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           April 1, 2013    Gout - The Misinformation, Confusion and Myth

Gout has been around for a very long time, and after all the research I have done, I now realise that dealing with it should be a simple matter.  Unfortunately, it’s not.  That’s because so much of what is said and written about gout is misinformation and myth.

   Advice about a low purine diet is wrong and based on woolly thinking – yet you’ll see it repeated again and again.  Gout sufferers over the years have made huge efforts to stick to this strict diet, but it doesn’t help at all!

   It’s easy to trick yourself into believing that some things work.  My father convinced himself that hard leather shoes were the best thing.  Delusion.

    The drugs that give temporary relief feel so good at the time that people go on using them, time and again, unaware of the damage these things can do to their overall health.

This web site is made by a fellow sufferer, hopeful to dispel some of these myths and pass on genuine, practical advice.  That is all.

April 12, 2013  Why the Low-Purine Diet for Gout Doesn’t Work.

The theory behind low purine diets, which you'll see talked about all over the Web, is that certain foodstuffs contain more purines.  Purines are broken down by the body, with our old friend uric acid as the by-product.  Purines are the essential organic compounds in all food which when broken down produce uric acid.

And excess uric acid, as we all know, causes gout.  (Click here for more detail about the causes of gout and what to do about them)

Be aware that, although there are foods which are high or low in purines, this does not necessarily translate into higher or lower uric acid.  The human metabolism is more complex than that.  In fact, despite the fact that you’ll see these low purine diets all over the Web, there is no evidence to say that a low purine diet will help gout sufferers, even in the long term.

A recent study, done over a number of years said that there was no evidence that a low purine diet was of any benefit at all.  An article in the September 2009 issue of the Journal of the American Dietetic Association called into question what it calls “this long-held belief”.

That’s right.  All those remedies and diet sheets DO NOT WORK.

For what it’s worth, here is some idea of the purine content of various foods:

High in Purines:  Liver, kidney, yeast, beer, codfish, sardines, mussels, scallops, trout, haddock, salmon, tuna, mung beans

Moderately High in Purines:  beef, pork, duck, chicken, lamb, some other white fish, crab, lobster, shrimp, lentils, some kinds of beans, cauliflower, green vegetables e.g. spinach, soya.

Beneficially Low in Purines: dairy products, eggs, wine(!), rice, potatoes, nuts, peanut butter

Now, would any gout sufferer, who was suffering some painful gout right now, notice the difference between eating liver for lunch, or supposedly beneficial cheese?  No.  He would not.

Compare that case to a person with a gout attack who had two glasses of wine with his lunch.  He would notice increased pain and swelling within thirty minutes.  (You try it).  Yet wine is in the “safe” category.

As if to further make the point for me, “official” advice on what to eat states that eating red meat is associated with gout, but eating green vegetables is not.  Yet both are moderately high in purines – beef steak being on the low end of moderate, below cauliflower and many legumes.  

So why so hard on red meat?  Because red meat is one of “the usual suspects”.  In reality there is no evidence, or science or even common sense behind this pervasive "purines" theory.

April 15, 2013   What Causes Gout?

First of all, gout is genetic.  It can’t be “cured”.  It can be treated, but never truly cured.  Your susceptibility to gout is always going to be with you, although of course you can make the painful symptoms of gout go away for good.  (For full info click here)

The villain of the piece, as you may already know, is a chemical called uric acid.

Uric acid is present in the bloodstream of the human body.  It is produced as an essential by-product in the breakdown and metabolism of purines in the human body.  The uric acid is therefore an unavoidable waste product in humans.  Uric acid is removed from the bloodstream via the kidneys and bladder, and excreted from the body in the urine – with which it shares its name.  

Uric acid is responsible for the hard white build-ups you see in urinals and toilets which have not been well cleaned.  Once these build ups have started it is not at all easy to get rid of them, or the smell they create.  This is the reason why modern toilet cleaning and sanitizing products have specific additives to get rid of the urea (uric acid in its solid form).

OK.  Uric acid is present in everyone’s bloodstream – so why do only some of us develop gout?

Two factors:

1. Some of us inherit less effective kidney function than others.  It’s not that we have more uric acid in our bodies.  It’s that we are less able to get rid of it.

2. Excess uric acid will lead to gout, because of one particular property.

That’s right, there’s something about uric acid which causes all the problems.  Uric acid is particularly insoluble.

This is the crux of the matter.  Uric acid is particularly insoluble. We tend to think of acids as liquids, but uric acid prefers to exist in solid form.  

Saying it is “insoluble” means that it requires 2,700 grams of water (or blood) to dissolve just one gram of uric acid into the blood stream at body temperature.  That means that all the blood in your body at any one time can only hold a couple of grams of this waste product in liquid solution form.  Any excess uric acid will solidify into tiny crystals in the blood.  These crystals gather in certain joints, causing painful gout.

Furthermore, in tests where dissolved uric acid was kept in a solution at the same acidity and temperature as human blood, even the uric acid which acid which had dissolved at first tended to form into crystals.

Which means that it’s not just the amount of excess uric acid in your body that’s the problem.  It becomes a greater problem when there’s less circulation of the blood.

How Do The Crystals Form?

You may remember in science lessons at school, if a solution of say, salt is “saturated” and can take no more salt into the water, crystals tend to form.  And wherever the crystals start, they will grow bigger, because the excess salt in the solution crystallizes onto the existing crystal deposits – forming bigger and bigger crystals of salt, until all the excess salt in that beaker of water has formed into crystals.

It’s the same with gout.  The excess uric acid in the bloodstream will naturally be drawn to the existing crystals forming in the joints of your foot, making the crystals bigger yet.  So once the crystal forms, it just gets bigger and bigger.  And the pain and swelling of gout ensues.

For much greater info on the physical and chemical causes of gout, and how to stop them, CLICK HERE.