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The actual trigger of attacks is often a mystery and western research hasn’t found much on it, I have seen Keith point out that it is the steak from a year ago that causes the crystals. some say it is a rapid fall or rise in UA (and yes that can happen pretty quickly). For some it is any local trauma to the area setting off an inflammatory cascade. Personally I haven’t found a pattern. Overall triggers should be less of the focus and the overall never having a flair up again should be the plan. There are many ways to manage this disease
also here is another thing to consider we already know that too much iron in our system(and that means iron that has not been processed by the cells) causes an increase in XO activity, one of the main trace elements that helps us process the iron is copper, which reduces as we age(it is linked to testosterone), guess what substance reduces the amount of copper in our body, yup mine and your friend alcohol. Jus found this in my research. Once again I know this news is a bummer, I treat patients all day(and if I followed my own advice I would never have been in this shitty situation to begin with, but I am getting out) and it always amazed me the number who would rather engage in their vices than get better (not me of course oh no not me I was somehow different from them), in fact usually if a patient is engaging in some addiction(not just drugs think over training, like ultra runners) and you point out they need to stop, that is the last time you see them. Listen this disease has been a blessing in some ways, one I have decided that longterm I will specialize in autoimmune and rheumatic conditions, two it forced me to make changes that even without the disease I needed to make, three since it is linked to metabolic syndrome my body could have easily told me I had went to far less gently, say a heart attack, stroke, or renal failure. Take this as an opportunity to change your life and really for the better. Perhaps with looking at the real causes of hyperuricemia you can actually live a gout free and medication free life. I am guessing you are in England(from the use of cider and pints) if so I may know someone for you to consult with.
Barry I am no expert and I am also a practitioner of Chinese medicine so I have my biases, however, your body is already telling you different. One of the things that is often neglected, is why do we have uric acid, one of the main reasons that we utilize uric acid is it is a antioxidant with powerful anti inflammatory properties, we produce more due to chronic inflammation, and since 90 % of gout sufferers are under excretors, and since a major reason the kidneys re-uptake uric acid is because of the inflammation, we should be looking at what causes our inflammation. Alcohol overall is very inflammatory, as are simple carbs, wheat, sugar, and many processed foods. The only person whose current research into gout and diet that I have read(besides keith here) that parallels what my research has found is(and whose books I am eagerly awaiting now) is rose scott the gout diet thepurine myth and the good bye to gout the new gout diet( don’t worry I have no business contacts with her so this is not a plug), which again parallels much of what keith has said here and what I have found. As a side note 10 pints of anything doesn’t sound like moderation to me(sorry to sound like such a dick)
I love scotch(cue someone singing the bit from weatherman) When I finally accepted my diagnosis, I still had a bottle of my favorite peaty scotch lying around the house. It is still here for my wifes cousin when he comes to visit I am done drinking. From a western/allopathic medicine point of view alcohol lowers the effectiveness of allopurinol, in addition since the medication and any of the meds that deal with flair ups can directly effect the liver, and so does alcohol one should be as kind to their liver as possible. If anybody wants I can also go into the causes of gout from the point of view of traditional Chinese medicine (TCM) and how the body uses uric acid(western science perspective) to help explain this, but in the end quitting drinking is what is necessary, there is unfortunately a point of view that once allopurinol is at the right level one can go back to the lifestyle that kicked the disease off in the first place(barring really bad genetics). And that simply isn’t true.
this was the article that mentions it, though re-reading it I see that I may have made an error and that the links may not be directly to extracted casein vs natural sources, though from what I practice, I have often seen that there tend to be more side effects from an isolated substance than say from a whole source. The reverse to that is the advantage is specific and more controllable dosing
http://www.weighttraining.com/faq/what-foods-contain-casein-proteinSo I think things are going fine I ended up getting a second meter and getting the blood test, the morning of the test I used the old meter which would with rechecks come up with a wide range of results with variations as much as 1.0 in either direction, the morning of the test I tested at 5.4 at home, the test was only about 3 hrs later and nothing ingested 4.9, the next morning I was able to compare the two home meters, the old one 6.1, the new one 4.9 and a second test at 4.7, so I would say the new one is more accurate and shows consistency when two tests in a row are done. Also able to compare the lab results in 3 weeks my uric acid went from 7.0 to 4.9, with dietary changes, herbs and acupuncture. What I will be interested to see is two things I will retest in 1 month(while keeping with weekly UA tests at home). My first test showed that while within normal limits my kidney function was at about 81% which is low for someone my age and expected health level, my SGOT enzyme( apotential marker for liver issues) was in normal range but at the high end of normal, since from an allopathic point of view my treatments all have functions of lowering elevated liver enzymes, recovering liver and kidney function, I would be interested to see the results
So I have two concerns with purixa the first is I contacted them to find out about the dosage of resveratrol in their product and how they determined an effective dose. That was over a week ago, no response. Compare that to contacting a major herbal company that exports out of Taiwan to find out how they test for the same substance in their powdered herbs, personal response in 24 hours. The second is contained in articles about whole food sources of casein vs. extracted, and the links to a host of potential issues including cancer
also to digitaldream, the second page you mentioned, when ordered goes to homelab diagnostics who have not answered any of my queries about if they are licensed by biooptik the makers of easymate, when I tried to email the contact on the page you put up it came back as a bad address and no answer to phone calls
You are welcome, thank you for your response. I also wanted to mention that for those whoare dealing with any medication side effects amny of the herbs used in the above patterns also have hepatoprotective and anti-nephrotoxic functions. Which most likely would help to reduce any longterm kidney and or liver complications from meds. But be warned the same issues one can have with allopathic MD’s one can have with any practitioners of any medicine. not everyone is good, or keeps up with modern research. Don’t be afraid to question any practitioner.
here are a few more links I found, most are only the abstracts
http://www.acupuncture.com/newsletters/m_jan06/res.htm
http://www.sigmaaldrich.com/catalog/papers/10671036
http://www.jbc.org/content/60/3/721.full.pdf
http://www.ncbi.nlm.nih.gov/pubmed/18686136
http://www.researchgate.net/publication/272360014_Magnesium_lithospermate_B_improves_metabolic_changes_in_high-fat_diet-fed_rats_with_metabolic_syndromeJust so everybody knows and please make this widely known, I ordered my easymate from amazon, I went to call customer support because there were a few weird readings, the number had a Chinese accented recording saying there was no existing number, when I went to look on amazon I couldn’t find my order history, when I went to look for the item it was removed from amazon, I could only find any info when I typed in reviews, the review revealed that easymate does not supply to amazon or ebay,
Oh yeah except for one blood test I have been testing with a home meter, I will be taking a second blood test son and check it with the meter to see the accuracy
currently I am managing through diet(vegetarian), low sodium( I found spikes when eating salty snack foods) water, Chinese herbal formulas, and just this week started a course of acupuncture based on numerous studies for proven reduction in SUA and increase in UA excretion, and green tea instead of coffee. I tend to have very strong reactions to meds so I consider allopurinol to be a last resort, though with the current changes low dosage is a possibility. The changes I mentioned have lead a very rapid reduction in UA from a level of 9.2 down to 6 and under in around 1 to two weeks, with occasional spikes as I modified herbs and diet(discovered one herb can increase sodium retention in the kidney’s) to significant weight loss, and a general sense of well being as well. I have also eliminated almost all sugar and no more alcohol. another thing was for other issues with pain management I was taking tramadol off and on, I had strong reactions to it, and wasn’t surprised when I found reports linking usage to uric acid retention. Since I am a practitioner of Chinese medicine and looking at the principles I believe that these changes can be made permanent though the dietary changes may also have to be permanent(currently I don’t really miss the other stuff)
as to the easy touch meter, I have one, overall in the mornings I have found consistent results of 5.1 to 5.6, tried it at various times of the day and usually it is consistent there were two times it seemed very variable, tonight was one I checked the index finger and suddenly it was up to 7.2 before dinner but after a snack of almonds, since that seemed off I checked it on the next finger,6.3,then thenext 6.8, then 10 minutes later 6.2. The only other change today was I felt a mild flair up that I assumed was coming on due to lowering UA levels, so I tried some colchicine and acetaminophen. That is the only change I have, been managing the gout with diet(primarily vegetarian),herbs, green tea, and acupuncture. it seemed to be successfully, but tonight has me thrown off. I have purchased a new meter and will check it against lab tests this week.
While researching I did find one study that said generally home meters overestimated UA levels in comparison to lab tests leading to over use of meds, so that is what I am hoping is going onAlso I found a very interesting connection, I was looking at the estim and rabbits article and it cited a different study in which kidney damaged induced in rats was reversed through estim of one of the same points and another on the kidney channel( I would post the link, but because it connects with something called karger journal it seems to have issues when I have posted it elsewhere) but you can find it in the reference section , I believe it is number 38. Since 2/3rds of uric acid is excretedthrough the kidneys and, according to my reading, for most gout sufferers there is an issue of under excretion, I feel this protocol shows promise. I have started it on my self(it would have been better if I had a measurement before and after) but I also just had a patient come in who is suffering from chronic renal failure, with elevated creatinine and protein levels, so as she is treated I will at least have a definitive measure of overall kidney function even if it is not direct to uric acid
ron thanks for the reply but I am confused, while I understand that under 5 is a safer number, as I understand from the charts under 6 still causes crystals to begin to dissolve just more slowly, since it is under the crystalisation point of 6.8. am I incorrect?
If you have the links to the original articles in Chinese I believe I can get them translated, he abstracts unfortunately don’t list the info I would need. I would also love to know if I could be put in contact with your guy in Australia as communicating with someone specializing in this would be invaluable. Thank you once again for all this info I am now wading through the systematic review article
I am going to step away from the research part for a minute and get to the idea that is really brewing around in my head. It actually comes from something you consistently say(in your own way) and from a basic rule of Asian medicine, treat the individual and not the condition. There is a book called the PI Wei Lun written by Li Dong Yuan in the jin dynasty and translated by Bob Flaws. In this book one of the central ideas is a condition called yin fire which most directly is a version of metabolic syndrome. It is a multi-system breakdown leading to a host of conditions, characterized by what we call a spleen and liver disharmony pattern, which I believe is the central root for gout(and many other health issues). In this book the central herbal formula is something called bu zhong yi qi tang, which is the base formula for addressing this yin fire. However that formual has about 50 variations in the book and according to the translator ahs innumerable variations and he considers(and he is no slouch in this field)it to be the most common base formula he uses. So what I mean by base is it is a starting point and then herbs are added or subtracted as individual needs and changes occur. Since these variations should be based on both classical indications, such as the patient has damp heat and yin deficiency so we will include huang bai, and modern research, such as the formula often calls for herbs which act as mild diuretics so let’s include liu yue xue which has that function but also specifically increases the elimination of uric acid ( this second area is where these studies impact the most). As a side note the main herb in bu zhong yi qi tang is huang qi or astragalus, which was pretty high in the arena of XO inhibitors. I think the main advantage that these treatments have over allopurinol is that (from my understanding) once you are on it you are on it for life, while the TCM(traditional Chinese medicine) approach may(key word) offer a restoration of balance, this means that someone may be able to quit the herbs and maintain their gout free life with mostly lifestyle and dietary changes. This is not definitive, and would have to be monitored, but I am going to do my best to be that person. As a side note in the formula one of the herbs that should be usually removed when dealing with gout is Gan cao or licorice root which can cause kidney’s to hold on to sodium, which as I understand it causes them to retain uric acid as well
I am using the easymate tester and overall it has seemed consistent, I am staying generally in the 5.5 range at around 5 in the morning
By the way 3.7 this morning, so all is working, I will stop the baking soda tonight I only did it for 3 days but I would like to not use it at all and see if that changes things. I was also curious about “regular” uric acid levels do you have any info on what the average person without gout walks around with on a daily basis. Another question I have is I looked at your chart on foods with that number/index in the last column of-4.9 etc.. for meats and I am having a hard time understanding it.
Keith you did nothing wrong, I have an obsessive personality so I obsessed and was overwhelmed by how little is known, and how much conflicting info is out there say about beans, peas, and certain veggies. I feel better now that the last two mornings(as I understand it a time when the levels will be at a high from the night before) I have been at 5.2 and checked it later in the day once and found it at a 4.3. So at least I know that what I am doing is working, as the levels lowered I had a flare, which thanks to you I understand why and I see it as a good thing, the sign that my body is starting to expose and get rid of these little fuckers. I intend to stay on this regimen for a while longer, I have also added a 1/2 teaspoon of baking soda at night in order to alkalize my body a bit more, since I don’t think this is something I want to take long term I will phase it out soon. Probably in 30 days or so I will decide how to proceed, with deeper changes, seeing how I can change what in Chinese medicine they call the root. The way to get my kidney and liver functioning in a proper way so the occasional piece of chicken or beef doesn’t seems like a death sentence. I have to say that this has been the most useful site I have found and while I lean more towards the use of “alternative” medicine, I applaud your caution in that area, there are a lot of false claims in that arena. I am also looking at that list and study you provided of the plants that have the ability to interrupt xanthine oxidase and comparing it to the herbs I use in Chinese medicine, to see which ones are appropriate for a gout condition, and trying to understand more the root of this condition. In addition though this falls in to the very (for many) way out there idea I have begun a specific meditative practice that is supposed to correct underlying imbalances in the body. I did feel positive changes early on though the standard is to practice at least 100 days before a full change is felt. If this works I can pass it on to any on these pages who may be interested.
Unfortunately I don’t have a doctor or insurance currently so getting the test can’t happen right now. So the first day of testing I tested 4 times that day levels went from 9.1 to 10 to 7.2 to 11, this was a day after I had some salmon. I decided that testing multiple times in a day was crazy so decided to do it each morning before breakfast but after meditation. the levels went as follows for the next 9.1, 8.2, 6.2, 9.1. My diet has been primarily vegetarian since reading about the dangers of this disease on your page, with some eggs and the occasional piece of chicken, I have also dramatically increased my water intake,(realizing that I was probably in a perpetual dehydration state before) yes my urine is pale straw or clear. For treatment my current regimen is two glasses a day of a combo of chianca piedra, chamomile, turmeric, tart cherry concentrate, and lemon(I am waiting for the banaba to arrive). I am 6′ somewhere between 195 and 200lbs, I try to exercise 6 times a week, in a combo of martial arts, yoga, weight lifting, hiking, archery, and meditation.
So one other question I have is how quickly do uric acid levels respond to a “stimulus”, so eating a piece of pork causes them to spike in 1 hour, a few hours, next day, are there any good books on this subject you could recommend.
So I know when I drank alcohol(scotch) I drank too much, I was also eating way too much meat(so the dietary changes are overall good), drank too little water, but also for a number of years, I really abused coffee, way too much, upwards of 10 cups a day I also took way too much ibuprofen, yesterday was the morning where my reading was 6.2, for the day before I had cut out coffee and hadn’t had any ibuprofen in a while. So I ended up taking some ibuprofen and drinking some coffee(I now about the inverse relationship to coffee and gout however with my level of abuse, I am wondering if it negatively affects my kidneys). If either of these are triggers could/would they change my uric acid level overnight.
Sorry it took me so long too get back but I have been a little overwhelmed with trying to understand this disease and I couldn’t talk about it for another minute for the last few days
DorianHey found this study that supports the use of this herb as a xanthine oxidase inhibitor
http://www.sciencedirect.com/science/article/pii/S037887410400203XKeith you make an excellent point. Herbs must be treated with the same respect as medications, since they are the original medication. That means that you should always monitor yourself while taking them the exact same way you would while on a medication. Also taking them doesn’t mean you are cured, any real herbalist will talk to you about diet and lifestyle changes as well, all they are is a potential alternative to medications, as one of my teachers used to say “it is medicine not magic”. If you choose to see a provider of alternative medicine they should and can work in conjunction with your regular MD.
I found a relatively inexpensive supplier http://www.tropilab.com/ for both banaba and chianca piedra(phyllanthus)
As to dosage general raw herb extracts are done as a tea, this is often done through boiling and then simmering herbs. certain herbs though have volatile oils that can be evaporated if cooked too long. Since I don’t know if these herbs are long term or short term cooking herbs I would suggest for those who want to try it that you use a French press of no more then two cups of water with a heaping tablespoon of the herb/ or one of each if doing both herbs. Let steep for a minimum of 15 minutes, you can have one cup at night and even save over night the rest and have a stronger cup in the morning. Do not microwave as it may change the nature of the function. In addition for those concerned with extracting only the right chemical compound, don’t be too concerned it many studies on herbs are all based on water extracts, in addition for most herbs it is actually all the components of it that can have a “safer effect” than isolating one compound, easiest thing to look at is aspirin and willow bark to understand this. That being said, herbal medicine is not inherently safe because it is “natural”, being under the care of an experienced practitioner is always safest. But since I have had a hard time finding known side effects of these two herbs, they may be “safer” than others
