Allopurinol Uric Acid And Cardiovascular Health

This investigation of over one thousand allopurinol takers, shows that less than half the gout patients achieved safe uric acid levels. In general, there were no risks of heart disease from taking allopurinol, but significant differences showed between low dose (100mg) and high dose (at least 300mg). At high doses of allopurinol, there is a significantly lower risk of heart disease and death.

Title:

Impact of allopurinol use on urate concentration and cardiovascular outcome.

Authors:

Wei L, Mackenzie IS, Chen Y, Struthers AD, MacDonald TM.

Published:

Br J Clin Pharmacol. 2011 Apr;71(4):600-7. doi: 10.1111/j.1365-2125.2010.03887.x.

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Can Uric Acid Go Too Low?

An investigation summarizing the benefits to gout patients if they start uric acid lowering treatment with a very low target. This reduces the time it takes to get rid of old uric acid crystals, but raises speculation that there could be negative effects if uric acid goes too low.

Fortunately, the author shows how there are no known ill-effects of very low uric acid levels, so you can set your target as low as you like.

Title:

Reassessing serum urate targets in the management of refractory gout: can you go too low?

Author:

Hershfield MS.

Published:

Curr Opin Rheumatol. 2009 Mar;21(2):138-42.

Treating Raised Uric Acid From Exercise Stress

Though exercise will generally benefit most gout sufferers, strenuous exercise can raise uric acid levels. This report looks at one possible solution from supplementation with a common fitness supplement – L-Carnitine.

For more information, please see the uric acid and exercise discussion.

Title:

L-Carnitine L-tartratesupplementation favorably affects markers of recovery from exercise stress.

Authors:

Jeff S. Volek, William J. Kraemer, Martyn R. Rubin, Ana L. Gómez, Nicholas A. Ratamess, and Paula Gaynor.

Published:

AJP – Endo February 2002 vol. 282 no. 2 E474-E482.

Gout And Athletic Endurance

A statistical study relating gout with exercise. This study gives some pointers about improving gout diet, exercise, and fitness, as these are associated with lower risks of gout. As with all statistical investigations into gout diet, it is important to measure any changes that you make by frequent blood tests for uric acid levels. Statistics give pointers, but only accurate measurement of your own uric acid levels will tell you if you are safe from gout.

This is particularly important when considering exercise, because failure to maintain uric acid in the blood at 5mg/dL (0.30mmol/L), or below, will increase your risks of joint damage – the last thing you want if you want to continue exercising.

Title:

Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men.

Author:

Paul T Williams.

Published:

American Journal of Clinical Nutrition, Vol. 87, No. 5, 1480-1487, May 2008.

Is Alkaline Diet uricosuric?

This study of alkaline forming diet vs acid forming diet shows higher uric acid excretion when urine pH is higher. Unfortunately, the study does not go far enough, and corresponding measurement of uric acid in the blood is not available. Not collecting such important data seems to be a glaring omission, or was the data collected but omitted from the report because it makes the results inconclusive? Cynicism aside, I believe this opens up an important research avenue. It may be too much to hope that scientific resources could be allocated to such a project. Perhaps those people wishing to lower uric acid using their own uric acid meter to guide dietary changes can contribute useful information.

Please discuss this in the Gout Diet Forum if you have any input. Relevant questions are:

Is an alkaline diet uricosuric?

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Gout And Montelukast

An investigation into a potential gout medicine. Montelukast, an anti-leukotriene used to reduce swelling for asthma sufferers, is compared to indomethacin, an anti-inflammatory commonly prescribed for gout. Although indomethacin comes off worse, we should remember that this is a very early non-human investigation, and we should note that the combined therapy seems better than either individual treatment.

Title:

The effect of montelukast in a model of gouty arthritis induced by sodium monourate crystals.

Authors:

Ponce L, Arjona M, Blanco G, Alvarez S, Arcila E, Ortega A, Nuñez D, Verzura J, Tovar R, Bethencourt S, Riera R, Mora-Orta S, Corado J.

Published:

Invest Clin. 2011 Mar;52(1):15-22.

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Obesity And Gout

A statistical analysis of a large sample of men, including over 700 gout patients.

Although you should be wary of applying general statisitical information to your specific health problems, this study does reveal a common link between excess weight and an increased risk of gout.

If your weight is high, then you should consider slow weight loss as a method for lowering uric acid. For more details of how to manage obesity and gout, see my Gout Diet Section

Title:

Obesity, Weight Change, Hypertension, Diuretic Use, and Risk of Gout in Men – The Health Professionals Follow-up Study.

Authors:

Hyon K. Choi, MD, DrPH; Karen Atkinson, MD, MPH; Elizabeth W. Karlson, MD; Gary Curhan, MD, ScD.

Published:

Arch Intern Med. 2005;165:742-748.