Gout PDF Ebooks
Gout PDF files are research reports in Portable Document Format (also called Adobe files or ebooks).
The gout information they contain can be viewed on screen or printed using a variety of reading software programs, many of which are free (see below).
Please note that most of these gout ebooks contain scientific terminology, however, I have added simple English summaries where possible.
Many of these gout reports cover several aspects of gout. Where possible, I have categorized these to match the subsections of the Understanding Gout section
- Understanding Uric Acid
- Hyperuricemia
- High Uric Acid
- Urate Deposits
- Immune Response
- Gout Pain
- Gout Diet
- Other Issues
These gouty PDFs are listed in alphabetical order on the Gout Information Page.
PDF File Viewers
There are many free PDF file viewers (or readers) available. Some computers are delivered with Adobe Acrobat Reader already installed. If you do not have a reader, then I recommend the free version of the Foxit Reader, which I find much faster than the Adobe version. You can search for Foxit using the GoutPal Universal Search Engine, or try “free PDF reader” to see alternatives.
Understanding Uric Acid eBooks
- On diurnal and nocturnal variations in the excretion of uric acid. Dec 1906. J. B. Leathes. Early study showing that uric acid excretion increases at night.
- Title
- Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis.
- Published
- Nov 1981
- Author(s)
- Ames BN, Cathcart R, Schwiers E, Hochstein P.
- Significance of circadian variations of uric acid elimination. Sep 1983. B. D. Owen-Smith. Short article explaining that uric acid excretion is higher at night because uric acid production rises during sleep.
- Serum uric acid in acute gout. Nov 1997. Logan JA et al. Gout study showing how uric acid often falls during an acute gout flare. In this study, the average fell from 9.4mg/dL to 7.4mg/dL (0.56mmol/L to 0.44mmol/L)
The authors emphasize that this increases the risk of mis-diagnosis and poor patient management.
- Title
- Loss of urate oxidase activity in hominoids and its evolutionary implications.
- Author(s)
- Oda M, Satta Y, Takenaka O, Takahata N.
- Published
- Mol Biol Evol. 2002 May;19(5):640-53.
- A retrospective study of the relationship between serum urate level and recurrent attacks of gouty arthritis: evidence for reduction of recurrent gouty arthritis with antihyperuricemic therapy. Jun 2004. Shoji A et al. Gout study showing the relationship between persistent reduction of blood uric acid below the saturation point, and the reduction in frequency of acute gouty attacks.
Hyperuricemia eBooks
- Hyperuricemia and incidence of hypertension among men without metabolic syndrome. Feb 2007, Krisnan et al. Establishes hyperuricemia at 7mg/dL, or above, and describes an 80% higher risk of high blood pressure at that level, rising by a further 9% for each mg unit increase.
- July 2008, Mandell. Although hyperuricemia is significant at 6.8mg/dL (0.40 mmol/L), some labs include higher values in the normal range. Hyperuricemia does not prove gout, but patients need to be reviewed individually to assess other factors, as untreated gout is serious.
High Uric Acid eBooks
Ann Rheum Dis. 2000 Jul;59(7):539-43.
Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study.
Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J.
This report shows useful, though limited, blood uric acid reduction on a calorie controlled diet where nutrition is balanced to a 40:30:30 carbohydrate:protein:fats ratio.To put this information in context, please see the Gout Diet Section.
- Effects of some anti-inflammatory drugs on 12 blood constituents: protocol for the study of in vivo effects of drugs. July 1985, Jeli?-Ivanovi? et al. New procedure to eliminate the effects of drugs on blood test results, and application of the procedures on uric acid by some anti-inflammatory drugs. [Abstract summary]
Purine Metabolism And Gout
The purine metabolism review is an in-depth analysis of how uric acid forms as a product of purine metabolism. This is not straightforward, as there are many different types of purines. Many common charts of foods high in uric acid list all purines as a total value. However, prompted by investigations and reviews such as this one, I have narrowed the list down to purine rich foods most likely to affect gout.Metabolism Of Purines And Diet
The report also explains important nutritional aspects of the metabolism of purines, including results of experiments in the laboratory and in humans.Purine Metabolism Review File Details
Purine and pyrimidine metabolism. Sep 1985 Zöllner. In-depth analysis of different sources of purines and uric acid, differentiating between endogenous purines, from body tissue, and exogenous purines, from diet. Reveals that allopurinol eliminates half of internally generated uric acid, and almost all dietary uric acid.- Milk- and soy-protein ingestion: acute effect on serum uric acid concentration. Mar 1991, Garrel DR et al. The uricosuric effect of milk proteins reduce blood uric acid concentration, but with soy protein this effect is offset by the high purine levels.
Milk can be incorporated into your diet as part of your plan to beat gout. See the Gout Treatment section for other food-based gout cures.
- A retrospective study of the relationship between serum urate level and recurrent attacks of gouty arthritis: evidence for reduction of recurrent gouty arthritis with antihyperuricemic therapy. Jun 2004. Shoji A et al. Gout study showing the relationship between persistent reduction of blood uric acid below the saturation point, and the reduction in frequency of acute gouty attacks.
- The Effects of Vitamin C Supplementation on Serum Concentrations of Uric Acid. June 2005, Han-Yao Huang et al. Results of a Randomized Controlled Trial (RCT), showing that 500mg/day vitamin C for 2 months reduces blood uric acid, with better reductions for higher uric acid.
Vitamin C can help as a gout treatment, and there are other natural products that can be used as gout cures.
Vitamin C And Uric Acid
The investigation reveals a very important point about vitamin C and uric acid - the higher the starting point, the better the reduction. But even with the benefits of vitamin C, uric acid level is unlikely to drop enough for most gout sufferers.The investigation breaks the subjects down to many different subgroups, with varying starting levels of uric acid in the blood. Though there are different absolute changes in uric acid, vitamin c achieves a fairly constant percentage reduction of around 10%. In this context, for effective treatment with vitamin c, uric acid needs to start at 5.5mg/dL (0.33mmol/L) for a 10% reduction to achieve a satisfactory target of 5mg/dL (0.30mmol/L). Of course, this might mean that, for higher starting levels of uric acid, vitamin C can make a contribution to a combination treatment program, but you must always get regular blood tests to make sure you stay in the safe zone.
- The Dual Actions of Morin (3,5,7,2',4'-Pentahydroxyflavone) as a Hypouricemic Agent: Uricosuric Effect and Xanthine Oxidase Inhibitory Activity. Jan 2006, Zhifeng Yu et al. Morin, found in figs and other fruit, reduces uric acid in rats.
Morin from figs or mulberry tea, are examples of foods that can be used as uric acid lowering gout treatments. See the Gout Treatment section for other food-based gout cures.
- Product information for Fasturtec a brandname for rasburicase sold as Elitek in the USA. Contains interesting tables of outstanding uric acid reduction.
- Briefing Document for Febuxostat. Nov 2008. Takeda Pharmaceuticals North America, Inc. Comprehensive review of studies carried out to support the application for febuxostat, released under the brand name Uloric (Adenuric outside USA).
Alopurinol Patient Information File Details
Patient information on allopurinol from the Australian Rheumatology Association. May 2009 (reviewed annually)Allopurinol Side Effects Alcohol
Please note that this information contains recommendations about limiting alcohol to 1 to 2 drinks, once or twice a week. There is no background to this information about allopurinol and alcohol, therefore it is difficult to judge how important this is.Allopurinol During Gout Attack
This allopurinol patient information clarifies the misunderstanding about taking allopurinol during an acute gout attack. Even some doctors are unsure, hence Jenny's cry for help: Doc says to stop allopurinol due to gout flare?? HELP!As the patient information makes clear:
You should also continue to take it during an attack of gout.
- Meta-Analysis of 28,141 Individuals Identifies Common Variants within Five New Loci That Influence Uric Acid Concentrations. June 2009, Melanie Kolz et al. This analysis of 14 studies reveals strong genetic influences on excess uric acid. 9 potential genetic weaknesses could be studied further for potential new treatments.
- US Prescribing information for rasburicase (brand name Elitek) supplied as a powder for intravenous use. This is only licensed for child and adult cancer patients with high uric acid from chemotherapy. Oct 2009
- Treatment failure gout. Nov 2009 Ali S, Lally EV. Describes some potential treatment options in refractory (unresponsive) gout. Reasons for treatment failure are:
- Physician failure to diagnose and treat gout
- Inadequate dosing of urate-lowering therapy
- Allergy or intolerance to urate-lowering therapy
- Allergy or intolerance to urate-lowering therapy
- Lack of compliance with prescribed therapy
Urate Deposits eBooks
- Studies of urate crystallisation in relation to gout. Aug 1983. Fiddis RW et al. Laboratory studies of uric acid crystals confirm that temperature increase improves uric acid solubility. They claim that crystals form very slowly, though dissolve quickly when concentrations fall. However, they conclude that much more real life investigation is required to understand how the crystallization process can be halted in the body as compared to the test tube.
- Growth of monosodium urate monohydrate crystals: effect of cartilage and synovial fluid components on in vitro growth rates. Oct 1986. Burt HM, Dutt YC. This study shows that Chondroitin sulphate and phosphatidylcholine increased the growth rate of uric acid crystals whilst albumin significantly inhibited crystallization. The authors admit that further work is needed to isolate other factors.
- Effect of Urate-Lowering Therapy on the Velocity of Size Reduction of Tophi in Chronic Gout. Aug 2002 Perez-Ruiz et al. This study of 63 gouty patients explodes the myth that a standard 300mg dose of allopurinol is adequate: “There is much more to the therapy of hyperuricemia than simply prescribing 300 mg/day of allopurinol. How much? As much as necessary to obtain low serum urate levels.” It shows that urate deposits will dissolve when uric acid is reduced below 7 mg/dL (0.42 mmol/L), but they dissolve about 4 times faster with urc acid levels below 4 mg/dL (0.24 mmol/L).
If you are taking allopurinol for gout, this shows how important it is to regularly discuss the right dosage with your doctor.
- Time required for disappearance of urate crystals from synovial fluid after successful hypouricaemic treatment relates to the duration of gout. Aug 2007. Pascual E, Sivera F. Gout study to find the time taken for urate crystals to disappear from gouty joints under uric acid lowering therapy.
Leave this page to browse the uric acid crystals in the Understanding Uric Acid Section
Immune Response To Gout eBooks
- Novel Targets for Antiinflammatory and Antiarthritic Agents. July 2006. Kulkarni RG et al. Explains how new understanding of tissue and joint inflammation processes within the human immune system offers new opportunities for pain relief medications. Also reviews currently available anti-inflammatory drugs.
New Anti Inflammatory Drugs
The report mentions some new anti inflammatory drugs that were being tested at the time of the report. Some of these are likely to be adopted for gout pain relief, and as they become available, I will report them in the Gout Treatment Section, and associated Gout Treatment Blog.It is always worth asking your doctor if new treatments are available. Often, your pharmacist is a good source of new anti inflammatory drugs, as they are in constant contact with representatives from pharmaceutical companies.
- Reduction of urate crystal-induced inflammation by root extracts from traditional oriental medicinal plants: elevation of prostaglandin D2 levels. July 2007, Sung Mun Jung et al. Traditional Chinese herbal root extracts of Siberian Ginseng, Dong Quai (Chinese Angelica), and Baikal Skullcap, reduced the inflammatory immune response to urate crystals in mice.
Though this investigation deals with artificially induced gout in mice, the researchers anticipate it could be effective in dealing with the joint inflammation processes in human gouty arthritis.
- Author:
- Kanevets U, Sharma K, Dresser K, Shi Y.
- Title:
- A role of IgM antibodies in monosodium urate crystal formation and associated adjuvanticity.
- Published:
- J Immunol. 2009 Feb 15;182(4):1912-8.
Leave this page to browse the Joint Inflammation pages in the Understanding Uric Acid Section
Gout Pain eBooks
- 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.
- Report describing the effectiveness of low level laser therapy for gout pain.
Please note that, although this report does give some convincing evidence that laser therapy is very effective for gout treatment, it also suggests that this might be better than allopurinol. This is nonsense. Allopurinol, or other urate lowering therapies are still required in the long term to remove the cause of gout. As they take several months to be effective, laser therapy is a useful addition to urate lowering treatment for the first few months.
- Review, showing that, if joint damage has occurred, common solutions do not really work, so best not to allow joint damage to happen in the first place.
- Title:
- Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis.
- Authors:
- Wandel S, Jüni P, Tendal B, Nüesch E, Villiger PM, Welton NJ, Reichenbach S, Trelle S.
- Published:
- BMJ. 2010 Sep 16;341:c4675. doi: 10.1136/bmj.c4675.
- Drug Class Review on Cyclo-oxygenase (COX)-2 Inhibitors and Non-steroidal Anti-inflammatory Drugs (NSAIDs). Nov 2006, Roger Chou, MD. A summary of 26 pain relieving drugs, many of which are prescribed for gout. It includes an assessment of risks for stomach and heart problems, which are associated with longterm use of COX inhibitors.
- Questions and Answers on the Review of Etoricoxib-Containing Medicines. June 2008, European Medicines Agency (EMEA). Etoricoxib should continue to be licensed for short term acute gout and other conditions. Doctors must be aware of heart and blood pressure risks before and during treatment.
Gout Diet eBooks
Ann Rheum Dis. 2000 Jul;59(7):539-43.
Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study.
Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J.
This report shows useful, though limited, blood uric acid reduction on a calorie controlled diet where nutrition is balanced to a 40:30:30 carbohydrate:protein:fats ratio.To put this information in context, please see the Gout Diet Section.
- Observation, and possible explanations for increase in xanthine oxidase followed by uric acid caused by excess iron in the blood. Though only demonstrated in rats, not humans, this investigation gives valuable insight into the dangers of excess iron for gout.
Rather than preventing generation of [uric acid,] a remarkably beneficial iron chelator and antioxidant with allopurinol or increasing its urinary excretion with probenecid, perhaps a more rational treatment for hyperuricemia might be not only the avoidance of highly absorbable iron in red meat, but also regular voluntary donation of blood to decrease the relatively elevated body iron stores of men and postmenopausal women, thereby balancing decreased uric acid production with antioxidant needs.
- Title:
- Iron regulates xanthine oxidase activity in the lung.
- Authors:
- Andrew J Ghio, Thomas P Kennedy, Jacqueline Stonehuerner, Jacqueline D Carter, Kelly A Skinner, Dale A Parks, John R Hoidal.
- Published:
- AJP - Lung Physiol September 2002 vol 283 no 3 L563-L572.
- Interesting investigation showing how a tomato-based soup can lower uric acid. This is a good addition to your diet if you have gout.
- Title:
- Mediterranean vegetable soup consumption increases plasma vitamin C and decreases F2-isoprostanes, prostaglandin E2 and monocyte chemotactic protein-1 in healthy humans.
- Authors:
- Sánchez-Moreno C, Cano MP, de Ancos B, Plaza L, Olmedilla B, Granado F, Martín A.
- Published:
- J Nutr Biochem. 2006 Mar;17(3):183-9. Epub 2005 Aug 15.
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.
- 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?Leave Is Alkaline Diet Uricosuric? to browse the Gout Diet Menu pages
- 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.
- 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.
- Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men. March 2004, Hyon K. Choi et al. Statistical study showing a link between increased meat and fish intake and increased risk of gout. Increased dairy is associated with lower risk of gout, and high purine vegetables have no association with gout.
Other Gouty Issues
These reports cover multiple sections or gout-related issues.
- Author: St Jeor ST, Howard BV, Prewitt TE, Bovee V, Bazzarre T, Eckel RH; Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association. Titled: Dietary protein and weight reduction: a statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association. Published: Circulation. 2001 Oct 9;104(15):1869-74.
Recommends a 15:55:30 protein:carbohydrate:fats ratio, but please read the accompanying analysis and background nutrition sources. Latest nutritional advice is to take care to avoid the dangers of such a simplistic view, and consider each case individually.
- Author:
- Robert Terkeltaub.
- Titled:
- Health Professionals Follow-up Study on Gout: What Do We Now Tell Patients About Diet and Alcohol?
- Published:
- May 2004
American College of Rheumatology expert state-of-the-art review on relationship between diet, alcohol intake and gout.
- Author:
- Hu M, Tomlinson B.
- Title:
- Febuxostat in the management of hyperuricemia and chronic gout: a review.
- Published:
- Ther Clin Risk Manag. 2008 Dec;4(6):1209-20.
- Author:
- Reinders MK, Jansen TL.
- Title:
- Management of hyperuricemia in gout: focus on febuxostat.
- Published:
- Clin Interv Aging. 2010 Feb 2;5:7-18.
- Author:
- Takeda Pharmaceuticals America, Inc.
- Title:
- Uloric Prescribing Information
- Published:
- Feb 2009.
- Highlights page, followed by full prescribing information, including gout patient information for the febuxostat drug marketed as Uloric.
- Effect of Short-Term Use of Different Non-Steroidal Anti-Inflammatory Drugs on Renal Function During Fasting in Ramadan. Jan-Mar 1985 Al-Arfaj HF et al. This investigation confirms a short term uric acid increase from fasting. They conclude that using NSAIDs at this time has no adverse effects, but note that there is an emphasis on short term use.
Leave Uric Acid & Pain Relief: Kidney Function Effects to browse the Gout Disease pages
- Title
- Bartter's syndrome with gouty arthritis.
- Published
- Sep 1992
- Author(s)
- Ogawa T, Fujise Y, Shibata S, Abiru M, Takigami Y, Miura T, Kikuchi K, Fukazawa Y, Iimura O.
- Seasonal variation in the onset of acute microcrystalline arthritis. Oct 1999. Gallerani M et al. Statistical evaluation of the incidence of gout and pseudogout in an Italian hospital. Gout was most prevalent in April and least prevalent in October. They found no significant seasonal variation in pseudogout.
- Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men. March 2004, Hyon K. Choi et al. Statistical study showing a link between increased meat and fish intake and increased risk of gout. Increased dairy is associated with lower risk of gout, and high purine vegetables have no association with gout.
- Pathology and proposed pathophysiology of diclofenac poisoning in free-living and experimentally exposed oriental white-backed vultures (Gyps bengalensis). Oct 2005. Meteyer CU et al. Report into diclofenac poisoning in vultures. Though the deaths are termed visceral gout, there is no apparent risk to gouty humans who take diclofenac for gout pain relief.
- Authors:
- Pacher P, Nivorozhkin A, Szabó C.
- Title:
- Therapeutic effects of xanthine oxidase inhibitors: renaissance half a century after the discovery of allopurinol.
- Published:
- Pacher P, Nivorozhkin A, Szabó C.
A review of uses of allopurinol to treat conditions other than gout. Includes references to febuxostat and other new gout treatments to lower uric acid.
- Serum uric acid and cognitive function in community-dwelling older adults. Neuropsychology. Jan 2007. Schretlen DJ et al. A uric acid measurement study on 96 men and women over 60 to assess the correlation between uric acid levels and cognitive function.
"Despite its antioxidant properties, these findings suggest that even mild elevations of UA might increase the risk of cognitive decline among older adults."
- British Society for Rheumatology and British Health Professionals in Rheumatology Guideline for the Management of Gout. Feb 2007, Kelsey M. Jordan et al. Comprehensive guidelines for gout management including wise-ranging references to supporting studies.
- Elevated Uric Acid Increases the Risk for Kidney Disease. Dec 2008. Obermayr RP et al. Though not offering any medical explanations, the study reveals a strong independent statistical link between high uric acid and increased likelihood of kidney disease. There is a suggestion that asymptomatic hyperuricemia (raised uric acid levels without gout flares) be taken more seriously, especially where high blood pressure is involved.
Leave High Uric Acid And Increased Kidney Disease to browse the Gout Disease pages
- Authors:
- Car S, Trkulja V.
- Title:
- Higher serum uric acid on admission is associated with higher short-term mortality and poorer long-term survival after myocardial infarction: retrospective prognostic study.
- Published:
- Croat Med J. 2009 Dec;50(6):559-66.
An investigation of a potential link between uric acid with short-term deaths and long-term survival from heart attacks.
Leave Uric Acid And Heart Attack Deaths to browse the Gout Disease pages
- Serum Cystatin C is a Potential Endogenous Marker for the Estimation of Renal Function in Male Gout Patients with Renal Impairment. Jan 2010, Choe JY et al. Shows Cystatin C is a better measure of kidney function than more traditional tests. Important for allopurinol users, and they recommend allopurinol for kidney patients.
Leave Assessing Kidney Function For Allopurinol In Gout to browse the Gout Disease pages
Next Gout PDF Steps
This list of gout reports barely scratches the surface of the huge number of gout studies that have been published.
If you know of any other gout reports that are available in PDF format, please let me know. Use the Gout Forum to share gout information ebooks, or any other good gout resources.