Drowning in milk
I think I have found a small glass-like crystal between a joint inthe article in New England Journal of Medicine.
Under the heading “Results” it states that
“Only 11 percent had undergone arthrocentisis, and of these, 65percent reported having urate crystals in their joint fluid.”
Well that’s not good enough
In Brian Emerson’s book <
“Because the human body is so complex, nothing in medicineapplies invariably. However, one can work on the basis that crystalsare ALWAYS present in the joint fluid in an acute attack of gout andthat, provided an adequate sample can be obtained, urate crystalsshould be detectable in the joint fluid!
Well in my opinion club rules are club rules. I don’t care how muchpain you have, no crystals no gout - so hop it !
Professor Emerson also states (same page) that
“Ninety-five percent of people who suffer from acute gouthave high urate concentrations in the blood serum for many yearsprior to the first acute attack.”
I note that the New England JofM article found that of the new goutcases 72 percent reported hyperuricemia [high urate concentrations inthe serum].
My take on this is that crystals and hyperuricemia are not asabsolute as factors as they had appeared to be, although they areobviously still the most important ones.
Walter’s information about the build up of uric acid in the fattytissue for [presumably as long as] 10 to 15 years before an attack,makes lots of sense to me. For most of us getting the secretionlevel right in the kidneys and getting the uric acid out of thesystem, over time, must be the answer.
But all of this seems to me to point to (at least) two controlmechanisms at work, hyperuricemia and an unknown factor (or maybemore than one). The unknown factor can cause acute gout even inpatients with low hyperuricemia and even with no crystal formationbut it is rare. Without the unknown factor patients can havehyperuricemia and crystals and yet no gout.
This is a typical problem in engineering it’s the over temperatureswitch AND the lubrication but everyone hayes that, they alwayswant a nice simple solution.
That is probably all that is confusing us in the technology led lobbyin this debate.
But the fact that just because the influence of my theoreticalunknown factor is rare does NOT mean it should be ignored. Raremeans that it is there. And I wonder if it is not related toDIGESTION (and stress) rather than to DIET as such.
Sabina Shamel on July 23rd, 2007
And I wonder if it is not related to
There are several among our groupo who are constantly searching forthe underlying reason why you get an attack and I want to put a fewcents of chemistry facts into your search.
I spent many years as a research chemist, in organic chemistry, whereI was attempting to make a large variety of pure organic compounds.If you wish, you can search on my name in the Chemistry citationliterature and several of my publications have been cited very often.I mention this to establish the fact that at least about the behaviorof pure compopunds in abd out of solution, I am as much an expert asthere is.
Organic chemists who try to obtain a pure compound often have thecrazy and terribly frusttrating task of trying to get a whitecolorless oily goo to turn into white powdery crystals. The fact ofnature is that molecules of the same kind will accumulate andcrystalize with identical molecules and this crystallizatin processis one of the most effectrive ways of isolating and identifying purecompounds. Of course there are numerous other ways of purifying achemial but it is very often the case that a person, or even a wholelaboratory is able to isolate a specific chemicaland that chemical isabsolutely pure by any test that is run on it. Analysis can show thatthere is nothing there other than the pure chemical and yet, forreasons that we do not fully yunderstand, that chemical in thatlaboratory, refuses to form crystals. I once had a yellow liquid thatstayed in liquid form for more than four years and defied any and allattempts I made to turn it into crystals.
I actually had a stash of the stubborn compounds that would notcrystallize and kept them all together. As time went on and as I gotbetter at making the pure compounds crystalllize, I would often goback and try new and different techniques on the old stubborncompounds.
I found, as the old German chemists from the turn of the century hadfound, that certain glass containers were a lot better than others atgetting compounds to crystallize and the reports of how elaborate thesurface scratching techniques were is both amusing and instructive.Indeed, I ended up getting a diamond scribe and scoring the bottom ofmany of my flasks and, after thoroughly cleaning the flasks used themto try to get the stubborn compounds to crystallize.
Much to my surprise and delight, almost al of my stubborn compoundsturned into solids when left in one of the vessels. I thereaftercalled it my magic flask and when the stubborn compounds were left init for hours or days or in some cases, weeks crystals would form. Theinteresting thing too, is that once that compound has crystallized ina lab, it will end up existing as the solid for everyone in that laband it is not possible to get the pure oily form to stay that way. Itjust crystalizes. Once a crystal surface has been formed, it willcontinue to form over and over again. You can heat up the flask andmelt the crystals, you can clean the flask, you can remove all tracesof the chemical from the area and yet, as long as that flask comes incontat with the compound, it will crystallize out of solutionwhenever its slubility is less than saturation.
I am boreing you with this discourse because my theory is that yourbody is like my magic flask. It has crystals in it. They are in everycrack and crevace in your entire system. Each and every small bone inboth of your feet has billions of crystal surfaces and no matter whatyou do to try to remove the crystals, you are not going to get rid ofall of them. Moreover, when your urate ion concentration exceeds thesolubility of mono sodium urate in water at 98.6 degrees Fahrenheit,you are going to get crystals of that monosodium urate forming inyour feet. It will form other places as well if you let it, as poorCristopher Columbus knew all too well, but with the medicaltreatments we have today, few if any are actually permanentlycrippled from gout.
In other words and in summary. Once the crystals are there, eitherthe actual crystals or the surface that caused them to form in thefirst place will always be there and if your overall uric acid levelis too high, you will get gout attacks. Your friend who has uricemiaand no gout just doesn’t have the site to induce crystal formation.You do and there is nothing you can do to stop it.
Now, to another related topic that is very important.
What will cause the most damage to your system. Please, this questionto your physician who is afraid of kidney, or liver damage fromallopurinol.
Which is the more dangerous condition to live in.1. A high concentration of uric acid.2. A low concentration of uric acid and allopurinol.
Several of you have gone on and on about the dangers your physicianhas warned you about if you take allopurinol.
Ask for the references that prove that it is the allopurinol that iscausing the problem.
Go look at the effect a high concentration of uric acid has on you.For openers, it will cause hypertention. High blood pressure, thesilent killer, and just because it does not make you feel bad, youwill be killed just as dead from it as from any of the other,terribly poorly documented, possible, side effects of allopurinol.
I don’t subscribe to a lifetime of allopurinol but I do believe thatyou need to take it for at least 3 years and in a disciplined andcareful way, you need to systematically increase your water intakeover those three years. I believe that in three years you will beable to clean out the system so that you can abuse it again foranother 10 years, if you wish, without gout.
Finally, I do wish that you would read about the long term effects oftaking allopurinol in conjunction with antioxidants such as vitamin Cand vitamin E. The cardiovascular benefits from allopurinol,independent of and entirely seperate than its effect on uric acidproduction, are remarkable and it is being used specifically for thatpurpose. Moreover, it is very effective in protecting you from heatstroke and problems associated with heat.
I challenge any and all of you to sit in front of a blood pressurecuff and look at the readings. What is it if you are not beingmedicated for high BP. Uric acid will induce high blood pressure.Take any population of rats, measure their BP and then inject themwith uric acid. Their blood pressure will go up. It will go up sohigh that a significant portion of the rats are killed from the uricacid induced, high BP.
Your gout is hurting you but you can live with the pain.
Your high uric acid level is killing you.
Terrance Molock on July 24th, 2007
AWWww C’mon man..WHAT IS WRONG with that??..I mean out of the50,000 in the study..700 got gout from eating bad..er..umm..Imean..well..they..ya I know..ya..we actually ONLY took ACTUAL samplesfrom about about 80 out of the 50,000..TO CONFIRM IT! and oh yeah..weACTUALLY did find the crystals in about 50..
Crystals in the joint fluid..BINGO!..true there can be/have beencases where there have been no crystals and then LABELLED NOGOUT!..as there have been cases where there are crystals and nogout…if gout is HIGHLY suspeceted and you don’t find the crystalsthis time..you will next time.As for the no crystals..what some ofthese people think they go sticking needles into SENSITIVE!areas..forlike a little kids Easter egg hunt?In almost EVERYcase..crystals=gout=crystals.. Again..this urate/uric acid blood thing..I agree that of coursethere has to be a LONG TERM accumulation..BUT this “accumulation”isNOT in the blood..the stuff is CIRCULATING in the blood..andtrue..more and more of it is arriving..even it’s form/composition inthe blood..is nothing..it is when it ACTUALLY crosses theinterstitial membrane..and starts collecting in thetissue/synovial..in/near/around the joints..AND in the synovial fluiditself..this is where it actually concentrates/CRYSTALIZES.. Hyperuricemia is almost irrelevant in discussions of gout.Over 90%of people with it NEVER develop gout.Sure as the level rises toSTUPID levels..well of course..there is just that much more in thenblood..and at an EXTREME level..it IS more than likely gonnahead/gravitate? to the joint area.The Dr’s I see say they are tiredof all these “sterotypes” in gout sufferers..THEY are the ones thatACTUALLY see the uric acid results..and the gout sufferers.Gout?take25-30% off the uric acid level with allopurinol..AND into the lowaverage range..let’s check this out..they do GLANCE at the levels andsee that gout sufferers are just normal people like you andme..average uric acid levels..with a LOT OF URIC acid in theirjoints..oh well..takellopurinol=patient cured=patient happy=doctorhappy..AND BONUS! this is a 10-20 year happineness thing..