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Me/I who lives by the motto: Don't ask the question, live the answer! is asking three questions. However, I don't want the answers, since, in my book, we can't get the answers. I am asking them to get people to think about Gout. And, it isn't my doing. The lady who was nice enough to send me the 80mg Uloric was the one who threw the monkey wrench into the gout-world, the gout philosophy: “There got to be one or more other factors relating to/responsible for gout than “too much uric acid” in the body.”
First question: What IS GOUT?
We really don't know!!! Just as we don't know what moves this universe, what makes it tick, what holds it together or drives it apart.
Oh yeah, we created a word: “GOUT” which is supposed to describe a condition called “inflammation” of the joints caused by crystals, with pains which the devil can't even inflict (or is it him/her/it who does it?) and is supposed be caused by too much “URIC ACID” in our body/metabolism.
We think we know because the bio-chemists tell us that “purines(? just another word/expression) are converted into uric acid and that is “transported” by the blood to all sorts of places in our body and it “settles out” out at the joints as crystals and so on and on!!!
3/4000 years ago, we didn't have bio-chemists with a vivid imagination, but people DID have GOUT then. Now, after 4000 years we got smarter and CAN explain the secrets of Gout!
Right! WRONG!!!
Second question: WHY DO SOME HAVE GOUT AND OTHERS NOT?
They have NOT explained YET, why only ~1% of all the descendants of the species Homo stupiens have gout, while ~99% go “scot-free”. Why do some homo stupiens walk around with 10+ SUA and NEVER have a single gout attack while some other nice/good gouties squirm in anguish with a SUA of 5-6 (even while being intoxicated with pharmas' “wonder drugs”?) And, please, don't tell me that some of that stuff is dissolving and is causing the pain.
Why do ALL the other “animals” have a mechanism to deal with uric acid (which is supposed be beneficial [antioxidant] while the ONLY ANIMAL=HOMO STUPIENS (which doesn't even deserve to be called animal since no animal does/behaves like him/her/it) lost that mechanism in his/her/its historic/heroic 2-3 million years “Development?”
Third question: WHAT CAUSES GOUT?
And, here, enters the lady who sent me the Uloric 80mg. She does NOT believe that ONLY Uric Acid is responsible for gout. She feels/thinks that there must be other factors involved, besides SUA.
After giving her statement some thought, I must agree with her. Her and my problem, though, is that we DON'T know what the other are. Who of you gouties knows what those factors are??? Don't bore me/us with pH's, temperatures, MSU's crystals, tophi, and whatever else is floating around the globe.
Hans- there is a wild card- it's a genetic lack in the enzyme dept! I'm sure Zip can clarify – I think there's info on here about it.
That's why only a few get gout- that could get it, on their SUA numbers.
The common inability to make Vit C is quoted as a possible factor.
Just a couple peripherals:
We HEAR anecdotal stories about “an SUA of 10″ without gout. It may be just that, anecdotal. I'll stick my neck out and say, show me a person who tests a 10 SUA and I'll show you a man who will be writhing in pain within a year.
You said “Don't bore me/us with pH's, temperatures, MSU's crystals, tophi, and whatever else is floating around the globe.” but it very well might just be the concurrence of unfortunates that at one tiime and place for one individual in ONE joint that these come together and crystals form. Once crystals form there is a locus of precipitation and the body can no longer keep a supersaturated serum/synovial fluid. More crystals grow atop the other crystals. Once a goutie, always a goutie.
The only difficulty is the WHY of the original precipitated crystals.
To that why is the compounded why of the immune system attack. It is the same question asked by a person who gets bitten by a yellowjacket and says DAMN! and another person drops dead from anphylactic shock. Some immune systems obviously ignore a uric acid crystal whiile others are driven WILD by it. Some people were immune to plague in the 13th century and an aside that is fascinating: descendents of these people have a highly disproportunate immunity to AIDS.
If we were all the same, the human race would have been wiped out by the 1918 influenza. Diversity is our friend but the price of diversityy is that some of us have gout, polio, tuberculosis, cancer, psoriasis, lupus, and warts.
As for the writing in pain with an SUA of 5.0 mg/dL, remember the concentration next to a pure urate tophus is 100% or with an assumed densityy of 1.87 that's an SUA of 187 grams/dL (or 100 grams of water) or 187,000mg./dL and that's a HELL of a lot of urate….twenty eight THOUSAND times the soluble limit. So to have it disperse around the edges and immediately reconstiitute itself would be the rule rather than the exception. That's why dissolving big tophi is so challenging. It's like trying to dissolve Mount Rushmore with a water pistol.
That's also why it is so important to lower uric acid before the first perceptible tophus forms. In an ideal world, brilliant doctors would be able to diagnose gout at the first sign of the first attack and begin treatment to guarantee a second attack never occurred.
There is an evolutionary benefit to uric acid, of that I am certain and I very much doubt it has ANYTHING to do with it being reducing agent (aka antioxidant, like wood) becasue there are thousands of reducing agents…like ALL FOOD. That benefit is, to date, alas, unknown. It may never be known. I am also convinced that it has something to do with man's overeating of meat and protein (hence, the rich man's disease and now Everyman's disease) and I also suspect it plays a role in man's intelligence…there have just been too many geniuses with gout.
It's probably hormonal: prepubescent boys don't have it, premenopausal women rarely get it. It is a man's disease. If good records were kept it would be curious to see if castrati ever got gout. It would be informative to compare testosterone levels with gout…Alzheimer's development with gout. But in the modern world if there's no money to be made, there's no funded research. PURE science is a thing of the past. If you can make billions or blow up a city then there's money.
All in all though, it is an IMMENSELY complicated and interesting disease.
trev said:
Hans- there is a wild card- it's a genetic lack in the enzyme dept! I'm sure Zip can clarify – I think there's info on here about it.
That's why only a few get gout- that could get it, on their SUA numbers.
The common inability to make Vit C is quoted as a possible factor.
Trev, I am sorry to say, that your answers don't hold up, if you don't mind. Everything you say is just supposition, theory, guess, etc. Even if they all were true, there is NO answer/explanation why “genetic lack in the enzyme dept!” and why “common inability to make Vit C”
zip2play said:
Post edited 12:54 am – November 8, 2010 by zip2play
Thanks, Zip, for taking the time and effort to comment in length to my post.
Just a couple peripherals:
We HEAR anecdotal stories about “an SUA of 10″ without gout. It may be just that, anecdotal. I'll stick my neck out and say, show me a person who tests a 10 SUA and I'll show you a man who will be writhing in pain within a year.
I hope you are not putting your head on the guillotine block. With approx. 65 million Gouties walking this globe and 6 billion, 435 million non-gouties surrounding them, I am sure there are plenty of non-gouties with a SUA of 10 or more who aren't screaming bloody murder because of gout attacks.
You said “Don't bore me/us with pH's, temperatures, MSU's crystals, tophi, and whatever else is floating around the globe.” but it very well might just be the concurrence of unfortunates that at one tiime and place for one individual in ONE joint that these come together and crystals form. Once crystals form there is a locus of precipitation and the body can no longer keep a supersaturated serum/synovial fluid. More crystals grow atop the other crystals. Once a goutie, always a goutie.
I am saying it because I know that those factors have an influence, but they don't explain gout or answer my questions.
The only difficulty is the WHY of the original precipitated crystals.
To that why is the compounded why of the immune system attack. It is the same question asked by a person who gets bitten by a yellowjacket and says DAMN! and another person drops dead from anphylactic shock. Some immune systems obviously ignore a uric acid crystal whiile others are driven WILD by it.
Some people were immune to plague in the 13th century and an aside that is fascinating: descendents of these people have a highly disproportunate immunity to AIDS.
How do you know? Who kept records of the people from the 13th century? I don't think anybody was being diagnosed with AIDS in the 13th century. That expression wasn't even coined until the 20th century.
If we were all the same, the human race would have been wiped out by the 1918 influenza. Diversity is our friend but the price of diversityy is that some of us have gout, polio, tuberculosis, cancer, psoriasis, lupus, and warts.
That does NOT explain “WHY?” So, what's “DIVERSITY?
As for the writing in pain with an SUA of 5.0 mg/dL, remember the concentration next to a pure urate tophus is 100% or with an assumed densityy of 1.87 that's an SUA of 187 grams/dL (or 100 grams of water) or 187,000mg./dL and that's a HELL of a lot of urate….twenty eight THOUSAND times the soluble limit. So to have it disperse around the edges and immediately reconstiitute itself would be the rule rather than the exception. That's why dissolving big tophi is so challenging. It's like trying to dissolve Mount Rushmore with a water pistol.
That's also why it is so important to lower uric acid before the first perceptible tophus forms. In an ideal world, brilliant doctors would be able to diagnose gout at the first sign of the first attack and begin treatment to guarantee a second attack never occurred.
There is an evolutionary benefit to uric acid, of that I am certain and I very much doubt it has ANYTHING to do with it being reducing agent (aka antioxidant, like wood) becasue there are thousands of reducing agents…like ALL FOOD. That benefit is, to date, alas, unknown. It may never be known. I am also convinced that it has something to do with man's overeating of meat and protein (hence, the rich man's disease and now Everyman's disease) and I also suspect it plays a role in man's intelligence…there have just been too many geniuses with gout.
Here is a monkey wrench (thrown in by Lynn, the lady who gave me the 80 mg Uloric):
http://www.thepaleodiet.com/ne…..;
The guy, certainly, has a point about our ancestors being/having been ferocious meat eaters. And most farmers, today, are meat eaters. So they all should be GOUTIES, around the world.
It's probably hormonal: prepubescent boys don't have it, premenopausal women rarely get it.
It is a man's disease.
Hell, NO, it ain't a man's disease! Zip, you are not only putting your head on the guillotine block, you are having all the gouty women all over the globe hunting you down and retiring the guillotine executioner.
If good records were kept it would be curious to see if castrati ever got gout. It would be informative to compare testosterone levels with gout…Alzheimer's development with gout.
You got a good point, there.
But in the modern world if there's no money to be made, there's no funded research. PURE science is a thing of the past. If you can make billions or blow up a city then there's money.
This is the one and only Point I agree with you 100%.
All in all though, it is an IMMENSELY complicated and interesting disease.
Zip, I give you an “A” for answering my post and an aattempt to aanswer my questions, however, I am sorry, I must give you an “F” for failing to really answer my questions, the way I see it. Like Trev, you only talk about factors working on/influencing/affecting/complicating GOUT, but you did NOT tell me/us the “why and what's”
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