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The Gout Dugout. Issue #018. Uric acid tests, cherries in season, a pegloticase decision is closer
June 03, 2009
A warm welcome to the June 2009 edition of the Gout Dugout newsletter, and to new readers who have signed up since May edition.
URIC ACID LEVELS NEED TO BE TESTED
A couple of issues ago I tried to point out the dangers of complacency when dealing with gout. In May I had another reminder about how easy it is to overlook something important when you're treating gout.
A friend of a relative - a lady in her late 70's - had her first gout attack 5 years ago, caused it was thought by blood pressure lowering medication. Gout served up its typical troubles - a big toe attack with excruciating pain for 2/3 days and no sleep.
Her doctor put her on Allopurinol, 100 mg daily, and she's been taking this Allopurinol dosage for the past 5 years. No repeat attacks, no known side effects, no walking difficulties. It doesn't seem too bad.
But something is overlooked. When she visits her doctor, a uric acid level test is not done. She has no idea what her uric acid level is, or whether indeed Allopurinol has really brought it down, although with no repeat attacks in 5 years it probably has.
This is all too cozy, too cushy, too complacent.
Supposing a UA test is done and supposing it's 5 mg/dL (0.297 mmol/L) or below? The level at which many gout attacks cease. Perhaps Allopurinol can be diascontinued, and her uric acid level kept down though dietary measures.
Or what if the uric acid level is above 7 mg/dL (0.416 mmol/L) and the absense of a gout attack is a matter of luck or a gout friendly diet ? I think they are driving blind. Know where you stand and ensure your doctor/rheumatologist,urologisty does that UA level test.
Cherries are now in season in temperate climate countries and anyone who has has a gout attack, or has hyperuricemia and knows it, should be eating cherries as much as possible.
The healthiest ones are those with the darker skins. Darker skinned ones have more of the bioflavonoid antioxidants - peonidin, pelargonidin etc. My local supermarket makes a point of calling its cherries "dark skinned", but doesn't say why it puts a premium on these words.
But cherry juice manufacturers don't even know this - they put images of bright red cherries on their packaging! Perhaps bright red are how cherries are best recognised but what we want are the dark skinned ones.
Do you want a free ebook of cherry heath information and cherry recipes? If so go
the cherries cure gout page
and click on the Traverse Bay farms advert. This will take you to the Traverse Bay Famrs home page, from where you can download
their free cherry health report.
Pegloticase, the biologic gout medication currently under revwiew at the U.S. FDA for possible approval, has been given a U.S. and European trade name. It's Krystexxa. More significant news is that on June 16 there will be an FDA special arthritis committee meeting to discuss its approval. When a similar committee met towards the end of last year about Febuxostat, the approval decision came not long after. We should know whether Pegloticase (Krystexxa) will be approved by August 1 this year.
THE NNL DATABASE
There are over 100 pages on BGR.com so there will be some readers of this newsletter who have not looked at the free-gout-resources page. The star download on this page is unquestionably the U.S.Dept of Agriculture's National Nutrient database. I reckon it would be worth about US$40-US$50 if it was sold, but it is free. I won't describe the contents here - you can read more on the free gout resources page - execpt to say that it's an excellent nutrition database, whose only major drawback for gout sufferers is its lack of information about purines in foods. But if you want a first rate nutrition database on your computer
visit the free gout resources page and click on the link to the US Dept of Agriculture
In last month's issue I described how to get a free Anti-Inflammation Zone book - order just one container of the Zone Diet's high quality OmegaRX fish oils.
The Zone Diet has another offer this month. Order a fish oil product - OmegRX or EicoRX plus a polyphenol (bioflavonoid) supplement or his SeaHealthPlus bioflavonoid product and you get 3 of Barry Sears' books free - the Anti-Inflammation Zone, A Week in the Zone, and Zone Meals in Seconds (400 pages of Zone recipes.
For both offers visit the Omega -6 page on BGR.com Click on the Zone diet ad which takes you to the Zone Diet's home page.
For the three free books with the fish oil product plus a bioflavonoid product Click on "Customize your own Zone core solution."
For the free Anti Inflammation Zone books with a purchase of a single container of the OmegaRX product. Click on the Shop tab on the home page and then click on the Specials tac at the top of this page or scroll down to the Zone specials button at the bottom of this page.
John Mepham BA (Hons)
165,Union Street, Maidstone, Kent, United Kingdom ME14 1EY
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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