Gout Diet Blog

Please note that the units I quoted for my wife’s urate levels ( e-mail ofNovember 4th) were in milli mols per litre, which seems to be standard in the UKwhile in the States the unit is milli grams per decilitre. To convert theformer to the latter multiply by 16.6 or 100/6 to be exact. This means that her0.39 in UK units is equivalent to 6.5 on the American scale and her 0.3 is thesame as 5 in the States. I guess this makes her a marginal candidate for goutand we hope that allopurinol will lower

The immune system is a threat detection and threatassessment system. It is more than just ’self versusnon-self’. For instance, anthrax is certainly not’self’ but is small and simple and is not viewed bythe immune system as a great threat.

Many vaccines are effective only because a large,complex molecule is attached and the immune systemhaving been “hit over the head” learns to treat thelarge molecule and the smaller one as ‘threats’.

What used to be ‘Immunology, Microbiology and GeneralPathology’ in medical school is now usually onehumongous course known as “host defense”.

If psoriasis is viewed solely as a dermatologycondition, little progress will be made. If if isviewed as a cutaneous manifestation of the underlying’host defense’ battle that is being waged, progress ismore likely.

Just as I was unable to get any testing for Pasturellamulticida when I had my intense gout pain, you willprobably be unable to get adequate testing for yourpsoriasis. I actually obtained petri dishes and mediapreparation kits including MacConkey’s Agar Agar and Idid my own testing for P. multocida. My apartment isnot suitable for media preparation or culturing. Iwould have preferred a medical laboratory. The testsare not cheap, it would have been less than twohundred dollars. The doctors would not order thetests. I had to do it myself.

High blood pressure, hypertension, is associated withgout. Moreover they can actually induce high bloodpressure in rats with high doses of uric acid.

High blood pressure is also associated with heavymetals, particularly Pb. So is gout.

Yet try getting quacks to test you lead levels if youhave either disease much less both.

Anyone had any experience of getting gout after being on ‘waterpills’for a number of years?

I do not drink coffee and haven’t for about 25 years. Nor do Iconsume much in the way of caffeinated soft drinks, but for someof us Coke, and stimulant drinks like Red Eye, Red Bull and “V”might be a problem.

If you are trying to analyse your caffeine intake don’t forget to countthese other things as well as coffee.

Gout is a form of arthritis.Gout is a cdd..(crystal depositiondisease). There is usually no mistaking gout for arthritis.Or viceversa.Gout has it’s own symptoms..A true and full blown gout attackis unique.BUT this only applies to early stage gout attacks..usuallybefore any arthritic problems.This is one very good and strong reasonwhy more and more experts like to deal with gout..early on..withdrugs..right now.Deal with this..BEFORE the patient develops otherjoint problems.This waythe gout is basically dealt with/undercontrol..and any arthritic problems can be basically treatedindependantly.Arthritic problems are not usuallysudden/crippling/unrelenting..while gout attacks are not usuallygradual..slow to develop. The problems usually arise when one has had numerous goutattacks..and have not treated them properly..with a uric acid controldrug.The gout attacks may have damaged the joint/area..leading tobasically permanent..unrepairable damage.This is not uncommon.Aperson may then have discomfort..from the joint..because of permanentdamage.Arthritis is known to set in to previously damaged joints.Uricacid deposits are known to attach themselves to a previouslydamaged/rough surface.So we now have a joint that is damaged fromgout..now beset with arthritis..with uric acid deposits..anyirritation from the damaged joint..can call a wbc attack intoplay..while the wbc’s are at it..they may as well..seeing as how theyare there working..get into a bit of a tussle with uric acidcrystals.What basically started as a bit of arthritic pain..can nowbecause of the presence of uric acid crystals end up being a fullblown gout attack.These kind of attacks are extremely difficult foreven experts to deal with.The patient is left sufferring andbewildered..knowing they have not done anything to contribute to agout attack.Often they fiddle around with over the counter med’s forthe arthritic attack..but it won’t go away.Off to theexpert..mayberight to the colchicne..it pretty much only works ongout and is a good test for gout.Sometimes the colchicneworks..hopefully..at least eliminating the gout attack..anddiminishing the pain.Other times..sure the colchicne is dealing withthe gout..but the real problem is the arthritis pain caused by goutdamage.Sometimes another drug..usually a NSAID..often a large dosageis used to deal with the problem.I dont’ agree with thistreatment..because while it is basically an antinflammatory..and cansometimes deal with both the gout and the arthritis at the sametime..this does not deal with the gout..only masking it..

Similar treatments?The medical/scientific community views..prettymuch the genarl viewpoints if you read enough.

Gout can be treated 5-15% with diet..the other 85-95% with a uricacid control drug. Arthritis..diet makes no difference.

At the early stages of gout attacks..and as well as somearthritis..some drugs..mainly NSAIDS will work for both…for somepeople.

I know that drugs are generally not Rx’d during anacute attack but are instead initiated after an attacksubsides.

However, I wonder if the people on this list wouldagree that it is proper to only initiate drug therapyto lower uric acid levels after the second attack ofgout, but not after the first attack of gout?

I find advice like ‘don’t eat too many purines’ useless in anypractical sense; how many is ‘too many’?

Are there any techniqes etc. for self-monitoring of uric acid levelsso that one can monitor the effectiveness of dietary control techniques?

Also, is there any way of working out / measuring what the criticalcontentration is for causing preciptation of uric acid crystals in anyparticular individual?

In other words, how can I adopt a ’scientific’ approach toself-management of uric acid levels. I feel it ought to be possibleto have some kind of daily / weekly metric such as “Today: 70% ofcritical level, yesterday 55%, last week 45%” and so on.

I suppose I’m looking for a Gout equivalent of a diabetic’s bloodsugar self-assessment kit.

Is there such a thing? Could there be?

I sympathise with your dilema but be of good heart. I have been on Warfarin(rat poison) around 5mg daily for 27 years following a stroke and atrialfibrillation.In 2000 I was prescribed Bendrofluazide to reduce hypertension which I didn’thave and “secondary gout” followed, in my elbows, hands and feet under my toesand in my big toes. My uric acid was tested at .39 UK mmols. Six weeks laterwhen I came off Bendrofluazide it was down to .3.

I persuaded my doctor to let me try Allopurinol in August 2003 on 100mg atfirst, then 200mg in January 2004 and now on 300mg from the middle of thismonth.My situation has improved slowly, attacks increasing in frequency (almostdailyin the early hours of the morning) but mercifully decreasing in severity anddur-ation and my recent uric acid test showed .2 so something is afoot (so tospeak !).

I have never had a synovial fluid test and doctor and rheumatologist say Ijust haveosteoarthritis, but I know that pain very well and this one is somethingelse….mind-blowing in fact. So far I tolerate Allopurinol well. I have given upGlucosamine sincehearing of its shellfish origin and, in fact, all supplements and vitamins togive Allya fair chance and until I am free of attacks I shall keep to a non-purinediet. I’ll keepyou posted.

“…RECENT FINDINGS: The first quality indicatorsfor gout management have been proposed. SelectiveCOX II inhibitors, as well as traditional NSAIDs,are effective in acute gout. A new xanthineoxidase inhibitor, febuxostat, and pegylateduricases are in clinical trials. SUMMARY: Thetherapeutic aims in gout include termination ofthe acute attack as promptly and gently aspossible, prevention of future attacks,prevention or reversal of complications of the,and prevention or reversal of associated featuressuch as obesity, hypertriglyceridemia,hypertension, or alcoholism.”

I know allopurinol happens to interfere withxanthine oxidase but is this its primary mode ofaction? Would xanthine oxidase disruption belikely to affect a fungus?