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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

#11

Post by tropdrop »

> 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 industry and then the world. Once gout was confined largely to Western civilization (with some outliers, like the Mongol ruler Kublai Khan); now its ravages are global.

High fructose corn syrup seems to me the strongest contender for "single biggest cause" – it ties in nicely with the obesity epidemic, and the two surely snowball together. That doesn't mean that other factors (the same as 18th century's) can't bring gout on, like a comment elsewhere here reports, but I just cannot believe that high fructose corn syrup's ubiquitous stance in our food isn't met with some pernicious and hard-to-trace effects on our health.

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

#12

Post by scythe »

centimeter wrote: post #5
lwansbrough wrote: post #2

I had my first gout attack on August 14th 2018 at just 24, following a night filled with liquor and red meat. Though I’ve gone through periods of continuous activity, it’s safe to say I lead a somewhat sedentary life. Today, at 26, I have been free of major gout symptoms since my first attack 2 years ago. Though I occasionally get mild inflammation in my gout-prone foot if I stray too far from my diet, I’ve been effe…

I don't believe the current scientific consensus has meat consumption as a risk factor for gout. I read a paper recently that specifically mentioned that simple sugars (glucose, fructose, sucrose) and purine. Purine is present in quantity in certain organ meats, but not meats that most people eat frequently, and you're more likely to get it from legumes.

See e.g. the Arthritis Foundation:

https://www.arthritis.org/health-wellness/healthy-living/nut...

EDIT: Coffee good! https://www.sciencedirect.com/science/article/abs/pii/S00490...

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

#13

Post by ehejsbbejsk »

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…

Colchicine (and its more natural forms) has been used for centuries.

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

#14

Post by dr_dshiv »

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…

Alcohol free Keto for two weeks twice a year. Lent and late summer.

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

#15

Post by sigmaprimus »

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…

Some people believe that cherry juice can negate the effects but by far Prednisone works at relieving the pain, almost to the point of seeming like a magic pill.

Unfortunately it is a short lasting treatment as after a few times it quickly becomes less effective and it has side effects such as mood swings.

But take a 50mg pill when you can't walk and an hour later you're dancing.

So I guess if I was a time traveler I would probably try something like making an alcohol based serum from pigs adrenal glands?

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

#16

Post by Taniwha »

chewz wrote: post #3
lwansbrough wrote: post #2

I had my first gout attack on August 14th 2018 at just 24, following a night filled with liquor and red meat. Though I’ve gone through periods of continuous activity, it’s safe to say I lead a somewhat sedentary life. Today, at 26, I have been free of major gout symptoms since my first attack 2 years ago. Though I occasionally get mild inflammation in my gout-prone foot if I stray too far from my diet, I’ve been effe…

I do not want to squash your hopes but with dietary changes alone it is not possible to stop progression of gout. In a few years you will probably start having more frequent attacks. Lossing weight is little more effective. Keeping your uric acid well below 6.0 mg/dL is when the process starts very very slowly reversing. Fortunately there is a better understanding of the dissease and more new therapies in the pipelin…

Allopurinol works for most people (but sadly not everyone), my gout kept me in bed for a month of agony, but once I was able to start allopurinol my uric acid levels have dropped and been managed for over a decade without issue, or gross dietary changes.

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

#17

Post by cyrusshepard »

I developed painful gout at 40. Now 10 years later, I hardly ever have any pain at all.

Lots of research link gout to different makeups of gut bacteria:

https://www.nature.com/articles/srep20602

And I certainly changed my diet over the past 10 years, and my gut bacteria has become more diverse and presumably more healthy as a result. I've verified this through various stool tests and 3rd party microbiome trackers over the years (uBiome, Thryve)

I don't want to get into pseudoscience or offer anyone advice, but I can tell you that my experience with increasing specific bacteria that increase butyric acid within the gut has seemed to work for me. In theory, one could do this by eating butyrate promoting foods such as almonds, apples, barley, kiwifruit, and more, or take a bifidobacteria-enhancing fiber such as GOS.

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

#18

Post by paranoidrobot »

lwansbrough wrote: post #2

I had my first gout attack on August 14th 2018 at just 24, following a night filled with liquor and red meat. Though I’ve gone through periods of continuous activity, it’s safe to say I lead a somewhat sedentary life. Today, at 26, I have been free of major gout symptoms since my first attack 2 years ago. Though I occasionally get mild inflammation in my gout-prone foot if I stray too far from my diet, I’ve been effe…

I had mine at about the same age or maybe a little younger - my foot was so swollen, and so sensitive that doctors couldn't believe it was anything other than a break, sprain or some other gross damage. When the X-Ray came back clear, and a blood test showed high Uric Acid they were stunned.

Still, I had no further symptoms for several years. Then I had another, then it became a yearly thing and now I'm on Allopurinol permanently.

My doctors insist that I cut down my drinking (I don't drink), my consumption of red meat (some, but not much) and a variety of other things which mostly don't apply to me.

It's in the family history - everyone on the male side of my family going back generations has had it. A great-something grandfather had attacks so bad that anyone even walking near his bed was threatened with a grisly end. I can certainly sympathise.

Trying to walk with a gouty foot is painful enough, but it's made worse by how inconsiderate so many people are - so many people will walk into you, people on bikes, skateboards, one-wheels, etc ride directly towards you. Which makes you brace, slightly in the event they don't swerve-away, which triggers another burst of pain from the bracing.

An uncle who has to use a walking stick at times complains of the same problem of appearing to be invisible to people on the streets, and of people brushing past and knocking against the walking stick.

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

#20

Post by cheezerman »

Something that I learned recently that blew my mind was that gout is caused primarily from consuming DNA.

How? Gout is caused by a buildup of uric acid, which is created in the body as a byproduct of breaking down purines. Purines are essentially broken down pieces of DNA.

This makes sense when you discover that beer can cause or worsen gout, because of the large amount of yeast present, but other fermented beverages such as wine do not.

Obviously there are other factors that go into gout, and other causes too, but the primary cause is eating DNA!

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