Gout Diet Blog

For those of you in that situation I suggest you make a copy of thispost and give it to your physician.

They treat your gout attack by trying to relieve the gout symptomswhich involves some kind of non-steroid anti-inflammatory drug, andusually culcchine is included in the treatment regime. Sometimes adaily maintenance dosage of culcchine is perscribed although thatparticular treatment seems to be fading because of the now provenlink of peripheral nuropathy, nerve damage, to prolonged use ofculcchine.

Any and all treatments that relieve and or stop the pain andinflammation that is associated with gout, are ignoring the fact thatthe underlying cause of gout is excess uric acid. Ask your physicianif this is not what he or she believes. Do they believe that thefundamental cause of gout is that your system has too much uric acidand that it is not able to get rid of it. When they treat you withpain relief, they are only treating the symtpom and they are failingto treat the cause of that symptom.

The next question must be, what have you, the patient, done to reducethe uric acid load on your system?

The reply will be, that you must reduce or eliminate the foods thattrigger an attack and that by reducing your intake of foods thatcontain purene you can reduce your exposure to a gout attack.

That last statement is where I want to question the logic of you andyour physician.

The fact is that you got gout because your system is not disposing ofuric acid as fast as it is accumulating it. Whether you accumulateuric acid because you make too much or because you just don’teliminate enough doesn’t matter. The fact is that the rate of buildup is greater than the rate of loss and that small differential willcontinue to tilt against you, that is, in favor of more and more uricacid for the rest of your life.

Here is the problem with the treatment logic. After your firstattack, your body will probably provide you with a period of graceduring which you will not have another attack and this period canlast for one to two and even three years. It is true that some peoplewill experience only one episode and then remain gout free for therest of their life. Based on this possibility, the medical communitywaits for the second attack before perscribing allopurinol and to myway of looking at it, it is terribly illogical.

Medicine is a practice of applied statistics and the statistics arethat more than 96% of the people who suffer an attack will have asecond attack within the first year and after 3 years that figuregoes up. The numbers after a year are not accurate but statistically,very few of us escape the second and third atatck and among those whosuffer the second attack, there is just no escape. You will continueto get attacks.

So, logically, I suggest that it is more statistically prudent totreat the first gout attack agressively with allopurinol. You willget at least 6 months to a year of no gout attack after the firstepisode anyway and if you are on allopurinol during that time, youwill be reducing your uric acid and 96% of the second attacks can beeliminated within tha first year.

If you approach it like someone posted earlier, and I am sorry Idon’t remember who, but approach it as a three year treatment period,that period will be a time during which you are seriously reducingyour overall uric acid load and during which you will be removinguric acid that has been accumulating in your system for 10 to 15years. Moreover and most important, statistically, there will be veryfew, if any, attacks of gout among the people who go on allopurinolafter the first attack.

Let’s then look at the result. With aggresive allopurinol treatmentafter the first attack you will have 96% or more of the people notsuffering the second attack during the three year treatment period.Moreover, if allopurinol is discontinued after the third year, itwill probably take another 3 to five years for most of those peopleto accumulate enough uric acid to start having gout attacks again. Inother words, three years of aggresive treatment with allopurinolafter the first attack will result in 96% of the patients being goutfree during that three year period and most of them will remain goutfree for at least another three years after the allopurinol isdiscontinued.

Those of you who have been forced into alloppurinol by your rentlessseries of attacks, go back and consider what life would have beenlike. You take the same pill that you are now on but you would nothave had the gout atatcks, the disfigured joints, the bulgingknuckles, the clawed hands the weak ankles and toes.

The only problem is that you will be taking a pill and you would beliving gout free.

“Gosh darn, this stupid pill, why am I taking it anyway. I only hadone attack and it was three years ago.”

It is very difficult, indeed, to appreciate what the value of a goutfree existence is when you have not lived through the opposite and Iknow that many will need the bad time with gout to appreciate thegood time without it. My treatment regine should buy 50% of thepeople freedom from gout for about 10 years. Moreover, by agressivelymeasuring uric acid level every year, you would be able to monitor ifand when a patient needed to return to some level of allopurinoltreatment.

What I am suggesting is that once a person has presented with a goutattack, from then on, the physician needs to treat the uric acidlevel and not the gout. The problem, the real illness if you will, isthat the patient has too much uric acid and that uric acid must beremoved. The fact that the patient also happens to get pain from thatexcess uric acid is not the issue. The issue is that the excess uricacid needs to be removed and there is a safe and effective treatmentfor that excess uric acid. From day one of the attack, the urateshould be measured and that level should be driven as low as possiblewith allopurinol treatment. When the uric acid level has beenreduced, and only when the uric acid level has been reduced, thepatient can reduce or perhaps stop, for a while at least, takingallopurinol.

Why does the physician need for you to go through a second episode ofpain to perscribe the cure? Does he or she really need to see yousuffer? Statistically, 96% of first time gout patients will suffer asecond attack within the first year, do they need to see that attack.Do they need to have you go through the pain? If you have had anattack your uric acid level is measurable and it is treatable and itis my considered opinion that from the day of the first atatck, thething that should be treated is the uric acid level and not thesymptoms of a painful attack. The second and third gout attack happenbecause the systemic uric acid level has continued to climb to wellabove what it was after the first attack. Start treating the rootcause of the gout attack, that is start a treatment program aimed atreducing uric acid level, and most of your gout patients will neversuffer another gout attack again.