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Once the disease of gluttonous aristocrats, gout is now tormenting the masses

nytimes.com

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Re: Once the disease of gluttonous aristocrats, gout is now tormenting the masses

#121

Post by darkerside »

bregma wrote: post #118
xref wrote: post #6

I watch/read a lot of history and I am always curious, if you traveled back in time how would you treat gout? Without medications to manage uric acid what would you do for Ben Franklin, DaVinci, Michelangelo or Charlemagne? Have them lose weight? Stay away from foods X, Y, and Z but eat more of A/B/C? Does exercise help/hurt? Are there any herbs etc that we know today would lower uric acid which you could find with y…

Both Franklin and Da Vinci were well-known and documented tea-totalling vegetarians. The kind you avoid inviting to parties because they won't stop proselytizing it. Turns out genetic metabolic problems have always been around and modern simple "life hacks" like a fad diet product or an exercise product aren't always the cure.

Or, they were able to manage this horrible condition, and lead extremely successful and productive lives, despite the lack of modern medicine, because of their personal experimentation and resulting lifestyle changes.

Or, yeah, maybe they were just dumb lifehacking sheep.

Re: Once the disease of gluttonous aristocrats, gout is now tormenting the masses

#122

Post by draw_down »

simtel20 wrote: post #80
AndrewDucker wrote: post #61

Earlier quoted context omitted.

I don't have gout, but my IBS is set off by fructose, and yes, I've had to drastically cut down on fruit. Fortunately, vegetables are even healthier for you, and don't have significant levels of fructose.

Since you mention IBS in the context of fructose, are you aware of the the phenomena of fructose malabsorption? My wife has this combination of issues at times, strongly related to eating or drinking of apples or apple juice and other similarly high fructose fruits and extracts like agave.

I hadn’t heard of that but I have the same problem when I eat apples. Makes sense now.

Re: Once the disease of gluttonous aristocrats, gout is now tormenting the masses

#123

Post by darkerside »

robbiep wrote: post #89
galaxyLogic wrote: post #42

Some years ago I had Goat and had to go to the doctor. The doctor prescribed (onlY)Aleve to me. I find it curious she didn't tell me anything about more effective medicines such as: https://medlineplus.gov/druginfo/meds/a682673.html?fbclid=Iw... Is it possible that a doctor does not know about this medicine? Or is this such a new treatment that it didn't exist about 8 years ago?

Allopurinol is as old as the hills. However it cannot be taken during an acute episode of gout or it will worsen it. Ie it is a preventative not a treatment. I’m presuming you went to your family doctor rather than the emergency room so your gout flare (relatively speaking, not necessarily from your perspective) probably wasn’t so bad which is why they gave an NSAID and sent you on your way. Ideally they should have…

Pain can be horrible at night but get relatively better in the morning. It took me a few visits to realize my doctors didn't realize that saying it was an 8 at night didn't make it clear that I was being rocked with waves of stabbing pain, where I couldn't sleep all night, and literally couldn't move my foot, even if I tried to pick it up with both hands. But because I was coherent and calm the next morning, an 8 must have seemed like a moderate amount of pain!

Anyway, the right place to go is rheumatologist. Urgent care or ER in the meantime, but insist that you get steroids or at least colchicine if you need pain relief.

Re: Once the disease of gluttonous aristocrats, gout is now tormenting the masses

#124

Post by darkerside »

galaxyLogic wrote: post #42

Some years ago I had Goat and had to go to the doctor. The doctor prescribed (onlY)Aleve to me. I find it curious she didn't tell me anything about more effective medicines such as: https://medlineplus.gov/druginfo/meds/a682673.html?fbclid=Iw... Is it possible that a doctor does not know about this medicine? Or is this such a new treatment that it didn't exist about 8 years ago?

Gout is a very misunderstood disease. I wouldn't be surprised if your PCP didn't treat it appropriately. And they may not have understood your pain level. See my other comment on a peer post.

Re: Once the disease of gluttonous aristocrats, gout is now tormenting the masses

#125

Post by bmcahren »

ben_w wrote: post #54
t-0 wrote: post #49

Earlier quoted context omitted.

This is not entirely true. Gout is caused by excessive levels of uric acid, which is an end-product of purine metabolism. You can get uric acid via two pathophysiologic mechanisms: under-excretion of uric acid, or over-production. Under-excretion is by far and away the most common cause of gout (think ~90% of cases). Causes for this include things like chronic kidney disease or an inborne/hereditary problem (like you…

> most diuretics Does that include caffeine and phenylalanine?

Phenylketonurics - this comment contains phenylalanine

Re: Once the disease of gluttonous aristocrats, gout is now tormenting the masses

#126

Post by darkerside »

TrackerFF wrote: post #40

Got gout the first time when I as 23 - at around 185 pounds and very fit. I was cutting down for summer, and had switched over to a very high-protein diet. The first time, I thought I had broke my toe, or gotten an infection - it was absolutely horrible. I get it roughly 2-3-4 times a year now, and it is always after the following pattern: - Not drinking enough water - Eating too much chicken - Drinking too much beer…

If it's steroids, I'd recommend getting off of them as soon as you can. Making those diet changes more permanent will help. If you can't or won't do that, getting on regular allo is probably better than treating regular attacks.

I have a similar story and have treated through diet successfully. Haven't taken steroids in almost 2 years.

Re: Once the disease of gluttonous aristocrats, gout is now tormenting the masses

#129

Post by perardi »

tropdrop wrote: post #11

> Some scientists point to the dramatic rise in rates of obesity — from 13.4 percent of adults in 1980 to 42.4 percent in 2017-18, again per the NHANES — since excess weight depresses kidney efficiency, and to the likely not unrelated introduction, in 1967, of high-fructose corn syrup , which can cause the body to produce higher levels of uric acid, and its wholesale embrace in the early 1980s by the American food in…

May I bro-science it for a second?

I shy away from blaming high-fructose corn syrup as some sort of subtle poison. A gram of HFCS is anywhere from 42–55% fructose, which is the same as what you’d get from an apple.

But I think there may be something to the dose of HFCS.

Fructose has to be metabolized in the liver, and there’s an upper bound of how much it can break down at once. (I believe 50 grams.) Which, if you’re eating fruit, is fine; the fiber slows down digestion, and also you’re probably not eating like 6 apples at once.

But oh man, look at an energy drink, or a sugary coffee drink. I am from Midwestern white trash stock, and during my obese younger years, I would frequently drink a 44oz Big Gulp of Mountain Dew. That’s a shotgun blast of fructose, and my gut instinct (hah) says that there’s a dose-response curve going on here.

Re: Once the disease of gluttonous aristocrats, gout is now tormenting the masses

#130

Post by JamesBarney »

johnyzee wrote: post #70
JamesBarney wrote: post #45

Earlier quoted context omitted.

Sugar does seem to be involved in gout but high fructose corn syrup is basically indistinguishable from sugar metabolically.

That is wrong. Fructose metabolism specifically differs from other types of sugars, by requiring a particular enzyme, which means it can only be broken down in the liver. https://en.wikipedia.org/wiki/Fructolysis Unlike glucose, which is directly metabolized widely in the body, fructose is almost entirely metabolized in the liver in humans, where it is directed toward replenishment of liver glycogen and triglyceride…

No you misread my comment. I never said fructose is indistinguishable from glucose. I said sucrose is almost indistinguishable from high fructose corn syrup.

Sucrose is 50% fructose 50% glucose and most high fructose corn syrup is 55% fructose 45% glucose. They are almost identical.

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