DEAR DR. GOTT: I started taking allopurinol about a year ago for gout with mixed success. I happened to mention having gout at my local gym about six weeks ago and was totally surprised to hear how many people have had it.
Then four people mentioned getting black cherry concentrate at the local health store at $17.00 for a three month supply. I cannot believe what a difference the cherry concentrate has made. My pain has been completely gone for the last month and I have been able to work out at the gym like I did before the gout started a year ago.
Thank you for the info on gout and keep your great medical column coming.
DEAR READER: Thank you for the compliment and yes, I certainly hope to keep the advice out there as long as I possibly can.
Gout is a complex form of arthritis caused by the buildup of uric acid crystals within a joint. It occurs either because the body produces too much uric acid or because the uric acid has difficulties being eliminated from the body. The condition most commonly affects the joint of the big toe but can occur in the feet, ankles, hands, wrists and knees. Men over the age of 40, post-menopausal women and individuals who over-indulge in alcohol are at greatest risk.
Symptoms include intense joint pain (commonly in one joint), inflammation and redness of the joint. Pain can come on suddenly and with a vengeance and the affected area may be warm to the touch. Attacks often go away after a few days, only to return again.
Diagnosis is commonly made by a physician’s visual examination of the joint involved and the complaint(s) presented. Laboratory testing, either through blood or urine, can easily detect high levels of uric acid in the system; however, not everyone with high levels will be diagnosed with gout. Additional testing, if appropriate, might include analysis of synovial fluid (the clear viscous fluid that lubricates joint linings and tendon sheaths), or through synovial biopsy.
Treatment might begin with non-steroidal anti-inflammatory drugs such as ibuprofen or indomethacin at the first indication of a minor attack. Colchicine is typically prescribed for moderate to severe attacks or your physician might choose to inject the inflamed joint with steroids for pain relief. Allopurinol or probenecid (both prescription remedies) are used as preventives if you have several within the same year; or your physician might choose to inject the inflamed joint with steroids for pain relief.
I once had a patient who arrived in my office on crutches, unable to put any pressure on his foot because of the intense pain. He was convinced he broke something and was extremely surprised when I examined him and indicated he had a gout attack — his first. I prescribed medication and he went away — something of a disbeliever. The next day he came charging in to my office jumping around without crutches and without pain. He was convinced it was just short of a miracle.
On the home front, people can control attacks by reducing their intake of high purine foods and alcohol and by keeping other conditions such as diabetes and high cholesterol levels under control. Foods rich in purines include mushrooms, cauliflower, gravies, mushrooms, organ meats to include liver and kidneys, sardines, anchovies, and legumes. A home remedy, as you have discovered, is cherries — dried, canned, fresh, or the concentrate form you purchased from your local health food store. Thank heavens you were in the right place at the right time and had acquaintances that had been through a similar situation. I don’t usually mention black cherry concentrate so the word is now out, thanks to you.
Readers who would like related information can order my Health Reports “About Gout” and “Compelling Home Remedies” by sending a self-addressed, stamped envelope and $2 US dollars for each report ordered to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) when writing or print out an order form from my website www.AskDrGottMD.com.