Calcium
Calcium must play a crucial role in gout and gout attacks butinformation about what it’s role might be is just not there.
I questioned Dr. Enzenauer, specifically about calcium, and hereplied that he did not know whether it played an active role or not.He specifically recommends that his female patients take a minimum of1000 Mg of calcium a day but this is a general recommendation forolder women because women suffer much mofe from osteoperosis, bonemass loss, as they age and the extra calcium for women is aprophelactic against this loss.
My belief is that calcuim, probably the surface of a bone in a jointin our toe, that is rich in calcuim, probably serves as a catalyticsite for urate crystal formation.
Why do I suspect calcuim in the bone?
First it is because the attack is always so specific to a bonerelated area and not a tissue ralated area syuch as a muscle, otvicera etc. Knees, toes and even leg when a break occures.
Second and probably more important is the well documented bone loss,specifically in the affected area of a gout attack. This bone loss isdirectly related to the severity and length of the gout attack.
Third, there is another affliction, they call pseudo gout, that lookslike gout and is in fact a deposition of calcium phospate in exactlythe same place and the same way that sodium urate percipitates orcrystallizes.
Thus I am theorizing that calcium, and perhaps a calcium phospatepercipitate is the original stimulation that gets the uratepercipitation started. Calcium urate is also a probable culprit butif it is in the literature I sure cannot find it.
By the way, one of the oldest known remedies from both Mesopataniaand from ancient Greece for gout, and one that has been shownrecently to be relatively effective, is to put the patient on a milkintensive diet. The Greeks and the Mesopatanians perscribed goatsmilk. The amount of milk recommended in these ancient remedies wouldraise your calcium levels well above normal limits and recentclinical studies have shown that that the milk diet does in factreduce the frequency, the intensity and the duration of gout attacks.The researchers also point out however, that the average patient onthe skim milk diet lost an average of more than 15 pounds over 3 to 6months and perhaps the weight loss alone caused the reduction ingout. “When all you can eat is milk, you end up losing your apetite.”
The real issue is this. Should we take calcuim, extra calcium, in ourdiet or not? I don’t know and I believe it is very important to findout the answer to that question.
Allie Belletto on July 27th, 2007
This discussion of calcium made me think about supplements and vitamins etc. In fact, it made a connection for me that I had not perceived previously between my use of supplements and my gout attacks. In hindsight, the very first attack I had was around the same time as I was first diagnosed with psoriatic arthritis. I had been tying everything to see what impact it would have on my arthritis. One of the remedies that I took was “Devil’s Claw” pills. I do not know the efficacy of Devil’s Claw, but it was shortly after I took it that my pain became unbearable. My most recent attack of gout immediately followed a week of taking vitamin and mineral supplement (Centrum Forte) to counteract my rundown feeling. I am now wondering whether there is some commonality between the ingredients of Devil’s Claw and Centrum Forte that could be a trigger for my gout. (the possibility that something here could be my gout trigger has me pretty excited) Anyone know what elements make up Devil’s Claw that might be in common with Centrum Forte?
Terrance Molock on July 28th, 2007
previously between my use of supplements and my gout attacks.as I was first diagnosed with psoriatic arthritis. I had been tyingeverything to see what impact it would have on my arthritis. One ofthe remedies that I took was “Devil’s Claw” pills. I do not know theefficacy of Devil’s Claw, but it was shortly after I took it that mypain became unbearable.vitamin and mineral supplement (Centrum Forte) to counteract myrundown feeling. I am now wondering whether there is somecommonality between the ingredients of Devil’s Claw and Centrum Fortethat could be a trigger for my gout. (the possibility that somethinghere could be my gout trigger has me pretty excited)common with Centrum Forte? Walter..there is a study/studies? where calcium does indeedreduce gout..however in fairness..the amount of calcium added was notreally much above what we should take normally.I think I came acrossthat on the net.You have hit the nail on the head about thecalcium/bone loss..there is something there..Idno what..but cleary inx-rays..there is bone loss..from gout..therefore there just has to bea calcium co-efficient..somewhere/somehow..weird..the crystals can’tbe seen on x-ray..BUT often the tophi can..and obviouslly so can thebone loss.. This to me one of the real TERRORS of gout..I know I was prettyparanoid when I first had my feet x-rayed..one of the real dangers ofrepeat gout attacks is that the erosion of the bone/joint..is notreally checked/suspect until..the joint becomes problematic..or it ispushed beyond it’s normal range..by that time..the irrepairabledamage has been done..yeah right..NASTY..go along forever..repeatgout attacks..twist your foot..x-rays..woops sorry..joint istoast..NASTY!
Brian.. have previouslly mentioned “Devils Claw”..quickly asanother method of lowerring uric acid levels.I really don’t/orpretend to know anything about it.I have heard/read..in a few veiledreferences..to it’s ability to lower uric acid levels..hence treatgout..I have seen no actual tests/research/talked to anyone who hastried it. What is “Devils Claw”..my mother knows a fair bit abouthealth/herbs/plantsays it has been around for..like..ever..and iswell..some people say that it is this/that..NOT just one plant..butsome people refer to it as a mixture..alrighty then..I can’t standthat kind of stuff..SOoo..coincidentally..we happened to be outshopping..I checked at a few pharmacies/stores..just what is thisstuff?Well you pick up a bottle and read the ingredients..of abottle of pills called “Devils Claw”..all the stuff I saw was “gelpacked” pill form..so clearly it is manufactured..what is in it?Idno..all the brands seemed to have different stuff in it.I think itis related to the Hawthorne..maybe Billberry family..indeed some ofthem list these as part of their ingredients.. There is also a huge price differential..and dosagerequirement..some of this would cost me about $30 Cdn/mo..others$10..my allopurinol is $2 something..I thnk $7 for 100 days
I think you gave me the most knowledge of “Devils Claw” byfar..you took it..along came MR.GOUT for a visit..I am going tosurmise..that it did indeed affect your uric acid levels..maybelowerring them to fast..it is pretty common for allopurinol to causeattacks when it is started..
Allie Belletto on July 29th, 2007
I did some further research on ingredients of Devil’s Claw and Centrum Forte…Here is what I have come up with (but I need a chemist to tell me what it means):
Devil’s Claw
is composed of
three iridoid glycosides:
harpagoside,
harpagide, and
procumbide, which may be responsible for its anti-inflammatory and analgesic properties.
Other active ingredients include:
beta-sitosterol,
Flavonoids (kaempferol and luteolin glycosides).
Phenolic acids,
chlorogenic acid,
cinnamic acid,
A quinone,
harpagoquinone,
triterpenes,
oleanolic acid derivatives,
ursolic acid derivatives,
esters,
sugars, and
gum resin.
Centrum Forte
vitamins:
beta-carotene (a source of vitamin A) 3 000 IU,
vitamin A 2 000 IU,
vitamin E 30 IU,
vitamin C 90 mg,
folic acid 0.4 mg,
vitamin B1 2.25 mg,
vitamin B2 3.2 mg,
niacinamide 40 mg,
vitamin B6 3 mg,
vitamin B12 9 g,
vitamin D 400 IU,
biotin 45 g,
pantothenic acid 10 mg;
minerals:
calcium 175 mg,
phosphorus 125 mg,
iodine 0.15 mg,
iron 10 mg,
magnesium 100 mg,
copper 2 mg,
manganese 5 mg,
potassium 40 mg,
chlorine 36 mg,
chromium 25 g,
molybdenum 25 g,
selenium 25 g,
zinc 15 mg,
nickel 5 g,
tin 10 g,
vanadium 10 g,
silicon 10 g.
Nonmedicinal ingredients:
ascorbyl palmitate,
BHT,
cellulose,
citric acid,
cornstarch,
crospovidone,
FD&C Yellow #6,
gelatin,
hydrolyzed protein,
lactose,
magnesium stearate,
mineral oil,
peanut oil,
polysorbate 80,
silicon dioxide,
sodium aluminum silicate,
sodium ascorbate,
sodium benzoate,
sodium citrate,
sodium lauryl sulfate,
sorbic acid,
stearic acid,
sucrose,
titanium dioxide and
triethyl citrate.
Energy: <4.2 kJ (1 kcal).
Sodium: <0.22 mmol (5 mg).
Cole Munis on July 30th, 2007
Niacin was a real problem for me, when I gave up the vitamin with niacin in it my tingling and lingering pain from gout left my toes immediately.
Sabina Shamel on August 1st, 2007
Niacin, nicotinamid, and most of the B complex vitamins, as well ascaffeine,and uric acid, have an interesting similarity in that theyall have a nitrogen incorporated into an aromatic ring. Maybestructure and effect of our gout problems are unrelated but thatwould not be consistent with what we know to be true in other relatedfields.
You cannot, by the way, continue to exist as a live specimin if youcompletely eliminate niacin from your diet. It is an essentialvitamin, but you sure don’t need to OD on it either hoping to makeyourself healthy.
Worth keeping in mind. I just might be willing to take a lot of it inthe next few days and see if it induces the feeling. It’s importanttoo because I do take a vitamin suppliment and in that suppliment ithas about 300% the recommended daily requirement. I think I couldfind a vitamin that has much less niacin.
Sabina Shamel on August 2nd, 2007
The problem with trying to pin down one substance as being anoffending substance is that it is always mixed in with so many othersubstances. This is particularly true of suppliments. In a supplimentyou could have a combination of ingredients that all do it to you,like, for example, because they might raise your overall serum saltconcentration and causes percipitation of the urate crystals.
As I was replying to you about caffene, it occured to me that ourbodies have uric acid in them, and meat, specifically beef andprobably chicken, will have some level of uric acid in it. Moreover,although the purene level in a substance may be low and onlycontribute 15% to our overall uric acid level, any uric acid that wedirectly injest will be there in our bodies as uric acid on a one toone basis that must be excreted. It cannot be broken down withallopurinol and allopurinol has no effect on the level of uric acidif we eat that uric acid, already formed and there in the meattissue.
Now, although it may be tough to get people to test their own uricacid level, it would be pretty easy to get good quantitative numberson things like chicken, beef, asparagas, shrimp etc. I have neverseen a direct measure of uric acid in food and there should be such ameasurement. Mayber it is so low that it doesn’t matter but I suspectthat poultry, lobster and shrimp are probably pretty heavily lacedwith it.