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The Gout Dugout.Issue #039. Lowering my UA level; my lucky neighbour; to learn to or not to learn?;
March 30, 2011
Hello and Welcome to the March 2011 edition of the Gout Dugout newsletter - the 10 minutes' read that gives you useful gout beating ideas. A March edition in March. I'm back on track, but the April issue will be earlier than at the end of April.
I promised recently in this newsletter that I'd be telling some hands on stories about my use of anti uric acid test kit, and at the risk of sounding egocentric, here goes.
pH test strips
Using pH test strips I learned my urine pH is 5.0 from an early morning (7.30am) pH reading. That means it's very acidic. I understand that 5.0 is quite a common number for a morning reading. Acidic urine, especially when you have gout, and when you don't, is an added risk for kidney stones developing.
And the way I interpreted my saliva pH reading - that also seemed not so good. More about saliva pH in a later issue. And since my uric acid (UA)level on the last lab test was 8.6 (but 7.1 just a few months earlier at a different lab) it seems I am a high uric acid case.
Why do I have high uric acid?
I don't eat high purine foods, don't drink much alcohol these days, and when I'm dieting, (and when I'm not),I don't eat much sugar except a small amount of fructose in fruit. I buy the idea that sugar causes gout in one, and possibly two ways. So it's high... probably because aging causes uric acid to rise. You only need a slight excess of UA self-production and from purines, over your excretion, for your total body pool to increase. Tortoise-style over the years,
What am I not doing that I probably should? Those eight glasses of water a day. I'll give them a miss unless sterner measures are required, and after I've had a few more UA readings.
So how do you alkalize urine?
The best alkalizer for urine is thought to be potassium citrate. So next time I see a doctor in a couple of weeks time, I'll ask for a prescription (RX) because you have to get the citrate form and because other forms of potassium tablets on general sale, are always restricted to only 99mg, which isn't enough for this. And you can use sodium bicarbonate (baking soda) if your doctor agrees, but I think potassium citrate is better for alkalising urine. (Make sure you work with a doctor to alkalize urine).
What am I currently doing to lower my UA level?
I'm taking 1 gram a day of Vitamin C, so often found to lower UA, which may not be enough.
More than caviar Finally on this strategy, I am adding pH drops to the water I drink. This stuff wasn't cheap. Even in the U.S.,(where these things are cheaper) the brand I bought costs almost US$50 for a couple of fluid ounces. In Britain it was over British pounds 40 (US$65) for those two fluid ounces, by the time I'd paid the shipping from the U.K. website - it's actually made in California - and the dreaded VAT, (a sales tax) recently put up to help pay for the economic events of July 2007 and their sequels.
That's more per ounce than most perfumes. More than caviar, mushroom truffles in a good season and bird's nest soup. And more than Allopurinol.
On the other hand I did buy the most expensive brand on the website because the product reviews said this one lasted a long time (at my current usage rate, they should last around 6 months) and are the strongest drops. Of course in the long run, it's cheaper to buy a water ionizer.
Better taste I've found the drops do improve the taste of water a bit for me. I tested the drops with pH test strips and their pH was 9.0 which of course is very alkaline. 9.0 is as advertised. When I put 5 drops in an 8 ounce glass of tap (faucet) water, the water's pH changes from 7.0 (its usual number) to 8.0 or 8.5 which is what I want. When 5 of these drops are added to one litre (liter) of tap (faucet) water the water's pH rises to pH 7.5 - 8.0.
Logarithmic scale Remember the pH scale is logarithmic, so these differences mean a considerable pH difference. On this scale, pH 8.0 means ten times higher than pH 7.0. pH 9.0 to ph 7.0 is a difference of 100 times. The drops are 100 times more alkaline than tap (faucet) water. The pH test strips I used said they could only measure saliva and urine, but the reading they showed for the drops themselves was spot on, so I expect the other numbers were correct.
However two glasses of water a day isn't enough, I guess, to bring about pH changes - I'd need a possibly gout busting 8 - 10 glasses with the drops at least, so we'll see what my current strategy can do and test again in a while. It's an easy going strategy - a diet, some Vitamin C, a bit of alkalization. in the hope that it will make uric acid more excretable. Only the dieting is difficult. I suspect I may need stronger and extra measures to reduce my UA.
don't happen quickly. I'll announce results later.
MY LUCKY NEIGHBOUR
There are still a few gout mysteries and one of them is why some people can get rid of, or control, gout quite easily and others can't. I know one elderly lady who pops in one Allopurinol a day (she doesn't forget) and has never had a problem again. But there are gout experts with an encyclopaedic knowledge of the disease who can't get rid of it. This story is about one of the lucky ones.
I have at least two male neighbours (neighbors) who have suffered gout. One still has it, the other got an attack at 32, is now 46, but hasn't had an attack for eleven years. His gout came after type 2 diabetes so his gout was probably caused by that pre type 2 diabetes condition, known as insulin resistance. It was a classic case, attacking his big left toe.
His doctor gave him meds for the diabetes, and a pain killer but not for gout. The doctor thought the gout had been caused by diabetes (or insulin resistance) and so he thought a gout med wasn't needed. My neighbour (neighbor) learnt that, in his case, shellfish and he thought string (aka runner, green, French) beans exacerbated the gout flares. I've no doubt about the shellfish, but these beans are low purine. Anyway, he avoided these foods. Not especially difficult, and when the medication got rid of the type 2 diabetes symptoms, the gout went too.
To repeat, he hasn't had an attack for eleven years and he now eats shellfish again, with no apparent problems so the cause probably was insulin resistance. But I think I still have to
convince him that he can't eat much shellfish - it could be a risk of gout again. It's easy to forget that Mr.Toby Gout can return at any age, and likes older people.
TO LEARN, OR NOT TO LEARN
I've recently read a couple a gout posts by posters who recommend that gouty folk need not bother to learn whether a food is high, medium, or low in purines. They think that because purines are not the Number One cause of gout, there's no need to bother. I beg to differ.
Purines in foods do get converted into uric acid. A low purine diet lowers uric acid by 1-2 mg/dL. Gouty folk do trigger gout attacks from excessive intake of high purine foods and drinks, and sometimes I hear, medium purine foods too. Even a small reduction might just do it, or make a useful reduction contribution.
So I think this is a too laid-back recommendation. I'm definitely a gout hardliner - it's military type discipline that is one of the factors which leads to success IMO.
Go to any list of purines in foods - and
they are NOT all exactly the same -
ours is on this page
- and copy and paste into a word processing programme (program). Print a couple of copies. Keep them in a place like your wallet or purse/handbag, and stick one on your fridge (refrigerator). Refer to them when shopping, eating out in restaurants and at relatives/friends homes, snacking out, opening the fridge door etc.
Or for techies, and maybe all of us in due course, visit this Israeli doctor's website...
Also you have to buy and install a database program for the iphone called TAP FORMS - an extra US$9.
So I think it's better to know your purines. And if a food you don't know about triggers a gout attack - and I say triggers because it often happens a few hours after eating the trigger food - you'll wish you had known before, not after.
Febuxostat (Uloric, Adenuric, Feburic) won its first medical authority marketing go-ahead by the European Medicines Agency in April 2008. This was followed by the U.S.FDA in February 2009. But in the world of medical authority approval, the wheels turn slowly.
This is a list of the countries where Febuxostat is now approved: U.S., Canada, Britain, Germany, Italy, Austria, France, Ireland, Greece, South Korea.
And now Japan, where it will be called Feburic, as it is in South Korea. It was approved for Japan in January 2011, and marketing begins there this spring. Febuxostat's (TMX-67)
inventors and developers, Teijin Pharma Ltd., hope for these approvals: Hong Kong in 2011; Taiwan in 2012 and China in 2014. Teijin have also said they seek approvals in Eastern Europe, Russia, Central and South America, more countries in the Far East, and the Middle East. There's a long way to go.
When an alkaline (pH) diet accompanies alkalizing water you are alkalizing doubly, and hopefully enough to make a difference. If you want a free pH food chart with 45 alkalizing recipes, click on this link to phionbalance.com and when the home page arrives, the download link for the chart is on the right. You can then print out the food chart, and take it with you when you go food shopping and eat out.
John Mepham BA.(Econ).
799, Infantry Street,
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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