Keith’s GoutPal Story 2020 Forums Please Help My Gout! Gout Treatment A cure…Have I hit on something?

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    Al O’Purinol

    Hi, Im a 43 year old male from Manchester UK. I have been experiencing crippling gout attacks for over 4 years now. At least 3 to 4 times a year I am forced to take time off work usually a week at a time because of the severity of the attacks. I refuse to take allopurinol, avoid red meat and only drink vodka with lemonade rather than beer. Despite all this, it still creeps up on me and I can always tell 2-3 days in advance that Im going to be iimmobilized. When I get the 'twinge' I reach straight for the NSAIDS (Ibuprofen) and drink as much water as possible. This happened recently on a trip to Malaysia. I had been in KL for 2 days with my partner when i felt an attack coming on. I was at the slight hobbling stage and hadnt yet reached for the NSAIDS, when walking around we came across a massage/refloxology centre . There are lots of these centres around KL but what caught my eye was that they offered a fish spa. This involves dipping your feet in a tank with about 40-50 Garra Rufa (translates as social fish) whom resemble carp. I believe they are imported from Japan. Here is a link.

    I had a good chat with the proprietors and what they told me that not only do the fish remove the hard scaly skin, but they break up toxins with their hard sucking motion. She also told me they can sense the uric crystal and get protein from it. Weird. My gout attacks are only confined to my left toe so i was quite happy to let three of the biggest Rufa concentrate on nibbling and sucking my big swollen left toe. Now Im sure there are those amongst you who thing Im stark raving bonkers , but whilst most of the fish nibbled on seperate bits of my feet then moved on , these three would not budge from my inflamed joint. The result was this. 6 weeks on and after spending 4 of those in Malaysia where vegetarian dishes are not usually an option, I have not had a solitary twinge. I drank every night whilst away, have not lost any weight and have not once reached for the medicine cabinet. I have enjoyed seafood in abundance, chicken and even red meat. Im sure there are those amongst you who are sceptical but I have nothing to gain from this. As far as I know there is nothing like this in the UK. I have not been able to eat and drink like this for 4 years and I feel this is worth sharing with you. The only downside for me in all this is that KL is a 12 hour flight away and they have to be a special kind of 'sociable' fish . I stayed on the path of caution for three or four days after the spa expecting a flare up, but it didnt come. I had the holiday of my lifetime. I havent felt like this for so long. Please let me know your thoughts and opinions. I'd love to hear them. Steve.


    Steve Carter said:

    Now Im sure there are those amongst you who thing Im stark raving bonkers

    Well you did say came from Manchester 😉

    [Explanatory note for readers outside UK, possibly outside North of England. People from Manchester are mad, known everywhere as Mad Mancs. It's probably to do with living on t'wrong side o' t' Pennines. None of this has anything to do with gout, and I apologise for abusing my authority]

    On a more serious note – anything that works for you, is OK by me.

    There are many areas of gout that are not fully understood. Nobody is clear why one person can live with high uric acid but never get gout attacks, whilst others have severe attacks at much lower readings. Also, the mechanism of gout pain is still something of a mystery. Why does inflammation vary so much between people, and between attacks in the same person?

    Another name for Gara Rufa is “Doctor fish” [see – you've sent me off on a new research path already]. There is plenty of evidence that these fish do help sufferers of many conditions – why not gout?

    We have a few visitors from Kuala Lumpar here at GoutPal.

    Kuala Lumpur Gout Visitors

    Perhaps someone in Malaysia has more information.


    Thanks for denouncing my geographical heritage admin ..:)

    Thanks for the reply too. Im really curious as to see if this has worked or aided anyone else. Also does anyone know anymore about these fish (Garra Rufa) and their capacity for taking toxins from the system? Would be really interested to hear any info. Obviously when I get a twinge in the toe it means that a uric crystal is forming or has formed. This could have taken weeks/months to evolve, who knows. What I do know is that with NSAIDS that twinge would have been with me for another few days before I had another attack. Im interested to know whether that crystal has now disappeared or been broken up by the action of the fish. I guess only an x-ray will tell. Also. do we know how long a uric crystal takes to form? I ask as Im trying to gauge how long it would be before I had another attack if im now feeling symptom free? Sorry for all the questions, Im just trying to make sense of this horribe and very painful affliction and would explore any treatment path that works for me. The cherries, cranberries, Ibuprofen, 2l of water daily etc etc just didnt help me. Thanks, Steve.


    Sorry Steve – I love Manchester really, and spent many happy years working there. I still enjoy the occasional good Manchester night out when there's something good on at the MEN arena. Any city that gave us Joseph Holt can't be bad.

    So far, I've found that Garra Rufa therapy has become available in the USA and Canada. Note that some states (Texas, Arizona, Oklahoma, Tennessee, Mississippi, and Washington) have banned the treatment and the International Nail Technicians Association disapproves of it. Concerns about maintaining sterile conditions in a colony of live fish appear to be the issue here. I can find no sign of this treatment being available in the UK.

    Understanding uric acid crystals and how uric acid causes gout pain are two foundations of learning how to manage gout. Understanding these processes does not directly help your gout, but it does help you understand how different treatments can work. You also need to  understand how lowering uric acid can cause gout pain, albeit on a temporary basis if you lower uric acid properly.

    Seeing common symptoms of gout in a similar way to 'flu helps understand some of those symptoms better. Feverishness and pain are due to your bodies immune system trying to fight inanimate uric acid cells just as they would a virus. I believe the pain is worse with gout because the inflammation is concentrated in a relatively small area.

    Whether your experience was a relief of symptoms, or a removal of cause is something we may never know, until the treatment is studied scientifically. The only evidence I can find relates to psoriasis, and the researchers cannot identify where the benefits derive from. The good news is that the studies where carried out in Turkey, where the fish originate. A much shorter flight for you.

    You might find the garra rufa report interesting, but I don't think it answers many questions.


    It was probably the sessions with Mr Joseph Holt that brought your gout on 🙂 I'm sure he has been responsible for a couple of attacks of my own. Yes it seems like the jury is out on this one at the moment. I guess we wont learn anymore until other sufferers have tried this treatment and reported back which I hope they do. The fish spa could have nipped it in the bud for me but I guess it may be many years before anything scientific is proven. Week 8 now, symptom free. Im enjoying it whilst it lasts. Have a nivce evening. Steve.


    Hello. I first posted on here some ten months ago after I had visited Malaysia and had had a rather interesting experience in a 'Fish Spa.' I have been a gout sufferer for some years and so extreme were the attacks, these resulted in me  being left housebound on several occasions. In Malaysia I subjected myself to dipping my feet in a pool full of Garra Rufa fish for thirty minutes. The purpose of this is that the fish are supposed to remove toxins and dead skin from your feet by sucking on them leaving your feet in a pristine and smooth condition. I noticed that three of the larger fish refused to move from my left large toe whilst the smaller fish just moved around my feet nibbling randomly. Its now almost a year since I experienced this and I have still not had a solitary flare up. I have frequently drunk alcohol, not modified my diet and do not weigh less than I did last year. If there was some element of disbelief at my first post outlining my findidngs I understand completely but I do want to share this. Gout caused me a lot of anxiety and pain and if this helps anyone else I would love to hear from you. I know that the fish spas are becoming more common in the UK now and that they can be found in many major towns and states in the US. I genuinely believe that the fish that spent so much time devouring my left toe broke down the uric crystal in my joint through the strong sucking motion. I know the majority of you will think Im mad but of one person can become gout free after reading and trying this, well, my work here is done.


    I guess we are all pretty skeptical, but until someone can explain all the mysteries of gout (e.g. why certain people get gout with uric acid at 7mg/dL, whilst others tolerate much higher levels without gout), then I say – if it works for you, then it works.

    I’d love to see other people’s experiences of Garra Ruffa


    Toe sucking has always, like gout, appeared in the upper echelons of society- no wonder it's been made illegal in the US between the fish & the hoi polloi ! 😉


    On a more serious note- Is it possible that, assuming there's no evidence of extraction [only attraction] by the fish that they could be shifting the crystals into solution in local tissues and its  then cleared by blood flow.

    Maybe with some fortuitous alcohol in your system (?) the kidneys flushed it out, whilst soluble.

    Sounds effective, cheap and fun- no wonder it's been banned!


    Couple thought:

    1. Sometimes vacations are nice, sometimes they suck.

    2. Sometimes we have gout attacks someitmes we don't.

    3. Never discount the effect of placebo..”You are getting VERRRRRY sleepy” (In my best Transylvanian accent.

    4. Never discount the effect of coincidence

    5. Have you gone from last October to this month without an attack…any sucky carp  involved in the meantime?

    6. If it works it works…I hope trips to the far east aren't required too often.

    7. If you fiind that the attacks start recurring with frequency, you will need allopurinol and it's very cheap. A trip to Malaysia will buy enough for several lifetimes.

    Steve….the fish are BOGUS just like rabbits' feet.

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