Trophi and crystaline monosodium urate
Uric acid is an organic acid.It is a solid at room temperature, it is soluble in organic solventsand it stays mainly in the adipose tissue of your body. Adipose isthe fatty tissue-so, for all intents and purposes, uric acid isstored in the body in and around the fat in your body. If you take ajar of water and put wesson oil into the jar and shake it up, thefat, that is the wesson oil, will stay on top and the water will sinkto the bottom. In reality there is a small amount of the wesson oildissolved in the water and a small amount of the water dissolved inthe oil but the amounts are so small that it is not worth mentioninghow much. If you take a salt, like good old sodium chloride and putit into the jar and shake it up, the salt will dissolve in the waterand none of it will dissolve in the wesson oil. Similarly, if you putan organic compound, like for example cholesterol, or motor oil, ortri nitro toluene into the jar and shake it up, be careful shakingtri nitro toluene-all the organic compound will dissolve in thewesson oil and none will dissolve in the water.
OK so far so good.
The fact is that organic acids, are substances that behave like otherorganic compounds for solubility except that they are acidic, whichmeans they can be nutralized by a base, for example, by sodiumhydroxide. When that happens, the organic acid is converted into asalt.
A dramatic example of this is acetic acid. Glacial acetic acid, thatmeans pure acetic acid, is a clear srong smelling colorless liquidthat you can pour out of a bottle. However, when you nutralize aceticacid with sodium hydroxide and then remove the water that is formedby evaporation, you get sodium acetate. The sodium salt of aceticacid is a solid with a high melting point, very soluble in water andit forms crystals in water when the water gets saturated with it.
By analogy the sodium salt of uric acid, specifically the monosodiumsalt of uric acid-mono sodium acetate, is also a solid with arelatively high melting point and the properties of the salt areentirely different from the properties of uric acid. Uric acid iswhat is in trophi. Not monosodium urate crystals. Trophi are painfulbecause they are a deposit of something that the body doesn’t need orwant and they are a lump that is uncomfortable because it is a lumpbut uric acid deposited in a trophi does not cause an inflammationreaction like the crystals of mono sodium urate do.
If you shake up the contents of trophi into that jar with wesson oiland water in it, the uric acid will dissolve in the wesson oil.Virtually none of the contents of the trophi will go into the watersolution because it does not contain the crystals that kill yourfeet. Similarly if you shake up the contents of the fluid in andaround a gout inflamed toe, in that wesson oil and water, none of thecrystals will go into the wesson oil and all the crystals willdissolve in the water.
If you have so much excess uric acid in your system that you areforming trophi, you need to be on allo and get started with theprocess of removing, by way of your kidneys, more uric acid-as urate-each day than your body produces. Allo blocks the production sidewhich allows your kidneys to get rid ot what was made before youstarted allo.
Sabina Shamel on September 23rd, 2007
Based on the overwhelming reply stream I judge that the interest inthis subject is so high that I’ll continue with my wesson oil andwater analogy.
Uric acid is not completely soluble in all proportions in wesson oilnor is mono-sodium urate completely soluble in all proportions inwater. Literally your blood is an aqueous system, that is, it is awater based medium with the salinity, the salt content, of sea water.
So just for fun lets take wesson oil that is saturated with uric acidand place it in contact with water that is saturated with sodiumacetate and shake the system and lat it stand for a while. What willhappen.
The sodium acatate will react with some of the uric acid in thewesson oil and it will neutralize it which will form sodium urate andacetic acid.
Now, lets push the limits of solubility of sodium urate and uric acidin both the water and the oil and put in more sodium urate than thewater can hold and more uric acid than the wesson oil can hold.
What will we get.
Of course this is a simple minded explanation but the uiric acid willform a semi solid goo of uric acid. The water will contain extra monosodium urate and those crystals will be deposited all around thewater layer. If the system is shaken and mixed, as in what you dowhan you walk, there will probably be some urate crystals that floatinto the oil layer and you will probably get some urate crystalsphysically imbedded in the uric acid goo just because both are solid,or semi-solid. The semi-solid goo stuff is the stuff of trophi andthe crystals are the monosodium urate that percipitate out in yourtoe and create the inflamation reaction that we all know and love tonot have.
The reason I bring thest things up is that gout is most often-notalways-but very very frequently associated with being over weight andthe mention of the relatin to high blood prewssure has been broughtup and i want to cover both of these things.
First the high blood pressure. Do a search in Goggle on hypertension-(high blood pressure)- and uric acid. What you will find with almostno effort is that in laboratory study after study in rats, dogs,mice, even cats, and clinical studies involving people, there is adirect, measurable, and predictable increase in blood pressureassociated with increasing levels of uric acid. That’s correct. Thehigh urate levels we all run is also causing high blood pressure.Take allo and your blood pressure goes down. Is it the allo thatreduces the blood pressure? Not really but indirectly yes. The allowill stop more urate from forming, the kidneys will slog away as theyalways do at removing the urate, and your blood urate level willfall. Abra ka dabra–so will your blood pressure.
Lets go back to the oil in water and look at a system where there isno solid urate in the water and there is no uric acid in the wessonoil as solid but a system in which both the water and the oil aresaturated with urate and uric acid respectively. This is thesituation most of us lived in just before our gout attacks started.Now, for whatever reason, we either decide to lose weight or we gothrough a period where we are not as hyungry as we were-lets say youfall in love- or lose your lover and lose your apetite and you startliving off of your stored fat -i.e. start to lose weight. What willhappen?The fat layer is essentially saturated with uric acid and you areselectively removing just the fat from the overall bottle. We have amagic membrane that will selectively allow the wesson oil moleculesto pass through but will not allow the uric acid molecules to gothrough. The system that was in equilibrium will now have excess uricacid and it will start to percipitate out. some of the excess uricacid will go into the water solution as urate and monosodium uratecrystals will start to form and in the oil the uric acid goo willstart to form.
It is a relatively simple concept to get your head around althoughthe specifics of how much of the urate can be tolerated and where,where is very complex indeed, the fact remains that, when you startto lose weight your body will remove adipose tissue and the uric acidwill be left behind and therefore the overall concentration of uratein your system will be increased and you will be more succeptable togout attacks.
Anectdotal summary-When I first got gout it was after having injured my knee by falling,nothing to do with gout per se, and I was relatively immobile andgained about 20 pounds. After regaining my left wheel, I went back tothe exercize routine, lost about 12 of the 20 pounds and and bam-agout attack. My first. I did not associate it with the weight loss.
Gout better after 6 weeks and of course gaining 6 of the 12 pounds Ihad lost. Lose more weight-bam a gout attack. This time longer goutbout and managed to eat my way all the way back to the original 20 Ihad gained. Gout gone and this time thinking about maybe I hadinjured myself to make the gout come back, I exercized but moreslowly and carefully, and at about the same milestone, only 8 poundsfrom my goal, a really big attack this time-Damn exercize. It iscausing my gout–
Well again it is true but it is indirect. The exercize helps with theweight loss and the weight loss reduces the fat content and that endsup raising the overall uric acid level which percipitates a goutattack.