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The Gout Dugout. Issue #014. Using fish oils for gout pain reduction; boost for Pegloticase.
February 01, 2009

A warm welcome to the February 2009 edition of the Gout Dugout newsletter, and to those new readers who have signed up since the January edition.


I’ve said a lot about the fish oils, gamma linolenic acid and insulin reduction (FILLIP) gout pain treatment in the past two issues. No question this is a very interesting gout pain treatment, with immense health possibilities, but there is a steep learning curve and tests to do.

Personally I always prefer to understand vitamins and diets as much as possible before putting them into practice, because I think that if I don’t I won’t do it correctly and I won’t stay the course. We all want fast solutions of course, but this one takes at least six weeks, possibly much longer.

But you may well different. So if you want to ask this, ask yourself “do I really need to grasp it all, or just get a rough idea of how it works, and then try it?” I think a rough idea is OK as long as you understand what you have to do. You should certainly understand why the protein: carbohydrate ratio of 0.75 is important – i.e. the control of insulin. I think many people will overlook this, thinking that fish oils and GLA are enough.

If you need to start learning it, begin at this page...

Click all the links to all related pages from it.

And the crucial question too is whether you should try this gout pain remedy. Remember you will need to work with a doctor who is familiar with these ideas. Don't attempt to do-it-yourself.

For just four reasons you may have a medical condition which precludes the use of high dose fish oil. It may thin the blood too much and it may cause a rise in blood glucose levels. It may be contraindicated with a medicine you are already taking. Some examples: warfarin, gingko biloba and low dose aspirin. (Gout sufferers should not take low dose aspirin because it can cause gout attacks at low doses). Cheap fish oils have too many impurities at the levels Dr.Sears talks about.


Latest about FILLIP on the website is a page about the role of three tests you need before you can start with fish oils. You certainly need to read this before you talk to a doctor...

The AA: EPA ratio is the amount of arachidonic acid compared with the amount of EPA fish oil in your body.

Eicosanoid balance cannot be measured by any publicly available test, but the AA: EPA ratio is an excellent indicator of the amounts and types of eicosanoids you produce. Almost certainly you need to reduce the starting number of this ratio. You need it to be down to 1.5 - 3.0. (At this level there is less AA, and more EPA, both desirable). A second reading after a period of fish oils will give you a very good idea of your progress. You also need TG/HDL and insulin level tests for the reasons you'll understand when you read the AA:EPA ratio page.

At present I think the Dr. Sears’ fish oils should be used mainly because they are the most refined ones, significantly more refined than even those which are molecularly distilled. And because these fish oils are the ones the gout people who wrote the testimonials, or were written about, used. There's one more reason.

The Eico Rx product includes toasted sesame oil concentrate which he believes inhibits gamma linolenic acid from producing arachidonic acid. (You must reduce arachidonic acid levels). This is patented. Other fish oils don’t have it.

Believe it or not, toasted sesame oil concentrate could make the difference between success or failure. But then again it might not. However, the possibility that it might means Eico Rx is the one to use.

They are only sold from his website, you won’t find them in health food shop, including in the U.S. where the Zone diet is based.

The final hurdle to overcome is getting these fish oils delivered. If you live in the U.S. delivery will be faster. If you live elsewhere they are sent by priority post. The Zone Diet site says this takes 4 – 10 days to most places in the world. You can ask Zone Diet support questions – go to the International tab on its home page. Or try the Zone Diet's live chat, which presumably works on U.S. time.

And definitely sign up for the AutoShip program (programme) to get cheaper prices. You can cancel it at any time. If you can go ahead and order, please buy from...

You will help me develop the site and make it more visited by gout sufferers. The price you pay will be the same as if you order from the Zone Diet site directly. There’s also some good offers on it at present. You can get some of the Sears’ books free when you order.

Let me end this item on an upbeat note. Part of the treatment is using the Zone Diet – a protein carbohydrate ratio at every meal of 0.75. The Zone Diet was studied against gout, as I’ve often written, and it had significant success. Fish oils were not used in the study. But the study participants, who were encouraged to eat fish four times a week, would not have got the amount of EPA and DHA from this fish intake, that you get from these oils. In fact, when the study was undertaken in 1999, these kinds of fish oils were not available at all.

If used they may well have improved its results.

If you do try it, please let me know what happens. What you say will be of great help to others. Reply to this email or use the Contact Us Form on the website.


The U.S.FDA was due to complete is assessment of febuxostat by January 18, but it hasn’t. It’s still working on trial results. But this means that a decision isn’t too far away.


Pegloticase received a much needed big boost right at the end of last year. For those readers who are reading this and who haven’t heard of Pegloticase I should explain briefly it’s a course of intravenous infusions for chronic gout sufferers for whom other gout treatments have not worked. Its trials are finished and its developers applied to the FDA for its approval a few months ago. If approved in the U.S., its developers will next try for approval in European Union countries.

The big boost is that the FDA has decided to give it a priority review. What this means is that its developers, U.S. based Savient Pharmaceuticals, hope the FDA will decide in favour (favor)of approval by the end of April 2009, sooner than otherwise might be expected. It will be reviewed by an Arthritis Advisory Committee of the FDA on March 5.

If you want to read up on Pegloticase visit this page... Pegloticase is not for your average gout sufferer, but it could be for some readers now and more readers later on in life. It has had significant success against tophi, but one of the key questions the FDA has to decide is whether it’s safe for the heart.


To help visitors to understand the whole FILLIP treatment, I mentioned in the last issue that I’m preparing a dietary diagrams for gout pain relief. It shows all involved substances and their actions and inter-actions, en route to a body producing more “good” eicosanoids and fewer “bad” ones. I said it would be ready in January. Well not quite. It’s almost finished and should be on the website in February.


Among other items, we’ll look at some tips on using fish oils and why the DHA in fish oils is important for gout sufferers. (It's mainly the EPA that works on improving eicosanoid balance). And there will be a link to the dietary diagram for gout pain relief.

Thanks for reading and all the best.

John Mepham

P.S. You may distribute this newsletter freely and free-of-charge, providing any links in it remain unchanged and it remains intact. Partial copying is not allowed.

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

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