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This intrigued me also, as it has others, and I found “Growth of monosodium urate monohydrate crystals: effect of cartilage and synovial fluid components on in vitro growth rates.”

In this study, Burt and Dutt found that

“Albumin significantly inhibited MSUM [monosodium urate monohydrate] crystallisation.”

Their findings apparently contradict other studies, which they suggest might be due to the difficulty of studying albumin which can be absorbed by lab equipment.

It is unfortunate that this is not the subject of much more analysis. It seems to me that there are substances (probably including iron), which promote uric acid crystallization. There must be others which inhibit it.

Interestingly, albumin is found in dairy products that have been shown to have a statistical link to lower incidence of gout.

Does anyone know of any current, or more recent, research in this area? The study I refer to was published in 1986.

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 »

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 »

Gout pain relief is the first stage of gout management. The second stage is treatment to reduce uric acid, but this can cause more pain and many people miss this vital treatment because they cannot tolerate the pain. Recent discoveries regarding gout pain have suggested an alternative approach that may well lead to a new, more effective form of gout pain relief.

Many people mistakenly believe that uric acid crystals, commonly described as needle-like, cause pain in the same way that sticking pins in your body will. If you’ve studied my U-D-R-P model of gout pain, you will know that it is actually your immune system reacting to the crystals that causes swelling and pain in a similar way to fighting a virus. And the pain doesn’t only arise when something triggers these uric acid crystals to form.

A few days after your immune system has attacked uric acid crystals, swelling and pain subside as the crystals become hidden by white blood cells. But you need to reduce uric acid levels to get rid of gout, and whether you do this by diet or by drugs like allopurinol, those gout crystals that were hidden will become visible as they dissolve. This is why most doctors subscribe gout pain relief drugs such as colchicine or other anti-inflammatories (NSAIDS) at the same time as allopurinol. But many people simply cannot stomach these anti-inflammatory drugs and medical researchers are always on the look out for new approaches to gout pain relief.

Recent research into the immune system reaction to uric acid crystals has identified a protein called interleukin-1 (IL-1) as part of the problem. This has long been known to be a factor in rheumatoid arthritis, and a recent study, A Pilot Study of IL-1 Inhibition by Anakinra in Acute Gout, has treated gout patients with the rheumatoid arthritis drug, anakinra. Though this pilot study needs to be confirmed with randomized clinical trials, the authors conclude:

” In this pilot study involving 10 patients with gouty arthritis refractory to conventional therapies, anakinra given at 100 mg daily for 3 days rapidly relieved the inflammatory symptoms of gout. “

It’s good to see that deeper understanding of how gout pain is caused by the immune system has led to scientists looking for different types of treatment. It’s even better to see that applying existing drugs in new ways has led to a real possibility of a new, effective form of gout pain relief.