Health

Joint Pain Gout Hyperuricaemia
Allopurinol Alcohol & Urates Disclaimer

Gout

Gout is a form of arthritis caused by deposition of uric acid crystals in the joints. These crystals form in the cooler parts of the body, so gout particularly effects the joints the toes, elbows, and fingers. This arthritis is accompanied by painful swellings.

Though other forms of arthritis may not be classified as gout, uric acid crystals could be a secondary cause.

Alcohol consumption is an important factor.

For more information, see hyperuricaemia and alcohol and urates.

Urates, uric acid & hyperuricaemia

*** Warning ***
It now seems that my urate problems were due to B12 deficiency.
Please read these notes with this in mind.
***

Urates are produced in the body by the breakdown of foods containing DNA, particularly red meat and fish food. They circulate in the blood stream, and are removed by the kidneys and excreted in urine.

Urates may be converted into uric acid in the body, especially if the blood is slightly more acid than normal. Uric acid forms crystals, which grow over time, and cause inflammation. Uric acid is deposited particularly in the cooler parts of the body, such as the joints of the toes, elbows and fingers. Inflammation in these areas is the classic feature of gout.

Blood acidity may be increased by consuming citric fruit, or as a result of consuming alcohol the previous night. Patients with gout are usually advised to cut down on alcohol consumption.

Urates are also deposited in the skin and scalp, where they can cause eczema. Consuming grapefruit or orange juice can produce uric acid crystals in the skin, giving rise to a skin rash.

Urates in the blood are perfectly normal, but levels fluctuate and some people have higher levels than others. The level of urates may be determined by a blood test. Very high levels are known as hyperuricaemia, and are seen as especially worthy of treatment.

Many people whose ancestors came from Northern Europe have high levels of urates in their blood. Urates are anti-oxidants, so help to fight disease when dietary Vitamin C is in short supply.

Symptoms

Symptoms include:

Joint Pain

Old Persons Crossing Sign Uric acid causes swellings particularly in the joints of the big toes, but it may effect other joints too, including joints in the hands. It may be the cause of lower back pain, neck pains, and elbow pains, often diagnosed as tendonitis. It may cause a bend at the top of the spine, resulting in bad posture.

The highways agency sign acknowledges that spinal problems are common in old age. If these problems could be prevented or cured, a great deal of human misery might be avoided.

database.prota.org says "Celery seed aids in the elimination of uric acid and is often used for the relief of symptoms of arthritis, rheumatism and inflammation of the joints".

Alcohol and Urates

Alcohol is a powerful and dangerous drug which interacts in many ways with the body. Its use cannot be recommended. Many people drink regularly, and some drink quite a lot. Alcoholism is particularly prevalent in some northern areas, where fatty meat from grazing animals is an important part of the diet, so levels of urates in the body are unusually high. The Scotsman reports "Deaths linked to alcohol in some areas of Scotland are six times higher than the UK average".

Alcohol in the bloodstream mobilises the urates and uric acid deposits in the body. This explains the immediate anti-depressant effect of alcohol.

As alcohol is metabolised, urates are liberated once more, producing a hang-over. This can be treated with a glass of water with sodium bicarbonate, or even the traditional Alka Selzer, which helps reduce the level of urates in the bloodstream.

Alcohol is metabolised by the liver, and uric acid is particularly deposited there. The liver seals off the damaged area and continues working as normal. Symptoms will not be noticed until damage is extensive. If you have any sign of liver disease, see a qualified professional medical practitioner immediately.

Symptoms of liver disease include digestive problems when eating red meat, and ketosis - a dreadful smell from the urine and elsewhere after eating fatty food.

Alcohol consumption is also a factor in gout. The continual dissolving and redeposition of uric acid in the joints causes inflammation.

Treatment

The usual treatment advised for hyperuricaemia is to be very careful what you eat, and to take allopurinol. Allopurinol is a prescription medicine. You need to continue to take it for life.

Urate deposits in the skin and scalp can be removed by taking a hot bath or shower, preferably in soft water. Water containing large amounts of lime is not so effective. I find an alkaline soap more effective than shower gel. You should find that washing your head and hair with shampoo has an immediate refreshing effect.

Potassium Citrate Bottle The action of the kidneys can be improved by taking small quantities of sodium bicarbonate and/or potassium citrate. These make the urine more alkaline, and reduce the reabsorption of urates. Both are available very cheaply without prescription. Potassium Citrate is often recommended to treat kidney stones.

I take a small half teaspoonful of sodium bicarbonate in a glass of water before breakfast, and 1.5mg of potassium citrate (5ml of mixture) after main meals. I find Potassium Citrate particularly effective in clearing urates from my bloodstream.

Sodium bicarbonate in water is also an effective means of counteracting the acidity of oranges and grapefruit.

Sodium bicarbonate is readily available in the 'home baking' section of the supermarket. It is an ingredient of baking powder, used in scones and cakes. It is an ingredient of some fizzy drinks. You can make a very pleasant drink by mixing a quarter teaspoonful of sodium bicarbonate in a glass of water, and adding a teaspoonful of lemon juice.

Alka-Seltzer Original contains 1916mg of sodium bicarbonate, 1000 mg of citric acid and 325 mg of aspirin per tablet. The recommended dose is 2 tablets every 4 hours as needed up to 8 tablets in 24 hours. It was widely used as a remedy for back aches, diarrhoea, leg cramps, heartburn and arthritis, and as a hang-over cure. It is no longer so popular, because of concerns over the safety of aspirin.

It seems that the celery I eat with my daily risotto may also be therapeutic. Coffee is a diuretic, and may also help flush urates from the body.

There is a long tradition of visiting spas and mineral water springs in the search for cures for many ailments. Lithium salts, present in many hot water springs, are known to be effective against hyperuricaemia. Lithium urate is more soluble and easier to excrete. Lithium salts were added to soft drinks and beer, until the toxic effects were recognised.

Taking alkali unfortunately reduces the amount of Vitamin B12 which you can absorb when you eat meat. Beware of B12 deficiency.

Treatment Options

It makes little difference whether the alkali is in the form of sodium bicarbonate or potassium citrate. Calcium carbonate, found in Vitamin D pills and indigestion remedies, is another option. In some areas of Britain, the public water supply contains a large amount of calcium carbonate. Calcium carbonate is unpleasant to take, unless washed down with orange juice. Coffee is a diuretic. In moderation, coffee will improve the action of the kidneys in removing urates.

Side Effects

Urates are antioxidants, which help fight off disease. Antioxidants play a very important part in biology, and are said to be important for male fertility. Taking alkali may also reduce the amount of Vitamin C in the body.

This may explain why I developed abscesses under my teeth. My teeth became loose, and I had to have a number of them extracted.

I am drinking more orange juice and taking 500mg Vitamin C daily. This has made a noticable difference to the strength of my toe nails. I strongly recommend you should take Vitamin C supplements.

Treating hyperuricaemia will relieve depression, and make your senses more acute. In the modern world of flashing lights and continuous noise, you may prefer not to have sharp eyes or good hearing.

Allopurinol

Allopurinol is a prescription-only medicine usually prescribed for gout. It is not a cure, so you need to continue to take it for life.

It works by inhibiting the enzyme xanthine oxidase, which enables the oxidation of xanthine to form uric acid. Xanthine is formed by the digestion of guanine, one of the four main bases found in the DNA and RNA of all living tissue.

Uric acid itself inhibits xanthine oxidase, so Allopurinol has similar effects in the body to urates, except that it does not cause gout. Side effects are said to be rare, effecting only 1% of patients. Recorded side effects include diarrhoea, skin rash, loss of taste, asthma, depression and tinnitus

Medical Studies

A Swiss study gave Potassium Citrate to a group of older women at risk of osteoporosis for 12 months together with Calcium and Vitamin D supplements. Few people dropped out of the study, as there were hardly any reported side effects. They found increased bone mass in the women given Potassium Citrate, compared with controls given Potassium Chloride. There were significant reductions in blood pressure in both groups.

A US Study found that Sodium Bicarbonate was also effective at reducing bone loss in older people. It seems that both bicarbonate and citrate reduce blood acidity. This leads to stronger bones and should also help remove uric acid deposits.

The University of Nottingham Centre of Evidence Based Dermatology is investigating the link between hard water and excema. I believe that washing with soap and warm soft water helps remove urates from the skin.

References & Further Information

Disclaimer

The information given here is based on my own experience, supplemented by other information obtained from the net. I have no medical qualifications.

I offer this advice in the hope that it will help you ask the right questions of your advisors, and in the belief that you will make better decisions as a result.

If you have any health problems, you should consult a qualified professional medical practitioner. In my own case, I feel the advice I have been offered has been dangerous, inadequate, and misleading.