Gout Pal Interactive

I got another interesting message recently that set me researching gout and stress.

It’s very early days yet, but I thought I’d better make a start now before I get bogged down in my gout diet plan. I’m hoping that if I set the ball rolling here, some better informed readers might guide me in the right direction.

I’ve come up with a couple of references. The first stress and gout article I came across is a 1972 article by Katz and Weiner. The report looks at hyperuricemia (excess uric acid - the forerunner to gout). Psychosomatic Considerations in Hyperuricemia and Gout concludes that:

“… the possible influence of stressful, psychosocial events on serum uric acid level make gout a potentially fertile area for psychosomatic research.”

The full text of this stress and gout article is available online.

The second reference is from Murray in 1980. Psychosomatic aspects of gout states (in the abstract):

Hyperuricemia is the specific biochemical vulnerability of gout sufferers. However, hyperuricemia is much more frequent than gout. Gout also is more frequent in men; after menopause gout attacks become more frequent in women; psychosocial factors, like stressful life events, tension, and anxiety can trigger attacks of gout, which modern pharmacology can moderate and control.

I need to try and find the full article - if you’ve got a copy I’d love to see it.

Please tell me about your experiences of gout and stress. You can comment below, or via my contact page (button near top of page).

How are Alcohol and Gout Related

Hot on the heels of my reader’s message that led to My gout diet Plan, came a message about alcohol and gout. I’ve been sitting on the fence about this for too long. Time to make a stand for alcohol. Or at least seek better information from people who know better - maybe you!

One of my first GoutPal.com pages was about the effects of alcohol. I’m not saying I know everything about gout now, but I knew a lot less then. Not that there is anything wrong with what I said. The main problem for me was including it in my Gout Causes section. At the time, I’d been led to believe that alcohol causes gout. I doubted it then, and I doubt it more now.

I looked at a lot of research, studies and reports about alcohol and gout. I wrote that I would summarize these. But I remained confused. I put things on the back burner until I got this message:

of ALL major types of alcohol which can i consume with the LEAST adverse affects. (i.e. vodka, gin, rum, all whiskeys, wines, beers, liquors, assorted cocktails, shots, etc. etc. etc. can’t i have ANYTHING at all? I know high sulfite content is BAD. SOOOO many conflicting answers, studies show beer the worst then liquor then wine..WHAT!!! wine has the HIGHEST sulfite content of ALL three? I’m totally confused here!!!!white wine okay, white wine bad, etc. etc.

Now I haven’t had time to look at sulfite and gout - that’s for another time. I have had a little think about alcohol. I know how alcohol affects me. I know how alcohol affects my gout. I think it’s time for a bit of controversy.

My Alcohol and Gout Theory

Alcohol has very little to do with gout. It’s easy to fall into the trap of getting hung up on it. Most doctors tell you alcohol is bad for you, and you end up feeling guilty. Now I’m not advocating alcohol abuse, but I can definitely see from my experience that alcohol has some positive effects.

I find it lifts my mood - important to me when I’m feeling a bit down with the pain of a gout attack.

I find it helps gout attacks to resolve quicker. I drink mainly beer, and I find that after a few pints the swelling goes down and the pain gets less.

Now these are both short term benefits. The downsides of alcohol probably come later, but unless you’re drinking excessively, they are beatable.

I do not recommend neat spirit. Spirit with a still mixer is, I think, better than fizzy mixers. Wine and beer should be OK. There’s very little more than alcohol and water in most drinks, so it’s not worth getting hung up over. In theory, red wine has more health giving trace elements than other drinks, so it should be preferred, but I don’t think it’s critical.

The first downside is dehydration. There’s only one answer to this - drink water. You may have seen my page on water and gout. Keeping hydrated is very important for managing gout. If you get into the water habit, you should never suffer from alcohol-induced dehydration. Make sure you drink water after alcohol, and drink more if you wake through the night.

The second downside is weight gain. You have to manage this over a week, not a night. If you’re overweight, aim to balance your diet to loose one or two pounds a week. No more. If you’re not overweight, try to maintain a fairly even weight. Managing your weight includes looking at calorie intake, exercise and metabolism. My soon-to-be-launched gout diet Plan will cover this in more detail.

There is a risk that alcohol can affect kidney function. Regular water drinking should more than compensate for this. I recommend kidney function tests as a normal part of health checks. Your health care provider should advise the interval.

All in all, I’d say stop reading the studies, and get drinking! Do it sensibly, and if anyone says alcohol causes gout, please ask them for me - How?

Your Thoughts On Alcohol And Gout

I’ve come to the conclusion that a lot of “scientific evidence” about alcohol and gout is worthless. Alcohol is to be enjoyed as part of a healthy social life, not studied in a lab. I’m much more interested in the practical aspects of living with gout. Deciliters of blood, and micrograms of alcohol, don’t interest me.

I’m happy to share my own thoughts on alcohol and gout, but I don’t wish to mislead anyone. Please share your experiences here so readers can see a balanced view. All you have to do is add a comment below. You can also write to me privately via my contact form.

Today, a reader asked me if there was any connection between his gall bladder removal and gout. Specifically he asked,

“I had my gall bladder removed a few years ago and since then I have noticed the gout creeping in.
Is there any significance with that?
Because of the digestion changing (no gall bladder).”

The first thing I have to point out is that I have no medical qualifications. It is always important to seek qualified medical advice when dealing with gout. It is doubly important when another condition co-exists. I have very little information to go on here, so I’ll stick to generalities.

From my knowledge of gout, and a quick look for related matter, I would say that there is no obvious connection. I will keep looking. I would appreciate it if anyone else who has any information would let me know, either by commenting below, or by my Contact form above.

Possible connections are:

• The gall bladder (often called gallbladder) produces bile which helps to digest fats and fat soluble vitamins (vitamins A, D, E, and K). Removal of the gallbladder (also called cholecystectomy) means no bile is available to aid digestion. Blood tests should identify any vitamin deficiencies. If there are any such deficiencies these could be investigated for potential links with gout.
• Lifestyle changes after surgery such as dramatic changes in exercise or weight can affect gout. Exercise risks are usually due to exertion. Rapid weight gain or loss can both cause gout. Being overweight increases the risk of gout.

It may be that gout is just a coincidence, and has nothing to do with gall bladder removal. In any case, it is important to deal with the gout as soon as you can do get uric acid levels down.

You can choose medical treatments to lower your uric acid level, or alternative remedies such as diets and dietary supplements. Whichever you chose, it is important to seek medical advice to ensure that you do not cause additional problems.

Please add your comments about gall bladder removal and gout below, or send me a private message via my contact form.

Reduce Uric Acid For Better Brains

Most gout sufferers try to reduce uric acid to lower the risk of acute gout attacks. New research suggests that there may be another reason - improving brain performance.

Serum Uric Acid and Cognitive Function in Community-Dwelling Older Adults looks at 96 men and women with normal uric acid levels. The study excludes people who are taking medications to reduce uric acid. Normal levels include men with up to 7.6 mg/dL and women up to 7.1 mg/dL. Of this group, the top 25% (men with uric acid levels between 5.8 and 7.6 mg/dL and women between 4.8 and 7.1 mg/dL) are classed as having high uric acid levels.

The chart above shows the percentage of people who performed worst in a number of tests. The data is taken from the following table:

The authors point out that nobody knows how uric acid levels and brain function are linked. It might be that high uric acid levels and reduced brain function have a common cause. The authors recommend further studies to see if medications to reduce uric acid result in corresponding brain function improvement.

Uric Acid Causes Reduced Nerve Damage

A new study explains how uric acid causes chemical processes in the body that might help damaged nerve cells.

The study explains that scientists have known about the beneficial effects on nerve cells, but have not understood how this works.

When spinal cord injury occurs, there are 2 types of damage. The first is physical trauma. The second is chemical damage as a substance called glutamate builds up in response to the damage. Glutamate is vital to healthy nerve function, but too much can choke other vital nerve cells to death.

Astroglia-mediated effects of uric acid to protect spinal cord neurons from glutamate toxicity looks at the processes involved. Professor Firestein, and others, reveal how uric acid works with other specialized non-neuronal support cells called astroglia (or astrocytes). It is this combination that promote transporters that combat excess glutamate.

Of course, this does not really help the gout sufferer. All we know is that excess uric acid causes gout pain. It does underline the usefulness of uric acid though.

The fact that uric acid is needed by the body to help prevent damage from other chemicals might hold clues as to why we produce excess uric acid in the first place.

Can Hypertension Drugs Lower Uric Acid Levels?

There are many types of hypertension drugs. The most commonly prescribed, diuretics, can often raise uric acid levels, and are often seen as a gout trigger.

Another class of hypertension drugs are ARBs. One of this class, losartan, has been reported as lowering uric acid levels, but other drugs in this class, e.g. candesartan, have no lowering effect.

A recent study by Takashi Iwanaga and others has investigated the effects of ARB drugs on uric acid levels. Concentration-Dependent Mode of Interaction of Angiotensin II Receptor Blockers with Uric Acid Transporter Formula is a study of the effects of different concentrations of ARB drugs on uric acid.

This is a very technical report, the outcome of which is demonstration that some ARBs lower uric acid levels, whilst others only do so at certain concentrations. The report concludes that this behavior can be predicted from the chemical structure and holds out hope that ARB drug development will avoid preparations that could increase uric acid.

Clearly, there is a long way to go before drugs are developed specifically for sufferers of both gout and hypertension. But this is a start.

Does High Uric Acid Cause Hypertension?

High uric acid is commonly called hyperuricemia. For a long time, this has been known as a starting point for gout. Hyperuricemia often, but not always, lead to gout.

Scientists also suspect links between hyperuricemia and hypertension (high blood pressure) and heart disease. A recent study by Eswar Krishnan, and others, has looked at this possible connection in more detail.

The results of Hyperuricemia and Incidence of Hypertension Among Men Without Metabolic Syndrome have recently been published in the journal of the American Heart Association. This project studied over 3000 men with high uric acid, but normal blood pressure.

After 6 years, results showed that these men had, on average, much higher blood pressure readings than equivalent subjects without high uric acid levels. The results also showed that risk of hypertension increased as levels of uric acid increased.

The study conludes that there is a link between hyperuricemia and hypertension. It is not clear what this link is. The results are adjusted for obvious factors such as weight, but there may be some other factor that could explain the results.

Until we know what the link is, it is too early to confirm that hyperuricemia causes hypertension. However, common sense tells me that if there is a link, then anyone with high uric acid levels should arrange regular blood pressure tests.