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Well, it’s been a while…(Hi Keith)
In short, I think you are right to be sceptical, Jason, which is not to say that Chinese Medicine cannot have a beneficial effect on your overall health, as it relates to gout & even on the specific inflammatory symptoms of an attack. But this is dependent on where a person is in the progression of the disease (in both the immediate situation & long term) as well as, most importantly, the skill & knowledge of the practitioner. Anyone selling patent remedies (pills in boxes) for gout should viewed, at best, as well-meaning, but ignorant of the limitations of their understanding of the disease & the medicine they practise.
As a practitioner of Chinese Medicine, myself, this is the position I have held for the past 4yrs – when I began taking Allopurinol. During this time I have not experienced a single attack, whilst eating & drinking whatever I like & taking part in physical activities that I could only dream about before I took it. Prior to that, I spent 2 yrs having acupuncture & patent Chinese herbs, while on an extreme exclusion diet that more or less consisted of baked potatoes, cottage cheese & broccoli & no alcohol ? all of which had little or no effect on the increasing regularity of my gout attacks.
In the interests of balance, I should concede that my herbal practitioner, at the time, was perhaps not of the highest order, so I don?t know what a more customised formula from an eminent clinician might have done for me. I mention this because I have recently been studying with a distinguished practitioner, with more than 30 yrs of clinical experience, who claims to have an amazing formula for gout that has resulted in none of her gout patients having had a flare up since ? the longest being 10 yrs. However, regardless of my respect for this teacher, I can only accept this as anecdotal evidence without access to full medical case histories – which is not going to happen. But I am going to ask her for the formula for future reference & personal analysis of whether it could possibly have a significant influence on permanently lowering SUA to safe levels (the only game in town, as far as gout is concerned), rather than a more temporary, local anti-inflammatory effect.
I plan to follow up on this because I am interested in current research on the inhibitory effects that flavonoids have on xanthine oxidase & more generally on inflammatory processes. This could be a step closer to a scientific understanding of the actions of herbal remedies.
The main problem with scientific tests done on traditional herbal formulas is that herbs are tested for evidence of their claimed healing properties in isolation rather than as precursors & catalysts in combination with each other, which then produces the clinical effect further down the line of metabolic processes. A curiously blinkered approach, considering that some conventional meds act in much the same way (Allopurinol, being one. Allo does not, itself, have a direct effect on uric acid; it inhibits the oxidation of hypoxanthine to xanthine, which in turn inhibits the catalytic oxidation of xanthine to uric acid). But before this post digresses even further into the murky motivations of Big Pharma, I?ll just reiterate:
Don?t be afraid, take Allopurinol; it works & it’s safe.
No it isn’t, so go get a SUA test; it’s the only thing that’s relevant. Dr. will probably want to check for things like Raynauds after that, if your SUA is low.
However, my guess is it will be dietary: either relating to gout or indirectly e.g.candida. Have you become complacent about diet? alcohol, purine rich food etc. 400mg Allo may prevent acute attacks, but you can still get minor symptoms, if you eat & drink recklessly.
Even assuming your SUA to be at a safe level, now, this doesn’t mean you won’t have long term musculoskeletal pain relating to permanent changes to bones, ligaments & tendons caused by gout over the years. Being overweight won’t help. Plenty of heavy people without gout have disabling problems with feet/ankles/knees.
pen said
I know you pee uric acid out naturally, but being on Allopurinol or any other ucic acid lowering medication. Does the medication make you poop it out or pee it out? Or does the drug and it’s waste just stay in your blood stream. I know allopurinol cause a sympton having too much in your system. I also want to know how long it stays working or not working in your system once you and your doctor decide to get off it. Thanks!
You seem to be rather confused about a number of things concerning how the human body & Allopurinol works, which is not surprising because it’s quite complicated, especially if you don’t have a science/biology background. You don’t really need to know most of it, but one thing YOU MUST BE CLEAR ABOUT is if you don’t want gout to return YOU DO NOT STOP TAKING IT – EVER!
It is not a cure, as in you don’t have gout anymore. It just prevents attacks from occurring by keeping your uric acid level low. If you stop, uric acid will rise & you will eventually get gout again.femaleveg said
Hello,
my uric acid level was a 4.7, which is the high end of normal but still within the normal range, which goes up to 6.5.You need to find out which units of measurement are being used for your SUA. Look at the box on the right and you will see that 4.7 can only be mg/dL and would be a low reading. However, if the decimal point has been put in the wrong place (which sounds likely) .47 mmol/L would be a high reading & consistent with hyperuricemia/gout.
Sounds like a misdiagnosis or misinterpretation by someone.
Yeah, doubt whether it’s legal. If you’ve ever seen any of the numerous Customs TV shows on daytime telly, you’ll know that after the usual narcotics smuggling, one of the most common busts is of people bringing prescription meds for their relatives in countries which don’t have a discounted supply through their Health Service. Big fines are possible, so be careful Delboy
Maybe only take as many as you could justifyably claim for personal use, plus the same again packed in a separate bag in case the other one got lost in transit. 
If it’s to draw blood and measure SUA to establish how much gout medication you need – no
If it’s to draw synovial fluid for a definitive diagnosis of gout – only necessary if there is any doubt whether you have gout
If he means a steroid (prednisolone) because you are in unbearably ‘exquisite’ pain – maybe, but perhaps unavoidable
If he doesn’t really know his ass from his elbow and can’t think of anything else to say – definitely yesAll you have to do is agree with your Dr on an optimum level for your SUA ~0.3 (or 5.00mg/dL) & the dosage will take care of itself: not low enough – take more. So schedule a SUA blood test after 1 month on 200mg. Your Dr will see the sense in this strategy. Forget about the Liv/Kid panel for the time being or, if you must, include it in the SUA test in a month.
1. Very probably
2. Anything less than 2 weeks & your Dr will probably start getting annoyed with you. 1 month should be fine.
3.KId/Liv panel annually (max) if you’re really worried. I’ve never had one since starting Allo (Aug 2010) & not planning to, any time soon.
4. Try Naproxen; it is generally the best tolerated NSAID, but I can’t take them for more than a few days. NSAIDs are only effective early on anyway. Confer with your Dr about colchicine & defer to his judgement.Re: kayak induced gout flares. Pedaling will improve blood circulation to the feet, which helps transport urate away from the inflamed area, but physical exercise produces more uric acid in the body. Swings & roundabouts
Be careful about too much flexing & extension of the toes – you might not notice with a fish on.
Don’t know what tides are like down your way, but try and avoid mid tide when you will have to work harder to stay over a mark unless you anchor (often the best time to fish though)No worries about any fruit & veg. Purine content is negligable. Maybe avoid tofu; I used to have problems with it in my pre-Allo days.
No such thing as normal.
Some people report various minor side effects when starting Allo. Some days, I remember feeling unaccountably tired during the 1st month – like a blood sugar spike. Might even have been something to do with not taking enough Allo (100mg) to do the job properly. Didn’t last. By the time I was on 200mg (2nd month) I was fine, except still not taking enough to get below 6.00mg/dL. Now on 300mg, I’m usually ~ 5.00, +- .5. Overindulgence in alcohol (by my standards, which is extremely moderate) can raise it to ~6.5. I eat/drink whatever I like, except shellfish & beer. I’ve never been overweight & was always v. fit/active until crippled by gout, which I no longer am.It is usual at this stage to become obsessed with every minor detail of perceived changes in physical functions.
Yeah, diet is a controversial topic with much disagreement, even on this forum. Absolutely, far more uric acid is created by natural metabolic breakdown than by diet and once SUA stable, diet becomes almost irrelevant. But my view is that everything needs to be taken in context of where you are on the recovery scale: in the acute, pre-medication stage, almost anything can & will cause a gout flare because your inflammatory response is like a cup full to the brim about to overflow. One drop will do it and that drop can represent a walk too far, a sly brewski, not enough H2o, a sudden drop in weight, too many physical jerks, etc. etc… and the wrong choice of food (although you will never know for sure what was responsible)… even Allo itself. So why not try and cover as many bases as possible to prevent sliding down the big snake instead of passing Go & collecting ?200? (if you’ll pardon the mixed metaphors). But hey, that’s just my opinion; everyone has their own gout journey back to health. You might just as easily argue that a strict gout diet when overweight might cause you to lose too much weight too quickly and cause a gout flare
Personally, I found Allo worked incredibly quickly, initially – like a couple of days, then went through a period of fluctuation up and down before leveling out at a fairly constant level after 2-3 weeks. But that’s me; your mileage may vary. In any event, I wish you an easy & incident free journey.
CHUNQX said
odo said
At this stage, a severely restricted diet can make a big difference to quicker recovery. Ideally, you should avoid all meat and go on a low protein veggy diet for a while. For some people this is worse news than having gout, but if you’re overweight/hypertensive, it would probably do you the world of good.
1. How long is “a while”?
2. It is not quite worse news than having gout but not far off…
3. I suppose I’m willing to consider it. But I know nothing of diets so what does a low protein veggie diet constitute? Can I make an exception for steamed/bake white fish perhaps twice or 3 times a week?1. Until your SUA is at a safe level
2. Fish is protein & not very different to meat. There’s no bargaining with goutCHUNQX said
On the subject of diet, my wife is getting a bit sick of having to eat chicken, fish and pork only. Something like spaghetti Bolognese (beef mince in tomoto base), is that a strict no-no or does food not play as big a part in this than popular belief?
We all know misery loves company, but no reason why your wife has to adopt the same eating habits as you. You will earn more brownie points & sympathy by not subjecting anyone else to the consequences of your disease.
At this stage, a severely restricted diet can make a big difference to quicker recovery. Ideally, you should avoid all meat and go on a low protein veggy diet for a while. For some people this is worse news than having gout, but if you’re overweight/hypertensive, it would probably do you the world of good. Once your SUA is stable at a safe level, you will be able to re-introduce most foods into your diet. But not all the sterotypes of gout are untrue: alcohol & greasy, fatty, rich foods ARE the worst things you can put in your body at the moment(or indeed anytime).
ianking said
contacting people for feedback.
…nevertheless, constitutes spam email.
You are trying to use this forum to promote your book (which may already contravene its terms of use).You are not the first person to do this, so people are cautious about giving out private contact details. I am not interested in becoming part of your database, but if you find a way to offer a no strings attached method of reading your material, I (and others) might be prepared to give you some feedback on the forum.
ianking said
Hi Everyone,
?
I’m a health practitioner and author.
?
My brother in law suffers gout and after a recent bad episode
I decided to dig into the topic a bit further.
?
I found some interesting stuff… way beyond “low-purine” diets.
?
In fact most of the research I found showed that the reasoning
behind this diet if fundamentally flawed (no suprise for those that
have tried this diet and had little symptomatic relief).
?
I put together all my findings explaing the causative factors of gout
and exactly what to do about it.
?
I’m looking for a handful of people interested in reading the book
for free in exchange for their feedback.
?
If you’re interested please email me: ianking531 (at) gmail (dot) com
replace (at) with “@” and (dot) with “.”
?
Regards
Ian
We all want to avoid Spammers, so if you are genuine, I suggest you place your file on a host site such as Dropbox which can provide a link for those that wish to take up your offer without having to give out their email addresses.
Once you get your SUA down to a stable ~5.00mg/dL your diet won't be nearly as important as you think it is now. Personally, I still avoid beer, offal & shellfish, but others may disagree.
zip2play said:
There really is no way around the dictum that once you have had a gout attack you will be on a drug for life…nothing else works.
And yet people are still so afraid of this notion…a drug for life.
Maybe what we should be doing on here is trying to quantify what this actually means and get people to view Allo as being as safe as aspirin, if not safer. But we need scientific studies rather than anecdotal evidence. Do long term studies on Allo &? liver & kidney function exist? (I guess this is what most people are worried about)
There are differences of course: most people don't start taking aspirin daily for their hearts until they're middle aged or older when regular medication seems more acceptable. Whereas, we see many more people getting gout in their 20s these days. But, strangely, it's rarely the younger gouties who seem to have the most problems with the idea of meds.
zip2play said:
BUT, take an aspirin every day. THIS I DEMAND! :D?There is no lottery win?quite like skipping a heart attack that you might have otherwise?had.
If only things were that simple
Get him to agree on medication to achieve a target level of 5.00mg/dL (~0.3 mmol/L).
Maximum 2 weeks initial low dose (100mg) Allopurinol to check for allergic reaction then straight on to 300+ (you can try, but he will probably demand?1 month, but that's better than the 2 or 3 he might say if you don't start the bargaining process)
Good luck
1. You need blood tests
2. You need blood tests
3. etc.
Your symptoms don't necessarily mean you have gout. Is there a history of gout in your family?
zip2play said:
Perhaps tell him that 20% of doctors are genetically incompetent but the other 80% have to work at it. (I'll bet he won't see the irony.)
Just to play devil's advocate here, although I agree with everyone that you should change your Dr, it has to be said that he is following best practice guidelines. Here is a link to a recent Lancet review
http://dl.dropbox.com/u/12859658/Gout.%20The%20Lancet.%20Jan%202010.pdf
However, he may also consider that obesity poses a greater risk to your health and feel that the threat of gout provides a strong incentive to lose weight, which is notoriously difficult for many people to achieve and maintain, as it involves so many adjustments to lifestyle rather than popping a daily pill.
Pretty tough love though, and one would question whether a Dr has the right to make such a subjective judgement about an individual which poses the risk of real pain & suffering. The main issue I have with his decision is whether dietery restrictions can lower uric acid by 2-3mg/dL. In most cases, I think not; in your case, who knows?
Both presentations you mention are common; the exact reasons for why you might get one and not the other are more difficult to explain, as they depend on so many individual variables which may make your immune response decide to be satisfied with a bit of whinging or losing the plot completely and throwing all the toys out of the pram.?
It's what makes the decision whether to take prophelactic medication, or not, so hard, if you're trying to keep meds to the minimum: NSAIDs, for example, which can be pretty corrosive on the intestines. Having not had a serious flare since starting Allo, I tend to wait & see a bit longer than I would have done before because I don't tolerate NSAIDs well, but I can't deny having taken one before bedtime on a number of occasions “just in case” when I've felt some twinges.
Keith (Gout Admin) said:
?it is not an excuse to sell overpriced pseudo-scientific reports.
and dishonestly claim 'a cure for gout'.
LTj – I'm afraid I have to agree with Hans that you're being very badly advised by your Dr, who clearly has no idea how to treat gout and why he is handing you over to someone else. Unfortunately, he doesn't even know who the right person you should see is.
Only you can improve your situation: first, find out if the 'joint specialist' is in fact a rheumatologist and if not, go back to your Dr and insist that you get referred to one; otherwise, you may find yourself having to wait another couple of months before you get re-referred. Secondly, if I were in your position, I would start taking 300 or 400mg per day (because this is what you should be taking – minimum) and then say the dog ate my pills or some other excuse and get a replacement prescription when they run out. Then do it again if necessary. You need have no fears about this being an unsafe dosage.
tonyccc said
Go ahead and remove all my posts.Nothing will please me more.
Well, you might as well finish the job he started Keith. He has contributed nothing of value to the forum & now he's being offensive.
Get rid of him.
?
(but don't ban the F word, some other misinformed individual might need help with understanding the facts surrounding this issue)
Welcome to the site John. I'll keep it short & sweet
100mg is a waste of time beyond the first 2 weeks to check whether you're allergic to it. You need to be taking at least 300mg p.d.? Do it today & when you run out tell your Doc you want a scrip for that much in future + a blood test immediately. Don't take no for an answer. When you get the results, ask for the exact figures, not some vague response like a bit high/low/normal etc. You need to be taking enough Allo to maintain a level of around 5.00mg/dL. Get your blood tested again in 1-2months.Are you taking any meds for the Parkinson's & Fibromyalgia?
