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Have you ever heard of vitamins triggering an attack? It seems as soon as I begin taking multivitamins again I get problems.
Not heard of this specifically, but I do recall reading somewhere that vitamin C can lower uric acid. If this causes existing crystals to dissolve, then this process can cause pain – even though you aare actually fixing (at least partially) your gout.
Another thought is that if you are anything like me, your decision to try and improve health with vitamins is backed with other improvememnts in lifestyle. Perhaps a combination of different things is bringing on the gout.
As I've said before, pain is really no indication of whether your gout is improving or not. Regular blood tests for uric acid, plus visual examination of tophi, if you have them, are the best ways to see if your gout is getting better.
I've had a suspicion that vitamins might be responsible for some of my gout attacks. I've had gout for a number of years now – at first it was rare – every 6 months but now its increased to almost twice a month. I think I am increasingly sensitive to triggers. Also there must be damage in my joints – mostly ankle – but also knee and of course the big toe. I started taking vitamins this spring and my gout increased – I stopped them and have had less – but last week took just one ! And yesterday – kaboom…
I've had similar negative experience with multi vitamins.
I threw them in the rubbish after the 2nd attack.
Have had a similar problem/flare-up now with vitamin c tablets. I'm going to knock them on the head too.
Cheers,
Paul.
Canadian Jeff said:
Have you ever heard of vitamins triggering an attack? It seems as soon as I begin taking multivitamins again I get problems.
Hi there Canadian Jeff,
I have been reading a lot more about this problem lately although I have not actually experienced it myself. It seems that one of the minerals that are in common multi-vits is causing this to happen. I think it may be iron.
My theory on this is that iron is in most high purine foods such as red meat and taking it in supplement form is causing gout to flare up.
I'll do more research on this theory and get back to you when I fully understand it.
Just to clarify… Vitamin C can give you amazing results in your quest to get rid of gout. Taking in excess of 1,500mg of vitamin C daily can help to prevent or cure gout by up to 45% compaired to taking only 250mg .
This is based on a study conducted in 2009 in America
Hope this helps,
Fergal 🙂
After having heard over the last 30 years that Vitamin C megadosing cures everything from the common cold to cancer I have grown quite skeptical of its overblown claims. It would seem to me quite simple to design a study of 100 people who have their serum uric acid measured on January 1 and give half of them a placebo and the other half 1500 mg. Measure the uric acid of the 100 people on December 31. Compare the two averages.
A simple enough trial.
The often touted study that fruges refers to required reporting by people about their pain and their Vitamin C dosage. Filling out questionaires is not a good substitute for a double blinded study.
So I remain a skeptic although I recognizing the possibility that overacidifying the body might cause increased urate excretion in the same way that megadosing with aspirin (6 g./day) can…and probably megadosing with hydrochloric acid.
Remember, anything that is reputed to cure ALL diseases probably cures NONE.
zip2play,
For over seven years I've professionally assisted in the study design and been directly responsible for the data management for geographically-distributed longitudinal studies and clinical trials for a leading research university in the United States, and I wanted to provide some feedback on your comment regarding how simple it would be to perform the simple double-blind study you propose, or any study for that matter, double blinded or not.
Designing a study, even a “simple” study, takes a great deal of effort and money if you want results that will stand up to peer review, because there are numerous factors to consider in several disciplines, including medicine, statistics, and information technology; you have to find a doctor who is smart enough to ask just the right question; then you have to get a statistician involved to get that question asked in the right way; then you have to get a good data manager to make sure that the answers are collected, maintained, and analyzed correctly; then you have to get the statistician and the data manager to work together to make sure that the data is analyzed correctly at the end of the study. There are hundreds of things to consider before even the simplest study is undertaken. For example, just one part of the study design you have to do is to thoroughly weed out perspective subjects who have medical histories or other factors that would impact the study, this is seldom easy to do. Should you only study one sex, or nonsmokers, or one age group? In the study your proposing any one of those factors might cause the results to be vastly different.
Questionaires are almost always used for medical research, both before the study to select subjects, and usually during the study to gauge compliance (how consistently has the subject been taking their vitamin C in this case, and for any number of other reasons. It is true that, where possible, it is preferable to use direct observation (for example, blood tests) to collect some of the data, instead of questionaires, but questionaires are almost always used at some point. But that direct observation comes with a high cost. The subjects have to make several trips to the clinic to have their blood drawn), the blood has to be tested, and you quickly realize that your talking about a hell of a lot of people, time, and money.
All of this work is expensive and time consuming, and the competition for the limited research resources is very tough. Drug companies have no financial motivation to pour research money into things they can't make money on like vitamins, so that leaves the research you are suggesting to educational researchers. Educational researchers get the bulk of their research money from the government, but competition for these funds is keen, so you better write a damn good grant proposal, then pray that you get funded. This system is scewed to reward the best grant writers, who are not always the best researchers.
I don't have time to do this right now, but there problably *are* some results from double blind studies on this question available from Google Scholar. Although the researchers might not have been directly asking about uric acid and vitamin C, they might have noticed some kind of relationship while looking at something else.
As for your closing statement: “Remember, anything that is reputed to cure ALL diseases probably cures NONE.” I would only point out that anything, including vitamin C, is only what it is, and its properties, like whether it cures a given disease or not, or its color, is, of course, not dependent on the claims that people make about it. In other words, if I were to put up thousands of websites that said that quinine cures every known disease in an effort to make a fortune creating a new market for quinine, that wouldn't make quinine any less effective against malaria.
Thanks Mike for taking the time to explain this. I don't think zip2play was underestimating the effort required to produce proper trials. Maybe, like me, he is getting fed up with people who produce less than perfect studies, then they get quoted all over the Internet as if they will cure gout.
It is very frustrating.
One thing that I have learned this month is that almost all uric acid studies are irrelevant to gout sufferers unless they have been done on gouties. Research on tea, which I am currently reviewing shows no effect on people with normal(*) uric acid levels, but will reduce uric acid level in gout sufferers.
(* that is clinically normal – not the statistically average “normal” that some doctors foist on their patients)
Yes, I recognize the difficulty of putting together a GOOD study, however some studies that limit themselves to a very simple hypothesis like “Does 1500 mg. ascorbic acid lower serum uric acid in men” is precise, simple and can be tested inexpensively. But since nobody will make money from it it will not be done and I guarantee that is HAS not been done.
In other words, if I were to put up thousands of websites that said that quinine cures every known disease in an effort to make a fortune creating a new market for quinine, that wouldn't make quinine any less effective against malaria.
Yes indeed…and by that logic, Vitamin C remains quite effective against scurvy as it will stay until the end of time. Unless of course one is among the whacko pulp scientists or Paulingites who claim that most diseases ARE scurvy (yes, I've seen that as I'm sure you have.)
But in general, I agree with everything you say with one BIG exception:
Although the researchers might not have been directly asking about uric acid and vitamin C, they might have noticed some kind of relationship while looking at something else.
To the extent that any relationship is found in this second-hand way, it is de facto BAD SCIENCE. You find out what you designed a good study to find out…nothing more, nothing less. For example when you design a study to determine whether CELEBREX causes an increased risk of stroke and heart attacks, you don't add “BTW, CELEBREX helps people with gout.” I'm sure we both hold to this Number one requirement:
The Basics of Study Design
(1) There must be a fully formed, clearly stated, focused research question and SINGLE primary outcome measure.
I was actually looking for something unrelated and stumbled across this today.
While only using 500mg / day, here is a double-blinded placebo-controlled randomized trial conducted in research units affiliated with Johns Hopkins:
“CONCLUSION: Supplementation with 500 mg/day of vitamin C for 2 months reduces serum uric acid, suggesting that vitamin C might be beneficial in the prevention and management of gout and other urate-related diseases.”
I particularly like the detail in the full version of that report (Vitamin C Reduces Uric Acid)
Among persons who were hyperuricemic at baseline (baseline serum uric acid >7mg/dl; n = 21), vitamin C supplementation reduced serum uric acid by a mean of 1.5mg/dL
As I have seen in studies of other uric acid reducing substances, the uric acid lowering effect increases in line with increasing baseline uric acid. Obviously, it might not be enough at the higher end, with uric acid levels over 9, but may be helpful for people who are just over 7mg/dL
Very interesting Mike…I will put that in my information repository as a bit of evidence.
Curious thoughts though:
Placebo group was 60% African American…Vitamin C group 40% African American (Gout is much more prevalent in the black races)
Placebo group had 12% on diuretics…Vitamin C group had only 7% (diuretics cause gout)
Placebo group was eating 49 grams of protein per day…Vitamin C group 54 grams.
I won't say any of these facts damn the significance results but given the small group I think it would be wise to run a larger study.
Using dicalcium phosphate, a rather significant alkalinizer as a placebo for a potent urine acidifier was a particularly poor choice.
But like I say, it is some evidence that Vitamin C is indeed uricosuric. Then one must ask, does it have anything to do with ascorbate or strictly the effect of over-acidification with a strong acid.
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