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zip2play said:
Why the problem getting febuxostat in Yorkshire?
Although Yorkshire is really all that matters, UK febuxostat shortage is a European-wide problem.
hansinnm said:
Thaijim
…I am curious to know how or what is used to measure alkalinity…?
Jim
Thank you, Jim, for raising that question. It's been on MY mind for some time. As a matter of fact, there are several questions:
1) How does one measure, relatively accurately, alkalinity (pH) of urine, stomach acid, saliva, body?
Zip has already mentioned that body pH (i.e. blood) is maintained pretty constantly. The mechanism is a little beyond me, but has much to do withe storing/relasing the aforementioned hydrogen ions in various bits of the body (wish I'd done more than disect frogs in biology class). Stomach acid is not something you could measure. Urine and saliva can be measured with pH papers or electronic meters.
2) What impact does the pH of the various items mentioned have on the well-being or ill-being of a person?
Though there are definitely a few new-agers who claim pH affects everything, there is a strong body of evidence to show that there are health effects. This is way beyond the scope of this site, but be very careful where you look for extra info. I have found pHbalance to be pretty well balanced, but I have not checked all their sources. Stick to claims that can be verified in PubMed.
3) How does/can one control and/or change the various pH's?
Eat properly! Protein and phosphorous are acidifying. Potassium, magnesium, and calcium are alkalyzing. You need all of those, but in the right balance. Learn about PRAL,follow the links, then ask more questions. If you are at risk medically from acidosis (or whatever the opposite is called, you usually get treated with baking soda (or whetever cures the opposite).
4) What significance does a “high” or “low” pH have?
It depends very much on context. The significance for gout sufferers is that uric acid forms crystals more readily when pH is lower. The only fluid you can really influence is urine, which is significant for risk of stone formation. Untreated gouties can alkalize urine to avoid uric acid kidney stones. Allopurinol takers can alkalize urine to avoid oxypurinol stones.
5) What is the “recommended” healthy pH to achieve and/or maintain a healthy body/life???
6.5 to 7.5 for urine, but best to read the link at the bottom of the pHbalance page I referred to earlier. This explains how pH changes during the day and what ranges are good to aim for.
One thing that is very important to watch for is that there are thousands of sites that repeat totally unfounded information about pH. Besides general confusion in the struggle to sell something worthless, there are 2 specific points which people just get wrong.
Myth #1. pH of food is important. No it is not. It makes as much sense as “if you eat yeast and shoe polish, next day you will rise and shine”. The alkalizing comes from minerals in the food and the way they combine with hydrogen atoms. Citric acid, acetic acid and any of the other dietary acids that we eat have as much to do with this as yeast and shoe polish has to a bright start to the day!
Myth#2. This is the worst one, because it almost sounds credible. The argument is that the food as we eat it is irrelevant, and the important thing is what is left when the food is digested. This has lead to reams and reams of information about the ash content of food, measured by burning the food until all water is completely removed. Though it runs fairly close to my toast recipe, it has absolutely no relevance. This is the source of thousands of lists of acid and alkalizing food, and they are ALL wrong
To summarize, I believe that alkalizing is important for gouties and allopurinol takers, but it should not be an issue unless you have a particularly high protein diet, or like eating fireworks, matches or phosphate fertilizer. Dietary assessments give an indication of what foods should be beneficial. PRAL is a good estimate for individual foods, and there is a more accurate calculation called NEAP that assesses total daily intake. Though they give a fairly accurate assessment of your diet, to be certain of pH you can confirm it by peeing on testing paper.
(Apologies to zip2play for any wonky chemistry. In chemistry class I only woke up when our amazing science teacer threw sodium in water)
A massive thank you to Hans for starting this topic, but first may I respond to a comment in the Black Bean Broth topic
Congratulations, Keith you have done a great service to mankind – especially all Gout Sufferers. We simply hopped onto your bandwagon and share the Fruit of your Labour and bask in glory of your SUCCESS.
metamorph
Now, I fully appreciate this, and I am truly heartened by it, but I cannot take the praise alone. I must especially mention zip2play, who miraculously arrived here during a personally difficult time for me. Without his selfless (totally unasked for) and humor-filled responses, I doubt I could have carried on.
More recently, several other people have continued to help others. I do not want to list names, because I will inevitably forget someone. The strength of this forum is because so many of you are willing to join in in the way that Hans has said.
Even the many people who ask questions help us all – who hasn't learned something from checking a fact or trying to put ourselves in anothers situation? I learn everyday because of the questions and experiences from all contributors.
There have been several times in my life when I have seen at first hand how leaving things to the professionals has led to poor quality of life. One thing I have learned is that the more professional someone becomes, the less likely they are to be helpful. We have proved that the best gout help comes from the people who live with it.
I'm inspired by Hans' words. I believe that what we need is more of the same. Just as the “go gently” approach is good for gout, I think the “grow gently” approach is best for this forum. I'm putting some effort into gradual reorganization – what has grown haphazardly is now getting a better structure. This attracts more visitors, but what makes people stay and learn, what makes people think and return, is you guys.
Every time you respond to someone here, more people see the helpfulness, and they are encouraged to contribute. First with questions, but then with advice and support. It is a wonderful thing to see, and be part of. The diversity of views is very special, and I feel that this is only achivable through continuing natural growth.
There are, I feel, some practical things that can be done to help achieve Hans' dream of a universally accepted voice for gout. I recently mentioned, almost in passing, a Gout Management Plan that would essentially be an agreement between doctor and patient on how the different phases of gout would be managed. It is vital that such a plan covers the collective fears and experience of all of us. There are several regulars who are reporting excellent progress in gout treatment. I need to collect this wisdom as a form of best practice, so fellow gouties can easily see what they need to do, and why they need to do it.
Anyone can contribute by reporting the clear practical steps that they took to help their gout, and the pitfalls they had to avoid on the way.
I guess before that, I need to return to Hans' final question, “How are we going about it to achieve this goal?” First, I think, we need to be clear what that goal is. Earlier this year, I restated the purpose of Gout Pal Interactive as “To provide news about gout, and to allow gout sufferers and their carers to ask questions, and share experiences and opinions, about gout.”
Perhaps that is a little bland and maybe needs evangelizing. Any suggestions?
The only way to manage gout, is to manage uric acid.
This is true however you choose to try to fix your gout.
Many people, including, unfortunately, some qualified people, see pain management as being most important, but it is not. Untreated high uric acid has many perils. The most obvious risk is slow build-up of urate deposits in joints, under the skin, and in the kidneys. These deposits are known to be capable of causing permanent physical damage, irrespective of gout flares. There might also be increased risks of heart disease with high uric acid, though current science can only see that there is a link, with an unknown cause.
Though pain management is important, it is absolutely no measure of how well you are managing gout in the long term. When I first heard about the processes that can cause gout attacks from old crystals dissolving, I suddenly realized that a huge portion of what I had previously learned about gout was worthless. The obsession with avoiding gout triggers is pointless if you cannot distinguish between an attack from new crystals forming, and an attack from old crystals dissolving.
If you measure uric acid at reasonable intervals, you at least have some factual information that you can use to track what is happening. In most instances, the figures reveal all, and you can use that feedback to decide if you need to change your management procedures. Sometimes the figures can be difficult to interpret, but at least you have that fixed data for comparison in future tests.
What is a “reasonable interval” will vary from person to person, and through time depending on what stage your treatment is at. When stable, once a year might be enough, but whilst trying to get to a stable state, with changes in medication or lifestyle, then more frequent feedback is needed to see if the changes are appropriate or enough. Every two weeks might be appropriate when trying to reach a new target level. Definitely no longer than a month.
Personally, I believe that the test interval should be determined as part of a gout management plan, and then stuck to. As part of the recording of test results, it is appropriate to note the incidence of gout flares, and anything else deemed appropriate (weight change, the weather etc). In this regard, results are not really false, they just need to be interpreted in the light of individual history. Without the tests, you have no history, and cannot manage gout other than by luck.
My ideal approach to gout management planning is very much in my head at the moment, but I will publish something soon. My suggestion is that everyone should develop an agreed gout management plan with their doctor, or in a friendly forum for self-managers. It might be pie in the sky, but I think it is a crucial development to get everyone involved “singing from the same sheet”. (aargh
cliches and mixed metaphors – anyway, I hope you understand what I'm suggesting)For me, the key is to be comprehensive, but not over-complicated. That is not always an easy balance to achieve, but my starting point will be a plan for “uncomplicated gout” first. Then some way to recognize the complications of treatment resistance and co-morbidities.
Uncomplicated gout is actually quite easy to manage if the basics are covered:
- Clear diagnosis
- Uric acid target to get rid of old crystals
- Urate deposit reducing medication an/or lifestyle strategies, including pain relief, at a maximum to remove old uric acid crystals
- Adjustment period to stabilize uric acid level around 6mg/dL
- Maintenance period for rest of life, continuing 6monthly, or even annual, uric acid monitoring.
Sounds easy doesn't it?
Cataflam is a brand of diclofenac, same as Voltaren.
This and other NSAIDs, like ibuprofen and naproxen, usually help with pain relief, but they all carry heart disease risks that increases the longer you take them.
Pain killers for gout need to be used as a short term measure until uric acid is brought under control.
The doctor will arrange uric acid tests, and will probably wait for the results before prescribing something like allopurinol to get uric acid under control. He might suggest colchicine for the pain until your uric acid has been low enough for a few months to get rid of all uric acid crystals.
Doctors have different approaches to gout, so it will beinteresting to see what yours recommends – do let us know how you get on.
metamorph said:
Sorry Keith, that this is “off Topic”.
I had been having a feeling that the number of times this topic has been view may not be very accurate. Exceeding 7500 views seems unbelievable to me. I did a quick test and found that every page I viewed is recorded as “1view”. So, as I scrolled through all the 11 pages of this topic it is recorded as 11 views. This is not of any grave concern though, but just an idle observation of mine as I have no gout problems at the moment…….. Thanks to BBB.
metamorph
The count might be exaggerated because of the counting issue you mention. It is still impressive, but a more accurate view:
The “86 pages” is because this count shows separate records for people hitting not only one of the 12 pages, but also if they arrive at a specific post. The chart is summarized by week, with the top week highlighted.
Other “off-topic” trivia, as we approach the first anniversary of this megatopic – 3rd February is also the birthday of my Mum and my stepson. We'll be sure to raise a glass to metamorph during the celebrations – Beer:Bacardi:Brandy
Welcome Bob – I'm also pleased you found this site
It would be good to see your uric acid numbers. If very high, it is unlikely diet alone will be enough (unless you had a really bad diet). I hope you and the doc can come up with a decent plan on Monday (tomorrow?) and get your uric acid down well below 6.
This allopurinol treatment topic is now closed.
If you need help with allopurinol, look at the allopurinol guidelines first. These cover all aspects of starting, continuing, and stopping allopurinol.
If you cannot find an answer there, please start a new topic.
phofab said:
I suspect the the Drug Companies had come up with some research and could see a marketing angle.
Marketing angle! Hmm…
It's taken a while, but I finally got round to finding the original, as it's not something I'm familiar with.
I love “there's always gonna be another lobster” but there is no way you'll get me to record this
For anyone else unfamiliar with it, just shout crag's lyrics over this performance:
4.4 is fantastic! I can't wait to hear about your dancing exploits in a few weeks.
If you do run into problems until all the old crystals have gone, we are lucky to be building a band of people here who can help. Now that you are on the road to recovery, I hope you can spend a little time pointing others in the right direction (and thank you very much for spreading the news about this site).
Utubelite said:
I am an example of “White Coat Syndrome”. Whenever I visit a doctor, my first BP reading is 140-155 / 90-100. My second reading taken within 5 minutes of first one improves dramatically, generally 125-140 / 85-90…..and if my diagnostics with doctors are satisfactory, the reading drops to 110-125 / 70-80.
It is a challenge for me when I visit a new doctor and tell to take my BP twice. They do not understand it at first. After few visits, they realize my point and then they do not care about my first reading.
Another known fact is that those who have WCS generally also suffer from Anxiety. This is another loop as anxiety can cause higher BP. I have suffered from anxiety a lot as I reported in another post earlier. The root cause of a lot of these things is Anxiety e.g. thinking too much about own body and own symptoms. WCS is also anxiety about BP being out of control or anticipation of something wrong. The moment that feel of something wrong goes away, the BP drops.
Once I got my head struck against a wall and thought something wrong. The whole night I had dizziness and uneasy feeling. Next day at doctor's clinic, the BP was 170 /105. After the tests performed on head( CAT scan and EEG) showed everything fine, the BP dropped back to 115/72.
So, I would suggest before starting on any BP medication, make it sure you actually have BP problem. BP medications are another loop like Allopurinol….once you start them, it is very difficult to get out of them.
[…]
My own guess is that your BP is most likely due to Anxiety induced WCS.
This is almost an exact description of my own situation. I got a high BP test result and an appointment in a few days to discuss with my usual doctor (it's a group practice). I had so many “symptoms” that I had to make an immediate appointment, with any doctor, and was lucky to draw one who was newly qualified and as yet unjaded. He explained to me the lack of symptoms with high blood pressure and suspected anxiety. A 24 hour portable monitoring device proved the point – no BP problem despite the enormous girth.
This is the first time I've heard the phrase “White Coat Syndrome”, but it is clearly common enough that doctors should be extremely wary before prescribing gout-risking BP drugs.
This is in no way meant to demean the treatment where it is necessary – treatment of genuine high blood pressure is a good thing. Just make sure that anxiety is considered before taking pills.
I'll sign off now to start the weekend, and avoid more anxiety with a trip to the pub
phofab said:
Allopurinol – attacks the kidneys.
This latter observation was also advised to me by a Doctor who discouraged me from using it as a long term remedy, many years ago. It was on the basis that I only suffered the attacks a few times a year and if it was him he wouldn't be taking the drug long term.
I'm really curious as to the source off this information. A good friend of mine was left in agony after years of peaceful life on allopurinol, when a new Practice Manager advised that it should be discontinued due to fears of the same risk.
I have tried to find what this risk is, but only came up with the opposite view – that allopurinol is good for kidney disease.
Sorry, this is a bit off the colchicine topic, so if anyone has more information about allopurinol and kidney disease, please can you start a new topic.
Peter,
Allopurinol is a drug that is used to manage uric acid. Without monitoring uric acid levels, the progress of gout is impossible to manage – particularly as you have not been on it long enough to get rid of all uric acid crystals yet.
I do not believe your moderate alcohol consumption has anything to do with this.
It is perfectly normal to have a gout attack in your circumstances. It is also common to cast around for causes, but the trouble is, without uric acid monitoring, you will never get a valid answer.
I'm sorry this is more rhetoric than clear advice, but the simple facts are that without clear history of gout attacks, allopurinol dose, and uric acid levels it is almost impossible to provide any clear advice.
My best assessment is that your latest attack is perfectly normal. Comparing the number of attacks per year before allopurinol, with the number of attacks per year since allopurinol will help confirm this, though it is not a complete answer.
In the light of all that, I will attempt to answer your questions:
Do I revisit the Doctor, get more bloodtests and reassess the quantities of Allop?
Absolutely. This should be a regular thing until you are stable. At least every three months in the first year. If travel makes this hard, get a uric acid meter and self-manage it.
Do I pack in the booze altogether (please no) Any advice is welcome.
The levels you mention are compatible with allopurinol therapy, but ensure adequate hydration. Pack in booze if it makes you feel better psychologically, but otherwise why bother? (sorry to throw the question back, but I do not see how the consumption you mention can make matters worse. In fact, I believe the “red wine and lots of water” probably did more good for your gout than any other beverage regime.)
Additionally, I've noticed that diarrhea equates to little or no gout with or without Colchicine?Could I just use laxatives instead, or in addition to Colchicine?
That would make absolutely no sense. Laxatives will not help your gout, and the diarrhea issue is mere coincidence. If you won the lottery on the same day that you accidentally lost the tip of a finger would you chop the rest of them off?
Posting problems.
The software that runs this forum is not very good at accepting pasted text if it has been copied from a web page. The solutions that I know of are:
- paste it into a plain text editor first to get rid of any formatting problems
- paste using the 'Paste as Plain Text' button at the top of the edit area
- paste after clicking the HTML button at the top of the area
- change the text edit method in your profile.
I cannot see this ever changing, as this is a fundamental problem with the way the default editor works. It is great for normally typed text, and great for pasted plain text, but posting in formatted web page text (or formatted text from a word processor) just screws it up.
fatdom said:
Also do many people regularly take >300mg doses? Is this something I should discuss with my GP during discussion of the blood test results.
A recent study in the states shows that almost two thirds of allopurinol users are prescribed 300mg. Only about 3% got more than 300mg, with most of them in the maximum 600-800mg range. However, the same study reveals hardly any backup testing for uric acid levels and a compliance rate of about 1 in 8. The sort of gout management that makes me despair.
The dose is definitely something to discuss when you get your results, as it is fundamental to getting uric acid at the right level to keep you gout free. 300mg is usually a pretty good maintenance dose, but a few months at a higher level will help get rid of old crystals.
Seeing the light is a great thing – can't wait to hear when you reach the end of that tunnel.
The only long-term prophylactic (i.e. preventative) for gout is uric acid below 6mg/dL. Doctors prescribe colchicine prophylactically during the early stages of urate lowering therapy to prevent pain from uric acid crystals dissolving.
Simply using colchicine, or other pain killers, as pain prevention does not stop gout. It just masks it so that uric acid crystals continue to build-up until they cause irreversible joint damage.
fatdom said:
[…] I am convinced that I have gout in one of my vertebrae as the pain in it mirrors that in my right toe and right knee which are all my worst affected joints. If the pain in these dies down then so does the vertebrae pain; also likewise for an increase in pain. I have had an x-ray and there were no issues; GP doesn't seem to think Gout can occur in the back; however I have read a paper on this very subject. I just wondered what the general consensus on here was regarding back pain and gout?
There is absolutely no doubt that gout can attack the spinal joints, though it would need a proper examination by someone who really knows their stuff to see if this is true in your case.
If it is the case, the lowering uric acid to the right levels will fix it, as your x-ray has discounted physical damage that long-term build-up of uric acid crystals could cause.
I must repeat my warnings about the recklessness of allopurinol without proper uric acid testing. What next, heart catheterization by guesswork without live imaging equipment? I applaud you trying to take the blame yourself, but if the doctor had warned you properly of the risks then I know you would have made the effort (sorry for remarks about $20 test – I didn't realize you were UK based until you mentioned stones of weight – which brings me to…).
Given your 3 stone weight loss (that's 42 pounds of purine-rich human flesh that doesn't even need your digestive system to get straight to the blood stream), it is no wonder you're suffering with gout pain. Your uric acid levels must be up and down like a yo-yo, with painful highs and new crystals forming, then painful lows with old crystals dissolving. Underdosed allopurinol – the sadist's dream
I'm sorry some of this sounds even more depressing, but I feel certain that once you get uric acid levels properly managed, you can look forward to a pain-free life.
Surely 'Hallux Limitus' just means 'a mechanical problem with the toe that we cannot diagnose'?
From my very limited knowledge of problems with this area of the foot, I suggest that your symptoms bear much more resemblance to a sesamoid or other mechanical toe problem than they do with gout. I remember earlier discussion on mechanical v rheumatological issues, but it seems that the mechanical specialists are not providing much help – unless of course the very stiff shoe is a reliable cure and not merely palliative.
It looks like your high uric acid is throwing up a gouty red herring, given the absence of any change in your condition in 10 months.
Though it pays to continue monitoring uric acid, without other indications of gout (i.e. painful swelling in other joints and confirmation of uric acid crystals), I cannot see how any gout treatment is going to help you.
I'm not throwing in the towel – but I think you need FootPal, rather than GoutPal – unfortunately, such a beast seems rather hard to find.
cjeezy said:
Just curious, if colchicine kills off white cells, is a person more susceptible to becoming sick with the flu (or whatever) when on the drug?
Once again, cjeezy asks the vital questions that we should all ask, but rarely do.
I can find little data on this in the ordinary treatment by colchicine, but I have found two particularly interesting though unusual views.
One paper discusses the role of infection after a young woman tried to commit suicide with 27.5mg of colchicine.
This paper discusses the role of colchicine poisoning in increasing susceptibility to infections. This aspect is usually under-appreciated in the clinical picture of colchicine overdose.
Another two papers give an interesting alternative view from studies of colchicine on the infecting invaders. It seems that colchicine also affects the bugs (at least in the case of Toxoplasma gondii and Cryptosporidium parvum), and the mechanism that represses white blood cell replication also represses those infectious organisms.
Very interesting (to me at least), but it probably has little bearing on the normal application of colchicine for gout pain relief.
Some great advice – thanks guys – but the real issue has only been hinted at.
Allopurinol is a urate lowering drug. It should only be taken as part of a properly controlled urate lowering program. Unfortunately, it does not appear to be illegal to prescribe allopurinol without monitoring uric acid levels and adjusting dosage as appropriate, but it is immoral and unprofessional.
You must get uric acid tested immediately. If your usual healthcare provider cannot do this immediately, I understand from several posts here that independent lab tests are available around $20 (why not try for a discount – you are going to be a regular)
The absolutely vital thing to do, is to ensure that your level is below 6mg/dL, and adjust your allopurinol dose accordingly. You should also consider a few months with a target level of around 3mg/dL, which will get rid of the uric acid crystal deposits from your joints and other tissues.
Come back with your uric acid numbers as soon as you can, and we can give better quality advice. Let's hope the Naproxen helps in the meantime, Dominic, but it can only be a short term plan to help you while you get your uric acid properly under control.
davidk said:
I know my gout will get worse before it gets better now that I'm on the Uloric, not looking forward to the next few weeks, but optimistic that there is a future for me that does not involve a walking cane. (I'm also taking colchicine and prednisone to get through the flare ups that will be coming).
Thanks again and I hope to be able to report good news over the coming weeks.
Dave
Dave, let's hope it is all good news. I'm guilty of overplaying the “gout flare when lowering uric acid” card. Yes, you have to be prepared for the possibility – hence the preventative colchicine and prednisone – but ultimately the flares will reduce to zero. Absolutely vital is getting the uric acid level below 6, so hopefully you have some follow-up tests scheduled.
Analytical (accountant), persistent (marketing) and logical (computer), maybe, but “highly intelligent”?
I wishFar better to get into a regular testing habit – say once a month, more frequently if you prefer. You need the facts, but it is a good idea to also keep a record of gout flares to help with interpretation.
Keep uric acid below 6mg/dL, and eventually you will never need to worry about gout flares. After several months testing with stable results, you can reduce frequency to every 3 months, maybe longer, but always at least once a year.
zip2play said:
Immune suppression is not always a bad thing. Many relatively benign problems are magnified to life threatening by an overactive immune system. Ask anyone suffering from rheumatoid arthritis, Lupus, shingles, or even hay fever or asthma, over-reaction to a bug bite.
In these and many other conditions the goal of treatment is to atenuate the immune system.
Some food for thought is the possibility of using colchicine to ameliorate the symptoms of other immune system caused diseases? (Heck maybe I should work on that for my NOBEL?)
Colchicine is already used widely for immune system diseases – familial Mediterranean fever(FMF) springs to mind immediately because of the colchicine crisis debate.
It has also been mooted as a cancer treatment, but largely discounted because of toxicity at the dose required t be effective.
Colchicine inhibits microtubules – part of the cell structure that regulates cell division (hence lower white cell count) and signalling functions (hence limiting our immune system call for backup that attracts more white blood cells leading to inflammation and the agonizing pain signals). I hope any lurking microbiologists will forgive my tentative layman interpretation – this cellular level of gout pain and colchicines unique ability to break the cause and reaction cycle is very complicated.
Perhaps what I should have said is:
The precise mechanism by which colchicine relieves the intense pain of gout is not known. However, it is believed that the major relief of pain involves colchicine's major pharmacological action: binding to tubulin dimers. Tubulin (MW approximately 10,000 Dalton) is a protein consisting of two forms, alpha and beta. Alpha and beta tubulin form dimers, and these dimers polymerize to form long filaments of microtubules. When colchicine binds to the tubulin dimers, the dimers are unable to form the microtubules. The microtubules are vital for formation of spindle fibers during mitosis and meiosis, intracellular transport of vesicles and proteins, flagella reassembly, ameboid motility, and other cellular processes. Inhibition of ameoboid motility prevents macrophage and leokocyte migration and phagocytosis, thereby presumably preventing the inflammation and pain of gout. Because colchicine disrupts mitosis, halting the process at metaphase, scientists have also evaluated colchicine as an anticancer agent. However, serious toxicities prevent the use of colchicine in antineoplastic therapies.
With thanks to Department of Medicinal Chemistry at Virginia Commonwealth University
. Therefore, it is immunosuppressivedlbarnha said:
I've been drinking distilled for 30 years and JUST NOW found out the pH is 6.2-6.4!
As GoutPal states in the diet section, what reall matters is what it does after assimilation….. Anyone know? Seems to me over 7.0 would be better.
This confuses 2 natural gout remedies.
Water primarily affects hydration. Hydration is important to help flush uric acid from the kidneys. For allopurinol takers, it also helps flush allopurinol by-products. It is also important to stop dehydration, as this can conentrate uric acid above saturation point – encouraging uric acid crystals to form. Any variation in pH from the standard value of 7 for plain water is almost entirely due to dissolved carbon dioxide.
Alkalizing diets are not related to the pH of what goes in the mouth. We are only concerned with the acid load on the kidneys, and this is a product of protein balanced by other minerals, as described on the PRAL page. Your diet would need to be completely weird for water intake to have any significant effect.
I would add to Zip's useful information that no single food can be judged in isolation. A protein balanced diet is important. Diet promotors will disagree on the percentage with heated debates as to 30% or 40%. The real issue is that it should probably not be more than 40%.
If you are taking whey protein as part of a balanced diet to replace some animal protein, or as a vegetarian, then you are OK. If you take it as a supplement to boost muscle mass, then there are lots of indications that increased muscle mass increases uric acid.
cjeezy said:
GoutPal said:
It begs the question – should we aim to be skinny (i.e. socially, but not medically, underweight), knowing it gives a lower risk of gout?
Good question, although I have gout and am skinny- 6 ft 180lbs with 12% body fat…so I'm thinking if its genetics you're screwed no matter what! lol
Larkin had it right, but I'll sanitize and amend to keep on topic
They screw you up your, Mum and Dad
They do not mean to, but they do
They give you all the gout they had
And add some extra just for you.
(Who is gonna tell him that medically he's overweight?
)modogg said:
I got my blood drawn after lunch last week. I got the results today and it was 8.0. Keep in mind it was near 10 a few months ago. Since my attack started 2 weeks ago, I have since elminated most high purine foods and alcohol from my diet. I am at a point now where I can begin exercising as my foot has healed for the most part. I just turned in my 24 hour urine sample this morning and they drew more blood as I was fasting. I am interested in the results and will keep you all posted. I did have a few more questions……:) You all have been very helpful and I appreciate it.
1) Any insight into the 24 hour uring test would be helpful. Why is this test important? Especially in deciding the dosage of Allo. My doctor did write a 300mg prescription. He said not to get it filled until after he reads the test results. After the test results come back, I will ask for a lower dosage of 100mg as you recommended.
It tests if you are an underexcreter or overproducer of uric acid – a useful insight into possible gout causes. If you are an underexcreter, you have more treatment choices because uricosurics (drugs that increase uric acid excretion) are suitable. Drugs like allopurinol or febuxostat, that inhibit uric acid production, work in both cases.
2) I have never had an attack last more than a few days. It has been over 2 weeks on this one. My ankle and toe has almost healed. Can this be b/c I have eliminated meats and alcohol for the past few weeks and my body is trying to dissolve the already accumulated deposits? I never used to get them in my ankle but recently I am. It was usually in the toe.
Gout is a progressive disease that can effect any joint, as well as causing tophi to build up under the skin. Classically, it starts in the toe, spreads to the ankle and rest of the foot, then the knee. It continues into the elbows, wrists and hands. Shoulders and back could be next. No joint is safe.
It is not predictable. You can go for weeks or months without getting a flare, though the chances are that crystals are slowly building up and destroying bone, cartilage and tendons even when you don't get the flare.
As the disease spreads, the flares become more frequent until they often feel like a continuous gout attack. By lowering from 10 to 8, you are not reversing anything, but might be slowing the progress slightly.
3) I asked this before and maybe crazy…..When I used to drink a few beers, I could almost immediately feel a rush into my toe. Like it was already accumulating. I told my doctor and he said he has heard this before. Anyone else had this feeling?
One thing we all get with gout is an obsession with linking what we put in our mouths with what happens in our bodies. We are also ever watchful for the next twinge that might signal the onset of an attack. Crazy is as good a definition as any, though anxiety might be more medically accurate.
I'm looking forward to some progress reports, but please could you start new topics for new questions. It stops discussions twisting and turning like this one is doing – which is a shame because you are asking the questions that all the lurkers are thinking
(this is a friendly ask – not a criticism)
