(Image copyright Nucleus Communications)

Gout is known to affect many joints including the knee, wrists, fingers, elbows, thumbs, ankles and even instep! However, in the majority of cases (around 75%) it affects the big toe. Often the first signs of gout disease are big toe pain or big toe inflammation and tenderness.

Interestingly, why does it target the big toe? The answer is unknown, but one prominent theory suggests the big toe is one of the fatherliest joints from the heart and therefore the blood is cooler around this joint which may contribute to uric acid crystal formation. This is further supported by anecdotal stories that a warm bath may alleviate big toe pain.

The file, which can be downloaded, includes details of the level of purines in certain foods including meats and vegetables. Also, it includes useful information on alcohol consumption and how it possibly contributes to gout.

I thoroughly recommend having a look at the gout diet health-sheet.

Plus an explanation of gout 'tophi'.

www.health24.com: A list of factors are detailed on this site that may cause a gout attack. A discussion of anti gout drugs. Importance of weight-loss for overweight people.

Alcohol intake is also mentioned.

www.bupa.co.uk: This article on the UK's Bupa site describes an important study about the relationship between alcohol consumption and gout development. There is now strong evidence that diet - and more significantly lager/beer intake - certainly plays a role in gout disease expression.

Whether diet can directly cause gout or not is still controversial, as there are possibly numerous factors involved, but diet can and does play a role in gout attacks, including aggravating and accelerating disease expression.

So is it possible to design a gout diet that accommodates your personal tastes while reducing the risk of painful gout attacks? I believe so.

First I would recommend reading the gout-diet factsheet from the UK Gout Society. Then sit down with a cup of tea or coffee and spend 30 minutes or so working out a daily diet plan that accommodates your personal tastes while reducing certain foods and food-type know to aggravate the condition. For example, avoiding foods very high in purines and limiting or dramatically reducing beer/lager consumption are the two main factors when considering your gout diet.

If you do include ‘high-risk’ foods in your anti-gout diet-plan, try to ensure they are consumed in small quantities, thus reducing the threat of irritating your gout.

Design a simple diet-plan like the following:

• Avoid or limit fish;
• Avoid or limit red, organ meat;
• Avoid or limit beer, lager, etc;
• Avoid products containing brewers yeast.

For more information about diets for people with gout go here.

Comment:

Cool weblog! During gout attacks, no medicine really works for me! It's a matter of bearing it. My gout has hits me hard - physically, mentally and emotionally! Surprisingly, the symptoms start when I drink a lot, but other than that nothing! I was thinking the other day, this disorder has got to be genetic related in most cases, I lead a healthy lifestyles – no heavy drinking or over-eating but I still developed gout. Special diet for me really helps. Surfing other websites keeps me up-to-date about gout! Organized and nicely designed. Mr Ferguson

• Pseudogout: a symptom-set brought on by excessive calcium in the body.
• Gout: inflammation, swelling and pain caused by excessive blood uric-acid levels.

Note: each disorder is usually treated differently with different drugs. Although anti inflammatories can be used for both

Comment:

Hello, this is an interesting gout blog. Only drugs help relive me from an attack. Ironically, this week has been my worst! Reading bits and pieces from websites about gout has helped relive my symptoms. Treatment with conventional drugs helped relieve many of my symptoms after being initially identified with pseudogout. Enjoyed reading and learning about gout. You’ve put some effort in to this: graphics and nice pics and very useful info! A. J. Banks

Recently, I searched the Net looking some kind of proof, and yes it may help! Old reports combined with recent studies suggest cherry juice contains certain compound that can inhibit inflammation and pain caused by uric acid crystal formation. So you may want to try this!

This is a very nice site. After reading about other symptoms, I find I get shooting pains in my right leg and back, for some unknown reason. As far as I can tell I've had it all my life! LOL! Early last year I changed my diet and added supplements including cherry juice, it really helped. Gout research leads me to believe that it's mainly caused by genes. Reading bits and pieces from other internet websites helps me understand my and cope with my disorder. Keep up the work your doing a great job so your site visitors should keep coming back! M. Jennings

• Liver
• Heart
• Sardines
• kidneys, etc.

Consuming low purine foods which undoubtedly reduce uric acid blood levels should, and there are some anecdotal reports to support this, help relieve some and perhaps many gout symptoms.

Comment:

I like the site. I've been reading gout sites for a while and yours is informative and nicely designed. Gout crippled me a while ago, but it’s under control now especially via diet and specifically through reducing purines. I use some medicines to control it and it works well. Surprisingly, it really affected my family more than me I. Some nice work here – book reviews, news info, stories – well done! A. Polly

The real cause of gout is excess uric acid. Normally a small amount of uric acid is present in the blood and eliminated through the kidneys. Uric acid is formed from purines. These are important compounds in the formation of DNA and RNA. which are essential to forming new cells and related to our genetic material. The origin of uric acid from purines is really the basis for the gout diet. It was believed that by eliminating purines from the diet there would be less uric acid and hence fewer or no gout attacks. Wild game is a rich source of purines, and a steady diet of wild game will definitely increase the purine intake.

That in turn means that it could elevate the uric acid level somewhat, and that may be just enough to precipitate an acute attack of gout. An attack does not occur until the uric acid in the blood reaches a critical level. Other foods that are rich in purines include organ meats such as liver, kidneys and sweetbreads. In the seafood group, anchovies, herring, sardines, mackerel and scallops arc high in purines. Meat broth, boullion cubes and goose are also high in purine items. It follows that gravies made from meat broth are also rich in purines. If a person wants to follow a dit to prevent gout, all of these should be avoided.

There are other foods that are moderately rich in purines. These include the meats, fish, shellfish, fowl, dried beans, peas, spinach and asparagus. These may be tolerated in small amounts in between acute attacks of gout. Finally, there are basic foods that are essentially purine-free. These include cheese, eggs, milk, bread, vegetables except those already mentioned, fruit and sugar. Some diets to prevent gout also recommend avoiding pies and pastries rich in fat, cauliflower, mushrooms and oatmeal. It has been thought that alcohol alone does not cause acute attacks of gout but that beer, ale and wine do. More recently, there is some evidence that alcohol may interfere with the elimination of uric acid through the kidneys, and in that way elevate the uric acid level, contributing to gout.

In a society that is body-weight conscious it is important to know that excessive weight loss can cause an acute attack of gout. As the body tissues are metabolized during weight reduction, uric acid is released in increased amounts. It is good for anyone who has gout to lose excess body fat, but it is important to do it with a diet that permits a very gradual loss of body fat. Crash diets are a no-no. Before modern medicines were available, diet treatment was all a doctor had to offer to prevent gout. His only medicine available was colchicine. which was useful and still is in the treatment of an acute attack, but did little to prevent a subsequent attack. But it is now know that the diet is not the most important factor in causing gout. In fact, the vast majority of uric acid is produced by your own body cells. Some people inherit a greater tendency to produce excess uric acid than others.

By following a strict gout diet a person may decrease his uric acid level by 1 to 2 mg. In some cases that is just enough to avoid acute attacks. The only way to tell if a diet is effective or not is by blood tests to measure the uric acid levels. Such tests are really the best guide as to the effectiveness of any type of treatment or management of gout. It has been illustrated, by putting animals on a milk diet, that the diet is not the main source of uric acid. Since milk is purine-free that should mean there would be no uric acid if the diet controlled it.

But even on a milk diet the body still produces uric acid. The answer, then, as to what eating wild game will do to your husband, can be assessed by measuring his uric acid level if he does. I am certain that some gout patients, or those with borderline elevations of uric acid, can be pushed into acute attacks by consuming a high purine diet. But despite that, dietary therapy is not usually adequate therapy to prevent future attacks.

Lawrence E Lamb - Wednesday, August 7, 1985 THE DAILY HERALD

Most of the time the symptom can be controlled by anti-inflammatory medications like naproxen or indomethacin. In severe cases steroids like prednisone may be needed. Some people even need injections into the joints. Fluid from the swollen joints can be removed and analyzed for the uric acid crystals.

The treatment includes medicines like allopurinol, which decrease the level of uric acid, or there are other medicines like colchicine, which decrease inflammation. Also there are medicines called uricosuric agents that increase the removal of uric acid in urine. Colchicine works best if taken really early in the attack and sometimes repeat does may need to be taken periodically such as every two hours or so till there is pain relief or a maximum dose is reached or there are side effects like gastrointestinal upset.

The specific dose and the manner of taking these medicines are best discussed with your healthcare provider.
Common side effects of these drugs include stomach upset and ulcers from prednisone and ibuprofen type of medications, diarrhea from colchicine and sometimes gout can get worse from allopurinol especially if the person is not on colchicine first during an acute attack.

Gout provides detailed information about gout, foods that cause gout, and more. Gout is affiliated with http://searchwarp.com/swa31480.htm

Most of you will have problems with your joints and it may be arthritis. Arthritis is associated with aging but it is not caused because you are aging. Arthritis is caused by the body not been fed the proper nutrients that keep your joints health and free of wear and tear.

There are plenty of joints in your body and typically there are only specific joints that have arthritic pain. Those are the ones that you use frequently. For men it is knees, spine, and feet. For women it is fingers, hands, knees, and spine.

Arthritis means inflammation of the joint. When your joints have bone-to-bone contact and grind against each other that area becomes swollen and inflamed.

There are two main type of arthritis – osteoarthritis and rheumatoid – and others that are less known.

Rheumatoid Arthritis: Rheumatoid means "similar to flowing pain." It is an autoimmune disease where good cell and tissue are attack by the immune system. Rheumatoid first affects the joint membranes and later the bone structure at the joint. Rheumatoid arthritis occurs in people of all ages. As this arthritis progresses it can becomes crippling.

Rheumatoid arthritis is a recent disease, which appeared at the turn of the 20th Century. Its cause can be associated with diet where the balance of the joint structure receives chemicals that destroy its balanced condition.

Gouty Arthritis: Gout is a disease where uric acid deposits in the joints of feet and legs. When the body has an excess of uric acid, which it can’t eliminate through normal channels of elimination- the kidney – the uric acid settles in the joints and soft tissue causing pain.

Gout is more common with men, people with high blood pressure, alcoholics, diabetics, and obesity. Gout means drop. It was thought by Romans that gout was caused by poisonous crystals coming from the blood, drop by drop, and depositing in the toes.

There is some evidence that gout is related to the amount of wine that is drunk with the meal. This put an extra strain on the liver that tries to detoxify the wine and the meal at the same time. Result is the liver is unable to detoxify the complete meal.

Other Types of Arthritis: There are other types of arthritis. These account for a small amount of the types of arthritis that most people have. Here is the list:

Bursitis – inflammation of the shoulder joints and muscles.

Neuritis – is know as rheumatism of your nerves. When the sheaths of your nerves dry out you have neuritis

Myositis - pain that comes from working hard and muscles have friction between them.

Fibrositis – is when your connective tissue become inflamed Lumbago – occurs before you get arthritis of the spine.

Which arthritis doe you have? In other articles, I'll tell you what you can do to prevent or eliminate arthritis of any kind.

Rudy Silva has a degree in Physics and is a Natural Nutritionist. He is the author of Constipation, Acne, Hemorrhoid, and Fatty Acid ebooks. He writes a newsletter called "Natural Remedies Thatwork.com". For more information on arthritis go to: http://www.familyresource.com/health/arthritis/what-type-of-arthritis-do-you-have

Three brothers with the same congenital heart ailment are recovering from operations which, doctors say, promise them a normal life span. A team of surgeons from the University of Southern California School of Medicine corrected the condition, a narrowing of the aorta—main blood vessel of the heart. The narrow section was
excised and the artery rejoined, in each case. The brothers are Jerry, 8; Edward. 12. and Jerome Ruzicka, 18. They held a news conference Wednesday. Jerry said he told the school nurse one day that he never felt full of pep. She sent horn to a clinic. Family histories disclosed his brothers had had the same kind of faulty hearts since birth. 99 often laugh through sheer ignorance. This disease is gout, a malady which has had a far more important impact on our country than, say, those twin ailments of the advertising world — halitosis and athlete's foot. Those who laugh at gout might not be here at all except for the dreaming boldness of a gout sufferer. Between his pangs this man — Christopher Columbus — discovered America. Those who laugh at gout might not be Americans at all except for two more gout victims; consider gout and health? One was the brilliant English orator, William Pitt. It is said: that only an attack of gout prevented him from stopping passage of the Stamp Act, a measure that speeded the American Revolution. The other was Benjamin Franklin, whose diplomatic genus despite "his throbs of gout did so much to win American freedom and establish our national unity. Those who laugh at gout do so in the belief that it is a heaven-sent penalty for high living. The truth is that gout is an inheritable metabolic disorder, a form of arthritis that afflicts more suspected sinners than known saints only because at any one time the world usually holds many sinners, few saints.

Gout, which is manifested by painful deposits in the joints and body cartilage and accompanied by a high uric acid content in the blood, is one of the oldest disease; known to man. It was accurately described by Hippocrates, the "father of medicine," and others as early as the 5th century, B C. As early as the 17th century Thomas Sydenham, 'the English Hippocrates," classified gout as a form of arthritis and gave his view that victims "have received ill seeds of the disease from their parents by inheritance." The general image of a man with the gout was that of a fat red-faced English lord lying in bed with a heavily bandaged foot propped up on a pillow, a wretch who screamed in agony if even
a fly landed on the bandage. For a couple of centuries thousands of high-minded men suffered the torture! of gout in secret and silence rather than admit they had a malady others thought comic. Today, say Drs. Lockie and Cooper, gout is the one form of arthritis that can be easily managed by medicine and diet.

So if you want to become the first man in your neighbourhood with a distinctive disease, never mind bragging about your ulcer. Ulcers are commonplace. Gout is the thing – it’s not about health anymore. Gout is becoming fashionable as well as respectable. The guy with gout may also have genius in his genes; the guy who still laughs at gout proves he is

Disease Called Gout - Is No Laughing Matter By HAL BOYLE NEW YORK (AP)

Uric acid deposits in the kidneys sometimes may lead to kidney insufficiency. In 1950 the Gout Clinic, using a drug called probenecid, which helps gout victims by drawing uric acid out through their kidneys, found that tophi could actually be made to disappear a major breakthrough in treatment In 1962 another drug, allopurinol, was developed, which actually prevents the formation of uric acid. Gout Clinic patients today are given whichever drug fits their particular case best, and they're usually permitted to eat and drink pretty much as they please. They do have to undergo periodic checkups of their uric acid levels, so that diet and pill dosage may be properly regulated. Dr. Yu points out that women seldom get gout about 95 percent of sufferers are men. She also notes that people with gout are believed by some to have above average intelligence. "How does Women's Lib feel about that?" she asks J Smith a smile.

Gout-is a hereditary" disease, with offspring of gouty patients far more likely than others to develop a high uric acid concentration. She says that about 100 of her patients bring their children in for preventive checkups. Hopefully research will be able to develop treatments which will prevent such offspring from developing the actual disease;. The generations pass "Some of these youngsters started at age 12, and they're still coming at age 30," she says. "I have to laugh at myself sometimes. When I was young I saw only old fellows. Now when much older, I see them young." Dr. Yu, a graduate of Peking Union Medical. College, began studying medicine largely at the instigation of her father. "In those days in China, boys were preferred to girls," she says. "But I had a good father—he didn't see why boys should be better treated. We were two girls and three boys. The others were all smarter than me, so I worked harder to compensate." Wherfshe first met Dr. Gutman, who then was at Columbia University,

Dr. Yu remembers he was "totally unprepared to receive a Chinese girl to work with him." "He gave me two reprints that he'd written," she says, "and said 'Read these articles—I don't know whether you'll understand them or not.' I felt insulted. I read his articles, which were written in a beautiful literary style. But he was right: I didn't understand them. But I didn't want to admit it. So I spent a whole week looking up references and going over the articles. Finally I went in and told him: 'Everything you wrote I understand.' I stayed three and a half years with him at Columbia, and then when he was appointed medical chief at Mount Sinai ,he took me with him. It was he who urged me to stay in gout research." World's largest Over the years the Gout Clinic launched by Dr. Gutman with the help of Dr. Yu has had 1700 patients, making it by far the largest "clinic of its kind in the world. Scientists from other countries come to study and work there and then take back the most modem treatment methods to their own lands. Gout patients who used to hobble in with canes and crutches now arrive briskly and cheerfully for the tests and treatments that enable them to lead active, pain-free lives. Their new-fourtd happiness is reflected in the quiet satisfaction of Dr. Yu, whose "three months of graduate work" has turned into a quarter of a century of service to humanity.

From Lincoln Star (1950)

What do Alexander the Great, Charlemagne, John Milton, Isaac Newton, Benjamin Franklin, Theodore Roosevelt and Hank Greenberg all have in common? The answer—in one word—is gout, a crippling disease which everybody laughs at except people who suffer from it.

The approximately one million gout victims in the U.S. don't see anything funny in their affliction. Seizures, which often come upon them in the middle of the night, cause excruciating pain, generally centered in the region of the big toe. "I feel," said the gout-ridden British essayist Sydney Smith, "as if I am walking on my eyeballs." Gout has been known to man ever since the ancient Egyptians. The Greeks even had a word for it. Hippocrates, their great physician, called it "podagra," from the Greek words pous (foot) and agra (attack).

After suffering from gout for centuries, the human race at last is doing something about it. More progress has been made in its treatment and control during the last 25 years than in the previous 3000. In fact, some of the knowledge gleaned from the study of gout is now being applied to research in such other medical problems as arthritis, diabetes and heart disease. Pain-free lives Treatment of gout itself has reached the point where patients can lead normal, pain-free lives with only minimal restrictions on their eating and drinking habits. The old "gout stool," on which sufferers used to rest their throbbing, bandaged foot, is rapidly passing into obsolescence.

Unfortunately, while effective, these drugs have their drawbacks. NSAIDS cause gastrointestinal complications; colchicines has been linked to severe neurologic and gastrointestinal problems; probenecid cannot be used in patients who do not have normal kidney function; and allopurinol has been associated with severe side effects including liver, skin, and blood toxicity.

Interestingly, drugs you may take for other medical conditions may help you with gout. Losartan (Cozaar), a blood pressure medication, and fenofibrate (Tricor), a triglyceride-lowering drug, works as mild uricosuric drugs. This means these agents help the kidneys get rid of excess uric acid- the major ingredient in the crystals that cause gout pain.

A new medicine, febuxostat, has recently undergone clinical trials. This medication is being heralded because of its safety profile. Obviously, all medicine decisions should be made in concert with your physician.

Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: http://www.onlinebuffalo.com/medicine/45917.php