Read previous post:Gout and TurmericThe healing power of this ancient spice Turmeric has been gaining popularity in the last few years as a home...A previous study in by Choi et al in the USA showed that people with a higher vitamin C intake have a lower risk of gout. There are also studies in healthy volunteers that suggest that vitamin C supplements reduce blood uric acid levels. It is thought that vitamin C increases the excretion of uric acid in the urine. The exact mechanism is not known, however, it is thought to be something to do with the way the kidneys excrete uric acid. There is some evidence that vitamin C might also reduce production of uric acid as well but the major mechanism is thought to be through increasing excretion through the kidneys. We recruited gout patients who had blood uric acid levels greater than the treatment target level of 0.36 mmol/L (6 mg/100 mL). Of the 40 participants with gout, 20 patients taking allopurinol were given an additional 500 mg dose of vitamin C daily or had the dose of allopurinol increased, while another 20 patients were either started on allopurinol or vitamin C (500 mg/day).
We analyzed blood levels of vitamin C (ascorbate), creatinine and uric acid at baseline and week eight. Our study showed that a modest vitamin C dose (500mg/d) for eight weeks did not lower urate levels to a clinically significant degree in gout patients, but did increase blood levels of ascorbate (vitamin C). Patients were given vitamin C pills.The dose of vitamin C we gave was higher than the daily recommended intake and the blood levels of ascorbate (vitamin C) increased suggesting that patients were receiving adequate amounts.The degree of change in uric acid levels is similar to that seen in other studies. The amount of change is unlikely to have any significant clinical benefit for patients with gout. Higher doses of vitamin C could be studied, however the risks of higher doses needs to be considered. The dose we gave is already above the recommended daily dose and the blood levels reached a point where increasing them further was unlikely to have any extra effect.
Cherries have been reported to lower uric acid levels in women. They have also been reported to reduce the number of gout attacks. The mechanism by which cherries exert these effects is not entirely clear. It has been suggested that cherries increase uric acid excretion via the kidneys and may lower urate production. There are also other anti-inflammatory chemicals in cherries that may have an effect. The amount of vitamin C in cherries is probably not high enough to have any effect. The two most common reasons patients don’t reach appropriate urate levels are not taking the medicines that lower uric acid levels regularly and that the dose of the medicine is too low. The research was funded by the Health Research Council of NZ. We have plans to look at the effects of omega three fats in acute gout. There are two things you need to do when you are treating gout. Firstly, you need to treat the acute attacks as they come, secondly, in the long term you need to lower the uric acid to prevent the attacks from coming.
Omega three fats work like a natural anti-inflammatory. The study, which is being led by one of my colleagues in Wellington, will look at whether we could treat those acute attacks of gout by omega three fats rather than using anti-inflammatory drugs. Anti-inflammatory drugs can have quite a lot of side effects. Patients can look on the clinical trial registry web sites for studies on gout medicines. Professor Lisa Stamp is a Rheumatologist at the University of Otago, Christchurch and Christchurch Hospital. She is director of the Canterbury Rheumatology Immunology Research Group and the University of Otago Arthritis Research Theme. She received a University of Otago Early Career Award for Distinction in Research in 2009 and the Rowheath Trust Award and Carl Smith Medal for Research in 2011. Professor Stamp has an active clinical role in adult rheumatology. Her research interests include individualization of drug treatments in gout and rheumatoid arthritis. Vitamin C May Help Prevent Gout
Study Shows Vitamin C From Food or Supplements May Reduce the Risk of Gout March 9, 2009 -- Boosting vitamin C intake may be a simple way to help prevent one of the most common forms of arthritis. A new study shows the vitamin better known for fighting colds may also prevent gout. Researchers found men who had the highest vitamin C intake from supplements and food were up to 45% less likely to develop the painful condition than those who had the lowest. Vitamin C is found naturally in citrus fruit, broccoli, and other fruits and vegetables; it is often taken in supplement form. Researcher Hyon K. Choi, MD, formerly of the University of British Columbia, Vancouver, and now of the Boston University School of Medicine, and colleagues say other studies have suggested that vitamin C appears to prevent gout by reducing levels of uric acid in the blood. Buildup of uric acid can lead to the formation of crystals, which can deposit in the body, leading to the pain, inflammation, and swelling associated with gout.
In the study, published in the Archives of Internal Medicine, researchers analyzed the relationship between vitamin C intake and gout among 46,994 healthy men from 1986 to 2006. The men answered questionnaires detailing vitamin C intake through diet and/or vitamin C supplements every four years. During the study period, 1,317 new cases of gout were diagnosed among the participants. The results showed that those with higher vitamin C intake had a consistently lower risk of developing gout than others. For example, men with a vitamin C intake of 1,500 milligrams or more per day had a 45% lower risk of gout compared with those who had a vitamin C intake of less than 250 milligrams per day. Nearly all the men who had vitamin C intakes over 500 milligrams per day took vitamin C supplements. Researchers found that for every 500 milligrams of vitamin C the men took, the risk of gout was reduced by an additional 15%. Researchers say the results suggest that taking vitamin C supplements at the levels in the study (less than 2,000 milligrams per day) may be a safe and effective way to prevent gout.