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Booze and gout, etc.

Booze doesn’t contain purines and that’s not why folks with gout should never drink alcohol — that’s a mistaken impression. Booze inhibits the elimination of uric acid, which is why it is poison to the gout sufferer. Secondly, the only meats that contain sodium notrite are processed luncheon meats, e.g., bologna, salami, ham, bacon, etc. There would appear to be no connection between sodium nitrites and purines, so far as I know. Somebody know about a connection I am not aware of? It is the purines in the meat products themselves that are the culprits, not sodium nitrite, NegevoliDo you Yahoo!?Yahoo! SiteBuilder - Free, easy-to-use web site design software

Low purine diet

Low-Purine Diet

IntroductionWhy this diet?Foods to avoidBest betsResourcesBibliographyA low-purine diet is often prescribed for individuals with gout andLesch-Nyhan Syndrome (a rare genetic disorder that occurs in 1/100,000people). People with diabetic nephropathy need to restrict proteins, aregimen that includes, but is not limited to, the restrictions imposed by alow-purine diet.

Why do people follow this diet?In people who have gout, uric acid production in the body is increased whileits elimination is reduced. The excess uric acid builds up in thebloodstream, is deposited in the small joints or soft tissues, and causessymptoms that resemble arthritis. Purine is a compound that is mainly foundin animal protein and is metabolized to uric acid in the body. A high-purinediet, obesity, regular alcohol consumption, and diuretic therapy can allcontribute to elevated uric acid levels in individuals with gout.Preliminary research suggests that insulin resistance may also play a rolein the development of gout. A low-purine diet and medications-such asnon-steroidal anti-inflammatory drugs, corticosteroids, and allopurinol-arecommonly used to treat gout. An effective diet is important to avoid orreduce complications and lessen the expense of drug treatment. Restrictingcalorie intake and alcohol consumption, and losing weight (if overweight),can also reduce uric acid levels. It is also important to drink plenty offluids to increase uric acid excretion from the body. Alternative sources ofprotein should be included in a low-purine diet.

What do I need to avoid?To avoid purine ask about ingredients at restaurants and others’ homes, andread food labels. The following list is not complete. Consult with ahealthcare professional before making any significant changes to your diet.

The following foods have very high purine levels, and should be avoidedcompletely:

AnchoviesBouillonBrainsBrothConsommDried legumesGooseGravyHeartHerringKidneysLiverMackerelMeat extractsMincementMusselsPartridgeRoeSardinesScallopsShrimpSweetbreadsYeast (baker’s and brewer’s)Yeast extracts (e.g., Marmite, Vegemite)These foods have high purine levels

Fish (including shellfish)PoultryMeat (except those with very high purine content, noted above, or those withmoderately high purine levels, noted below)These foods have moderately high purine levels

AsparagusCauliflowerLegumesLentilsMushroomsOatmealPeas (dried)SoySpinachTripe

Best betsBeverages (carbonated)ButterCereals and cereal productsCheese (all kinds)Cocoa (however, caffeine is prohibited in Lesch-Nyhan Syndrome)CornCornbreadEggsFruit juicesFruitsGelatinIce creamMilkNoodlesNutsRefined wheat flourTapiocaVegetables (except those noted above)White bread and crackers (but not whole wheat, which is moderately high inpurines)White rice

Are there any groups or books?National Institute of Arthritis and Musculoskeletal and Skin Diseaseshttp://www.nih.gov/niams/

Arthritis Foundationhttp://www.arthritis.org

The Purine Metabolic Patient’s Associationhttp://www.pumpa.co.uk

BibliographyDessein PH, Shipton EA, Stanwix AE, et al. Beneficial effects of weight lossassociated with moderate calorie/carbohydrate restriction, and increasedproportional intake of protein and unsaturated fat on serum urate andlipoprotein levels in gout: a pilot study. Ann Rheum Dis. 2000;59:539-43.

Emmerson BT. The management of gout. N Engl J Med 1996;334:445-51.

Mahan LK, Escott-Stump S, eds. Krause’s Food, Nutrition and Diet Therapy.10th ed. Philadelphia, PA: W.B. Saunders Company; 2000.

http://www.marinurology.com/articles/calculi/foods/purines.htm

Wolfram G. [Diet therapy in gout]. Ther Umsch 1995;52:524-7.

Gout and skinny people

I was wondering if anyone who has gout is thin?

Because it’s mentioned that you should lose weight, if you have gout.

Is everyone alittle overweight?

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.

Advice? support?

I wonder if anyone out there can help me. My family doctor suspects I’ve gotgout, but says I need to get tests to be sure. The confusing thing is - I’m awoman! Feels weird to get this (provisional) diagnosis…I thought this was onefor the boys. So here’s what it feels like: swollen, red, so stretched theskin isitchy and VERY sore, although I’m still able to walk. Oh - and by ‘it’, I meanmy big toe. So what do the people who know say - is this gout?

Uric acid, blood pressure and heart disease

I have referenced multiple studies that link high uricacid levels with high blood pressure, arterial detioration and withheart disease. There are even several well done studies that showthat the link is causative and not simply linked because when theyarbitrarily cause an animals (not human) uric acid to rise, thatanimal gets high blood pressure and has severe arterial deterioration.

So much we already know and therefore taking allopurinol will reducethe exposure we all experience from this risk factor.

It occurred to me that1. There are many people who have very high levels of uric acid whodo not have gout.2. High Blood Pressure is thought to be the #1 cause of, or at leastlinked to, early death from heart disease and arterial complications.3. A very large percentage of the population suffers from high bloodpressure.

Is it possible that uric acid is a much bigger problem thatn just amenace to us gout sufferers? This would be particularly true forsomeone who is overweight and would therefore have a large storeroom, so to speak, where they can store large amounts of utris acid.

For example, if there were, which there is not, a good clinicalmeasure of the total uric acid level in a person, not just the bloodlevel but the total uric acid, then it might be prudent to put a muchlarger population onto allopurinol than is now on it.

Since I am on allopurinol and will not go off it why do I care?

Why do we, or why should we care.

Well, from a purely selfish point of view, if uric acid can be shownto be participating, even mildly, in causing high blood pressure, andif those same people also have gout free but elevated levels of uricacid, there would be a significant amount of money and researchallocated toward making this elevation of uric acid not happen.

In other words, when or if the focus of medical science falls on uricacid and how to eliminate it from our systems, there will be new waysuncovered, new treatments and all of them will apply, in a totalsense, to helping gout sufferers as well.

Gout and low carb diet

I’ve had gout for 15 years and have generally kept in under controlwith indomethacin at the first twinges. I’m sure that the extra 50lbs that I’m carrying are a big factor. I’m interested in trying alowcarb diet but am concerned that a high protein diet will increase myuric acid levels. Have any of you tried a low carb diet? What wasyour experience? Is it a good idea or not ?

General gout stuff…

I’m going to go to a podiatrist and see if they’ll let me get onAllopurinol. A few questions about this…

1) Do you take it daily (i.e. like vitamins) or just when you feela “flare up” coming on?

2) Does is eliminate gout or just make the outbreaks less painfuland less severe? By “eliminate”, I mean does it stop the gout fromspreading to other, larger joints (hip, elbow, fingers, etc.)

3) What, if any, side effects does it have? I’m working on changingmy diet to include more water if anything and about the only realvice I have is beer (sorry, that won’t go until I’m old andwithered).

As I mentioned, I’ve had only three outbreaks and I’m figuring if Ican “nip this in the bud” now, I’ll be better off in the future.

Lastly, I’m a swimmer, but haven’t been actively swimming for over ayear. With my last outbreak in my ankle, I noticed while swimmingit was a little stiff, but once I got going, it kind of feltbetter. Is something like swimming better for gout as it hasno “direct” contact on the joints as opposed to something likerunning?

Allopurinol and me

I was golfing yesterday and ended up playing with a man who also hasgout. We kind of compared stories (though he’s been suffering for20 years) and when I told him I had just recently had my secondattack; he asked me if I was on allopurinol. I told him that mydoctor told me that if I had more than one outbreak a year, she toldme I should get on it. His advice, though, was that I should be onit as “…I was just waiting on another attack to occur…”.

Granted he’s not a doctor, but he has more of a knowledge of thewhole thing. Any ideas as to what I should do?

He also told me that seafood (oysters, etc.) really set it off andwhen I thought about it, I had raw oysters a few days before my last

Beer

Alright I know beer is bad. Yes I know I should not drink it. But IF one was to drink a beer is any kind better or worse than another? Brand name or brew type, i.e. Bud vs. Becks, or Ale vs. Stout.

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