Talk:Gout

From Wikipedia, the free encyclopedia

This is the talk page for discussing improvements to the Gout article.
Article policies
WikiProject Medicine This article is within the scope of WikiProject Medicine. Please visit the project page for details or ask questions at the doctor's mess.
B This page has been rated as B-Class on the quality assessment scale
High This article has been rated as High-importance on the importance assessment scale

Contents

[edit] Epidemiology

Where in the world is the epidemiology? There needs to be a section near the beginning that tells how common the disease is, what ages, genders, etc. are commonly involved.

[edit] Purines vs proteins

The connection between high purine and high protein diets needs explanation, because purines are not proteins. Una Smith 20:50, 4 June 2007 (UTC)

This is an excellent if nonobvious question. For many years protein content in foods was used as a proxy for purine content; not because purines are a component of proteins (as you point out, they're not) but because the protein content of many foods was well-known and easy to measure, whereas the purine content was not as well-known; and because there was a general non-scientific association of certain high-protein foods like red meat and beans with gout. But in [1] "Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men" Choi et al. (cited in the main article) showed quite the opposite, as you surmise, namely:

These data support our findings that the consumption of protein does not increase the risk of gout but, rather, may actually decrease the risk and that the protein content of foods may not be a good surrogate for their purine content.

So, you are correct, but it was only recently that the protein-purine association was shown to be false.Derek Balsam(talk) 21:17, 4 June 2007 (UTC)
Hm. A diet high in nitrogen (meaning high in purine and/or protein) was associated with improved excretion of uric acid as early as 1912.[1] Una Smith 03:18, 5 June 2007 (UTC)

[edit] Overconsumer vs underexcreter

The connection between normal serum urea and gout is poorly explained. Also, does diet modification help if the problem is underexcretion? Una Smith 20:50, 4 June 2007 (UTC)

[edit] Bad sentence requires clarification

The following confusing sentence in the gout article needs work: "Avoiding alcohol, high-purine foods, such as meat, fish, dry beans (also lentils and peas), mushrooms, spinach, asparagus, and cauliflower can lower plasma urate levels." Is spinach, for instance, something for gout patients to avoid, or is it something that lowers plasma urate levels? You can't tell from the sentence. --Jim —The preceding unsigned comment was added by 64.58.2.30 (talk) 17:30, 18 February 2007 (UTC).

How about this one: (Under 'Prevention') In conjuction with the below some people may find that some food is a 'trigger food' some items include large amounts of vitamin C and oats (flapjacks). Two sentences in one? Nobody saw and corrected this one? Kortsleting 04:20, 27 May 2007 (UTC)
Also, it says "oats (flapjacks)". I know that in UK flapjacks are made of oats (what we in North America might call granola or oat bars). But in the US these are two entirely different foodstuffs, which could be confusing to North American readers. "Oats" alone would be much less ambiguous. Derek Balsam(talk) 17:41, 27 May 2007 (UTC)

The following sentence is also confusing for someone who (like me) doesn't already know what it's trying to say: "Uric acid is more likely to form into crystals when there is a hyperuricemia, although it is 10 times more common without clinical gout than with it.[3]" What is the "it"? Is this sentence trying to say something along the lines of "Uric acid is more likely to form into crystals when there is hyperuricemia (although in nine out of ten cases, hyperuricemia does not involve gout)." I don't know anything about gout, so I don't feel comfortable actually editing the gout page myself—could someone who does please clarify this sentence? Thanks! 67.183.139.255 (talk) 19:41, 23 March 2008 (UTC)

[edit] What about Water

Is a high ph or low ph better for gout? Is soft or hard water better for gout?(24.115.145.150 21:44, 10 March 2007 (UTC))3/10/2007

[edit] Weasel Words

This article has a Weasel Words tag on it. Thus the entire article is list as having weasel words. I'm removing that tag and adding a Weasel Words tag just to the sections that appear to have weasel words rather than letting the entire article be branded weasel. Fanra 13:35, 2 May 2007 (UTC)

[edit] References to reference

One of the references in this article, Abrams B. Gout Is an Indicator of Sleep Apnea Journal SLEEP 28(2), Feb 2005, p. 275., is to an article that is not freely available on the web. That author has written two related articles that are freely available covering the same material. I am not certain if it would be appropriate to link to them in the main article or not. They are not as formal as the article in SLEEP. They Are: Curing Gout: a Personal Journey of Discovery and Burton Abrams Follows Up on Sleep Apnea and Gout

I have lifted the dietary recommendation from the page in French and translated them with a free translation service ( hence the poor grammar) but some recommendaitons clearly contradict the page in English. Particularly Tuna and salmon are recommended while the English version says to avoid fish. Does this imply the pysiologies of diefferent language speakers are different? What about bilingual people?

A useful article on gout is by Zina Kroner, D.O. Associate Medical Director, The Hoffman Center.LoopTel (talk) 23:26, 26 December 2007 (UTC)

"The dietary system is encouraged with a food poor in purines: --129.96.142.21 04:29, 26 June 2006 (UTC) Avoid the offals, the anchovies, the bouillons, the seafood, the asparagus, the spinach, the legumes. Consume preferably: cherries, celery, strawberries, cornflowers, weak dairy products in fat, bread (without white flour), tuna, salmon. An slimming is desirable as well as a significant decrease of the taken one of alcohol.

[edit] Diet Soda?

It says in the article diet soda should be avoided because it acts as a diuretic. But so does any drink that contains caffeine. And some diet sodas are caffeine-free. There's no citation for the claim that diet soda in particular is bad for gout, so unless one is added within the next few days (and not from some crackpot's (i.e. Joseph Mercola) web page, I'm removing the statement.

I haven't looked up a reference for you, but diet soda is a diuretic and can dehydrate you. As urine is how uric acid is expelled, being dehydrated can really hurt a gout sufferer. - JNighthawk 22:08, 15 July 2006 (UTC)

It is the caffeine in diet soda that makes it a diuretic. At the very least the article should be changed to specify all drinks containing caffine not just diet soda. I would also add that caffenines diuretic effects are relatively mild and to say that it is a cause of gout is proabbly pushing it a bit.Graemec2 09:48, 8 March 2007 (UTC)

Diet soda pop generally contains the sweetener Nutrisweet. This sweetener uses aspartame which converts into formaldehyde above 80 degrees F. This is then converted into uric acid.

No, formaldehyde is not converted to uric acid. Formaldehyde is converted to formate via aldehyde dehydrogenase, then the formic acid is converted to CO2 by folate dependent pathways or excreted directly via renal mechanisms. Aspartame is nowhere on the urate pathway. See for example http://www.hpa.org.uk/chemicals/compendium/Methanol/kinetics.htm. Derek Balsam(talk) 22:03, 2 July 2007 (UTC)

[edit] Diagnostic Confusion

Yes, jdwolff, it is the most common mistake made in the mis-diagnosis of gout .. in my experience. However, I can not point to any references, only my experience.

[edit] Extra-articular effects

rstWhat about extra-articular effects of the deposition of uric acid crystals ? Soft tissue, kidneys etc
Kpjas 07:43, 8 Oct 2003 (UTC)

Why don't you add that in? --Alex.tan 07:06, 9 Oct 2003 (UTC)

[edit] Overindulgence

Should not drinking alcohol to excess have been removed from the bulleted list? (as a method of avoiding dehydration)

And gout is commonly believed to be caused by overindulgence in rich food and alcohol... could someone debunk this if it's not true. fabiform 02:24, 11 Jan 2004

I was a vegetarian in my 20s when I had my first gout attack, and I hardly ever drink alcohol. -phma 14:50, 27 Jun 2004 (UTC)
There's also a genetic component to this condition. Gout sometimes runs in families. I have it, and so have others on both sides of my family. I'm pretty sure I've got a genetic predisposition towards gout.
JesseG 06:02, Jun 5, 2005 (UTC)
I recently had an attack of gout. My doctor decided to draw blood to do a test for uric acid. He said that the normal level was from about 3 to about 7 mg of the stuff, mine was up over 8.
JesseG 19:48, July 23, 2005 (UTC)
My first gout attack was after eating a lot of rich French goose liver spread Pate de foie gras. My second gout attack was triggered by a bottle of beer a couple years later. It was not necessarily the alcohol contents but the brewer's yeast that caused the on-set. Brewer's yeast is a rich source of purine. Alcohol is not the only cause, but it should be one of the major cause. The overindulgence theory had been around since Roman time. Removing an age old theory because one sufferer didn't drink alcohol is a bad move. Kowloonese 19:01, Jun 7, 2005 (UTC)

Perhaps there can be a cumulative effect. Being 63 years old I lead a fairly steady life, however we celebrated the end of term with a party last Sunday, and I spent the week eating up the left-overs - salmon, souvlaki and keftedes (meat balls)etc. I had a delicious "ladera" - olive oil based vegetable dish rich in tomatoes, onions, courgettes and aubergines - it is about 50% tomato sauce on Wednesday. Then a few glasses of wine and a couple of beers with friends on Thursday and I woke up yesterday morning with an agonising pain in my right big toe and aches in other joints. I tried drowning it in pain killers, but to no effect, so I went to the doctor this morning and he said "Gout". He has prescribed Colchichine as a short term remedy, 1 mg every two hours. I looked it up on the net, The effects are similar to Arsenic poison, ending with death from respiratory problems. I have supplemented it with cherries. If you do not hear from me again you can assume that this is a somewhat unwanted side effect. Otherwise, I will report progress. (please see warning at bottom of post) Sunday 16.15 GMT I have kept a log of the effects of the medication I have taken since starting to take Colchichine yesterday at 11.00 GMT. 13.00 GMT No noticeable effect. Went to bed, drank a lot of water, took 1 mg Colchicine,two ibuprofen tablets (400 mg) and one stilnox sleeping tablet. 15.00 GMT Woke up and took another 1 mg Colchicine. no change. 17.00 GMT Woke up. Noticeable improvement in condition generally, less pain but still acute. Took 1 mg Colchichine. No noticeable side effects. Practised the piano - feasible. Surfing the net I discovered that all the foods I had been eating(see above) were prime suspects in causing gout, but this seems to be true of almost everything with any flavour. 19.00 GMT Phoned my brother - a long time sufferer from gout. Told me he took colchichine. Said pain would go in a couple of days. Told me to stop taking tablets when side effects became noticeable - i.e diarrhea. Took 1 mg Colchichine. Drank plenty of water. Ate spaghetti with kefalotiri (cheese) topping. 21.00 GMT Took 1 mg Colchichine and one Ibuprofen. Definite improvement. No side effects noticed. Being 23.00 hours local time I took another stilnox tablet and went to bed. Drank some more water. 21.00 to 05.00 GMT today. Effects of drinking large quantities of water woke me about every two hours for trips to bathroom. Did not take any Colchichine until 05.00 GMT. 05.00 GMT (07.00 local time) Got up. definite improvement - only mild pain. Took 1 mg Colchichine. Drank 1/4 ltre low fat milk. 07.00 GMT Took 1 mg Colchichine and 1 Neurofen plus. Temporarily discontinued medication for High Blood pressure (Triatec and Tenoretic) as both of these are diuretics. Cannot decide whether possible stroke/heart attack is preferable to re-occurence of gout. 09.00 GMT Took 1 mg Colchichine. Mild attack of diarrhea. 13.00 GMT Took 1 Ibuprofen. Colchichine ended. Definite improvement, though still sore. Went swimming. 15.00 GMT Afternoon sleep. 16.45 GMT END OF CHRONOLOGY. I hope this may be of help if you suddenly get a first time attack of gout. Advice received tells me that Colchichine is now an old fashioned remedy with possible dangerous side effects, both long term and short term. "....stop using colchicine as it is very dangerous and causes chromosonal damage."

Glad to hear that you recovered. For me, a lot of fluid and elimination of high purine food from diet kept me gout free for couple of years now. Note that pure water is not as good a hydrating agent as electrolyte type of drinks. To me, my lowest moment was passing a kidney stone because of gout. When the uric acid is concentrate enough, it not only crystalizes into your toe joints, it deposits stones in your kidney too. If you think the gouty toe is agonising, think again for a passing kidney stone. I could tolerate the gout by sitting still. I had to go to the emergency room and asked the doctor to knock me out for the kidney stone. Anyway, keep watching that diet and beer. "May the gout be without you".  :-) Kowloonese 00:09, July 16, 2005 (UTC)
How to describe the pain? Saying it felt like someone doused the foot in gasoline, lit it on fire, dropped a semi on the foot, and drove rusty nails all at the same time to describe the pain doesn't feel to me to do justice to what the pain feels like.
JesseG 22:22, July 27, 2005 (UTC)
It feels like stabbing a blade of knife into the joint. Leave it there and wiggle it occasionally. That is the joint pain. Then for the swollen skin surface pain, your gasoline description seems appropriate. Kowloonese 23:47, September 1, 2005 (UTC)
I recently had one of those "get everything away from my foot" gout attacks a few months ago. I had to take my sock off and lay with it in a specific position to get to sleep. It was probably the most agonizing pain I've ever felt, whenever I moved it. I'm thinking it's right up there with kidney stones and child birth. - JNighthawk 22:15, 15 July 2006 (UTC)

Colchicine is rarely used, but its main side-effects are gastrointestinal upset. All those scary side-effects are rare. Its other main indication is FMF. JFW | T@lk 09:54, 17 July 2005 (UTC)

I don't think it's that rare; I and at least one friend of mine have both been prescribed colchicine - although in my case it was as an adjunct to probenecid. --moof 06:19, 2 September 2005 (UTC)
I've also been prescribed it. I believe doctors tend to use it in extreme cases that don't seem to respond to indomethacin right away. I had an attack that laid me up for almost 2 months and when I was originally in the hospital they said they'd never seen anyone in as much pain as I was in. I'd take some indomethacin for a couple days and no relief was forthcoming, they put me on colchicine and I took 11 doses of it in a single day and it finally broke the worst of it. --Crossmr 20:30, 13 May 2006 (UTC)


Drs prefer using NSAID such as indomethacin due to high risk of adverse effects from colchicine; up to 80% of patients on colchicine experience GI upsets (reference below). However, as a drug it is extremely effective, esp when administered early on (within 24h of symptom onset). May also prove beneficial for pts in whom NSAIDs are contraindicated (due to gastric reflux/ulcer, congestive heart failure, anticoagulant therapy). YC.


Reference Type: Journal Article Record Number: 105 Author: Wallace, S. L. Singer, J. Z. Year: 1988 Title: Review: systemic toxicity associated with the intravenous administration of colchicine - guidelines for use Journal: Journal of Rheumatology Volume: 15 Issue: 3 Pages: 495-9 —The preceding unsigned comment was added by 129.94.6.30 (talk • contribs) 01:43, 6 July 2006.

[edit] Alcohol

Why is alcohol rich in purines? The claims seem unrealistic. In particular, brewer's yeast may be rich in purines (I don't know for sure), but there's no yeast in beer: with very few exceptions (cloudy beers), it's all filtered out before distribution. Also, the current page did not refer to red wine (or port), a classic substance to blame for gout. I've updated accordingly.

I've suffered from gout for 9 years now, and my doctors have almost universally said "diet may help a little, but don't get your hopes up". One mentioned red wine; none have mentioned beer. --Groogle 04:12, 2 April 2006 (UTC)

It probably depends how you got it. Mine was caused by diet, and my doctor said diet and exercise would help the most.—Preceding unsigned comment added by JNighthawk (talk • contribs) 22:19, 15 July 2006


The author may have been misguided when linking alcohol to gout based on purine content alone. Rather, the mechanism of ethanol degradation may be the true culprit. Through a series of reactions, our bodies degrade ethanol to Acetyl CoA, an important metabolic substrate for the TCA cycle as well as the end product of fatty acid beta-oxidation. During this series of reactions, Adenosine Mono-Phosphate (AMP) is generated (specifically from the step that takes Acetyl-AMP to Acetyl CoA). Once generated, AMP can enter the Purine degradation cycle to ultimately produce Uric Acid and Urate. One key thing to note is that the increased AMP burden noted here is not unique to alcohol consumption and can be seen after any event that results in the rapid conversion of ATP to ADP & AMP, such as strenuous exercise. Thus, alcohol and exercise have synergistic effects on urate production.
Reference: Yamamoto et al, Clinica Chimica Acta 356 (2005) 35-57
RS52547 00:02, 26 March 2007 (UTC)RS52547

Alchol is a misconception. While beer can slow prgogress of medication only wheat beer can truely spur ant attack.--69.62.180.166 01:03, 4 August 2007 (UTC)

[edit] Tea

It wasn't clear - is only green tea and caffinated tea contraindicated in cases of gout? Or herbal teas as well?

Hmmm. Caffeine is a xanthine derivative and hence a purine. I wonder if it really makes if difference. JFW | T@lk 15:29, 2 Jun 2005 (UTC)
Dehydration will cause the on-set of a gout attack. I guess you have to look at both aspects, 1. caffeine is a purine, 2. Tea and coffee are diuretic and hence increase purine concentration via dehydration. Kowloonese 19:16, Jun 2, 2005 (UTC)

Also can someone verify if all caffeine containing drinks increase the uric acid level or not? i would like to know if i can drink coffee or coke.

The article now specificly lists tea as GOOD for gout and BAD for gout in different places. I'm sure that both statements are properly referenced, but the contradiction should at least be mentioned, it seems to me.75.83.0.34 (talk) 23:23, 21 May 2008 (UTC)

[edit] Famous people

Perhaps it's because it is the only mention of gout in the mainstream media, but the mention of king of the hill seems rather incongrous. I'd say either remove it or add more modern-day references if possible.

[edit] Genetics

I believe my problem with gout is partially due to genetics - there have been people on both sides of my family who've had gout. What I was wondering is how gout would work its way down a family tree. Would a person inhierit the condition from his mother's side, or his father's side? Or could it come from either side?
JesseG 02:43, August 11, 2005 (UTC)

My sister and I both suffer from gout, which suggests that any genetic influence is not on the Y chromosome. Also, my father does not suffer from gout, though he does have another arthritic condition. My guess would be that you could inherit from either side of the family, but that only inheriting from the paternal side is unlikely. --Groogle 04:17, 2 April 2006 (UTC)

My father has the gout. All but one of 5 children have now been diognosed with it. I was the first child at the age of 22 back in 1988 to be diognosed. At that time my age was considered very low for gout.--69.62.180.166 01:05, 4 August 2007 (UTC)

[edit] Great article but Needs image

 It is requested that a photograph or photographs be included in this article to improve its quality.
The Free Image Search Tool (FIST) may be able to locate suitable images on Flickr and other web sites.

This is a really good article. I'd put it up for peer review as the first step to featured status, but I'm pretty sure the response would be: needs a picture.

I had a picture of my feet taken during my second episode of gout outbreak. However, the swelling was not severe enough to be representative. Compared to my first outbreak (sorry, forgot to take picture), the picture is not really worth posting. I'll pass this to someone else and I wish I would never have another outbreak again. Kowloonese 23:43, September 1, 2005 (UTC)

[edit] Celery, cherries, strawberries, blueberries: citations

James A. Duke PHD, in The Green Pharmacy makes several comments:

  • Some people recommend cherries but suggest a dose of 8 oz a day canned or fresh, these would be expensive and according to the writer its never been scientifically demonstrated but many people swear by it (so it's probably worth a try). The comment is followed by onbe that some people favor strawberries
  • Celery: this is the suggestion for celery: tablets of celery seed or celery stalks. The author tried this so it has anecdotal support; he admits he was a skeptic but now believes.
  • while clery has the highest recommendation there are also chiso, licorice, turmeric.

The Encylcopedia or Natural Medicine by Murray and Pizzorno lists cherries (again, at a does of half a pound per day) but states it has been shown to be effective in lowering uric acid levels and preventing attacks of gout. It mentions that Cherries, harthron berries blueberries and other dark red-blue berries are rich sources of flavonoids remarkable in preventing collagen destruction and are good antioxidants and inhibit formation of leukotrienes.

The Holistic Herbal by David Hoffamn recommends a tead of burdock root, celery seed and yarrow (not the celery seed, it seems to be common treatment-my comment RJFJR).This includes a note that diet is paramount; "Coffee and tea should be left alone and any over-indulgence in general is out" (I still find 'left alone' to be ambiguous-RJFJR) and "Alcohol has to be totally avoid".

The above refernce also states: that the body metabolises purines into uric acid (which I'm not sure is stated in the article as why a low purine diet is recommended; if not I'll add it).

Can we make specific citations for any of the other statements in the article? If we get a picture I'd send it to peer-review but I suspect we'll be asked to cleanup the citations. (But looks like an excellent article to me!) RJFJR 14:30, September 11, 2005 (UTC)

[edit] Modern commonality

It seems that gout is relatively rare in the modern day but quite common throughout history. What accounts for this? What modern factors have decreased the prevalence of gout? —Lowellian (reply) 10:04, 22 December 2005 (UTC)

It is my opinion that the prevalence of gout is unchanged over the years. What has changed is the duration of an attack from weeks to hours due to modern medication. I can go from laying on the bathroom floor unable to move at 8:00 a.m. to teeing off for 18 holes at 11:00 a.m. Niloc--Niloc 11:43, 6 May 2006 (UTC)

How?! My gout attacks last days to a week or two. 25% of the time during an attack, I can't walk. What medications, life changes, etc. help?—Preceding unsigned comment added by JNighthawk (talk • contribs) 22:24, 15 July 2006

Indometacin is the answer!--Niloc 02:57, 18 July 2006 (UTC)

Just FYI, Indomethacin seems to work well for me as well.--Randomthoughts 12:19, 9 September 2006 (UTC)

-- I suffer severe attacks. Incredible pain. Recommend to avoid alcohol / beef / spinach. On the other hand pure black cherry juice,(small amounts daily ), celery and milk have definitely helped. When I feel the "twinge" at the start of an attack ( regular sufferers will know what I mean )I can avoid full blown attack with over the counter Ibuprofen. -- Alan —Preceding unsigned comment added by 69.17.157.212 (talk) 18:30, 16 April 2008 (UTC)

[edit] Galen

Not sure if citing the second most influential doctor (and perhaps most influential annatomist) in antiquity as a 'gladiatorial doctor' is something that I'd encounter in a reputable publication. But that might be my snobbery talking. Wilhelm Ritter 17:37, 12 August 2006 (UTC)

[edit] Fructose

Since high levels of fructose in diet is a cause of Hyperuricemia, how come this page didn't mention fructose at all ? —Preceding unsigned comment added by 38.113.177.205 (talk • contribs) 22:12, August 27, 2006

Not sure, its possible no one has gotten around to adding it yet. You can do so if you think it should be included.--Crossmr 22:21, 27 August 2006 (UTC)
Thanks for long overdue encouragement. I volunteered to add.LoopTel (talk) 14:19, 6 June 2008 (UTC)

[edit] Podagra?

I was taught that podagra was specifically gout of the first interphalangeal joint of either foot and does NOT refer to gout in general --Gak 21:28, 30 August 2006 (UTC)

Google doesn't exactly give much guidance on this. Its referred to on many sites in the same breath as gout, or qualified with "especially of the big toe" but not "exclusive" to that joint. You might have more luck looking at an actual medical dictionary to get a clearer definition.--Crossmr 02:10, 31 August 2006 (UTC)
My copy of Merck's agrees with User:Gak's assertion; however, it wouldn't surprise me if in antiquity 'podagra' referred to all types of gout. --moof 06:03, 4 September 2006 (UTC)

[edit] Inconsistency with regard to spinach

In the article, under the Prevention section, spinach is simultaneously recommended and avoided:

1) Avoiding alcohol, high-purine foods, such as meat, fish, dry beans (also lentils and peas), mushrooms, spinach,

2) juicing a combination of carrot and spinach can greatly reduce the pains of gout as well as lower euric acid levels.

I don't know which one is correct, though.

--Randomthoughts 17:34, 31 August 2006 (UTC)

Its quite possible that the juice of spinach helps it, but something in the leafy part makes it worse? Someone can possibly provide clarity on that, if none is forth coming we should probably remove it until its cleared up.--Crossmr 22:49, 31 August 2006 (UTC)
Further research seems to indicate that spinach is a food to be avoided and that the compounds (oxalates) involved are soluble (not totally sure on that last point). I'm going to remove spinach juice from the remedy list. http://www.umm.edu/patiented/articles/what_lifestyle_measures_can_help_prevent_gout_000093_9.htm among many other articles--Randomthoughts 18:11, 6 September 2006 (UTC)
I may add my personal experience. Research data notwithstanding, after eating any of asparagus. cauliflower. mushrooms. or spinach, I am sure to develop gout. LoopTel (talk) 23:55, 3 June 2008 (UTC)

[edit] Added to Prevention

Under prevention, I added information from the 2004 study reported in the New England Journal of Medicine. It was very highly reported throughout the media and details that vegetable purines did not affect incidences of gout while confirming that animal flesh sources of purine did increase the incidence of gout. It also reported that low fat dairy products had some preventative effects.

The source was already cited in the references section.

Anecdotally, I'm currently trying to stave off the beginnings of an attack after a week of pork and steak. I stopped drinking milk in quantity years ago due to allergies and generally have a diet that is high in animal products. I'm slightly overweight but not close to clinically obese.--Randomthoughts 12:14, 9 September 2006 (UTC)

(I'm being utterly insensitive)... If it flares, could you take a picture??? Hope it doesn't though... -- Samir धर्म 12:16, 9 September 2006 (UTC)
Haha. It's not much to see, just a bit of swelling and a bit red - not much compared to the last time when it was much worse (didn't have indomethacin). If I can get a good pic, I'll try to take one.--Randomthoughts 17:17, 11 September 2006 (UTC)

[edit] T-Rex with gout

I've added Sue, the T-Rex, to famous people with gout (I know T-Rexes are not people but Sue is really famous). I used the original Nature citation. However few WP readers have access to 1997 Nature so possibly we should change the citation to this Discovery feature about the paper. What do you think? Friendly Neighbour 12:49, 28 September 2006 (UTC)

[edit] Blood pH and bicarbonate as a remedy

I just wanted to mention sodium bicarbonate and its effects on raising blood pH for gout treatment. I'm pretty skeptical, and really don't think remedies such as this should be in the article until reliably sourced, but I've tried baking soda myself whenever I've found myself in the beginning stages of an attack, and I'll be damned if it doesn't work. It seems like such a hokey remedy, and I'm not too keen on the increased sodium consumption, but I've been using baking soda alone for gout treatment for nearly a year, and haven't refilled my indomethacin or painkiller prescriptons since last fall.

But realizing that my own example doesn't make for good science, and that baking soda is all over huckster, home-remedy websites, I'll just advise that people keep their eyes open for any legitimate gout-related studies involving pH.--Trypsin 15:11, 19 October 2006 (UTC)

It is an old remedy: http://www.henriettesherbal.com/eclectic/bpc1911/sodium.html . And perhaps this is a reliable source? Una Smith 02:51, 5 June 2007 (UTC)
Even if that site does accurately reproduce the British Pharmaceutical Codex of 1911, then all that means is that in 1911 pharmacists in Britain prescribed bicarb for gout, and apparently for just about everything else too. Given the age of the source, I'd be very hesitant to consider it as a reliable source for a current medical article; I think its very age makes it unreliable for anything except as a historical note.Derek Balsam(talk) 02:59, 5 June 2007 (UTC)
Here [2] is a much more recent article reference about modern-day use of bicarbonate in gout treatment. Derek Balsam(talk) 03:08, 5 June 2007 (UTC)

[edit] Removed - probable vandalism

'Gout symptoms can be completely eradicated by simply mixing a flat teaspoon of baking soda in a glass of water. This stop the prurines from crystalizing in the joints. I am a twin. He suffers and takes medication. I simply brush my teeth with baking soda and that takes care of the problem.' I'm almost sure this is just plain vandalism. --204.155.226.2 17:20, 26 October 2006 (UTC)

If you look at the topic above about bicarbonate, you'll see that it might actually be legit. Still, it is unsupported and unencyclopedic. I fully support the removal. I just wouldn't strictly call it 'valdalism'. --Mdwyer 19:06, 26 October 2006 (UTC)

[edit] Horse fucking?

Why is gout related to "horse fucking" (first paragraph, no citation)? Even if this is true, isn't there a better phrase for this? Unfortunately, I am no expert on the subject of equine coitus.—Preceding unsigned comment added by 70.161.10.94 (talk • contribs)

It was vandalism. --Mjrmtg 02:47, 27 December 2006 (UTC)
Funny thing but the question above was posted by 70.161.10.94 (talk · contribs) over one hour after I reverted the vandalism. Friendly Neighbour 09:25, 27 December 2006 (UTC)

[edit] Allopurinol

The decision to take allopurinol is a life long one. Then why has my doctor recommended this after the end of my gout attack? What other forms of treatment are there to prevent recurrence of gout? {{unsignedIP|122.167.181.16|07:57, 20 June 2007}

Your choices are simple: Take the Allipurinol or never ever be further than 3 hours away from your Indomethacin! All of the homopathic remedies don't work other than to give you a great story to tell about the time you "drank pregnant monkey urin". I drank some "potion" made from the bark of a tree for 3 months straight, with no noticable difference. --Niloc 02:45, 21 June 2007 (UTC)

oh, thanks thats a great relief to know that i'm a slave for life...only problem is Indomethacin makes my stomach go bad and puke and what not...

Me too, but Indomethacin + Symptoms (mine is just dizziness/diarrhea) is better than a lifelong decision of allopurinol. - JNighthawk 03:20, 24 July 2007 (UTC)
Is there any discussion about the effects of the over the counter drug "Aleave". I have had gout for 20 years and not longer have medical insurance and cannot get my Idonin any longer. I have been taking Aleave now, and it seem s to work well and cost drasticaly less money!--Amadscientist 01:12, 4 August 2007 (UTC)
I presume you mean "indocin", a brand of Indomethacin and "Aleve", a brand of Naproxen. Both of these are NSAIDs. In general you can switch one for the other, but the dosage can be tough to figure out. For example Advil (another OTC NSAID, Ibuprophen) could also be used, but the dosage on the label may not provide enough anti-inflamatory effect. On the other hand, Advil can be just as bad -- or worse -- than indomethacin if the dosage is too high. All NSAIDs hurt the gut in some way or another. Although, as much as a gout attack hurts, I'd almost consider a bleeding ulcer an improvement...
Anyway, check out some of the pages that I linked above, but if you can, PLEASE go talk to your doctor. They will be able to tell you which OTC drugs will work safely for you. Besides, Wikipedia does not give medical advice! --Mdwyer 02:42, 4 August 2007 (UTC)

[edit] Colchicum autumnale

I have removed this text below because it needs a citation.

The homeopathic preparation of the plant, Colchicum autumnale, from which Colchicine is derived, is a non-toxic alternative treatment.

I take great exception to the non-toxic claim in particualr, since the plant's article says the plant is poisonous due to its colchicine content. The line was reverted once before by an anon user with the edit summary of "fairies and unicorns cure gout". Amusing! --Mdwyer 04:39, 11 July 2007 (UTC)

While certainly not devoid of side effects, I highly doubt an actual homeopathic preparation of C. autumnale would contain any colchicine whatsoever. It would be interesting to find a reference to this effect. Fvasconcellos (t·c) 10:06, 11 July 2007 (UTC)

[edit] Question

I didn't go back far enough in the history to figure who added this, but this question was in the text of the article in chief:

What is the diagnosis code ICD for gout??

I moved it here. Perhaps someone has an answer? - Smerdis of Tlön 18:39, 2 August 2007 (UTC)

[edit] Harvard Researcher Hyon Choi

Althouh Choi's research is cited in "Food's to Avoid" (references 27 and 28) it isn't very well represented. He followed 47,000 men for 12 years and concluded that purine rich vegetables such as peas, mushrooms, spinach, do not cause gout. I believe also that his work implicates beer, but not red wine, as a cause of gout.

In a recent publication discussed here: http://www.scientificblogging.com/news/coffee_prevents_gout Choi concludes:

Their findings, featured in the June 2007 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), provide compelling evidence that drinking 4 or more cups of coffee a day dramatically reduces the risk of gout for men.


A lot of the stuff in the main article seems out of date and/or fallacious in light of Choi's work.

[edit] Gout - Kilkenny Punk Rock Band

For the greater interest, GOUT (Gareth Sweeney, Morris Deegan, Mickey Burgan) were also an incredibly talented punk rock band, who created great interest in Ireland, the US and in Italy, during late 1990's and the early noughties. They were spotted by Winston Smith, the famed Dead Kennedy's artist, who quicly offered to paint their album cover FOR FREE for them. Having turned down a Sony contract, unfortunately each went their way. Among lesser claims, the drummer has so far unanimoyusly been defined "the loudest man in Ireland".

[edit] History--Bloodletting

Okay guys the history section is totally weak...especially considering the fact that in the quote from our doctor ahead of his time, he recommends blood letting. Come on, there's gotta be better historical information on a disease that's been around for sooooo long.

128.97.68.15 17:38, 23 August 2007 (UTC)

[edit] Age Claims?

Ok, the article claims that Gout affect people above 40; but i'm only 27, so either there is a wrong diagnosis or i'm an exception or age doesn't matter —Preceding unsigned comment added by 68.100.199.183 (talk) 03:27, August 26, 2007 (UTC)

It says mostly, not only.--Crossmr 03:32, 26 August 2007 (UTC)

[edit] TOPHI, from GOUT

How do I get the swelling out of my elbows? I look like pop-eye. Please help, I'm taking celery seed and tart cherry and have no pain but the swelling is still there. My doctor used a needle once and drained some fulid out but it was still a large bump...Will the large bumps go away? or is surgery needed? Joejbryant 02:30, 23 October 2007 (UTC)


I'm only 26, and have had too many attacks to count. I've had it for over 6 years. The common age might be 40 to 50, but the article never metions anything about the higher levels of uric acid in younger people.

For your swelling try Indomethacin and ice. It will mess up your stomach, but you will feel alot of the pressure go away in hours. —Preceding unsigned comment added by 76.101.142.180 (talk) 02:52, 29 January 2008 (UTC)

[edit] Is Vitamin C good or bad

The page list Vitamin C as a positive force in treating and preventing gout. Then it is later listed as something to avoid.Skafkas 03:42, 25 October 2007 (UTC)

Heh. Good catch. Actually, I think that should be read as "it is believed that diuretics might have a role in causing the disease, and so one should avoid the dehydrating effects of Vitamin C. Under the guidance of a doctor, Vitamin C might be an effective treatment, presumably along with a hydration therapy." I'm getting really close to weasel words and WP's prohibition on giving medical advice, though. Suffice to say that this page is difficult to maintain. --Mdwyer 14:44, 29 October 2007 (UTC)

[edit] this article contains a lot of specious claims and misleading information

Such as it said gout is congenital- which I have removed. There may be increased risk to some people genetically but it is usually a result of lifestyle, or other diseases. Also a lot of flakey alternative medicine or anecdotal claims in here.Merkinsmum (talk) 23:10, 23 November 2007 (UTC)

Agree. Please remove whatever sounds doubtful, or copy it here for discussion. JFW | T@lk 23:37, 26 May 2008 (UTC)

[edit] Gout and CVD

Gout patients have a 35% higher risk of cardiovascular disease. Those with high uric acid but no gout had no significant association. http://archinte.ama-assn.org/cgi/content/abstract/168/10/1104 JFW | T@lk 23:37, 26 May 2008 (UTC)