Posts Tagged NSAIDs
Questions Being Raised About the Importance of Diet on Gout
Posted by Victor Konshin in Diet on August 27th, 2009
An article that will appear in the September Issue of the Journal of the American Dietetic Association calls into question the long held belief that those with gout need to maintain a “purine-restricted” diet. This article points out that some foods, such as some vegetables are very high in purines, yet research has consistently shown that consumption of these vegetables is strongly correlated with a reduction in uric acid levels and in gout attacks. Research has also shown that beer is strongly correlated with higher instances of gout even though modern beers often have very low levels of purines.
Although diet has long been assumed to be associated with hyperuricemia, this association remains to be verified. Studies that have reviewed the relationship of diet and hyperuricemia have found it to be a difficult and complex issue.
The Most Misused Gout Drug, Colchicine
Posted by Victor Konshin in Gout Treatments on May 19th, 2009
Gout is a disease that medical science obsessed over for, well, since medical science came into being. Only in the last fifty years has gout become a “forgotten” disease. Through this long and amazing history, gout has had a more or less faithful companion: the autumn crocus flower. It’s from the bulb of this flower that colchicine comes.
Some reports say that colchicine has been in use for over 6000 years while other reports say its a much newer drug that has only been in use for 2000 years. Regardless, it is still considered to be a first line drug by many doctors. Unfortunately, those doctors are grossly out-of-date. Not only in using colchicine first, but also in how they use it…
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.
Alternative Medicine for Gout
Posted by Victor Konshin in Alternative Medicine on April 15th, 2009
Gout is the only disease in all of medicine that has been correctly identified as a unique disease throughout all of recorded medical history. For over four thousand years doctors and healers have recognized pain and swelling of the big toe as most likely being gout. People often ask me what the “scientific name” for gout is. It’s just ‘gout’ – there has never been any need to rename it. Things like heart attacks where given more specific names like, myocardial infarction, when our understanding increased, but there has never been any need to rename gout.
In the past, gout was a disease that doctors and healers obsessed over. The disease tended to affected mostly kings and noblemen because they had the means to live a lifestyle that made gout more prevalent - peasants rarely developed gout, even if they where genetically predisposed to gout because their sparse diet and over all fitness (from really hard work) cancelled out this predisposition.
This meant that anyone that came up with an effective treatment, or better yet, a cure for gout would be on the fast track to riches as the wealthy would be willing to pay handsomely for a solution to their gout pain. This resulted in a myriad of claims about gout treatments and cures, many of which not only still exist today but are widely believed as being helpful for gout. Of course, some of these ancient doctors actually did stumble on substances that have proven to be helpful for gout, but most just do not work.
In this article I will look at some of these treatments and look at which have scientific backing, which do not and which are potentially dangerous.
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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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