Gout Pal Interactive

Insanity and apple cider vinegar (ACV) have never been linked before, but some of the stuff I am reading is driving me mad.
I am researching apple cider vinegar for gout. Does it help? If so, how?

I start by looking for scientific research - there is none.

I try things myself - haven’t got round to ACV yet.

I listen to other people - but only sane ones, without a commercial affiliation.

Now, you ask is this another GoutPal rant. Sorry, yes.

I know that everybody has different gouty experiences and gout treatments that work for some people never work for others. That is life.

I love getting messages from people who have found something that brings them some relief from gout so I can share this with other gout sufferers, but I get suspicious when people shout about miracle cures. The latest message was quite sensible, offering vitamin C ^(*), which he took at the same time as ACV, as a potential alternative explanation for his gout improvement. But he directed me to a website that was brimming with testimonies about apple cider vinegar as a cure for gout.

I will not give that website publicity by naming it. It is either a deliberate scam or an appalling attempt to mislead people who are seeking help and advice. I would contact the site owners to discuss the contents privately before public comment, but as they hide behind an anonymous registration service, I cannot.

I can understand anonymity to prevent spamming, but they seem quite happy to publish the email addresses of their contributors. They promote their independence by claiming they will not endorse manufacturers. Well, they wouldn’t if they were also one, would they. Might look a bit suspicious if they only promoted their own products. Grooming the alternative medicine market when you have a good market share is at least one way that an unethical company might operate. On the other hand, they may be a completely legitimate advice organization - I really wish I knew. If you have worked out who I am talking about, and you know who they are, please let me know.

The pity is, there is some quite good gout information mixed in with the bad. I will unravel it and report back. This may take some time, as one page of gout cures covers over 7000 words - not all of it about apple cider vinegar. I will do the analysis in stages, and hope that the ACV induced madness is only temporary.

^(*)Vitamin C has been shown to lower uric acid, but probably not by enough to cure gout.

Can you cure your own gout?
You might have to.
If you do not take responsibility, and demand the right long term treatment, you will never cure your gout.
If you do not take action, the chances are nobody else will.

I get many messages from disillusioned gout patients who don’t feel that their gout treatment is working. I’ve just seen an article that suggests that you might have to cure your own gout.

In Patients Learn Chronic Disease Self-Management Online on MedScape, the authors note that:

managing a chronic disease has become a normal part of life. The healthcare system, however, … was designed to focus on acute illness and injury, not long-term conditions.

This is why most gout sufferers get pain relief treatment, but many go without the long-term uric acid lowering treatments that are crucial to curing gout. But it is vital that you get this treatment to avoid crippling joint damage and skin bursting tophi.

The authors conclude:

There is no doubt that patients will need to become good chronic disease self-managers. The healthcare system and individual professionals providing healthcare should increase the focus on ways to offer patients with chronic disease convenient, economical, and high-quality programs to help them attain the best possible therapeutic and quality-of-life goals. For the growing proportion of the population, this vision is becoming a reality through use of the Internet.

Compared with individual visits and group-based programs, the Internet is far less expensive and has the potential to reach many more people. … Online disease self-management can be an effective delivery method for teaching patients the skills and self-confidence they need to take charge of their chronic disease care.

I don’t know what online services your healthcare provider offers, but my online advice to help you cure your own gout starts with:

1. See the listing of rheumatologists, go and see one, and make a plan to get your uric acid levels down to 5mg/dL. Then monitor uric acid every few weeks
2. Drink about a gallon of fluids daily. Spread throughout the day, so you are drinking more or less constantly. All fluids count, but water is best.
3. Consider baking soda (I’m also researching potassium citrate for gout) unless you have high blood pressure. This, and the increased fluid intake, helps avoid kidney stones.
4. Lose weight slowly - uric acid can increase from binge eating and starvation.
5. Exercise regularly, but gently - uric acid can increase from prolonged exertion.
6. Don’t become obsessed with particular foods. Gout sufferers need a healthy balanced diet that includes a wide variety of different food types. Keep meat and fish to about 20% of your diet - balanced with plenty of fruit and vegetables.
7. Painful swelling will occur occasionally until you get rid of all the uric acid crystals in your body. You and your doctor should discuss different pain relief options. You might need to try different medications until you find something that suits you.

Take responsibility, seek a little expert help, and you can cure your own gout.

Gout sufferers know that colchicine side effects are often unpleasant. Diarrhea, nausea and vomiting are common, but one side effect is less well known and much more dangerous.

I’ve written before about the potential problems with biaxin and colchicine. Biaxin labeling is supposed to carry a warning. There has certainly been plenty of publicity about this in the medical press due to a small number of deaths from colchicine poisoning, but still the problem occurs.

I got this message yesterday:

My Dad was given Colchicine 0.6mg and was told to stop taking it when he got diarhea. He did this but was still bothered with cramping and diarhea. Could this also be caused by the fact he was also given biaxin xl 500 mg. Can these to medications be taken at the same time.

Colchicine and biaxin must not be taken at the same time. This is so serious that I am repeating my warning.

I am not qualified to advise you what to do if you have taken both, but you must seek medical attention immediately.

Tags: biaxin, colchicine-side-effects, _colchicine

A recent comment from a reader about stubborn gout pain has set me thinking. I started writing a short comment reply, but as I thought about the problem, I realized that this subject deserves it’s own article.

Tom wrote about his stubborn gout pain:

I have used prescription NSAIDS (Ibuprofen,Indicin, etc.) to sucessfully treat a gout attack that affected my toes, ankles and knees.

Second and subsequent gout attacks did not respond to NSAIDS and I tried fresh cherries, dried cherries and cherry juice concentrate. The Cherries worked at first and then failed to give relief.

Next, I tried Colchicine and that worked - with gastric upset side-effects.

I’ve also noticed a difference in pain treatment response to different attacks. The pain is caused by a complicated immune response that scientists are only just beginning to understand.

Read the rest of this entry »

Tags: stubborn gout pain, _acute gout management, _anti inflammatories, _colchicine, _pain relief

White horse courtesy of morguefile

What do horses have to do with gout?
Not much, unless you tend to overindulge in The White Horse pub, but there is a link.

The nice thing about having a gout news page, is that you often spot interesting news items. My attention was drawn to “Research Into Why Common Anti-Inflammatory Drugs Harm Intestines”.

Non-Steroidal Anti-Inflammatory Drugs, commonly called NSAIDs, play a significant role in managing acute gout (see acute gout management chart), but they cause stomach problems for many. As you may know, I seem to tolerate NSAIDs pretty well, but who knows if I am at risk, but have not yet had any side-effects. Many other gout sufferers are not so lucky

I nearly turned away when I read that this was research by Kansas State University’s College of Veterinary Medicine and that the research would benefit horses and other animals that require NSAIDs for ailments related to their athletic activities. Animals and athletics - not much interest for me then, until I spotted a quote from the research leader:

“We treat horses the same way we treat humans, and horses get the same side effects,” Lillich said.

So, although uric acid metabolism in horses is different from humans, they still suffer the same pain from inflammation that gout patients do. NSAIDs for pain relief have the same effects on horses as they do on gout sufferers. So any benefits from this research will help us gouty folk as well. And there are some benefits…

Lillich said the research he is doing at K-State will lead to better treatment for patients requiring nonsteroidal anti-inflammatory drugs.

“What we’re trying to do is get better at drug design,” Lillich said. “… Manufacturers will be able to make a drug with fewer harmful side effects.”

Great news for gout sufferers everywhere. And horses.

Tags: nsaids research, _anti inflammatories, _pain relief

I’ve recently been discussing the itchy side effects of allopurinol with a reader. I wonder if it is caused by insufficient fluids or something else. Whatever the reason, it is vital that you get good advice.

I first emailed this gout sufferer about the advice given when allopurinol was first prescribed, as it caused a nasty rash. Since then they have had to return to allopurinol because there was no suitable alternative. It is difficult for me to comment properly on this advice as I have no direct involvement, but I find that hard to believe no other suitable uricosuric is available.

Now the allopurinol side effects seem to be limited to itching. Again, I don’t know if this is due to reduced dosage, or some other reason.

You might ask why I chose to comment on something that I am so far removed from with so little verifiable information. Allopurinol is so important to gout management, yet so often mismanaged, that I’m glad of any opportunity to try and emphasize the correct procedure.

• Before taking allopurinol, it is important to have kidney function tests. Any kidney deficiency can render allopurinol unsuitable.
• You should be advised that allopurinol treatment can cause gout flares at first and discuss your choice of preventative anti-inflammatory treatment, or pain killers as you need them.
• You should be advised to drink plenty of fluids when you take allopurinol, though as a gout patient you should be doing this anyway.
• You should be advised about allopurinol side effects, distinguishing from those that are harmless, and those that should prompt immediate consultation with your doctor.
• You should be asked to return every few weeks for uric acid tests and dosage review.

If you are not getting this advice, check the listing of rheumatologists and consult one as soon as you can.

Don’t forget to discuss your experience of side effects of allopurinol on your gout forum.

Yesterday, I wrote about the guidelines for longterm gouty arthritis cures. I’ve added topics to your gout forum, so you can share your experiences.

The discussion topics for the longterm gout management guidelines (in reverse order) are:

OLD TOPICS NOW DELETED. PLEASE START NEW DISCUSSIONS IN THE GOUT FORUM

Join the forum discussion on this post - (2) Posts

Some of your recent messages activated quercetin interest in me. Or perhaps I should say reactivated.

Ever since I started researching gout, I’ve kept coming across quercetin. I know it’s a flavonoid - a part of a plant that isn’t a classed as a nutrient (like carbohydrate, fat or protein) and isn’t quite a vitamin - though early flavonoid discoveries where classed as vitamins.

I found that quercetin was being pushed as a wonder product, and shied away from it, fearing that it was just an excuse for more snake oil to foist upon us poor gout sufferers. Recently, I found mention of it when I was researching red wine and uric acid, and it also reminded me of my post about morin as a natural gout remedy.

The study that mentioned red wine was “Flow injection determination of xanthine oxidase inhibitory activity and its application to food samples”, and the reference to red wine was so insignificant that I nearly discarded it as irrelevant. Then I read how several natural compounds compared to allopurinol as a xanthine oxidase inhibitor. Chief amongst these is quercetin, though it’s more effective cousin apigenin, is also very interesting.

I didn’t want to waste my time researching this further, if there is nothing significant to report, but I’ve found a lot of very important information, that I want to present soon, including a table of quercetin and apigenin content in food. I need to finish my review of the gout management guidelines, then I’ll be straight on to this. Sorry if it delays responding to emails, but I promise that I will respond as soon as I can. If you have urgent questions, go to the gout forum - that has the greatest chance of a response.

Sorry to post a teaser like this, but I think quercetin and related flavonoids are important enough to warrant a mention. Writing this makes it less likely that I will forget about this important topic. If I’ve activated quercetin interest in you, please remind me to finish this.

---

Due to a recent comment, I’ve opened this up as a quercetin discussion. Please discuss any aspects of gout, uric acid and quercetin in the gout forum.

Tags: _apigenin, _flavonoid, _quercetin

You can see I’ve added quite a lot of allopurinol gout treatment information recently, both here and on GoutPal.com. It’s no coincidence that I have also been accepted as an expert author for top article publishing website, ezinearticles.com.

I would really appreciate it if you would check out my article about allopurinol and gout. I’ve tried to concentrate on the key points of this vital gout cure. Please let me know what you think about it. You can add comments here, discuss in the forum, send me a private message, or even comment directly on the article itself.

Please don’t hold back. Of course I’d love to get some praise, but I really want to know what you think, so that I can improve for future articles.

If you are on allopurinol medication for your gout, you should be getting good advice and regular checkups from your doctor. Like myself, I know many of you look for more information on the Internet. That’s a good thing if it helps you, but beware of misleading lies and half-truths.

Experience tells me that there is a lot of misinformation about gout, and also opinion masquerading as fact. Sometimes opinions, including my own, turn out wrong, but that is the nature of gout, which needs much more research. Wherever I can, I like to give references for my information, so that you can check it yourself.

I’m so appalled by what I found today when searching for “allopurinol medication”, that I’m not going to refer directly to my source, though you can probably search for it yourself using my gout search form.

One page at the top, or near the top of my search for “allopurinol medication” purports to be an expert quiz. The quiz itself is largely banal, but worst of all, some of it is confusing if not misleading - not what I would expect from a gout expert.

The first question asks for the most common side effect from using allopurinol, and lists the possibilities as diarrhea, weight gain, coughing, joint pain. It’s got to be joint pain, yes? No - they reckon the correct answer is diarrhea. Now this just cannot be right. There are several side-effects to allopurinol, and diarrhea is one of them, but it is not the most common. Allopurinol causes joint pain in just about every gout patient that takes it - and if it doesn’t, it should! The only way to get rid of gout is to melt the uric acid crystals that can damage your joints. As they dissolve, chances are you’ll get a painful gout flare. That’s the way it works, and it’s why most doctors prescribe an anti-inflammatory, usually colchicine, to take at the same time.

The next question asks: what commonly prescribed antibiotic should not be used when taking Allopurinol? Choices are biaxin, pennicillin (yes, they stuck an extra n in penicillin), amoxicillin, or diflucan. Now this is just plain confusing. I actually went for biaxin, as I remembered it could be dangerous for some gout patients, though I didn’t remember why. When I got it wrong, I checked on my biaxin page, and realized I’d confused allopurinol with colchicine. So was it a trick question? Whether it was or not, it was confusing, and potentially dangerous to suggest to a gout sufferer that biaxin is OK to take, when the chances are that they will be taking colchicine. And why not take amoxicillin? Some studies have revealed that rashes are more prevalent when people take it with allopurinol, but nobody knows whether it is drug interaction, or some other factor of having gout that increases the chances of a rash.

I could go on, but I think you get the point. If you are taking allopurinol medication, you should be taking advice from a doctor, preferably a rheumatologist.