Ascertainment Of Incident Cases Of Gout
We ascertained incident cases of gout by the American College of Rheumatology survey gout criteria, as previously described. Briefly, on each biennial questionnaire, participants indicated whether they had received a physician diagnosis of gout. We mailed to those subjects with self-reported incident gout 1986 onwards a supplementary questionnaire to confirm the report and to ascertain the American College of Rheumatology survey gout criteria., The primary end point in this study was an incident case of gout that met 6 or more of the 11 gout criteria., To confirm the validity of the survey gout criteria in our cohort, we reviewed the relevant medical records from a sample of 50 of the men who had reported having gout. The concordance rate of confirming the report of gout between the gout survey criteria and the medical record review was 94% .
More About Zinc Gluconate
1. “Product Information. Galzin .” Teva Pharmaceuticals USA, North Wales, PA.
2. Mossad SB, Macknin ML, Medendorp SV, Mason P “Zinc gluconate lozenges for treating the common cold. A randomized, double-blind, placebo-controlled study.” Ann Intern Med 125 : 81-8
3. Al-Nakib W, Higgins PG, Barrow I, Batstone G, Tyrrell DA “Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges.” J Antimicrob Chemother 20 : 893-901
4. Eby GA, Davis DR, Halcomb WW “Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study.” Antimicrob Agents Chemother 25 : 20-4
5. Godfrey JC, Conant Sloane B, Smith DS, Turco JH, Mercer N, Godfrey NJ “Zinc gluconate and the common cold: a controlled clinical study.” J Int Med Res 20 : 234-46
6. Macknin ML, Piedmonte M, Calendine C, Janosky J, Wald E “Zinc gluconate lozenges for treating the common cold in children: a randomized controlled trial [see comments.” JAMA 279 : 1962-7
Keep Track Of Your Triggers
Gout triggers differ from person to person. Some people can eat a steak or drink an occasional beer with no problems. Others canât tolerate a bite or a sip without a flare. So you need to learn what yourtriggers are.
Keep a diary of what you eat for a while. That way, you can go back and see whether you can link flares with specific foods. Then youâll know what you really need to avoid.
Along with avoiding triggers, here are other things you can do to stay healthy and prevent flares:
- See your doctor regularly. You may need adjust your dose of gout medication over time.
- Always have medicine on hand for flares. The faster you take it, the sooner you can control the symptoms.
- Eat a heart-healthy diet full of vegetables, fruits, whole grains, low-fat dairy, and plant proteins . Cut down on processed foods .
- Get regular exercise.
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The Role Of Hyperuricemia In Other Conditions
Although hyperuricemia is most often associated with gout, elevated blood levels of uric acid have also been associated with other diseases. Hyperuricemia and gout are both risk factors for kidney or bladder stones . Both conditions increase the risk of forming not only uric acid stones, but also the more common calcium oxalate stones. The presence of calcium oxalate stones is 10â30 times higher in gout patients than those without gout.25 Deposits of monosodium urate crystals in kidney tissues can result in kidney damage , either acutely by formation of crystals within the tubules of the kidney, or through a chronic inflammatory response to urate deposits in other tissues of the kidney.26 Prior to the development of uric acid lowering treatments, kidney disease occurred in up to 40% of gout patients renal failure was the usual cause of death in 18â25% of these patients.7
Hyperuricemia is an integral part of metabolic syndrome,20 and epidemiological studies have demonstrated that elevated uric acid levels substantially increase metabolic syndrome risk .33,34 Data from the Multiple Risk Factor Intervention Trial showed hyperuricemia was associated with increased risk of type 2 diabetes, and that male patients with gout had a 41% increased risk for the disease.35
Disclaimer And Safety Information
This information is not intended to replace the attention or advice of a physician or other qualified health care professional. Anyone who wishes to embark on any dietary, drug, exercise, or other lifestyle change intended to prevent or treat a specific disease or condition should first consult with and seek clearance from a physician or other qualified health care professional. Pregnant women in particular should seek the advice of a physician before using any protocol listed on this website. The protocols described on this website are for adults only, unless otherwise specified. Product labels may contain important safety information and the most recent product information provided by the product manufacturers should be carefully reviewed prior to use to verify the dose, administration, and contraindications. National, state, and local laws may vary regarding the use and application of many of the therapies discussed. The reader assumes the risk of any injuries. The authors and publishers, their affiliates and assigns are not liable for any injury and/or damage to persons arising from this protocol and expressly disclaim responsibility for any adverse effects resulting from the use of the information contained herein.
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Treating Gout Pain With Compounded Pain Creams
Gout is a complicated medical condition that usually affects the feet. It begins with too little uric acid being eliminated out of the body. Excess uric acid in the body builds up and forms crystals in the joints, causing swelling and pain. The pain that typically accompanies sudden gout attacks is intense and can feel as though the foot or joint is on fire. The small joint at the base of the big toe is the most common site for a gout attack. Other joints that can be affected include the ankles, knees, wrists, fingers, and elbows.
Conventional Treatment Of Gout
Treatments for acute gout attacks typically manage pain and inflammation, and include NSAIDS, corticosteroids, and colchicine. While treatments for acute gout are typically short term, there are risks of significant gastrointestinal side effects for NSAIDs and colchicine in some individuals. Moreover, though colchicine is approved by the Food and Drug Administration to treat acute gout flares, it has a low therapeutic index, meaning the dose required to exert a beneficial effect is near that which is potentially toxic. Aspiration of affected joints to relieve pressure, and injection of long-acting steroids are commonly used treatments in practice, although they have not been investigated in controlled trials.49
After the initial attack has subsided, patients are usually encouraged to adopt lifestyle changes that may reduce hyperuricemia and gout risk . Many will be placed on longer-term uric acid-reduction therapy. Recall that uric acid levels are controlled by the rate of uric acid production and the rate of uric acid excretion current therapies address either of these two aspects.
Uricosuric drugs increase the excretion of uric acid from the kidneys, primarily by reducing the absorption of uric acid from the kidneys back into the blood. Probenecid and sulfinpyrazone are two examples. These drugs tend to increase urinary uric acid levels, which can cause kidney stones.
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Innovative New Drugs For The Management Of Chronic Gout
As mentioned earlier in this protocol, in most mammals uric acid is converted into the more soluble compound allantoin by an enzyme called uricase. This conversion allows for the urinary excretion of allantoin, thereby reducing uric acid blood levels. However, humans are unable to facilitate this conversion due to an evolutionary loss of the uricase enzyme.
Recently, scientists have recreated the mammalian uricase enzyme in the laboratory and generated injectable medications that deliver the recombinant enzyme it into the blood. Once in the blood stream, the recombinant uricase enzyme breaks down uric acid into allantoin, which is then easily excreted through the human kidneys.
Two such medications are availableârasburicase, and a chemically modified version of this same drug, called pegloticase . Pegloticase is FDA approved to lower uric acid levels in patients with chronic gout.53
In two concurrent randomized, double-blind, placebo-controlled trials, pegloticase, administered at a dose of 8 mg either every two weeks or every four weeks, efficiently lowered uric acid levels.54 The participants in these studies consisted of patients with chronic gout, which had not been relieved by allopurinol, and blood uric acid levels above 8.0 mg/dL at baseline. Reduction of uric acid levels to < = 6.0 mg/dL was the primary endpoint, and was achieved in 38% of patients receiving biweekly injections, and in 49% of those receiving monthly injections.
Assessment Of Vitamin C And Diet
To assess dietary intake including vitamin C intake, we used a semiquantitative food-frequency questionnaire that inquired about the average use of > 130 foods and beverages during the previous year., , In addition, respondents provided information on the use of supplemental vitamins, taken either alone or in multivitamin form. The baseline dietary questionnaire was completed in 1986 and was updated every four years. Nutrient intake was computed from the reported frequency of consumption of each specified unit of food or beverage and from published data on the nutrient content of the specified portions. For supplemental vitamin C, respondents chose from the following categories: 0, 1 to 399, 400 to 700, 750 to 1250, and 1300 mg or more daily. The amount of vitamin C in multivitamin preparations was determined by the brand, type, and frequency of reported use. Food and nutrient intakes assessed by this dietary questionnaire have been validated previously against two 1-week diet records in this cohort., Specifically, the Pearson correlation coefficient for energy adjusted total vitamin C intake between the dietary records and the questionnaire was 0.86. After adjustment for the week-to-week variation in vitamin C intake the correlation coefficient was 0.92. After excluding supplemental vitamin use the correlation coefficient for vitamin C was 0.77.
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What Is The Fastest Way To Get Rid Of Gout
- Nonsteroidal anti-inflammatory drugs : These can quickly relieve the pain and swelling of an acute gout episode. They can shorten the attack, especially if taken in the first 24 hours.
- Corticosteroids: These drugs can be taken by mouth or injected into an inflamed joint to quickly relieve the pain and swelling of an acute attack. Corticosteroids usually start working within 24 hours after they are taken.
- Colchicine: An anti-inflammatory medicine that works best if taken within the first 24 hours of a gout attack.
Medications for reducing uric acid levels: These are usually prescribed after an acute attack ends to reduce uric acid levels in the body to prevent future attacks.
- Colchicine: Regular and low doses of colchicine may be given along with other medications below to prevent flare-ups.
- Allopurinol: It reduces uric acid production in the body.
- : It reduces uric acid production in the body.
- Probenecid: It acts on the kidneys to help eliminate uric acid.
- Pegloticase: This is a medication that is injected every 2 weeks. It reduces uric acid quickly and used when other medications fail.
Lifestyle and home remedies to treat acute gout and can prevent recurrent attacks:
- Limiting or avoiding alcohol consumption and drinks sweetened with fructose
- Limiting intake of foods high in purines, such as red meat, organ meats, and seafood
- Drinking plenty of fluids
Other Foods To Eat To Manage Gout
Instead of oatmeal, you can try:
- Fresh fruit smoothies made with plant-based milk
- Homemade oat and cherry muffins
- A Mediterranean breakfast
A Mediterranean diet involves choosing fruit, nuts and seeds, whole grains and cereals, potatoes, herbs and spices, and extra-virgin olive oil. It has consistently been associated with disease reduction. One study linked the diet to a reduced risk of gout attacks.
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Diagnosis And Conventional Medical Treatments
Blood tests can determine whether a patient is hyperuricemic , but the most definitive feature in the diagnosis of gout is the identification of monosodium urate crystals in joint fluid or aspirates of tophi. Once gout has been diagnosed, conventional medical treatments include:
- Drugs for acute attacks
- Drugs to reduce hyperuricemia
Are Tomatoes Recommended For Gout
Many sources, such as the Centers for Disease Control and Harvard Health recommend a diet high in colored vegetables and fruits, including nightshades like tomatoes. These foods contain nutrients like carotenoids called beta-cryptoxanthin and zeaxanthin, lycopene, and Vitamin C, all of which could help reduce inflammation and improve joint function.
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How Can You Tell If Tomatoes Are A Trigger For You
The best way to tell if tomatoes are a trigger for you is to eliminate all tomato products from your diet for a few weeks to see if your symptoms improve. Keeping a detailed record of what you eat for a while can help you pinpoint which foods might be triggering you.
Keep a food journal, record the following details each day:
- How you slept the night before
- What you eat for each meal and snack, including all beverages and condiments
- How much water you drink
- Your mood throughout the day
- What physical activity and exercise you do
- All medications and supplements you take
- Your areas and levels of pain in your body throughout the day
- Your energy or fatigue level throughout the day
See if any patterns emerge that could be connected to your diet or something else. Showing this record to your healthcare provider could also help uncover underlying triggers.
What Is Zinc Gluconate
Zinc is a mineral that is used as a dietary supplement in people who do not get enough zinc from food.
Zinc gluconate is not effective in treating flu or allergy symptoms.
Zinc gluconate may also be used for purposes not listed in this medication guide.
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Pregnant And Lactating Women
Increased nutritional demands during pregnancy and lactation predispose women to zinc deficiency. These demands are greater during lactation, although, physiological adjustments in zinc absorption help to meet the needs for lactation. A number of studies have demonstrated a negative impact of therapeutic supplemental iron on zinc absorption during pregnancy and lactation. In pregnant women where dietary intakes of zinc were low, supplemental iron, in dosages as low as 60 mg/day prevented them from meeting their needs for zinc. Situations that seem most likely to encounter problematic interactions are those in which the iron is administered in solution or as a separate supplement rather than incorporated into a meal.
What Are Some Other Side Effects Of This Drug
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if you have any side effects that bother you or do not go away.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.
Applies to zinc gluconate: compounding powder, oral lozenge, oral tablet, oral tablet dispersible
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Genetic And Physiological Diversity
Primates. In humans and higher primates, uric acid is the final oxidation product of purine metabolism and is excreted in urine, whereas in most other mammals, the enzyme uricase further oxidizes uric acid to allantoin. The loss of uricase in higher primates parallels the similar loss of the ability to synthesize ascorbic acid, leading to the suggestion that urate may partially substitute for ascorbate in such species. Both uric acid and ascorbic acid are strong reducing agents and potent antioxidants. In humans, over half the antioxidant capacity of blood plasma comes from hydrogen urate ion.
Humans. The normal concentration range of uric acid in human blood is 25 to 80 mg/L for men and 15 to 60 mg/L for women . An individual can have serum values as high as 96 mg/L and not have gout. In humans, about 70% of daily uric acid disposal occurs via the kidneys, and in 525% of humans, impaired renal excretion leads to hyperuricemia. Normal excretion of uric acid in the urine is 250 to 750 mg per day .
Dogs. The Dalmatian dog has a genetic defect in uric acid uptake by the liver and kidneys, resulting in decreased conversion to allantoin, so this breed excretes uric acid, and not allantoin, in the urine.
Invertebrates. Platynereis dumerilii, a marine polychaete worm, uses uric acid as a sexual pheromone. The female of the species releases uric acid into the water during mating, to induce males to release sperm.
Other Low Fat Dairy Products To Include In Your Diet
Apart from low fat yogurt, there are more options out there when it comes to dairy products. Stick to low or no fat milk for your cereals and cooking recipes the same rule applies to yogurt. Cottage cheese represents another good option same rule applies.
Fancy a different type of cheese? There is plenty of low fat or no fat alternatives to most options out there, from cream cheese and mozzarella to feta, cheddar, Parmesan or American cheese.
When considering such alternatives, make sure you actually get the right products. Many low fat products bring in false advertising. Check the label and ensure they actually include dairy products and not some alternatives or substitutes. Keep an eye on the whole list of ingredients, as some components might be associated with gout or other affections. For instance, some fat free yogurt may come with lots of sugar, while other brands include more sodium.
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