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Gout Dugout.Issue#050 milk for gout - new study | lifetime gout treatment | is gout treated well?
February 25, 2012
Hello and Welcome to the February 2012 issue of the Gout Dugout newsletter. Since this is a special issue, its number 50, I have what I think are a couple of bumper items.
Last month I mentioned a new study about green tea and uric acid in humans. This month I also have interesting and useful news about another natural gout remedy. A real study of a natural gout remedy. It is possibly the best natural gout treatment study since the South African study of the Zone diet for gout in 1999. What is it? It is further evidence that a specially formulated milk product reduces gout flare frequency and delivers other gout related benefits.
And we'll take a short look (with more next month) at a recent, very encouraging study of over 200 gout patients. It confirmed again that uric acid crystals will break down below a serum uric acid level of 6.0 mg/dL, and remain dissolved as long as the level is under 7.0 mg/dL. It shows that dealing with gout for life can be easier than what is often said and written. And easier when you take its treatment seriously. Unfortunately, in the third item this month we'll see that too many people do not.
But first, back to milk for gout.
I once compiled a list of some of the distinguished gout experts throughout history who have recommended milk for gout. The list included the philosopher John Locke; Sir Alfred Garrod, the Britishman who discovered that an excess of uric acid is usually the cause of gout; Sir William Osler a notable Canadian doctor who was in his time called "the father of North American medicine;" and Dr. Alexander Haig, who wrote voluminously about uric acid (UA) in the early 1900's.
And the 17th century doctor, Thomas Sydenham, recommended white wine whey for gout. Whey is a milk derivative, as in curds and whey, and cheese making. I'm sure there have been other fans of milk for gout in the past.
Thomas Sydenham recommended whey for gout over 300 years ago
This new milk for gout study was published online last month by the Annals of the Rheumatic Diseases journal and took place in Auckland, New Zealand. Its results were so interesting that I decided to write a full page on the website. It's just about the most encouraging study about milk for gout yet. There was a reasonably good participants' number - 102 finished the trial. And I don't think anyone has drunk a milk product in a milk for gout study before for so long. How much and how long? A glass a day for three months.
You can have a headlines-only type of understanding of this study if you watch this Reuters video at the website of the Chicago Tribune newspaper, (There might be one ad to watch before the gout item starts) The video says there could be a commercial milk product for gout within a couple of years. If so, it will be the first.
because this newsletter item doesn't say everything about it.
Read about how the frequency of gout flares fell, uric acid excretions rose, serum (blood) uric acid fell, gout pain reduced and tender joints improved. The only real disappointment was that swollen joints didn’t improve. And all this from just one glass of a specially prepared and tasty, milk product drink a day for three months.
The uric acid reduction
I had to look at the scales of one diagram in the study for an estimation of the reduction and then convert from mmol/L to µmol/L to mg/dL, which is the preferred uric acid measurement of best-gout-remedies.com, to get the following figures for serum (blood) uric acid reductions during the 3 month study. These were my calculations for the fall:
Lactose powder No real change. Skim milk 0.25 mg/dL (midpoint) to 0.59 mg/dL (best). Skim milk plus glycomacropeptide (GMP) and G600 milk fat extract 0.37 mg/dL (mid point) to 0.84 mg/dL (best).
To me these reduction numbers feel about right. Natural gout remedies seldom lower uric acid by more than 1.0 mg/dL in the short term which is why you can't expect miracles from them, and why they probably only help those with gout whose uric acid level is NOT high. Say between 7 and 8 mg/dL when gout first strikes, where the reduction to the critical less than 6.0 mg/dL level isn't a lot. Diets will probably reduce uric acid more in most cases and drug medications the most of all.
Even lactose powder did some good
Lactose is milk sugar which is broken down by the enzyme lactase. According to one leading nutritionist the Scandinavians plus another 20% of the world's population are the only people to digest it properly. The rest (especially true of Asians) haven't yet developed the ability to keep lactase functioning properly and so don't digest milk well. And that's why you probably find lactose free milk on your supermarket shelves.
A couple of months ago, I told the vet who had saved our puppy Labrador's life by pumping him full of antibiotics to kill a virus, that I fed him whole milk. I was gently scolded. Apparently, I should be giving him lactose free milk. Our puppy, according to this vet, can't metabolise (metabolize) milk properly either it seems.
And now, in this study, we curiously learn that even lactose powder, however well metabolised, has cut gout flares a little, reduced gout pain, and reduced the number of tender joints a bit. This was a randomised (randomized) double blind study. The participants didn't know exactly what they were drinking. Our leading nutritionist, and our vet, may have to revise the theory at the very least because this layman thinks lactose powder could not have had an effect if it had not been metabolised. Or perhaps the study needs more confirmation, which it will get.
Milk fat extract too...
And, just as curiously it seems, G600 milk fat extract played a part in lowering serum (blood) uric acid, reducing gout flares and their pain, improving uric acid excretion, and improving tender joints. In an earlier study, it did this, along with glycomacropeptide (GMP), by inhibiting Interleukin 1-β (IL-1β). Types of fat aren't supposed to do good things are they? But here one did.
Did a glass a day for three months make them put on weight? No. Did it adversely affect their total cholesterol, LDL cholesterol and HDL cholesterol, and triglycerides? No.
How good can this milk product be?
The best performer in this study was skimmed (skim) milk enriched with GMP and G600 milk fat extract. As a result of this and earlier studies, you might be able to buy a milk for gout product in just two years, according to the video (above), and a patent has been taken out. What probably hasn't yet been decided is how much glycomacropeptide (GMP) and G600 should go in a commercial product. Maybe more is better but this hasn't yet been learnt. Doubling the intake of standard skimmed (skim) milk in the trial didn't have much effect.
However accomplished the product turns out to be, I doubt it will be 100% effective against gout flares and related symptoms because it hasn't demonstrated this in this study. I'd bet it will take longer than two years to be on sale where you are. However, although there are still a number of questions to answer about it, the eventual product should be a tasty tool in your gout armoury (armory) that can do some good.
Of course what we need now is a study of whole, aka full cream, aka full fat, milk for gout.
Read it yourself
If you wish to read the study itself, you can download it from the milk for gout page. Use the
link above. A day's access will cost GB £24 (US$38). Unfortunately, these studies (usually 7 – 8, US letter or A4 size pages, cost as much as many lengthy hard bound books. I suppose it's the price you pay to read about cutting-edge science.
DEALING WITH GOUT: OLD TRUTHS RE-AFFIRMED
Dealing with gout can be such a tricky business that it's good to hear when a couple of inviolate truths are found to be.... well inviolate. Such news was delivered recently when a Spanish study with 211 participants, published in the journal Arthritis & Rheumatism, re-affirmed that 6.0 mg/dL (and a bit less in women), is indeed the level at which gout crystals begin to go.
And that to control gout and avoid future flares, you must keep your serum (blood) uric acid below 7.0 mg/dL, which again is the conventional wisdom. One group of their participants, who had lowered uric acid sufficiently, maintained their serum uric acid below 7.0 mg/dL and avoided future flares, after they had lowered it sufficiently to break up the MSU crystals. That's good news.
This study has been dubbed, somewhat unfortunately I think, the "dirty dish hypothesis." Why? Because it takes more effort to clean a dirty dish than to keep it clean. The researchers wanted to highlight this idea because that's what they learnt about drugs and uric acid. i.e. the medication dose required to lower uric acid (the cleaning) was greater than any dose that might be required to keep it subsequently below the gout crystal formation level, 7.0 mg/dL (keeping it clean). A lower target than 7 is not necessary. This might mean you could eat more meat and fish, and have a few more beers, if you've got your uric acid figured out.
The study highlights a number of truths about dealing with gout for life so I'll come back to it in more detail next month. This will include the study's positive news about weight loss being associated with lower uric acid, which again is the conventional wisdom, but it’s still nice to hear it again.
And after a couple of upbeat items, here's a downbeat
HOW WELL IS GOUT TREATED?
When I was researching best-gout-remedies.com about 5 years ago, Robert Wortmann was one of those names that frequently appeared on studies I read. In the gout experts diaspora he is one of the leading figures because most new drugs are being developed in the U.S., where he lives, and the developers invariably use him as an advisor. He is one of the gout experts who are in the vanguard of the subject.
Referring recently, at a rheumatology conference in Colorado to gout treatment in the U.S., but I strongly suspect it also applies to many countries elsewhere, Dr.Wortmann was especially dismayed that Primary Care Physicians (PCP's), usually known elsewhere as General Practitioners (GP's), were not taking having a tophus (or tophI) sufficiently seriously. He also pointed out that only 40% of patients on allopurinol are prescribed a heavy enough dose. The usual recommended allopurinol dose is 300mg daily.
Those appear to be doctor related issues but there are patient related issues too.
For example, if it's true that 8.3 million Americans have gout, but only 3.1 million are prescribed drugs then over 5 million in the U.S. (equal to the population of Singapore) are taking a natural gout remedy (not likely) or doing nothing much about their gout (very likely). A study a few years ago found that over half of patients who started uric acid lowering gout treatment were non adherents i.e. they dropped out. (1) This is happening during an age when gout is a growing disease, and uric acid levels in people are rising.
Is this a question of money? It certainly shouldn't be in a rich country like America, debts or no debts. The most basic treatment, allopurinol, is very cheap and surely even those on social security can get a free or subsidised visit to a PCP doctor, if not a rheumatologist. (Tell me if I am wrong).
These days gout sufferers with an Internet connection (or access to an Internet café, public library or friends/relatives' connection) can get tons of free, basic, information about gout from websites. But the Internet is not everything to gouty folk by any means. I know from best-gout-remedies.com's statistics that too many people visiting the website, and other gout websites, who have used gout related words to find it, don’t spend enough time on it. It's rather like the sufferers who don't finish their allopurinol course. One has to conclude therefore that the biggest problem is sufferers' attitudes.
So you may be surprised to know that you are very much an exception, not the rule, by reading this newsletter.
Keep reading ! The more you know the better.
The UASure is a DIY home uric acid test kit. It measures the level of uric acid in the blood. Click on the link below to visit a company who can ship it world-wide, including the United States and Canada, from Britain.
I say this because it cannot be bought in many countries.
If you are not a subscriber to the Gout Dugout, this free monthly gout newsletter, you can sign up at this page - click on the link below.
Go to the www.best-gout-remedies.com home page by clicking on the link below.
NEXT MONTH'S EDITION
Among other items we'll look in more detail at "the dirty dish hypothesis" to see what lessons the study had for controlling gout.
Thanks for reading, and all the best of health.
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.
(1) Leslie R Harrold, Susan E Andrade, Becky A Briesacher, Marsha A Raebel, Hassan Fouayzi, Robert A Yood, Ira S Ockene. Adherence with urate-lowering therapies for the treatment of gout. Arthritis Research &Therapy. Published online 2009 March 27. doi: 10.1186/ar2659
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