normal uric acid - Natural Gout Treatment - The Results Of A Gout Diet That Had A Lot Of Success
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Natural Gout Treatment - The Results Of A Gout Diet That Had A Lot Of Success

This is the second article of a series about this diet. Please see Natural Gout Treatment - The Rules Of A Gout Diet That Had A Lot Of Success, for the first article.


One complicating factor is that elusive fact that most people with hyperuricemia (excess uric acid)do not get gout. Another is that some people with normal uric acid levels do.

The non-steroidal anti-inflammatory drugs (NSAID) are also used to treat gout, which does not have the side effects of colhicine. Indomethacin is a widely used NSAID in the treatment of gout. Patients should avoid Aspirin and aspirin-containing products during the attack of gout.


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 Other encouraging statements were that all extension trial patients who had responded earlier to treatment and who were on the every two week course maintained normal uric acid levels, (some were new joiners). 70% of those on an every four week course who had responded earlier to treatment, maintained normal uric acid levels.

Should you take Vitamin C for gout? The answer is probably yes, but read on for a possibly relevant caution. Gout cures require that uric acid levels be reduced. Vitamins and drugs work in two ways to reduce uric acid levels. One is restricting its supply by inhibiting purine breakdown into uric acid, the other is improving uric acid's breakdown into the urine. Vitamin C is thought to be a uric acid excretory, not an inhibitor. Improving excretion may be more important than reducing production.

A few studies over the past 30 years have concluded that Vitamin C will reduce the uric acid level. They have differed in the amount of Vitamin C given to study participants. A U.S. study of 184 non-smokers, published in 2005, concluded that the amount required to achieve a serum (blood) uric acid level reduction was 500 mg daily. (The Vitamin C was taken as a supplement). This is not a mega dose.

However, restricting purines in your diet is not difficult, so it is still worth doing. The conventional wisdom may be correct. Uric acid level tests should tell if a low purine diet works for you.

In the study report, uric acid levels were expressed as mmol/l. In this article I have converted these mmol/l numbers to mg/dL, which is a more frequently used measurement.

The study can be found online if you search "Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study." Copy and paste this into a search engine search box and hit enter.

Those people who have had multiple attacks or developed tophi or kidney stones should stabilize uric acid level in the blood. Probenecid is an important drug, which helps the kidney, eliminate uric acid. Another drug called Alopurinol is used to block the excess production of uric acid by the body. The drug of choice between these types of drugs depends upon the quantity of uric acid excreted through urine.

In May 2008 the U.S. based company developing Pegloticase made another upbeat statement assessment of what they have learnt in its Phase 3 and open label extension trials. Note that Pegloticase still awaits approval from medical authorities so I am writing here about a new gout drug that is still under development.

Such a rapid change concerned the authors of one study in the 1970's who had recorded that mega doses of Vitamin C (4,000 mg and 8,000 mg daily) reduced uric acid levels significantly, and by more than in the 2005 study. However, as far as Vitamin C induced changes in uric acid levels is concerned, this triggering has not been reported in any study.

If you suffer from gout, see your doctor and discuss a pain relief program and a correct diet to reduce gout occurrences. With correct treatment and diet, gout outbreaks can be well controlled.

After four months on this diet the effects on uric acid levels and gout attacks were quite impressive. Weight loss and uric acid levels Weight loss over the period was almost 17lbs (7.7kg) i.e. at a rate of about 1lb a week. All but one of the patients lost weight. The median uric acid (UA) fall was 1.7mg/dL.Another very interesting finding was that a more elevated blood uric acid level at the start of the study, meant a large fall of blood uric acid by the end of it. Uric acid levels normalised in 7 of 12 patients who had raised levels of uric acid (UA) before the study.

It also reached the well-known and accepted conclusion that hypertension (high blood pressure) and obesity are risk factors for gout. And one other very different conclusion from the conventional wisdom about purines -- purine intake, with the exception of alcohol, was NOT associated with a risk of gout.

Pegloticase's answer to the excess uric acid level problem is to remove it by ingeniously converting uric acid into something else, a substance called Allantoin. Allantoin is more soluble and better excreted than uric acid. The principle comes from the way most animals do it. They do it by converting UA to Allantoin, but this is something humans cannot do naturally. Hence the formulation of Pegloticase.

VITAMIN C AS A GOUT PREVENTOR If 500 mg daily of Vitamin C can reduce uric acid levels, then Vitamin C ought to act as a preventative gout vitamin too. A Taiwan study of males in the late 1990's examined the weight, diet and lifestyles of gout and non-gout sufferers in Taiwan. It concluded that Vitamin C, folic acid (folate) and fibre were protective against gout.

In the world of natural gout remedies, uric acid's removal can be improved by making it more soluble. This is achieved by drinking lots of water and by raising body pH levels in various ways.

Alcoholic beverages should not exceed 3 ounces per day. Reduce or eliminate the purine-containing foods such as organ meats (sweet breads, liver, and kidneys), shrimp, sardines, dried legumes, and anchovies.

Although gout is well known, it is not a typical arthritic condition. Gout is caused by an accumulation of uric acid crystals in joints, causing joint pain and inflammation.

Zyloprim, is a potent treatment for gout, and is usually prescribe for gout patients with kidney stones or other kidney problems. This drug slows down the rate of production of uric acid by the body. The patients who took this drug showed side effects such as skin rashes and stomach upset. Both of these symptoms usually go away as the body began accustomed to the drug.

0.5 mg/dL is a useful reduction but for most people probably not a natural remedy for gout, although the 0.5 mg/dL figure is an average and some participants did better. But a 0.5mg/dL reduction will not be enough to reduce uric acid below the 6.0 mg/dL level at which the MSU crystals may dissolve. However, when combined with other vitamins for gout, a low purine diet and other natural remedies for gout, it could be.

TRIAL SUCCESS WITH DIFFICULT TO TREAT GOUT PATIENTS Pegloticase is significant because its trials have focused on gout patients who have not had success with other gout drugs, or who have medical conditions which prohibit the use of them. Thus it has been tackling harder-to-treat gout cases, not the easier ones. Hard to treat cases are a significant percentage of the gout sufferer universe.

31% of patients who had not reduced tophi at the end of these phase 3 trials did show tophi reduction in the extension trial. It would seem that the longer a gout sufferer is able to take Pegloticase the more successful it may be, in tophi cases at least.

The results were sufficiently impressive to give hope and encouragement to any gout sufferer who tries this diet as accurately as possible. The study was conducted in 1999. Unfortunately it has not been followed up by a much larger one designed on the same lines. If conducted, such a study would expand our knowledge of natural gout treatment, perhaps considerably. A natural gout cure is what most gout sufferers want.

AFTER ONE YEAR About a year later, five of nine patients had no more gout attacks and three had just one attack. So there was a further decrease in attack frequency overall. One patient gained weight after the end of the study. He must have given up on the diet. He suffered three attacks over three months. His blood uric acid levels rose with his weight.

Note especially that the mean uric acid (UA) fall was 1.7mg/dL. In a couple of cases it fell by 2.2 mg/dL and by 2.5mg/dL respectively. Hyperuricemia, (excess uric acid), which may lead to gout, is reckoned to exist if the UA levels exceed 7.2 mg/dL (men), and 6.0 mg/dL (women). The usual UA target in gout treatment is 6.0 mg/dL (somewhat less in women) because at this level the MSU crystals, formed mainly from uric acid may dissolve. (It is the immune system's response to these crystals, which it regards as foreign bodies, which causes the pain and inflammation of gout).

 
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Previously it has been thought that the amount needed was at least 4,000 mg (4 grams) daily. For example, Dr. Robert Atkins in his book " Vita Nutrient Solutions," recommended 5,000 -10,000 mg as part of his formula natural remedy for gout.

NB. The contents of this article contain medical information not medical advice. Please always discuss remedies with your doctor or other health care professional before implementing any treatment.

This suggests that progression of the disease may be contained in difficult-to-treat cases, and therefore may not cause other medical conditions such as kidney stones heart disease and hypertension.

One participant did not have a raised UA level before the start. It was about 5.9mg/dL. But we already know that gout can occur in people with normal uric acid levels, so this was not unusual.

There are many natural products available in the market. Incorporate flax seed or omega 3 oil into your diet to help reduce inflammation and tissue damage. Burdock root can help rid the body of acidic waste build up and help supports normal uric acid levels in the body.

May was a good month for gout sufferers. Febuxostat, (EU trade/brand name Adenuric), the first new major drug medication for gout in over 40 years, was approved for marketing in member countries of the European Union.

As we know, prevention is better than treatment; avoiding the intake of food high in uric acid can readily prevent the occurrence of gout. Reducing alcohol consumption is also often helpful.

John Mepham has spent much time researching gout. His best tip for curing gout naturally? Get to your ideal weight whatever the sacrifices may be. Learn more about this study and about natural gout treatment at www.gout-smashers-guide.com It's an e-book with a emphasis on natural gout treatment. The Zone diet, and other books by Barry Sears, are available at Official site of The Zone Diet The books can be found by clicking on the products tab on the home page.

And gout attacks? Results overall were expressed as a median. Before the study, participants had at least two attacks in the preceding four months. Median monthly attacks before the study were 2.1. After it, attacks fell to 0.6. The fall in the number of gout attacks occurred in all except one patient. The exception participant had shorter and less severe attacks. Eight of the 13 did not have a gout attack during the four month study period, although as mentioned, they had all had at least two in the previous four months and, as noted above, the median was 2.1 a month, or one attack a fortnight, (every two weeks).

SIDE EFFECTS Of course Pegloticase has caused side effects, in the extension trial in about 1 in 5 patients. The developing company has said that most were mild, moderate, or controllable. But in some cases more severe side effects have been described as including chest and back pains, muscle cramps, sweating and flushes.

Colchicine is a traditional drug used since the 1800's as a treatment for gout. Although Colhicine produces desirable results, it does have side effects of nausea, vomiting, and diarrhea.

So a fall of 1.7 mg/dL, given these numbers, is quite significant, although you should note that many gout sufferers have UA levels much higher than 7.2 mg/dL, and some gout sufferers do not have excess uric acid.

It has been having a decent degree of success. Elimination of gout attacks In its most recent statement the developing company's most significant remark was that the extension trial group receiving Pegloticase every two weeks, there were only four gout attacks among those who had been administered Pegloticase (8 mg) every fortnight for two months, in subsequent months. And none in this group had a gout attack after five months of Pegloticase treatment, in following months. All were patients who had been through a phase 3 trial.

THE CAUTION Rapid changes in uric acid levels can trigger a gout attack. This rapid change can be brought about by many factors in addition to possibly mega doses of Vitamin C and by drugs such as probenecid and sulfinpyrazone. People who are susceptible to gout must consider these rapid changes.

Pegloticase is getting closer to an application for approval by the U.S. FDA. Its developers hope to apply for a Biologics Licence Application in September 2008, and begin marketing it in 2009.

Were the study patients taking long term medications, such as Allopurinol, for their gout? They were not. They were only taking medications for gout attacks. The study report did not say how much water they drank. Most gout sufferers know that drinking lots of water helps to remove uric acid. In gout treatment there are always caveats. The study was small. Only 13 male gout sufferers. The study lasted just four months, although there were follow-up results after one year (median). The researchers noted a connection between weight loss and a fall in uric acid levels in another study and expected the nutrient proportions (40:30:30) contributed to the uric acid fall. They thought that the dietary measures caused the desired improvement in insulin sensitivity.

HOW PEGLOTICASE WORKS What makes Pegloticase a very interesting, and more importantly, a hopeful new gout drug, is the way it works. All drugs used in gout try to cure or alleviate the disease by reducing the body's uric acid (UA) levels. They do this by either inhibiting its production or making it easier to remove.

NB. The contents of this article contain medical information not medical advice. Please always discuss gout remedies with your doctor or other health care professional, before implementing any treatment.

In other patient groups there were reductions in attacks and improvement in tophi reduction. Tophi are those knobbly shaped, awkward looking, lumps of MSU crystals that often develop in longer term gout sufferers.

There is no cure for gout, but it can be controlled and treated. Usually, the pain associated with gout will subside within 24 hours after treatment has begun. The main objectives of treatment are pain relieving and prevent future attacks of gout.

In the 2005 study by how much did 500 mg of Vitamin C reduce their uric acid level? It found an average, across all participants, reduction of about 10% (0.5 mg/dL). In addition, reductions were larger among participants who had higher levels of uric acid at the start of the study. Participants took the 500 mg daily level for two months. Those who were given a placebo (i.e. not Vitamin C) showed a slight increase in uric acid levels.

1,000 MG PLUS DOSES If you wish to try Vitamin C for gout in doses over 1,000 mg as part of a natural gout remedy discuss it with your doctor or a qualified naturopathic doctor. The 500 mg level is below the British government's 1,000 mg (1 gram) recommended upper safety level safety limit for Vitamin C. It is half of the maximum amount (1,000 mg) in a Vitamin C tablet sold in the U.S. and many other countries.

This study, based on the Zone diet, did have a positive effect on markers of insulin resistance: triglycerides, total cholesterol, LDL cholesterol ("bad" cholesterol) fell. HDL cholesterol ("good" cholesterol) did not fall. But my purpose in this article is mainly to describe its direct effect on uric acid levels and gout attacks.


If you take Vitamin C for gout as a dietary supplement, remember that it is reckoned to work better in a product that contains added citrus bioflavonoids. In addition, because it is excreted quickly, take it twice daily. To avoid excess acidity (lower pH) also take alkalizing minerals, or another alkalizing agent recommended by your doctor.


 
 
     
 
 





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