Archive for category General
Gout: The Forgotten Disease
Posted by Victor Konshin in General on June 2nd, 2009
I think what’s most amazing about medical science is how small it’s focus has become. I’m not talking about the scale of medical science, or the focus on making people healthy, but on the scale at which it is studying the complex mechanisms of the human body.
Over the past few hundred years medical science has gone from looking at the structure of the body, to its organs, down to the cells that make up those organs and now down to the most tiny and intricate molecular machines that make everything actually work. Molecules so small and sophisticated that ever the most advanced microscopes in the world can only view them dimly and we are only just beginning to grasp how they actually function.
However, this all seems to be changing. This focus on the very small has obscured a larger reality – that the human body is a large, unimaginably complex and integrated machine – a single machine. If something is broken in one part of that machine, the function of the whole suffers.
I think that more and more researchers are starting to get their heads out of their microscopes and starting to look at what happens to the whole machine when those microscopic machines misbehave. And I think this will be the next great step forward for medical science.
Uric Acid Levels and Gout
Posted by Victor Konshin in Diet, General, Gout Treatments on May 8th, 2009
If you have gout, it is important to get your uric acid levels tested regularly. This is important for a couple of reasons. First, if you are taking medication, or even natural remedies to lower uric acid levels, you want to make sure that they are actually working. You also want to make sure that you are maintaining a healthy uric acid level – too much uric acid and gout can occur (bad) – too little uric acid and neurological issues can occur (rare, but worse).
Second, uric acid levels can fluctuate wildly, from day to day, even hour to hour. A blood test gives you a snapshot of what your uric acid level is at that moment. You could be having a good day and your uric acid level is low. This might make you feel as though you do not need to take so much medication and scale back. Unfortunately, this will likely result in a gout attack.
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Swine Flu and Gout
Posted by Victor Konshin in General, Gout Treatments on April 28th, 2009
I have been sitting in my office this morning with the television on, watching the coverage of the swine flu outbreak. I am always impress at how much panic an infections disease can generate. Personally, if the swine flu does become pandemic, I hope I am one of the first to come down with the disease. Why? With a disease as virulent as the flu, the odds are very good that I will develop the disease eventually and if that happens, I want to get it before the medical system is overloaded and drugs like Tamiflu run out. Beside, I am a healthy 38 year old and the risk of serious complications, let alone death, are small. This way, I would get the best care, medications, will get it over with quickly, and be healthy (and immune to the disease) when the disease hits it’s peak so I can help care for others. So you won’t find me walking around with a mask on – which really doesn’t provide much protection anyway.
What does swine flu have to do with gout?
Not much really, however some medications used to treat gout can suppress the immune system which can make you more susceptible to disease including the flu and can make the flu worse if you should get it. If you are unlucky enough to develop the flu just as you are being treated with corticosteroids or colchicine for a gout attack, it could make it much worse - particularly if you are elderly. Note that NSAIDs and medications to lower uric acid levels do not suppress the immune system.
Of course, if you manage gout properly by lowering uric acid levels, there is no need to ever treat a gout attack because you will not get them.
Update: NYC Assistant Principal in Critical Condition
In New York City an Assistant Principal has come down with the N1H1 flu and is now in critical condition. It has been reported in the media that the only preexisting health condition he had was gout. As a result I have seen a lot of interest in any possible connection between gout and swine flu. It has been reported in the media that this Assistant Principal is suffering from kidney failure. As I have written previously (see,Is Gout Dangerous) that gout is strongly associated with kidney failure. If fact, nearly all people suffering from gout have significant kidney damage at the time of death.
So, did gout combine with swine flu contribute to this man’s kidney failure? That remains to be seen, but I would not be surprised if this turns out to be the case. The flu could have found a comfortable home in the already damaged kidneys. As the disease spreads, we will see if more people suffering from gout develop serious kidney complications.
Update 2: NYC Assistant Principal Passes Away
Unfortunately, NYC Assistant Principal Matthew Wiener passed away Sunday, May 17th. Our sympathies go out to his family.
As for the connection between gout and swine flu… Its unlikely that gout played a role, but it is possible. I hope that the CDC takes a close look to see if there was a connection. If they can find a connection, then I hope that they will at least advise the public of the risk and advise the medical community to treat those that have gout and develop swine flu more aggressively.
The Impact of Gout on Your Quality-of-Life, Finances and Family
Posted by Victor Konshin in General, Gout Treatments on April 27th, 2009
If you have gout, you understand that gout has a definite impact on your quality-of-life during an attack — life sucks. The pain can be unbearable. Researchers have looked at this question more quantitatively though and come up with some interesting findings.
As we know, gout is caused by uric acid crystalizing in our joints, which causes an immune response (if you don’t know this, see, Gout Basics). Even when you are not in the middle of a gout attack, if you have high uric acid levels, crystals are always forming and dissolving and not just in your joints, but all over your body. These crystals are seen as invaders by your immune system which causes it to respond. This causes your immune system to alway be in a heightened state of alert and it causes inflammation in your body which can cause many deadly diseases (see, Is Gout Dangerous). But the problems do not stop there…
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Kidney Stones, a Gout Early Warning?
Posted by Victor Konshin in General, New Research on April 22nd, 2009
The “German Professional Association of Internists” released a statement on Monday saying that kidney stones may be an early warning sign for gout. The statement claimed that as many as 40% developed kidney stones as a first indication of gout.
This makes sense. It had been known for a long time that high levels of uric acid in the body can cause increased levels of uric acid excreted by the kidneys. This excess uric acid can form uric acid kidney stones. Not only that, but uric acid crystals can serve as a catalyst for the formation of kidney stones based on other substances such as calcium.
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Gout in Women
Posted by Victor Konshin in General on April 16th, 2009
A friend of mine once asked, “Gout? Isn’t that the old, rich, fat man’s disease?” Besides being uncharitable, this statement is wrong on pretty much all counts.
- People are developing gout at a much younger age now days thanks to the high-fructose corn syrup and other unhealthy dietary habits, but it is still rare for anyone under the age of thirty to get gout – hardly ‘old’.
- Now days, you don’t need to be rich to live a sedentary lifestyle and eat the unhealthy foods that helped gout develop its reputation as being a rich person’s disease.
- Gout is mostly influenced by genetics, so even those that are not “fat” can get gout.
- It’s not just a man’s disease….
Gout: Not Just for Men Anymore
Gout has long been considered male disease because estrogen plays a powerful role in keeping uric acid levels down in women. However, once women hit menopause, estrogen levels decrease and uric acid levels rise. In fact, after menopause, women are just as likely to develop gout as men of the same age.
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Gout and the Sleep Apnea Connection
Posted by Burton Abrams in General, Gout Treatments on April 14th, 2009
There is a frequently overlooked factor that can cause an acute increase in the concentration of uric acid in the blood as well as increased likelihood of its precipitation as MSU (monosodium urate or uric acid crystals. See, Gout Basics for background). That factor is the reduction of the concentration of oxygen in the blood, which occurs in an individual suffering from sleep apnea.
Sleep apnea is the repeated cessation of breathing for many seconds at a time during sleep, when the muscles lining the airway relax enough to allow it to close, until the brain jolts them to reopen. The resulting reduction of oxygen in the blood causes the cells in the body to undergo a process of disintegration, which leads to their generation of excess uric acid. Once the uric acid is formed, the process is irreversible, even when breathing restarts. With each apneic period, more and more uric acid is fed into the blood, faster than the kidneys can dispose of it. Furthermore, the increased ratio of carbon dioxide to oxygen in the blood makes the blood more acidic, so that its ability to hold uric acid in solution is reduced and MSU is more likely to precipitate. These processes were described in medical journal literature about twenty years ago, and subsequent literature has confirmed that sleep apnea leads to excess uric acid in the blood and in the urine.
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Why is Gout so Often Mismanaged
Posted by Victor Konshin in General on April 13th, 2009
I often quote the statistic that 78% of doctors do not properly manage gout. This statistic is true (based on the research study that reported it) but the big question is, why? This article with take a look at this question.
First off, let me start by saying that I am not someone that bashes doctors and the medical community or says things like, “all doctors are arrogant, lazy, over-paid idiots.” Though, as with any profession, there will always be some that fit this description, most doctors are caring, compassionate, highly competent people that do a fantastic job. The problem however, is that the medical profession is the victim of technology, its own success and its failures…
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Secondary Gout
Posted by Victor Konshin in Diet, General, Gout Treatments on April 10th, 2009
For the overwhelming majority of people with gout (90%), gout is a genetic disease. These cases are called primary gout. In this article will talk about the other 10% – what is called secondary gout. There is a very long list of causes of secondary gout. Here I will talk about the most common and the most serious.
Lifestyle
The single most common cause of secondary gout are lifestyle issues. Lifestyle covers a lot of different areas. Unfortunately, one of the most common is obesity. About 60% of Americans are now considered obese and the number is still growing and is the leading reason why the incidence of gout continues to rise. Being overweight causes the body to create more uric acid but also reduces the bodies ability to eliminate uric acid. If you have gout and are overweight, the single best thing you can do for your gout, and for your overall health, is to eat a healthy, well balanced, reduced calorie diet, lose weight and exercise regularly (See “The ‘Skinny’ on Gout Diets”). Of course everyone that is overweight wants to do this but few people are actually successful, myself included.
Is Gout Dangerous?
Posted by Victor Konshin in General on April 6th, 2009
The overwhelming belief by most doctors is that gout is a relatively benign disease – that is, it may cause a lot of pain but really doesn’t cause too many problems otherwise. Unfortunately this belief is wrong. Gout is dangerous in a couple different ways. First is the damage that gout attacks directly cause. Second is the underlying cause of gout, a condition called hyperuricemia is associated with many very serious and life-threatening diseases.
The Damage of Gout Attacks
As described in one of my previous post, Gout Basics, gout is cause by an immune response to uric acid crystals that form in the joints. This immune response causes much inflammation, which is the actual source of the pain of a gout attack. This inflammation also damages the joint slightly. If gout is not properly managed, over the course of years and many gout attacks, this damage can accumulate and cause constant pain in the joint, limiting of the mobility of the joint (the joint will become stiff and painful to move), it will cause boney changes in the joints called punch-out lesions (where the bone grows in abnormal ways) and ultimately, it will cause the gout to become completely immobilized.
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Top 10 Gout Myths
Posted by Victor Konshin in Alternative Medicine, Diet, General, Gout Treatments on April 2nd, 2009
I am always taken aback at the number and persistence of gout myths. Just read a few Internet web pages on gout and gout treatments and it won’t take you long to find contradicting information – even from supposedly reputable sites. These myths are one of the key reasons why the quality of gout care for gout has fallen so much over the past few decades. Bad information keeps getting passed on – over and over. This article will help you understand some of these myths and learn the truth.
Myth #1: Gout is curable. There are tons of websites out there that promise “gout cures” if only you send them some amount of money. The truth is, that for 90% of cases, gout is a genetic condition. This is why gout often runs in families. Genetic conditions cannot be cured, only managed. The other 10 % of cases are called secondary gout. These are usually caused by some underlying medical condition. Some of these conditions can be very serious such as lymphoma or kidney disease. Only a small number of cases are truly ‘curable’. These cases are usually caused by high blood pressure medications called diuretics or extreme obesity. If you have gout, your doctor should check for a secondary cause of gout, if none is found, then you have a genetic condition that can only be managed.
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Gout Basics
Posted by Victor Konshin in General on April 1st, 2009
Since this is a new blog, I thought it would be a good idea to write about the basics of gout. I am often surprised about just how little some people who have had this condition for years know about this disease that effects their lives so much. The treatments for gout can get complicated, often requiring three different medications on different schedules so understanding what causes gout and the exact process of the disease is key to understanding the role of each of these medications and how to use them effectively. If you properly treat this disease, there is no reason to ever have to suffer another painful attack.
Gout is cause by having too much uric acid in your body, a condition called hyperuricemia. Uric acid is a natural substance in the body that is created through metabolism. People with hyperuricemia either create too much uric acid and/or have trouble eliminating it from their body. When levels of uric acid get high enough, this uric acid can start to crystalize.
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Welcome to The Beating Gout Blog!
Thank you for visiting The Beating Gout Blog. In this blog I will discuss the latest news on gout research, treatments and news around gout. I hope you find this information useful and feel free to leave comments or ask questions.
Below is the first episode of The Beating Gout Podcast:
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