Where do you go for gout diagnosis?

You might think that any qualified doctor could tell if you have gout, but even your doctor is not sure.

In a recent survey of different types of physicians, only rheumatologists are 100% certain that they can diagnose gout.

This supports my advice that you should always consult a rheumatologist if you have gout, or show any gout symptoms.

Read the rest of this entry »

I’ve just read a fascinating study about a substance called L-carnitine and it’s effect on uric acid.

The study is not concerned with gout, but anything related to uric acid interests me. This particular study looks at how uric acid rises after strenuous exercise. The fact that exertion raises uric acid is the reason why I recommend gentle exercise for gout sufferers - exercise is important to aid mobility and help weight loss, but too much can have a bad effect.

L-Carnitine

$5 VITAMIN SALE!! Plus get FREE SHIPPING on any order over $25. No coupon needed. Hurry, sale ends soon!

L-carnitine is currently being promoted widely as an anti-aging / anti-dementia supplement. It is produced naturally in the body if sufficient lysine (an amino acid found in protein), vitamins B1, B6 and iron is available. It is available from diet - mainly muscle and organ meat, fish and milk products.

The study about uric acid, exercise, and l-carnitine (L-Carnitine L-tartrate supplementation favorably affects markers of recovery from exercise stress) uses a commonly available carnitine supplement LCLT, combining L-carnitine with L-tartrate.

In the study, the subjects took the LCLT supplement for a 6 day rest period prior to starting the exercises. Although the study is mainly concerned with the effects during and after exercise, the volunteers on LCLT displayed lower uric acid levels even during the rest period.

The big question is - will it do any good for gout? If you’ve taken this supplement, please let me know how you got on with it.

Here is the answer to your short gout question, “How long between gout attacks?”

As with many gout questions, the short answer is, “It depends.”

The long answer needs an explanation of what it depends on.

First, let me define what a gout attack is. You know it from painful swelling of one or more joints, usually accompanied by redness and/or flaky skin. You might also experience some feverishness.

The gout attack is caused by Read the rest of this entry »

This article answers the short gout question “swollen toes diagnosis”. It also addresses a point raised in a recent comment about infection and gout.

Swollen toes are a common sign of gout, but there could be other reasons.

If you go to the doctors with swollen toes, they will usually start by asking about any possible recent Read the rest of this entry »

The first of today’s short gout questions is graph uric acid level.

It seems a strange question. Graph uric acid level against what? A particular gout treatment? A particular gout diet? Let me explain uric acid levels in general terms, then you can interpret your data against particular aspects of your own gout treatment or lifestyle.

The most important thing about uric acid level graphs is Read the rest of this entry »

Each day I get a new question about gout in my inbox. Gout is very complicated so you keep asking questions about what causes gout, how gout attacks are triggered, and treatments for gout.

I love getting these gouty questions. Many of them set me off to research new ideas about gout.

One of my most recent gout questions is:

Question about gout: A month ago my right ankle was quite red and very warm. But the pain I had was terrible. I woke up with this and did not know what I did to get this. I could not even put a sheet on my foot.

Advil worked wonders and in a few days it was like nothing happened. That is until today. Now my left bit toe although not showing any redness or swelling the pain in my big toe feels like my big toe is not in it’s socket.

When I move it a certain way when I walk oh boy what pain.

I have not seen the doctor regarding this as it does go away. Is the pain in big toe in which I feel like the toe is not in it’s socket sound like gout to you?

I’ve removed a little personal information, as I do not want to make the writer identifiable. I may quote from interesting gout messages occasionally, but I will never reveal personal information. If you write to me, you can mark your message confidential, and I will not quote from it.

Please note that Advil is a particular brand of ibuprofen. I spent a few minutes responding:

This does sound like gout to me, though the only way to be absolutely
certain is to have fluid drawn from the affected joint and analyzed
under microscope. Some family doctors do this, but many are not up to
speed with the latest developments.

I recommend that you see a rheumatologist. If you look at my article
at http://www.gout-pal.com/gout-treatment/2007/01/ you will see a link
to a listing of rheumatologists. You should be able to find one near
you.

It is important to get some treatment as soon as you can, because gout
is a progressive illness and your condition is bound to get worse if
you do nothing.

Whoever you choose to consult about your suspected gout, the most
important thing is to arrange a plan to keep your uric acid level
below 6mg/dL. You will also need some pain relief for a few weeks
until the uric acid crystals that are causing the pain in your joints
gets completely dissolved.

If there is anything that you don’t understand, please contact me
again and I will try to explain it. Gout is a complicated disease, but
it is treatable with the right approach.

And added some personal comments. A minute after sending it I got the message back from AOL saying that the address would not accept messages from me.

Can I beg you, if you write to me, to make sure that replies from goutpal.com are allowed through to you. Most email systems that have spam filters call this whitelisting. Most of my message forms send out an automated reply before I answer the message personally. If you don’t get this automated reply within a few minutes of sending your message, then the chances are that you are blocking messages from me. I will never be able to reply to you if this happens.

The best way to avoid this is to ask your question about gout in your gout forum. Messages appear there as soon as you post them so you have 2 important benefits:

1. I usually check the forum every day - my inbox often takes longer if it is very full.
2. Other people see the forum messages and you might get an answer from them

So please keep the questions about gout coming - but make sure I can answer them.

Yesterday, Paul commented about his gout, and suggested possible causes. One cause of gout that he didn’t mention is sleep apnea.

You may have heard of sleep apnea. Burton Abrams has commented about sleep apnea and gout, and there is a discussion about sleep apnea in my gout forum. [2008 update - old forum lost. If you want more on this topic, please start a new discussion in the gout forum]

Burt has recently published a book about the perils of sleep apnea, which not only looks at gout, but also other health effects.

See other posts about this common cause of gout by clicking the sleep apnea link below.

Your messages.
My research.
News alerts.
Every week I hear about a new gout remedy.
Many are just an excuse to lighten your pockets.
This one is simple - stop snoring.

Well, not quite that simple, but read on…

When we think of gout remedies, we usually think of pain killers and uric acid lowering drugs. Many people look for natural remedies, but these are only alternatives to the standard “treat the symptom” medicines.

What if we could find a gout remedy that treats the cause? Somebody has.

Burton Abrams has shown, conclusively, that sleep apnea is a common cause of raised uric acid levels and gout. As he says at Curing Gout - My Personal Discovery: -

reduction of oxygen in the blood, which results from sleep apnea, has been shown to cause the cells in the body to begin to disintegrate and generate an excess of uric acid in the blood. Also, the percentage of carbon dioxide in the blood increases, which makes the blood more acidic and increases the likelihood of uric acid precipitation in the form of monosodium urate

I won’t repeat everything on the site. It’s a concise summary of sleep apnea with well researched links to gout, including personal experience. I urge you to go and read it now, then come back here and tell me what you think.

You can comment below, or let me know with a private message. Better still, please join the debate on my gout forum. I’d love to here about your experience. I’ll summarize experiences and opinions on GoutPal.com.

Sleep apnea is not always easy to diagnose, but it’s a lot easier to treat than gout. If your gout is caused by sleep apnea, then curing it is a surefire gout remedy.

Is Back Pain Caused By Gout?

Your back pain might be spinal gout. A recent study, that I missed from my December 2006 Newsletter, shows that spinal gout is much more common than previously thought.

In a study by Bhandaru and others, Prevalence of Spinal Gout, 630 medical records of gout patients were reviewed and 64 selected where CT scans were available. The authors found that 9 of the 64 scans (17%) showed signs of gout in the spine.

Spinal gout is much more prevalent than previously thought. The authors note that the number of cases, 9, is small and they recommend further study.

On reflection, I suppose gout in the spine is to be expected. After all, the spine consists of several joints. I occasionally get back pain. It’s never been as severe as gout pain in my joints. I’ve always assumed it is caused by posture change due to me limping with gout in my foot or knee.

Given the prevalence, I think I’d better add back pain to my gout symptoms survey.

Do you have any back pain with gout? Have you had it confirmed as spinal gout? Please share your experiences using the comment box below, or on my Contact Page.

Of all the causes of gout, I’ve just heard of the most outlandish (in every sense of the word). It’s the moon!

Now I’ve often thought of myself as a lunatic, but now I know there might be a scientific reason. Actually, this is not real news, as the study was published in 2000, but it has been cited a lot recently due to other lunar effect studies.

The study, “Gout attacks and the lunar cycle” by Mikulecky and Rovensky, mapped 126 gout attacks between 1972 and 1994. It found that gout attacks were higher during full and new moons. This coincides with the moons greatest tide effects.

No reasons are offered, and I’m certainly not going to provide one. In just the same way that I can provide no explanation to the mouthwash story from my reader on Your Gout Views page.

What causes of gout do you know about? Please tell me by commenting below, or via my Contact Page.