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The Gout Dugout. Issue #022.Dealing with gout attacks on aircraft;eating cherries; krystexxa latest;
October 02, 2009

Welcome to the October 2009 edition of The Gout Dugout newsletter, and especially to those new readers who have signed up since the last issue. It takes under ten minutes to read and if you get and retain two good gout ideas from it, it will be time well spent.


If you haven't been able to freeze a large supply of cherries(and most won't) you face the question of what to do about eating cherries until around the end of May next year. There's no question that cherries should be eaten regularly by anyone who has had a gout attack. Or drink cherry juice for gout, probably daily. You can always buy cherry juice, all year round.

From the perspective of different kinds of diet, all of which are helpful in gout treatment - a restricted carbohydrate, a low purine diet or a low calorie/low fat, cherries are fine with all of them. They aren't particularly high in carbohydrate, and they are low calorie. They are also low purine, and reckoned to be slightly alkaline. It's only when you buy the canned cherries in syrup that you've got to really start counting the carbohydrates because of the syrup.

Some people find cherries expensive, and I must say I do too. There are a lot of much cheaper fruits around, including strawberries, that excellent gout berry. I actually live at present in a cherry growing area, but that doesn't make them much cheaper. They simply get priced up to just below the price level of imported ones that have come from Spain, the U.S., and Holland. Even farmers selling direct to consumer at roadside stalls do this.

So they aren't the cheapest fruit. But here's something useful that will be a tip for those who haven't done the pricing. If you can buy frozen or canned cherries in the winter, do so. They will almost certainly be cheaper. In my most frequented supermarket, I calculated about 25%-31% cheaper than the fresh ones. Of course frozen and canned are cheaper because they don't have to be sold quickly. The canned ones are better value price wise than frozen.

One cherry product I saw the other day in my local supermarket looked good initially, and then disappointed. It's cherry yoghurt, made with a live active bio culture. The live active culture is gout positive, but the cherries plus cherry juice comprised only 10% of the product. This isn't enough cherry.

The real question is - are frozen or canned as gout positive as the fresh ones? Unfortunately no one really knows, although some gout individuals have learnt what's best for them through trial and error. All you can do is follow people who say their gout was helped with frozen or canned and see what happens.

There is a database at the USDA website which has analysis of the nutrient content of frozen and canned compared to fresh. Last time I looked at this I was surprised by how close frozen and canned got to the higher level of nutrient capability among the fresh foods it analysed.

Dried cherries can be eaten all year round too. I have read a gout sufferers account of how dried cherries helped his gout.

And, if you live in the U.S., or want this delivered from the U.S., Traverse Bay Farms are now selling Montmorency tart cherry powder. They say it's three months supply if used as they suggest, and it costs $40. Find out more if you go to the cherries page at the website and click on the Traverse Bay Farms ad.


You are the kind of gout sufferer who suffers quite frequent acute gout attacks, and you're going on a plane journey. Or you are a vigilante gout sufferer, always on guard against a gout flare, despite the fact that your last attack was over a year ago.

You've got your allopurinol, your indomethacin, or ibuprofen. There's two things about plane journeys that could bring on an attack, especially long journeys. One is you're sitting in a fairly cramped location. You may need to move the body to improve blood circulation. That means walking up and down the plane's aisles to improve it. This is similar to what you need to do on a flight to counter deep vein thrombosis (DVT), which as in gout treatment, also includes drinking water on the plane (see further on).

The theory is that sluggish blood circulation may precipitate a gout attack because when the blood is moving slowly the crystals are more likely to settle. On a one hour flight you can miss this, but anything over an hour-and-a-half or so, and you should at least consider it.

Is it just a coincidence that the area of the body where blood circulation is slowest is the feet, and that's where a majority of gout attacks begin?

Secondly, dehydration. Planes are dehydrating locations because their cabin air has much less humidity than the air most of us breathe on terra firma. Dehydration is not good for gout. It can trigger a gout attack. The risk grows with a longer flight. So get moving up and down the aisles and drink water!

Have I met gout sufferers who have experienced a gout attack on a plane, or soon after arrival? Yes I have. In fact the person in question had had only one attack in his life, and that was soon after landing from a very long flight. So I am really tempted to believe the circumstances of the flight had precipitated it. His uric acid level was probably above 7.0 mg/DL (0.416 mmol/L) the level at which the risk of an attack grows, and the afore mentioned conditions of the flight were the gout trigger.

He also may have drunk too much alcohol, and too little water, the third possible cause of an inflight gout attack. This page at the Qantas airline website explains some inflight exercises you can do, which it says may be effective at increasing blood circulation. (If the link


For those readers who are following the Pegloticase approval saga because they want to know when (or if) it will be available... in mid September the drug's developers, Savient Pharmaceuticals, explained their progress with the FDA. Savient said they expect to re-file with the FDA in early 2010, and they don't expect additional trials for Pegloticase to be required.

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Thanks for reading and all the best.

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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