Arthritis Treatment: What Is Synovial Fluid and Why Is It Important in Arthritis Diagnosis?

Arthritis Treatment: What Is Synovial Fluid and Why Is It Important in Arthritis Diagnosis? When a patient with arthritis presents to a rheumatologist, the most important thing to establish is a correct diagnosis. A careful history and physical examination are the most important tools. Laboratory tests and diagnostic procedures such as magnetic resonance imaging can also be helpful. One other important element is the examination of joint fluid. This material, referred to as synovial fluid (SF), is an important constituent of a normal joint. It is a somewhat viscous liquid manufactured by synovial cells, the cells that form the lining of a joint. Under normal circumstances only a small amount of the fluid is produced. The purpose of SF is to provide nutrients for cartilage and also to provide lubrication for the joint. When evaluating a patient with arthritis, if there is the opportunity to examine SF, it is essential that it be done. The fluid should be evaluated for appearance, total white blood cell count, the types of white blood cells, and also be cultured for bacteria. Normal SF is slightly yellow and clear- clear enough to read newsprint through. SF that has a lot of white blood cells will be cloudy and turbid. Cloudy synovial fluid is usually due to an inflammatory form of arthritis. When it becomes extremely cloudy, infection should be considered. Under normal circumstances, the total number of white blood cells in a SF specimen is less than 200 white blood cells per cubic milliliter. If there is infection, the total number of white blood cells will rise dramatically and the type of white blood cell changes. Joint fluid that contains more than 100,000 white blood cells per cubic milliliter is almost always due to infection. In special conditions, if suspected, the fluid should be cultured for fungus or tuberculosis. Careful examination of the SF for crystals can be rewarding as far as establishing a diagnosis. The most common forms of crystal induced arthritis are gout and pseudogout. Using a polarizing microscope is key to making the diagnosis when crystal-induced arthritis is suspected. The appearance of crystals of monosodium urate in gout is very distinct from the appearance of calcium pyrophosphate, seen in pseudogout. Monosodium urate crystals are needle shaped and calcium pyrophosphate crystals are stubby rod-shaped objects. One caveat: just because crystals are present doesn't mean there is no infection. Joint fluid should always be cultured. On rare occasion, fat droplets are seen in SF. This can signify either a fracture or a disorder of the pancreas.

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Choosing the Right Walking Stick for You

Choosing the Right Walking Stick for You If you are looking to buy a walking stick you may be surprised by the incredible range that is available. Although they may seem to be a very simple accessory, there is a huge variety of colours, lengths and styles on the market. Whether you are short or tall or just looking for a cane to match a particular outfit we will help you decide which one is right for you. When choosing your walking stick, first decide which type of handle you would like. One of the most popular handle types is the Derby handle, invented by Lord Derby. The idea for the handle came from Lord Derby requiring a practical cane that he could hook over his arm. The Derby handle offers excellent support as the user's weight is carried directly over the shaft of the walking stick. The Fischer handle is ideal for people who suffer from hand problems such as arthritis and rheumatism. This comfortable handle is named after Dr Fischer, an Austrian arthritis specialist who invented this type of handle. A Fischer handle orthopaedic walking stick will suit hands of many shapes and sizes and is available in left or right handed models. There are many more styles of handles available, all with different shapes and uses to choose from. Most walking sticks on the market will be height adjustable. This is incredibly useful is you are short or tall, or find that you prefer your cane a particular length. Orthopaedic canes are a very popular range as they address specific conditions such as arthritis, joint problems, visual impairment and rheumatism. Shock Absorber walking sticks contain a spring mechanism near the bottom of the cane. This spring reduces jarring each time the stick makes contact with the ground. A Shock Absorber cane is beneficial to those suffering from wrist or elbow problems. The practicality of a walking stick can be very important and if you travel frequently a folding cane is the ideal choice. Available in all handle types and colours, these canes can be folded away when not in use such as in a car or aeroplane. Folding sticks can also be height adjustable making them extremely versatile. If you do not see yourself using a traditional brown or black walking stick, there are hundreds of beautifully patterned and coloured canes available. Whether it is a subtly coloured handle or a full floral pattern there is a cane to suit your every mood. Floral canes with petite handles make the perfect gift for a little lady. Many women have small hands and find it difficult to hold a standard handle

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Arthritis Treatment: What Are the Common Tests Ordered on Arthritis Patients?

Arthritis Treatment: What Are the Common Tests Ordered on Arthritis Patients? Laboratory tests are an integral part of "working up" a patient with arthritis. While there is no substitute for a careful and thoughtful history and physical examination, laboratory testing has a number of important functions including screening in and out different conditions, confirming diagnostic suspicions, staging disease, monitoring progress of disease and checking on effects of therapy. While routine testing including complete blood count (CBC), chemistries, urinalysis, and such are part and parcel of "standard" testing, this article will focus on the "arthritis tests' most often ordered. The erythrocyte sedimentation rate (sed rate) is a time honored blood test for measuring inflammation. As a response to inflammation, the liver produces proteins that coat red blood cells. This causes the blood cells to clump and sediment faster than individual red blood cells. The sed rate is sensitive but not very specific, so that it can be increased as a result of inflammation due to arthritis, malignancy, or infection. Other conditions where the sed rate can be elevated are pregnancy and diabetes. The C-reactive protein (CRP) is another blood test that measures inflammation. It rises more quickly than the sed rate and resolves more quickly as well. In that respect it probably is a better test for monitoring the inflammation of arthritis. Unfortunately it can also be elevated in patients with other conditions such as heart disease, diabetes, cigarette smoking, and obesity. Rheumatoid factor is an antibody (IgM) that binds to another antibody (IgG). It is positive in about 70-75 per cent of patients with rheumatoid arthritis. Early in the disease it can be negative and it remains negative in about 20 per cent of patients with rheumatoid arthritis. It can also be positive in other diseases such as syphilis, sarcoidosis, malignancies, and infections. In recent years, other forms of rheumatoid factor have been identified which can be useful in diagnosing patients who have rheumatoid arthritis but don't fit the "usual mold." Anti-CCP is another blood test that is based on an autoantibody directed against the amino acid, arginine. It is much more specific than rheumatoid factor for rheumatoid arthritis although in our lab it is a bit less sensitive. Anti- CCP can occur early in the disease and predicts patients who will have more aggressive disease. We often will use the combination of rheumatoid factor and anti-CCP to achieve both increased sensitivity and specificity for diagnosis. Antinuclear antibodies are just that... antibodies directed against the nucleus of cells. This is a test that is useful for screening for systemic lupus erythematosus. A patient who is negative for ANA does not have lupus with about 99 per cent certainty. Unfortunately, ANA can be positive in many other conditions including other autoimmune diseases such as Sjogren's disease, scleroderma, inflammatory muscle disease, malignancy, and infection. It can also be positive in up to 30 per cent of healthy people. For patients where a high level of ANA is noted, there are more specific tests that can be ordered in order to sort out the diagnosis.

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The Presence of Arthritis Increases Heart Disease Risk

The Presence of Arthritis Increases Heart Disease Risk Arthritis is a widely-known joint disorder that's associated with a considerable amount of pain and often results in limited joint movement. While this disorder is associated with numerous other complications related to the joints alone, newer studies have revealed a possible association with heart disorders. It has been reported that the presence of arthritis such as rheumatoid arthritis and psoriatic arthritis, increases your risk of developing heart disorders! Risk of Atherosclerosis Atherosclerosis is a condition characterized by accumulation of fatty material (referred as plaque) along the walls of the blood vessels. This often results in narrowing of the blood vessels thereby reducing the amount of blood flowing through them. This in turn increases the workload of the heart, leading to numerous changes in the heart structure and functions. Additionally, the fatty material can often get dislodged from its original location and form blocks in the blood vessels within the heart (known as coronary arteries) and also other organs. Such a condition often results in blockage of the blood supply to the heart, which can lead to heart attacks. The study which evaluated the risk of heart disorders in individuals suffering from arthritis reported several findings which are a matter of concern. It was noted that individuals with arthritis had many important changes in the heart structure which were considered to be dangerous. Risk of atherosclerosis was one of the main concerns in arthritic individuals. Although these individuals did not have any prior symptoms of heart disorders, the findings suggested an increased risk of such an occurrence. It was noted that the thickness of the walls of the blood vessels was greater than before. The presence of plaque within the blood vessels was also observed. Further, the walls of the blood vessels had become stiff and were damaged at different places. All these findings suggested an increased risk of heart disorders in these individuals. Factors That Increased the Risk The authors of the study noted that the risk of heart disorders in individuals suffering from psoriatic or rheumatoid arthritis was higher in certain cases only. Individuals with severe form of arthritis or those with widespread arthritis had a higher risk of developing heart related complications than others. Additionally, factors such as the presence of rheumatoid arthritis, involvement of other organs, high cholesterol levels, and high blood pressure, further accentuated such abnormal changes in the blood vessels. Conclusion It was concluded that individuals suffering from arthritis are more prone to develop heart related disorders due to the increased risk of atherosclerosis. Therefore, such individuals should take adequate care to ensure that the cholesterol levels and blood pressure levels are within normal ranges. The symptoms and other related factors in psoriatic and rheumatoid arthritis must also be kept under control by strictly following the advice of the doctor. Although there is a risk of heart disorders in individuals with arthritis, with proper care and adequate preventive steps, it can definitely be decreased.

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Some Useful Home Remedies for Gout

Some Useful Home Remedies for Gout It is common knowledge that gout is a kind of arthritis that is most prevalent in men aged 40 and above. Although it may occur in younger people, particularly children, it is uncommon. The characteristic of gout that appears on individuals afflicted with it is that the person suffers extreme pain and inflammation on the joints. Not only is it painful to bear, but it also comes with a burning feeling that anybody would swear that it is not a good thing to undergo. Many who are under its spell find sleeping at night to be particularly difficult to achieve. Because of this, a lot of people are in search for gout remedies just to alleviate their situation. One can always consult a doctor or specialist for the treatment of gout. There are commercial pain medications available that will be recommended by your physician to treat and deal with the pain. However, this solution provides only a short term or temporary relief from the serious threat that gout brings. You may feel relieved from the pain, but the source of the pain is not addressed with certainty. A more holistic approach is recommended if you want to get rid of this disease at its source. It has been established in research that the main causes of gout are the following: • Hereditary factors - if your family has a medical history of gout, then you are prone to acquiring it as well; • Stress - this factor seems to pop out in every disease known to man; • Alcohol consumption - if you want to fight gout, then this is something you should be paying attention to; • Sugary foods - consumption of too much sweets can lead to gout; • Protein rich foods - meats and other sources of protein is a source of uric acid which is responsible for gout. The accumulation uric acid inside the body promotes the formation of urate crystals. These, on the other hand, build up around the joints of the body which becomes gout eventually. It is therefore advisable to watch your diet if you want to prevent gout from happening. You can also use lime juice which is also a favorite herbal remedy against gout. It helps breakdown the uric acid formation. Consume at least 4 glasses of this particular juice everyday mixed with water. Another juice which has the similar effect is black cherry juice. When it comes to fruits, nothing beats a serving of banana or apple each day. These fruits are champions when it comes to fighting uric acid inside the body. Try to consume garlic or saffron which is known to deal with gout as well. Nobody wants to fall prey to the excruciating pain that gout brings. Wit the help of these gout remedies, you can be in better position to deal with this affliction permanently. Remember, however, that though these gout remedies are effective, you need to couple these remedies with a change in your lifestyle to keep gout at bay.

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Arthritis Treatment: Osteoarthritis - What Is It?

Arthritis Treatment: Osteoarthritis - What Is It? Osteoarthritis (OA) is the most common joint disease. It affects approximately 28 million Americans and tends to become more common with increasing age. It is a universal condition in people past the age of 70 although not everyone is symptomatic. There are risk factors for the disease. Increasing age, as mentioned earlier is one. In addition, female gender, genetic predisposition, obesity, and trauma are the other important items. The most frequent targets for OA to strike are the neck, low back, fingers, base of the thumb, knees, and hips. Less commonly the ankles, shoulders, and elbows are involved. In these areas, antecedent trauma appears to be the primary cause. OA is what is called, a focal disease. What that means is that it doesn't affect the whole joint. It preferentially attacks certain areas within the joint. An example would be the knee where the medial (inside) part of the joint is affected far more often than the lateral (outside) part. In the hip, the top part of the joint tends to become involved while the rest of the joint is relatively spared. The same is true for other joints affected by OA. Symptoms of the condition consist of pain that is aggravated by use and relieved by rest. Also, there is short term stiffness with inactivity. This is called "gelling." Night time pain is also a common feature. Another common lament is crunching of the joint with movement. This is called "crepitus." On exam the rheumatologist will often spot swelling due to the formation of bone spurs, called "osteophytes." There can be tenderness of the joint, pain with movement, swelling due to fluid accumulation, and muscle wasting around the joint. In advanced cases, there is clear deformity and sometimes evidence of instability. Laboratory tests are usually normal. Imaging studies can help with the diagnosis. Magnetic resonance imaging will pick up early changes. X-ray findings also can help with the diagnosis. The problem is that if x-ray changes are evident, then the disease has progressed substantially. The primary changes seen on x-ray are narrowing of the joint, bone spurs, and changes in the bone underlying the cartilage. Joint fluid, if present, should be aspirated. The joint fluid is typically viscous, translucent, and has fewer than 200 white blood cells per cubic milliliter. Occasionally the white blood cell count will be higher if a patient has a particularly inflammatory form of osteoarthritis. This is the conundrum of OA. While the old thinking was that the condition was primarily a mechanical disease, it has become quite clear that OA has a significant inflammatory component as well. In future articles I will discuss more of the pathophysiology as well as treatment

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Knee Pain and It's Causes

Knee Pain and It's Causes Inner knee pain is a problem for many Americans. The fact that so many individuals have issues with pain in their knees makes for a very lucrative career for anyone interested in Sports Medicine. But the way the economy is many people don't have the money that is needed to pay someone to either tell them what is wrong with them or to fix the problem. Home diagnosis is becoming more common place than ever due to a lagging economy and the current state of the healthcare system and unfortunately some of the information that people are getting is either no good for their situation or is just plain no good. People want to know the reason that their knees are hurting and I am here to help elaborate on that. One of the most common causes of knee pain is age. As we grow older, our bones begin to breakdown and give out on us. The muscle fibers begin to lose the necessary elasticity that is required for them to move the way that they need to. At a certain age, we need to be aware of how our bodies are changing and respond accordingly. By adding certain vitamins to your diet you can help to revitalize your deprived joints. Another cause is a person's health, and by health we are referring to not only the amount of exercise that they engage in on a regular basis but also the types of food you take into your body. Things like salmon and almonds are great for your joints because they contain nutrients such as omega-3 fatty acids and are good sources of protein. Omega-3 has anti-inflammatory compounds that work wonders for someone who has issues with how their knees respond to certain activities. The protein that it provides also helps to rebuild muscle fiber and helps to rejuvenate your swollen and sore bones. One of the best things you can do, not only for your legs but for your life as a whole, is to start or continue a regular workout regiment and implement foods that are high in protein and healthy fats so that your body can take in what it needs and ensure that you are going to be able to maintain an active and long-lasting lifestyle. These are just a few of the reasons you may have pain in your knees but there are a gamut of causes and each instance is different. For situations you may feel are more than you can handle on your own please consult a physician for a full diagnosis.

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What Are the Elevated Uric Acid Symptoms of Gout?

What Are the Elevated Uric Acid Symptoms of Gout? It's generally accepted that the underlying cause of gout is elevated uric acid - a condition called 'hyperuricemia.' But many people get confused when they learn that not everybody with high levels will get gout and that there are folks with relatively low levels who will get gout. The truth is that, although there have been strides in understanding gout and how to treat it, there is still a lot that we don't know about gout, for example just why some people with high uric acid never get gout and some who have low levels do. Reasons for Elevated Uric Acid There are several reasons for high uric acid:- - diet high in purines (exists in body cells and foods) and fructose - abrupt changes to diet including fasting - rapid weight loss - hereditary reasons - kidneys not excreting excess acid fast enough - too much acid being produced for kidneys to handle Whatever the reason for hyperuricemia there is definitely a link between elevated acid levels and gout. But it isn't the uric acid itself that causes the symptoms but rather crystals of urate that can form out of the elevated acid levels and deposit themselves in the joints, tendons and surrounding tissue. Symptoms of Elevated Uric Acid and Gout The typical symptoms of gout are: - redness - swelling - inflammation - hot to touch - stiffness - great pain The majority of times - 50% to 70% of cases - these symptoms are found in the joint of the big toe, but they can also occur in the side of the foot, the ankles, knees, fingers, hands, and elbows. And because gout is caused by high acid levels then it's easy to see why some folks call these 'elevated uric acid symptoms.' Consequences of High Uric Acid and Gout One of the most serious long-term consequences of having recurring gout that most people aren't aware of is the damage that it can do to joints and kidneys. Frequently recurring gout can, over time, lead to permanently damaged joints as well as kidney issues such as painful kidney stones. Another fact that not enough people know about is that once a person has a gout attack the risk of having more attacks is significantly increased. And as time goes on these attacks can become more frequent and their symptoms more severe. That's why there is a pressing need for people with gout to not only get rid of their symptoms, but also to do everything possible to reduce their elevated uric acid levels and maintain them at more healthy levels, e.g. under 6 mg / dL.

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Arthritis Treatment: Psoriatic Arthritis - Background and Finally Getting Some Respect

Arthritis Treatment: Psoriatic Arthritis - Background and Finally Getting Some Respect One common form of arthritis that has been relatively ignored until recently is psoriatic arthritis. It is a systemic inflammatory destructive form of arthritis that is perhaps second only to rheumatoid arthritis in its ability to cause disability. It is often described as a mixed disease since unlike rheumatoid arthritis which is purely a destructive breakdown disease that causes bone loss, joint erosions, and joint destruction, psoriatic arthritis (PA), also causes new bone formation. The types of systemic features that accompany this condition are also unique in that inflammatory bowel disease, eye inflammation (uveitis), and psoriasis tend to accompany this type of arthritis. Another unique feature of the disease is the presence of enthesopathy, a localized inflammation at the site where the tendons attach to bone. Areas where this commonly occurs are the Achilles tendon, lateral epicondyle of the elbow, iliac crest, patellar tendon of the knee, plantar fascia of the heel, and the lateral hip. In addition, PA often presents with a peculiar condition called dactylitis. This occurs when the joints and tendon of a single digit or a few digits become acutely inflamed. This presentation is a hallmark of the disease. Patients with PA also have co-morbid conditions that can affect the disease. Examples include, high blood pressure, obesity, diabetes, elevated lipids, and heart disease. Treatments for psoriatic arthritis are not nearly as agreed upon as those for rheumatoid arthritis. While non-steroidal anti-inflammatory drugs (NSIADS) may be useful for early symptomatic relief, they are ineffective in regards to slowing disease progression. Second line drugs, called disease-modifying anti-rheumatic drugs (DMARDS), while often used in a similar fashion to the way they're used in rheumatoid arthritis, are not nearly as effective. For example, the DMARD of choice in rheumatoid arthritis is methotrexate. While this drug works in some cases of psoriatic arthritis, its results are not as predictable. Also, it appears that patients with this condition may be at more risk for liver toxicity due to methotrexate. Plaquenil, another DMARD that is used for RA, rarely is effective for the disease. Sulfasalazine (Azulfidine), has been used with some success but again, the results are not as predictable or dependable. The only group of medicines that appears to work well for psoriatic arthritis in a predicable fashion are the TNF inhibitors. There is some debate that certain TNF inhibitors work better for the skin than others. This is the subject of continued investigation. Other biologic treatmdnts are in the pipeline.

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3 Simple Increased Uric Acid Excretion Tips to Prevent Gout

3 Simple Increased Uric Acid Excretion Tips to Prevent Gout Gout sufferers have high uric acid because insufficient is being excreted from the body. This condition is called 'hyperuricemia' which eventually leads to gout. Here you'll discover 3 simple tips on how you can increase uric acid excretion in order to help prevent those excruciating gout attacks... Under normal conditions your kidneys flush excess uric acid from your body via your urine with a little excreted via stools. However, where your kidneys aren't working to their full potential and / or your body is just producing too much acid for your kidneys to handle, then not enough is being excreted leading to higher-than-normal levels of uric acid in the bloodstream. These high levels - a condition called hyperuricemia - can lead to the formation of microscopic crystals of urate forming in your joints and surrounding tissue causing the agonizing symptoms we know as gout. So if you suffer from gout, you are generally more likely to have high acid levels that need to be reduced. And once they have been reduced to much healthier levels they need to be maintained there for the long-term. The long-term is very important because recurring gout can lead to some serious health problems over time. These are issues such as permanently damaged joints and kidney problems such as stones. So a gout sufferer really needs to work hard to lower their high acid levels and maintain them there. One of the ways to do that is through increased uric acid excretion, i.e. by helping your kidneys to process and expel as much of it as possible. Here are 3 simple but effective ways of increasing your uric acid excretion:- 1. Vitamin C Vitamin C has been shown to help in the urinary excretion process and reduce overall acid levels. Although its better to do this through a diet that is rich in vitamin C, studies have shown that good quality supplements can also be effective. Note: Talk to your physician / doctor before taking any supplements to ensure they are right for your particular case. 2. Water Drinking at least 2.5 litres of water per day is a great help to your kidneys in excreting uric acid. Water has the added benefit of helping to prevent crystals forming because it's harder for them to form in a well-hydrated body. And it also helps in expelling crystals that have already formed. It's better if you drink the water regularly and evenly throughout the day. 3. Limit or Eliminate Alcohol Consumption Alcohol can actually inhibit the amount of uric acid excreted. This is why it is one of the most potent triggers for gout attacks. Remember that we want to increase uric acid excretion not inhibit it. That means eliminating alcohol altogether or, at the very least, limiting its consumption to a max of 2 units per day for men and 1 unit for women. Over 65's should limit their consumption to 1 unit per day. So there you have it, 3 simple tips for increased uric acid excretion..

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7 Foods to Avoid for Uric Acid Buildup and Prevent Gout

7 Foods to Avoid for Uric Acid Buildup and Prevent Gout If you are a sufferer then you know that high uric acid leads to gout. So you know you need to reduce those levels. A key part of the process is to avoid certain foods. But which foods? Here you'll discover 7 foods to avoid for uric acid buildup in order to prevent gout... "You are what you eat" may never be truer than in the case of gout. You see, although gout symptoms are caused by the buildup of crystals in your joints and connective tissue, these crystals generally only form when you have higher-than-normal levels of uric acid in your system. So how does high uric acid come about and what part does the food you eat play in all this? Uric acid is a normal byproduct of your body's metabolism, produced by chemical compounds in your body called 'purines' that breakdown during this process. Now, normal healthy levels are a good thing because this acid is a very important antioxidant. The problem is that higher-than-normal levels isn't such a good thing, causing things like gout and kidney stones, among other things. But as long as your kidneys are healthy and working to their full potential they process and flush excess uric acid out of your body, leaving sufficient to do all the good things necessary. However if your kidneys aren't working effectively then not enough acid is being excreted and the excess is retained in the blood. This can lead to crystals forming in the joints and so gout. The problem is that even when your kidneys are working effectively there is another cause of high uric acid, which is that your body is producing too much for your kidneys to handle. One of the reasons for this could be your diet. The foods you eat also contain purines, some much more than others. So eating a diet that's high in purines only produces more uric acid, maybe more than your kidneys can handle. That's why it's important for gout sufferers to take a close look at their diet and consider making any changes necessary to help reduce the production of uric acid. 7 Foods to Avoid for Uric Acid So what foods should you avoid for uric acid? Seven foods that are particularly high in purines are:- 1. Organ meats: e.g. liver, heart, kidneys, brains, sweetbreads. 2. Game and game birds: e.g. venison, rabbit, partridge, pheasant, duck. 3. Shellfish: e.g. prawns, shrimp, langoustine, scallops, mussels. 4. Certain fish: e.g. mackerel, herring, anchovies, sardines, fish roe. 5. Some poultry: e.g. goose, turkey, chicken. 6. A few vegetables: e.g. mushrooms, spinach, cauliflower, asparagus. 7. Gravy / meat extracts: e.g. gravies, consomme, broth, boullion. Although not a food, alcohol is known for being a major trigger of gout and should be avoided, especially beer, because brewer's yeast - and baker's yeast - is also high in purines. Whilst it's much better to avoid these foods if you can, it clearly can be difficult to stick to long-term. So, if you find it difficult then, at the very least, you should reduce their consumption in terms of how much you eat at one sitting and how often you eat them. For example, eat no more than a total of 6 ounces of lean meat, fish and poultry per day. But, while doing this, you're still best to avoid game and organ meat altogether as they are so very high in purines. [Note: Before changing your diet you must always consult your healthcare provider / physician for advice about its suitability for your particular case.]

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How to Lower Uric Acid Symptoms of Gout Using This Simple Fruit

How to Lower Uric Acid Symptoms of Gout Using This Simple Fruit The uric acid symptoms of gout - redness, warmth, swelling, inflammation, stiffness and horrible pain - can be prevented if you can lower your uric acid levels and keep them there. Here you'll discover a popular fruit that can help you achieve that aim... High uric acid is the precursor to gout because urate crystals can form and settle in your joints, thus causing your painful gout attacks. Now, if this is your first gout attack, you need to know that your are most likely to have more. And as these occur they can become more frequent and more intense. You must prevent this happening to you, not just because these attacks are so debilitating, but because recurring gout can actually leave you with permanently damaged joints and kidney problems such as painful kidney stones. So, by reducing these acid levels in your body, you can help to prevent your gout reoccurring time and time again and prevent some serious health issues in the future. When you have a gout attack the usual thing is to take NSAIDs - non-steroidal anti-inflammatory drugs - either over-the-counter or through prescription. And these can work over time to reduce inflammation and relieve pain. What they don't do is prevent future attacks. For future attack prevention your physician sometimes prescribes drugs to lower your uric acid. These can also be very effective. But they are only effective whilst being taken. If you stop them they cannot work and your gout can come back. This is why they are a long-term solution, sometimes being taken for life. Not everybody wants to take drugs and even those who do can suffer side effects from taking these medications. Luckily, there are many natural remedies for gout which more and more gout victims are turning to today. One such home remedy to lower uric acid symptoms is to consume cherries on a daily basis... Cherries contain anthocyanins which have natural anti-inflammatory properties. And studies have shown that they can also lower uric acid levels. So not only are cherries excellent for reducing inflammation and relieving the pain of an actual gout attack, they can be very effective in reducing your uric acid levels and so helping to prevent those dangerous recurring attacks. Some research points to 20 cherries a day as having the same effect as taking one NSAID. In terms of lowering uric acid levels for gout prevention, suggestions for the correct daily 'dose' varies anywhere between 6 and 40... In the 1950s a certain Dr. Blau recorded that he had 'cured' his gout by consuming 6 cherries per day. But more recent studies seem to suggest you probably need more than that. Of course everyone's metabolism is different, so you need to use trial and error to discover what works for you. One report suggests 30 to 40 cherries every 4 hours to help relieve uric acid symptoms during an actual gout attack. For gout prevention through lowering uric acid you might want to consider 30 to 40 cherries per day. Studies have also pointed to the effectiveness of cherry juice. So, where you can't get fresh cherries, you could use cherry juice as an alternative. But don't use the juice you get in cans of cherries you get in the supermarket. You need to get this juice from a health food store or perhaps the pharmacy.

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Rheumatoid Arthritis Pain Management Tips

Rheumatoid Arthritis Pain Management Tips Rheumatoid arthritis is an inflammatory disease. The disease progresses and affects the joints. It can also affect other parts of the body. One of the most difficult issues with rheumatoid arthritis is the pain from inflammation. Little is known about the cause of the disease; however, it causes the immune system to attack healthy tissues within the body. The symptoms of the disease present themselves slowly, usually starting with stiff joints in the ankles, wrists, feet or fingers. Over a period of time, the disease can cause the hands, or other affected areas, to become deformed. The process for managing rheumatoid arthritis is a combination of many factors over a patient's lifetime. The severe pain can make sleep difficult and contribute to a low quality of life and fatigue. Managing the pain associated with rheumatoid arthritis is one of the most important components of living with the disease. There are several techniques sufferers can use to lessen the pain. Following are some rheumatoid arthritis pain management tips. Joint Techniques Move your joints consistently. When you wake up in the mornings and before you retire to bed at night, you should move your joints as much as possible. Moving the joints to the full range you can will keep your joints in motion, which can reduce pain. Make sure you don't move them to the point of pain and be gentle during your movement exercises. Hold items using the palms of your hands. Using your fingers to pinch items, such as paper, pens or books, for extended periods can cause your pain to arise. If you plan to hold something for an extended time, make sure you use your palms. Physical Therapy Use heating techniques. Heating inflamed areas can provide great relief from pain. Use a heating pad on the joints that are causing a problem. You can also contact a physical therapist for professionally administered and monitored electrical treatments. Use cold compresses to reduce swelling. An ice pack or ice in a soft cloth can help reduce any swelling and inflammation. Dietary Options Studies suggest that omega-3 fatty acids have a positive impact on rheumatoid sufferers. You can consume more fish oils by increasing your fish intake or purchasing the supplements at your local grocer, convenience store or health food shop. Avoid saturated fats. Studies also show that consumption of saturated fats can increase inflammation, which will cause more pain. Furthermore, consuming a lot of omega-6 fatty acids can also cause additional inflammation, cancer or heart disease. Select a magnet for natural therapy. You can locate magnets in many forms at natural product stores or health shops. The magnets come in a number of forms and may assist with reducing your pain.

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Arthritis Treatment: New Trends in Gout Management

Arthritis Treatment: New Trends in Gout Management At a recent conference in Colorado, discussion of the optimal treatment for gout was a major area of discussion among rheumatologists. It appears that the disease, while growing in incidence and prevalence is not being treated appropriately. Factors that seem to contribute to this phenomenon are: metabolic syndrome (the association of diabetes, obesity, high blood pressure, elevated blood lipids), obesity, excessive alcohol ingestion, and the increased intake of high fructose containing beverages. Roughly eight million Americans have the disease; yet, only three million are being treated. Another issue is noncompliance. Studies have shown that about half of patients with gout don't take their medicines. Some important issues have been raised. First, not all patients with an elevated serum uric acid (SUA) have gout and not everyone with an elevated SUA should be treated with uric acid lowering therapies because of potential side effects. That being said, very elevated SUA levels should not be ignored because they are linked to high blood pressure, diabetes, chronic kidney disease, and cardiovascular problems. Any level of 6.8 mgs/dl or higher is abnormal. Nowadays, laboratory "normal values" are higher than they were in the past because of the changing health status of Americans. More are obese and more have elevated SUA. They are the ones on whom the new "normal values" have been based. Does that make the "new normal" acceptable? Absolutely not! The Framingham study showed that people who had SUA levels higher than 9.8 mg/dl had a 22 per cent chance of getting gout within 5 years. Clearly, instituting early treatment for a gout attack is wise. Among the drugs that work well include non-steroidal anti-inflammatory drugs, colchicine, and glucocorticoids. Sometimes, combinations of these drugs need to be used in order to break an attack. SUA lowering treatments should not be started until the acute attack has been resolved. One big mistake is that some physicians unfamiliar with gout will start uric acid lowering treatment at much too high a dose. This only increases the likelihood of drug toxicity without increasing the chances of successfully controlling the gout. The two most effective drugs available for lowering SUA currently are allopurinol and febuxostat (Uloric). In patients where these drugs are ineffective, peguricase (Krystexxxa) is a viable option. The way to treat gout is to start low and go slow with frequent monitoring of SUA level shooting for a target of less than 6.0 mgs/dl.

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Arthritis Treatment: Lumbar Spinal Stenosis - An Increasingly Common Arthritis Problem

Arthritis Treatment: Lumbar Spinal Stenosis - An Increasingly Common Arthritis Problem Lumbar spinal stenosis (LSS) is one of the most common maladies seen by rheumatologists. It is a condition that affects the low back. To understand what happens with this condition, it's important to briefly review the anatomy. The lumbar spine consists of bones, called vertebrae, which are stacked one upon the other and separated by rubbery discs in the front and by joints (called "facet joints") in back. Down the center of this stack is a tunnel that where the spinal cord is housed. The column of bones is supported inside and outside the tunnel by a series of ligaments. LSS occurs when the spinal cord is compressed. There are three abnormalities that are responsible. First, the discs begin to bulge as a result of aging. They dry out and flatten. This leads to disc protrusion into the tunnel where the spinal cord passes. Second, the facet joints develop arthritis and the spurs from these facet joints protrude into the tunnel also. Finally, one of the ligaments that supports the spinal column inside the tunnel begins to hypertrophy and this also protrudes into the tunnel. The end result is pressure on the spinal cord. The history and physical examination are usually enough to suspect the diagnosis. Typically a patient older than 70 years will present with low back pain that is aggravated by walking or standing and relieved by sitting or by bending forward. The pain radiates from the back into the buttocks and sometimes the thighs. Patients will walk with a wide-based gait- legs wider than usual because they feel unstable. This is because the normal signals that are sent from the brain to the feet are not being received so the patient's sense of where they are in space is abnormal. Severe spinal stenosis is accompanied by bladder problems such as urinary frequency- going to the bathroom much more often than normal. LSS is often confused for vascular claudication. This is a disorder where the blood flow to the legs is compromised because of narrowing of the arteries. The symptoms are similar. Also, narrowing of the spinal canal in the neck and hip disorders can also mimic lumbar spinal stenosis. The diagnosis can be confirmed by either magnetic resonance imaging (MRI) or by CT scan of the low back. The natural history of the disorder is one of progression. Conservative measures such as epidural steroid injections and physical therapy can be useful but most patients will require surgery which is often very effective.

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Arthritis Treatment: Four Drugs That Can Cause Excruciating Aches and Pains

Arthritis Treatment: Four Drugs That Can Cause Excruciating Aches and Pains One area that is overlooked when it comes to arthritis are drug-induced aches and pains. Here are four categories of medicines you might want to avoid. Statins: Statin drugs cause a number of muscle problems. First, they can cause simple muscle aches and pains. This condition usually gets better once the drug is discontinued. The second problem statins cause is mild muscle inflammation along with weakness. The blood muscle enzyme, CPK, is mildly elevated. While this problem also gets better once the drug is stopped, it may take several months to resolve. Finally, statins can cause extreme muscle inflammation, damage leading to profound weakness. The CPK, is markedly elevated. When the muscles get this damaged, they release a protein called myoglobin into the blood. Myoglobin in large quantities can lead to kidney failure. The risk of muscle injury is increased when a statin is used with other drugs that also affect muscles. When statins are combined with drugs like niacin or fenofibrate, the incidence of muscle damage is greatly increased. Fluoroquinolone antibiotics: Fluoroquinolone-induced tendon problems such as rupture, are described in the medical literature. The Achilles tendon is the commonly involved site, although other tendons can be affected. Usually, spontaneous tendon rupture happens during or shortly after a course of treatment, but symptoms can occur even months after taking these antibiotics. Whether fluoroquinolone antibiotics should be used in patients with a history of tendon problems or who have risk factors for the development of tendon ruptures basically depends on how serious the infection is and whether there are suitable alternatives. People at the highest risk are those over the age of 60 years, people taking steroid drugs, and people who have had an organ transplant. Patients who exercise and already have tendon problems are also at risk. Aromatase inhibitors: A small number of women receiving estrogen-depleting treatment termed "aromatase inhibitors" will develop aches and pains. Symptoms are most prominent in the hands and can be so severe that patients ask to be taken off therapy. More than 25% of women can be affected by this syndrome which affects hands, knees, elbows, ankles, and a few other other areas. Symptoms are usually transient and resolve when the aromatase inhibitor is discontinued. There have been incidences reported in the literature of patients developing rheumatoid arthritis after treatment with these drugs. Therefore, assumptions regarding the cause of aches and pains with these drugs should not be made. Symptomatic treatment with non-steroidal anti-inflammatory drugs may be helpful. Bisphosphonates: These drugs are used for osteoporosis treatment. Unfortunately they cause two types of pain syndromes. The first is the acute phase response which consists of fevers, chills, bone pain, muscle and joint pains that starts after initial administration of bisphosphonates. These symptoms tend to resolve within several days after discontinuation of the drug. The second syndrome is experienced either within days of taking the bisphosphonate or it can occur after months, and even years of being on the drug. The pain is excruciating and incapacitating in many cases. Some patients get better after stopping taking the bisphosphonate but there are others who do not.

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5 Uric Acid Reduction Supplements to Help You Beat Gout

5 Uric Acid Reduction Supplements to Help You Beat Gout If you suffer from gout then you probably already know about uric acid reduction through changes to your diet. This normally takes the form of a low-purine diet so that your body produces less overall acid. This is because purines -- chemical compounds in your body and food -- break down during your body's metabolizing process and form uric acid which is ordinarily flushed from your body by your kidneys. But, if your kidneys aren't working effectively, or your body's producing too much acid for your kidneys to deal with, then excess acid is retained in your blood. This gives rise to the formation of crystals of urate in your joints, thus leading to the excruciating symptoms of gout. The problem is that many diets that are low in purines are also low in some important vitamins and nutrients that your body needs to stay healthy. This is why taking dietary supplements can be so important when you're on these low-purine diets. An added benefit of taking such supplements when you're on a low-purine diet is that some of them can actually help to reduce your acid levels as well. But, even without such a diet, these acid-reducing supplements can still help, although they would be even more effective if they were combined with a low-purine diet. So what are the supplements that can help to lower uric acid levels in your body? The following are 5 uric acid reduction supplements to help you beat your gout:- 1. Vitamin B complex: Helps your body to convert uric acid in the blood into harmless components. 2. L-glutathione: Aids your renal glands in excreting uric acid out of your body. 3. Tissue salts: These help prevent the formation of crystals of urate in your joints. 4. Vitamin C: Lowers your uric acid levels as well as helping to reduce inflammation. 5. Vitamin E: Although this won't reduce your acid levels, it's been listed here because a lot of low-purine diets are low in vitamin E. So you might want to consider taking it if you're on such a diet. (Note: As always you should talk to your doctor before making any changes to your diet and / or taking any supplements. Always be guided by them because they know your individual health circumstances.) But a word of caution here; not all supplements are the same. Make sure you go to a reputable health food store and talk to the owner about where their supplements come from and where their ingredients are sourced. You only want the very best ones. Uric acid reduction is just so important for victims of gout. You see, if you can't reduce your acid levels to normal healthy levels and keep them there over the long-term, you are highly likely to keep getting gout attacks. And recurring gout is known to cause serious joint and kidney problems (e.g. kidney stones) down the line. This is why a combination of dietary changes with additional supplementation can be an effective first step in uric acid reduction...

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Arthritis Prevention And Relief

Arthritis Prevention And Relief About 50 million people in the U.S. have some form of arthritis. Arthritis is a general term that means inflammation of the joints and is often accompanied by symptoms such as redness, swelling, stiffness, and pain. There are more than 100 types of arthritis with osteoarthritis and rheumatoid arthritis being the most common. Causes vary depending on the type of arthritis. However, in all arthritic conditions, the degeneration of joints involves some ongoing biochemical processes which negatively alter the metabolism that is essential for maintaining healthy joints. Common Forms Of Arthritis Here is a brief explanation of some frequently diagnosed forms of arthritis: Osteoarthritis (OA), also known as degenerative arthritis or wear-and-tear arthritis, is the most prevalent type of arthritis affecting over 20 million Americans. OA is the degeneration of the cartilage within a joint. The synovial fluid that keeps the joint lubricated and cushioned is typically reduced as well, eventually leading to abnormal bone changes. OA is the most common form of arthritis. It is not a systemic condition and does not spread throughout the body. It affects only the joint(s) where the deterioration has occurred, of which most common are the knees, hips, spine, hands, and toes. Rheumatoid arthritis (RA) is a systemic inflammatory disease which manifests itself in multiple joints of the body, especially the fingers, wrists, feet, and ankles. It primarily affects the lining of the joints (synovial membrane), leading to erosions of the cartilage and bone and sometimes, joint deformity. RA may also affect nearly every other part of the body. It is an autoimmune disease, which means the body's immune system mistakenly attacks the healthy tissues. RA usually affects joints on both sides of the body equally and is often associated with fatigue and prolonged stiffness after rest. Gouty arthritis is a defective metabolic disease of uric acid crystals depositing in the smaller bones of the feet and is usually accompanied with acute pain. Uric acid is a metabolic product of fructose and purines (nitrogen compounds) found in meats and organ meats. Juvenile arthritis refers to all types of arthritis that occur in children. Adkylosing spondylitis affects the spine. Due to inflammation, the bones of the spine grow together. Fibromyalgia affects the muscles and attachments to the bone. It is most commonly found in women. Infectious or septic arthritis is infection of one or more joints caused by bacteria, viruses, and fungi. In some cases, infectious arthritis can occur as a manifestation of Lyme disease, which is transmitted through the bite of an infected deer tick. Psoriatic arthritis is a form of inflammatory arthritis that is associated with the autoimmune skin disease called psoriasis. Systemic lupus erthematosus (lupus) is an autoimmune disorder that can inflame the skin, joints and connective tissues, kidneys, brain and other organs throughout the body. Causes Of Arthritis The causes associated with inflammation of the joints depend on the form of arthritis. They may include: Age: The older you are, the more likely you are to develop arthritis, especially osteoarthritis. Autoimmunity: Rheumatoid arthritis, psoriatic arthritis, and lupus arthritis are examples of autoimmune disorders in which the body's tissues are attacked by its own immune system. Heredity: Scientists have discovered that the genetic marker HLA-DR4 is linked to rheumatoid arthritis, and HLA-B27 to ankylosing spondylitis and psoriatic arthritis. Although having the gene doesn't mean that you will absolutely get this form of arthritis, you can if the conditions are right. Infections: Some forms of arthritis are the result of bacteria, viruses, or fungi that can either cause the disease or trigger it in susceptible people. Lyme arthritis comes from bacteria transmitted by the bite of a deer tick. Rheumatoid arthritis may be triggered by a virus in people with a certain genetic marker. Metabolic abnormalities: Gout, which affects mostly men, is the result of a defect in body chemistry, and in this case, the metabolism of uric acid. Overuse: Repetitive motions can put tremendous strain on joints. Sustaining an injury to a joint further increases the odds of developing osteoarthritis in that joint. Eat Right To Beat Joint Inflammation Check for food sensitivities Researchers found that rheumatoid arthritis and many other autoimmune disorders are highly related to food sensitivities, one of which is gluten. Gluten is a protein composite found in grass-related grains such as wheat, rye, barley, spelt, and kamut. When the immune system misidentifies certain foods as "foreign", chemicals are released from immune cells to destroy these "invaders". As a result, tissue inflammation and damage occurs. Overtime, food sensitivities compromise the integrity of the gastrointestinal lining and lead to a condition called "leaky gut syndrome", whereby molecules that are usually too large to exit through the gastrointestinal lining escape to the bloodstream, causing systemic inflammation and in some cases, joint destruction. If you have autoimmune-related arthritis, you should get a blood test, such as the Mediator Release Test (test for IgG, IgM, C3, C4), for food sensitivities. You can contact me if you need to do this test. Once you have determined your reactive foods, abstain from eating them for 3-6 months. The best way to be sure that a reactive food is safe again to eat is to challenge it by having it three times a day for three consecutive days. If no adverse symptoms appear, you are no longer sensitive to it. More Omega-3, Less Omega-6 Cyclooxygenase or COX is an enzyme your body produces that regulates prostaglandins, which are mediators and messengers. There are two different COX enzymes - COX-1 and COX-2. COX-1 is an enzyme that regulates prostaglandins that maintain the health of your stomach and kidneys. COX-2 is an enzyme created when there is inflammation. When you take a non-steroidal anti-inflammatory drug (NSAID) such as aspirin, acetaminophen, or ibuprofen to treat pain and inflammation, it inhibits the production of COX-2, hence, reducing pain and speeding up the recovery. However, one of the side effects of NSAID is that it also inhibits COX-1. Since COX-1 keeps your stomach lining healthy and affects blood clotting, NSAID has the tendency to cause stomach irritation and ulcers. Fortunately, there is a non-drug way to cut down your inflammation. Researchers learned that COX-2 enzymes become more active and cause more inflammation when you take in too much omega-6 fatty acids relative to omega-3 fatty acids in your diet. Omega-6 fatty acids are abundantly found in corn, cottonseed, safflower, soybean, sunflower, and vegetable oils. Beware that many processed foods, snack foods, deep fried foods, and restaurant foods are prepared with such oils, so you want to keep consumption of these products to a minimum. Foods that are rich in omega-3 fatty acids are fatty, cold-water fish such as Alaskan salmon, anchovies, sardines, and herrings and meats from grass-fed animals. Numerous studies have shown that omega-3 fats are remarkably effective in combating inflammation-related disorders, including arthritis. Lastly, you should never use canola oil although it has been marketed as "heart-healthy" and is higher in omega-3 and lower in omega-6. The reason is that canola does not come from a natural plant but instead, the genetically engineered rapeseed plant. What's more, a recent study indicates that canola contributes to vitamin E deficiency, a vitamin that's essential for a healthy heart. Eat Your Vegetables Have generous servings of organically grown vegetables every day. They are low in sugar and full of antioxidants which help reduce tissue damage from inflammation. However, when you have arthritis, you should avoid the nightshade vegetables (eggplant, all kinds of peppers, white potatoes, and tomatoes). They contain a substance called solanine, to which some people are highly sensitive. Solanine interferes with enzymes in the muscles and may cause pain and discomfort. Other Nutrients For Joint Health Astaxanthin Belongs to a group of natural pigments in the carotenoid family. Sea creatures with a red or pinkish color such as salmon, lobster, shrimp, and crab get this color from a diet of krill and other small organisms that eat astaxanthin-rich algae and plankton. Research found that astaxanthin is the strongest natural antioxidant known. It is many times more potent than vitamin C, E, beta-carotene, lutein, or pycnogenol. However, you need a higher concentration than what you normally get in seafood to reap the benefits. Astaxanthin is a very effective remedy for joint pain from osteoarthritis and rheumatoid arthritis. If you have arthritis, start with 2 mg a day and gradually build up to 8-10 mg a day. Make sure your astaxanthin supplement is derived from marine algae and not synthetic. Vitamin D Cartilage loss, one of the distinctive signs of osteoarthritis, is associated with low levels of vitamin D. If you have joint pain due to osteoarthritis, get a blood test for your vitamin D level. The optimal is between 50-70 ug/ml. Glucosamine Provides joints with the building blocks they need to help repair the wear-and-tear on cartilage. Takes a few months to build up enough to see a benefit. If you have arthritis, you need to take up 2-3 grams a day. Many glucosamine supplements come with chondroitin or MSM (methylsulfonylmethane). Studies on the effectiveness of chondroitin and MSM have been inconclusive. Glucosamine supplements are always attached to salt. If your body is sensitive to salt, you should be careful with it. Most of the glucosamine on the market is derived from shellfish. If you are allergic to shellfish, you should avoid it. Some studies found that glucosamine may raise blood sugar levels in some people. If you are diabetic, you should be very cautious. Concentrated tart cherry juice Most effective for gouty arthritis. Drink several tablespoons per day. Exercise To Keep Joints Healthy & Flexible Exercise is a must when you have arthritis. It helps build muscles, increase joint flexibility, and improve your general sense of well-being. If you have not been exercising regularly, start slowly and build up to higher activity levels to prevent injuries. Avoid intense activities that may strain the affected joint(s). Your goal is to keep moving and commit yourself to regular exercise that includes these three types of activities: flexibility exercises (such as stretching, tai chi, yoga) weight training to strengthen surrounding muscles that support and protect the joint(s) aerobic exercises (such as walking, swimming, stationary cycling) If you have significant pain with movement, you should consider working with a physical therapist or qualified personal trainer who can develop a safe and effective workout program for you. Lose Weight If You Are Overweight One of the benefits of exercise is its ability to help you achieve and maintain your ideal weight. Arthritis rates are more than twice as high in obese people as those who are normal weight. If you are overweight or obese, you have a higher risk of developing osteoarthritis. Each additional pound of body weight increases the compressive load over your knee by roughly four pounds. Fat cells also produce cytokines which are proteins that encourage inflammation. The more fats cells you have, the more inflammation in the body. Carol Chuang is a Certified Nutrition Specialist and a Metabolic Typing Advisor. She has a Masters degree in Nutrition and is the founder of CC Health Counseling, LLC. Her passion in life is to stay healthy and to help others become healthy. She believes that a key ingredient to optimal health is to eat a diet that is right for one's specific body type. Eating organic or eating healthy is not enough to guarantee good health. The truth is that there is no one diet that is right for everyone. Our metabolisms are different, so should our diets. Carol specializes in Metabolic Typing, helping her clients find the right diet for their Metabolic Type. To learn more about Metabolic Typing, her nutrition counseling practice, and how to get a complimentary phone consultation

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Arthritis Treatment: New Hope for Tophaceous Gout?

Arthritis Treatment: New Hope for Tophaceous Gout? Gout, a disease of antiquity, is experiencing a resurgence. In fact, it's been estimated that more than eight million Americans may have the disease. There are several reasons for this. First, more Americans are obese, a significant risk factor for gout. Second the obesity is often accompanied by other risk factors such as high blood pressure, diabetes, and elevated blood lipids, the combination being known as "the metabolic syndrome." Finally, there has been an increased availability as well as increased consumption of high fructose containing beverages, another risk factor for gout. The underlying physiologic reason for gout is the inability of the body to rid itself of uric acid. Uric acid is a byproduct of the metabolism of purines, a major constituent of many foods. Ordinarily, the kidneys are responsible for the bulk of elimination of uric acid but in gout they cannot keep up with the huge burden of uric acid in the blood. While most people who experience one or two attacks a year can be managed conservatively, patients who experience repeated attacks or who have markedly elevated levels of serum uric acid (SUA), are candidates for medical treatment. Medicines such as colchicine, non-steroidal-anti-inflammatory drugs, and steroids are helpful for breaking acute attacks of the disease. For chronic disease where the aim is to lower SUA, medicines such as probenecid, allopurinol, and febuxostat (Uloric) are useful. However, a small percentage of patients will not respond to these measures. Some patients with long-standing gout develop tophi, collections of uric acid near the skin surface. These are an indication of a tremendous uric acid burden. A new drug called pegloticase (Krystexxa) lowers SUA by converting it to allantoin, an inert ingredient. It is administered intravenously in a dose of 8 mgs intravenously every two weeks and drives the SUA to 0 within 3 months. Tophi "melt away." The down side is that approximately 25-50 per cent of patients will develop blocking antibodies to the drug and if not recognized, can experience severe infusion reactions. The way to spot this coming is get a SUA level the morning before a proposed infusion. If the SUA is 4 mgs/dl or higher the patient has developed antibodies and is at high risk for an infusion reaction and should not be given pegloticase. Patients should not receive other SUA lowering therapies along with pegloticase since they may mask the development of antibodies. Patients should be screened for G6PD deficiency since this is a contraindication to receiving pegloticase. Finally, "prepping" a patient with steroids and an antihistamine also lower the risk of infusion reactions.

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Lowering Uric Acid to Prevent Painful Gout and Kidney Stones

Lowering Uric Acid to Prevent Painful Gout and Kidney Stones As you probably already know, uric acid crystals in the joints cause the horrible symptoms of gout. But did you know that recurring gout can cause permanent joint damage? And did you know that crystals can also form in the kidneys where they can eventually 'clump' together to form painful kidney stones? So what can you do to prevent this happening to you? First, let us look at how these crystals are formed in the first place... Urate Crystals Crystals of urate can form when you have high uric acid levels in your blood. They usually don't when your levels are normal because your kidneys process and flush excess acid out of your body. But if your kidneys aren't working to their full potential, or your body is over-producing uric acid, then you are left with excess in your bloodstream that, over time, can form into crystals in your joints and kidneys. Medical tests can pinpoint which of the two scenarios above could be the underlying problem. For example, if they show that you have high acid levels in your blood but low levels in your urine, this could indicate that your kidneys aren't working efficiently. If, on the other hand, the tests show high levels in your blood and high levels in your urine as well, then this could indicate that your kidneys are fine but that the body is producing too much acid for your kidneys to cope with. Either way, your body has too much acid which then forms crystals in your joints, causing gout and possible long-term joint damage. But then, crystals can also be deposited in your kidneys where they clump together to form stones. So you need to think about lowering uric acid and maintaining it at healthy levels... Lowering Uric Acid In order to prevent urate crystals forming you need to find ways of lowering your uric acid levels and maintaining them at these healthier levels going forward. There are drugs that can do this of course, but they have to be taken long-term or, in some cases, for a lifetime because they only work whilst being taken. However, there are natural ways of lowering uric acid in order to help prevent gout, permanent joint damage and kidney stones... 1. Vitamin C Studies have shown that this vitamin can help your kidneys to excrete excess acid via urine and lower overall levels in your body. Dietary changes can do this but good quality supplements are effective too. 2. Water Drinking at least 3 litres of water a day can not only help your kidneys flush the acid out of your body, helping to lower acid levels, but it can also help to prevent crystal formation since it's harder for them to form in a well-hydrated environment. 3. Herbs Herbs such as Bachu (dissolves crystals and helps to flush them) and Devil's Claw (lowers uric acid levels) can be used. But, as with vitamin C above, you should talk to your doctor about the suitability of any kind of herb or supplement for your particular case. These are simple, sensible tips for lowering uric acid to help prevent gout and kidney stones. But they are only three of many other natural ways out there. Unfortunately, there are just too many to go into here...

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