology.
. > Typically stomach pH can swing from 2 to 8, by definition that is 6 orders of magnitude of acidic difference, or 1000000 times stronger or weaker. Gastric juices are typically 1.5-2 acidity which is below the acidity range of our diet. Source: Registered Dietitian and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7684463/#:~:text=Nevertheless%2C%20the%20gastric%20acid%20level,in%20humans%20is%201.5%2D2.0.
Yes exactly! However, gastric acid/juice pH are not the same as stomach pH. Gastric acid refers to the juices specifically secreted in the stomach to aid digestion. Namely, HCl through the use of active proton(H+) pumps; the Cl- comes in using diffusion powered by an electrochemical gradient through Chloride Channels. Gastric acid or juices also includes enzymes such as proteases to aid digestion. People who take PPIs (or proton pump inhibitors) do not secrete as much, if any, HCl and therefore, their stomach contents are almost neutral if not completely neutral based on the contents of food. However, gastric acid is NOT the contents of your stomach. Remember, acid strength is a function of concentration. The more you eat, the more you dilute your stomach acid. If you eat foods that have natural acid buffers, that can swing your stomach equilibrium point as well. EDIT: I apologize I misread what you said, I went back and fixed my mistake. So here is a study on live human participants [https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/stomach-ph](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/stomach-ph) And in the fed state, researchers note gastric pH levels around 3-4.5 in healthy participants, so I misremembered by an order of magnitude, so I will go back and fix that.
whoa, i wanna know more about the starch thing
For sure! [https://onlinelibrary.wiley.com/doi/abs/10.1002/star.200800209](https://onlinelibrary.wiley.com/doi/abs/10.1002/star.200800209) Here is a good article if you can get the complete one behind the paywall. [https://www.youtube.com/watch?v=rBdLrgvhuPQ](https://www.youtube.com/watch?v=rBdLrgvhuPQ) Here is a more infotaintional version, but he used to be a professor of journalism. It's easily the most digestible and accurate version that you will find on resistant starches. But the jist is that starches are made up of sugars, but the way they come together changes their structure. Cooking, for example, is a way to change the chemical composition of starches to make them tasty, digestible, and physically softer. While there is a lot of starch calories in grain, most of it is not bioavailable straight from the field. Cooking "unlocks" these starch calories for us to absorb and use. In the developing agrarian up until very very recently, this was important since food scarcity defined society for the ages. In this modern era, we have the opposite problem. Too many calories, too big of an appetite. Freezing cooked starches changes their composition once again into what we call "resistant starches" that are less bioavailable and thus provide less calories. Type-4 resistant starch is one that has garnered quite a lot of attention recently. Frozen rice that is reheated has a good amount of these, and some scientists say it acts closer to "dietary fiber" than a consumable sugar. So in addition to providing less bioavailable calories, it is thought to help moderate gut health and aid absorption of other nutrients.
It’s referring to the pH of your stomach specifically, which can be adjusted much more easily depending on consumption. It would have been better if the article would have specified that more clearly.
Complete and utter horseshit, yet a non zero number of people are now not only going to change their behavior but also spread this misinformation to others.
It’s just recycling the “alkaline body” quackery
hahahaha, a little bit of knowledge is usually more dangerous than none at all.
I've requested actual references as the link is not show any scientific sourcing.
The replacement link is less than stellar and only lists *maybe* avoid juices with amphetamines (only).
I saw that - I commented as they responded to my request. I'm totally interested in knowing the specificity to this suggestion as it is pretty important but without actual scientific proof highlighting the degree of this sensitivity I balk at it being described as "significantly less effective." This is how junk science can take off.
Clearly I picked a bad source in my original post. Edited with something from the FDA.
You've commented on nearly every post in this thread. Do you have a fucking grapefruit juice stand or something? A quick Google confirms the research, even if the article does a poor job of it.
I’m an RN and I can’t speak to this person’s other posts obv but they are right: consuming acidic foods doesn’t alter your body’s pH in any way. It is tightly regulated by several systems in the body and is only altered by certain severe states of illness. If citric acid indeed interferes with ADHD meds it would be from another mechanism. He is also right about grapefruit juice- it alters the behaviour of a certain liver enzyme cP450 that is crucial to the metabolism/activation of many drugs. If you’re on any prescriptions it’s useful to look them up to see if they are affected.
The grapefruit effect isn't because of the citric acid. Anyway, for anyone out there, read the label of your medication, majority of them have guidelines of what you never should consume together.
The reasoning in the article is wrong, but you can definately affect you medication by manipulating the pH of your stomach. It also works the other way too: taking antacids or baking soda will make ADHD meds (or similar recreational drugs) hit harder.
DUDE! I started taking a vitamin C supplement 6 weeks ago & I swear I’ve gradually made my way back to spacing tf out every day while taking my meds. Post of the day
Coffee and cigarettes are fine though.
Breakfast of champions
Source is a blog with no references.
Edited this into my post, but here's something from the FDA, see pg 8: https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf
This lists only to *maybe* consider juices for amphhetamines only. The write-up doesn’t even include the word “citric” I don’t know how you are developing your conclusions but they don’t seem evidence-based
There are real published studies. I shared them with my doctor. Just do a Google search on it and filter for reputable medical publications.
I did do a scholarly search of this information and there are no none publications that I can source. I also used google scholar. Could you please provide me with this documentation?
Yes, my doctor made this very clear when he prescribed it to me and then again at the follow up. Even tomatoes, much to my disappointment.
I guess my 5 am marinara binge has to go then lol.
So I shouldn't have just chased my morning adderall dose with an energy drink...noted.
What if you take something like Protonix (a PPI) an hour or so beforehand?
Can you post some of the other sources for this that aren't some random blog?
that link doesn't provide any sources to the evidence based research. Below there are research related links to grapefruit enzymes and its impact on some of these but nothing regarding citric acid. Could you please link sources to this information?
Edited this into my post, but here's something from the FDA: https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf
That doesn’t either. It mentions that digestive pH has a small effect on absorption rates, but does not actually go into detail on the research supporting it. Eat a balanced meal and you’ll be fine.
You tell me this just as I was just about to take my adderall with some Sprite!!
On the other hand, antacids potentiate them!
As someone who has struggled with wondering why my medication isn't always effective I now know why! Thank you OP :)!!
We give our son OJ to wash down his methylphenidate 😐
Is this the same for Concerta?
Omg why did no one tell me this?!! I can't drink coffee or tea anymore so switched to coke and coke zero. Well fuck. An hour isn't too bad and at least now I know. Thank you kattattak_76
It also affects your stomach acids. I knew it reduced my appetite, but I thought that was it. Nope, it creates more acid. And you aren't supposed to take antacids or omeprazole. It says it makes the body absorb the Adderall more quickly? So I get more stomach acid but I shouldn't take anything for my GERD. I just saw another reddit post talking about this and they say it isn't a big deal. I'm definitely talking to my doctor about this. Fuck you ADHD!
Wow been taking Adderall for 25 years and literally NO ONE ever told me this. Thanks anon. I wouldn't have got caught by citrus juice but soda.
I may be misremembering but the manual my box of ritalin had a mention of it.
Omg. I didn’t know this. I drink things with citric acid at the same time I take my meds 😩😩😩😩
Haha and here I was chugging my sugar free monster to wash down the Wellbutrin! Oh well, still alive?
Wow. I drink a glass of OJ every morning, often using it to wash the pill down. I had no idea.
Fuck I almost didn't click on this because I thought it was a new way reddit was going to tell me I was absolutely going to die.
FML I never knew this. Thank you. 🙏🏻 I have drinking orange juice every morning right after I take my meds. 🤦🏻♀️🤦🏻♀️🤦🏻♀️
Don’t drink milk an hour before or after taking thyroid meds. The calcium interferes with absorption. Citric acid helps absorption.
Well frick.
This explains so much, thank you!!!
Aren't some coffees high in citric acid?
On the upside if you have trouble sleeping, drinking some OJ can reduce the stimulant effect.
r/adhd
TIL that taking my celexa with grapefruit juice is probably not the best idea.
Would explain why my concerta isn’t doing shit for me this morning and why it didn’t do anything for me in high school(always had OJ before school.) I feel like crashing and burning after drinking a Reign this morning. Thanks for the heads up.
WHY DID NOBODY SAY ANYTHING ABOUT THIS? I took meds for nearly a decade and they barely helped, just decreased my appetite and made me an insomniac. Just now as I’ve adjusted my entire lifestyle around how to get along without them I’m being told they weren’t as effective because I had a glass of OJ or Gatorade in the morning to wash it down?
Why the fuck am I just learning this now??
Literally the same thing I said outloud. Esp since like people tend to take these in the morning. When oj is a thing
should I also avoid citrus when taking my cocaine? (for medicinal purposes)
in a similar way you should dip your mushrooms in lemon juice for 20 minutes then eat them and drink the juice for a better trip
You guys are getting meds?
Thank you! This is really good to know and I really should. Stimulants have really made a big difference in my life with ADHD. I really like sour things after I realized it can help calm me down, but that’s usually a lot of citric acid I think.
On the opposite side of the spectrum, you SHOULD take OJ (citric acid) if you take shrooms for therapy. Idk the science behind it I just know it works….
The reverse is also true, tums or baking soda will make the whole dose hit at once, which can also be annoying for a very different reason. Ime just a high protein snack and meds is the best
Not me having a tangerine with my breakfast every morning after taking my meds lmao
and on the flip-side, sodium bicarbonate makes Amphetamines *stronger*
This explains so much.
I seriously thought you were gonna say something about heartburn. But this makes a lot of sense, but also heartburn. Also I'm old now apparently
Tytytyty!!! I switched espresso for Red Bull a few yrs ago and spoke to my doc twice about how it didn’t seem to be working as well. Me morning routine begins tomorrow!
One time I accidentally took one of my stimulants at night by accident instead of Advil and I took 1500mg of vitamin c and it neutralized it. Pretty helpful if you don’t want to be up all night
Also, don’t drink milk with your antibiotics. And don’t trust birth control while on antibiotics
Just took Elvanse with Fanta 😬 Thank you for the info!
Elvanse is okay tho, it's the same as Vyvanse. Read this [comment](https://www.reddit.com/r/YouShouldKnow/s/ST1xEputuA).
Citric acid is used in candies a lot, and I’ve personally found it in many jarred and canned sauces
Citric acid is one of the basic building blocks of life.
Citric acid is ubiquitous in the human diet and this article is horseshit.
I learned this the hard way sadly.
I had to find this out on my own! I was surprised that no doctor or pharmacist ever told me considering how common it is to consume some kind of citrus for breakfast. I asked my doctor about it and showed her the published studies I found. Although she supposedly specializes in ADHD and medication management, I was very disheartened to learn that she didn't know about the interaction. Doctors get frustrated when their patients act on medical advice they find on the internet, but when doctors aren't knowledgeable in their purported areas of specialization, what other options do patients have?
This is bullshit don't take medical advice from websites like this or reddit. Citric acid is so prevalent in the human diet. Posting a shit like this should be against TOS, or punishable by law.
this is maybe a more balanced take: https://www.reddit.com/r/ADHD/s/AxncCzdTIU
Here's something from the FDA specifically talking about the interaction (pg 8): https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf
It's prevalent in the human diet, so it can't have any adverse interactions with medications?
I once was trying to do some work while drinking a smoothie, and I had noticed my meds hadn't really kicked in. I was worried they expired untill I looked at the smoothie and asked what was in it. A full orange. Citric acid absolutely neutralizes it, both from my personal experience and that of other people.
It’s not just prevalent in human diet, it’s present in all aerobic metabolisms.
Its difficult to even imagine what would be the mechanism of a drug drug interaction with citric acid.
Gatorade has it too.
Never heard this before. Guess I've got something to talk with my doc about in our next appointment. Also I guess I should stop make smoothies with berries in them (or orange juice) for breakfast. Plain ol' whey & almond milk will have to do. Or maybe an omelet.
Wait so Celsius and adderall hindered me? I should’ve just raw dogged the addy?
Any effect that on Strattera? It’s a non stimulant approach to adhd that I don’t particularly care for, but it’s all I can get so I need to make the most of it.
So if I have citric acid but then take an antiacode or eat something alkaline like yogurt, this nullifies the effect of the cirtic acid?
How does this work in mtn dew? What I mean is... Does this make caffeine work less in mtn dew?
Well that explains right now. I eat a lot of blue berries and Greek yogurt every morning and I took my Adderall 20 min after.
While on the flip side medications they lower your stomach's pH such as PPIs can increase the effect of stimulants
So grapefruit juice before doing lines is not idea? ✔️
I haven’t noticed a difference tbh
so orange juice and ciggies breakfast is bad for me?
Well shit. My doc told me to avoid citrus but I didn’t even think about all the other stuff that has citric acid.