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Kim Glasgow said:
Keith (Gout Admin) said:
I call one the bad phase, where uric acid is high, and crystals start to form – usually in one or two isolated locations. The other phase is the good phase, where uric acid is low and crystals start to dissolve – usually more widespread, throughout the body.
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I hope this is not straying too far from the topic a hand, but this is the first time I have seen the distinction made about isolated vs. widespread locations in the two immune reaction phases. When I was in the bad phase, I only had gout attacks in my left big toe. Since March I have been in the good phase (as documented by my uric acid number), and I have had attacks in almost all the toes on my left foot, in my right big toe, multiple attacks in both heels, and most recently, I've had attacks in both knees (one earlier this summer, the other going on currently). I rarely go more than a couple of weeks without an attack. At least my feet have been feeling much better.
Are these new gout attack locations due to “stealth” deposits of uric acid crystals that would have eventually caused a “bad” gout attack? What's next after my knees? My hips? And then? My UA number is well into the therapeutic levels (has been checked monthly). Is this discussed someplace else in the forum? I'd like to know more.
I find your post intriguing and I will explain why.
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Background: I've suffered from gout attacks since 2005 and started urate reduction therapy with Allopurinal in February 2011.
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In December 2010 I started waking up at night finding I was scratching at my beard. Over the nexct couple of months I lost significant patches of my beard (it's called alopecia barbae). My doctor assured me it had nothing to do with gout. Over the next few months the beard grew back, albeit not as coarse or as dark as originally.
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Fast forward to August 2011. I've been in complete misery since starting Allopurinal in February, with some joint or another in my feet or knees undergoing an acute gout attack. No more than a few days between gout attacks! Additionally, I'm under a lot of stress due to a family illness. (I mean, a LOT of stress). I'm noticing LOTS of hair loss (hairs collecting in the shower drain and on my sweaters). Then I discovered a complete bald spot on the back of my neck. This is called alopecia areata, an autoummune disorder in which the hair follicles are attacked by your own immune system. My doctor continues to assure me this has no connection to the gout. I am not so sure! I've received 2 series of cortisone shots to the scalp to suppress the immune system and stimulate new hair growth. Seems to be working as I have “peach fuzz” growing back (though it lacks any pigment, so this is going to look interesting for a while – the doctor says eventually the ahirs will re-pigment). Since receiving the cortisone treatments, I have noticed a tingling, sometimes itchy, sensation at the back of my neck. I am told this can be either a sign of new hair loss via alopecia mechanism, or due to the growth of new hair. I do notice far less shedding so I assuming it's new hair growth. I hope.
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Eczema and alopecia are both considered autoimmune disorders. That alone does not prove anything. But, as I said, my curiousity is piqued.
Well now, here are some things I know about: celery, black cherries, and gout.
First of all: about black cherries, and black cherry juice, here is a stern word of warning to the wise: cherries, and cherry juice, are LOADED with sugar. If you are diabetic (or pre-diabetic, or have insulin resistance) you cannot and must not eat large quantities of cherries, or drink lots of cherry juice, with abandon! This is not even a debatable point, one cannot intake large amounts of sugar if they have diabetes, or if they are headed in the direction of diabetes. Don't screw around with this!
There is one way I know of to gain the benefits of black cherries without excessive sugar intake, and that is black cherry extract.
I have found this formulation to be somewhat helpful, but it is by no means a panacea.
Now on to celery.
When I had my first acute gout attack in 2006, my naturopathic doctor coached me about good gout diet, and he gave me the following prescription: eat 3 stalks of organic celery a day. Regular celery is not good, it has lots of pesticides and lacks the “vitality” of organic celery. (Hey, that's what my doctor said).
I followed that regimen for about 4 years, and I had an acute gout attack about once a year.
Then a funny thing happened: one day I absolutely, positively could not stomach the thought of even another bite of celery! I'm not kidding, to this very day the sight of celery makes me want to gag. Understatement!
So I started taking a standardized celery seed extract by Natural Factors:
http://www.allstarhealth.com/f/natural_factors-celery_seed_extract.htm
This stuff is recommended by a well-known naturopathic doctor (he graduated from a local naturopathic school with an excellent reputation, so I think he has good credibility). Celery seed extract is also good for cardiovascular health. You can download a PDF of his article about this stuff here:
http://www.lifestylevitaminsupplements.com/images/Dr-Murray-Celery-Seed-Extract.pdf
Well, as far as gout goes, this celery seed extract did not work as well as eating celery, though it was helpful in conjunction with a good gout diet. I started having acute attacks about every 6 months.
Then about a year ago I stumbled and fell while hiking and badly jammed my “big gout toe”. This provoked the mother of all gout attacks in that toe! When I recovered from this attack I could clearly see (visually) that I had finally developed a tophi on my big toe joint. And the attacks kept coming. I increased my celery seed intake and went on a full vegetarian diet, but by the start of 2011 I cried “uncle”. I was in too much pain too often and I practially begged my MD to prescribe Allopurinal. I have posted about that in these forums previously, and should probably update that post because I have learned my gout is MUCH worse than anyone ever suspected. I have been paying dearly for this as the Allopurinol allows the gout deposits in my feet and ankles dissolve. Almost constant gout pain in one joint or another for the past four months!
My bottom line is: I wish I had not been so phobic about taking a prespecription medicine for my gout! Things would have been much easier overall (there would have been much less pain and agony) if I'd started taking Allopurinol when my MD first suggested it.
I strongly urge anyone that is experiementing with natural remedies and diet to keep in mind you are experimenting on yourself, and if things do not work out, you will pay the consequences. If celery seed and black cherries cause a total remission of gout attacks I would say, “carry on”, but if you continue with sporadic attacks, please take my case into consideration and get on the Allopurinal! Because it is only a matter of time before you do, and the longer you wait the more you will pay.
Well that's my story and hard-won advice.
The reason why: there is still uric acid deposited in your joints that is being dissolved and carried away, which triggers your immune system.
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The six-month guideline for experiencing gout attacks after starting Allopurinal is, I am sure, some sort of average number with a statistical distribution around it. As such there are people that will experience attacks for less than six months, and some that will experience them for longer. So smile, you are above average!
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Andrew
hansinnm said:
Have you considered buying Colchicine in Canada?
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Yes, my doctor even suggested that as a possibility, and wrote an Rx that I could use for the purpose.
However, I do not want to risk any more alopecia, it is one thing to have a few bald spots on one's beard (just shave and it's hard to notice), but it's quite another if the hair loss is on the head! Since the allopurinal is working and I will not have many more gout attacks to endure, I would rather get by with the Indomethacin.
“Purines are found in the meat of the fish but not in highly purified,
molecularly distilled fish oil, so it should not affect your gout”
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http://www.arthritistoday.org/community/expert-q–a/gout/fish-oil-gout.php
