To Arnoldtheskier et. al.
Time for a summary of what is going on with uric acid and u, and me
and anyone else that has gout.
First, people can, and many people do, have very elevated levels of
sodium urate in their blood and show absolutely no sign of gout. Why
this is, or to be more precise, why it is that some of us get gout,
i.e. crystallization of sodium urate is a big unknown. I'll leave it
at that because I have no information on that one.
The next most important issue is allopurinol and what it does. This
is very well documented and in fact the Nobel Prize was awarded, in
part for this finding.
Allopurinol does not affect your uric acid level, your dissolved
sodium urate level or your crystal deposits of sodium urate. No
effect at all, none nada. Uric acid is a completely stable substance
in the body and the only way, short of surgery, to remove uric acid
is to excrete it through your kidneys or to sweat it out through your
skin or, some physicians now believe, to move it out through your
bowls when you have dihreah, which culciccine does for us after we
have taken enough of it.
Allopurinol inhibits the enzyme in your body that converts the
precursor for uric acid into uric acid. The precursor and its
precursor, that is the two things that are there just before uric
acid is formed, are both much more soluble in water and more easily
handled by the kidney than uric acid. Allopurinol does nothing,
besides the side effects, but stop the production of new uric acid.
If you have a lot of uric acid stored in your body as uric acid, not
as the urate salt, then you will have to lower the uric acid level
through excretion and if you have a lot of excess uric acid, as
apparently arnoldtheskier did, it can take as long as three or more
years to eliminate the excess uric acid. Trophi are an extreme form
or excess uric acid and, by the way, not all people who suffer from
trophi get the gout attacks that are caused by the crystals.
More later, I have to go to lunch....
end of part one...
Give me your e mail address and I'll give you the detailed references.
Allopurinol does not affect the uric acid that you have in your
system. It prevents new uric acid from being formed. Since new uric
acid is not being formed, your body, through its own natural
processes, will work to remove the residual uric acid that was there
before you started the allopurinol.
Perhaps I didn't say it as precisely as I should but the fact is that
allopurinol does not affect the uric acid that is already there in
your body. This is important and it is important to understand the
difference between the uric acid that you already have in your system
and the uric acid that gets formed every day if you don't have
allopurinol. I'm refering to the uric acid that forms every day from
living and from the food that you eat.
Allopurinol will inhibit the formation of any new uric acid. If you
already have too much uric acid in your system, allopurinol will do
nothing to either help you get rid of it or to break it down.
Show me one credible reference that shows that allopurinol has any
affect at all on the uric acid that is already in your system. It
stops the formation, that's all it does.
This is a very important point for each of us to consider too. It is
important because even though we are on allopurinol, we may still
have high levels of residual uric acid and that uric acid must be
excreted before the overall uric acid levels can be brought under
control.
If you wish to challenge this assertion, either in this forum or
privately, please suggest a reference or references that describe how
allopurinol is active in breaking down uric acid. If I am incorrect,
then so be it. I do not have an emotional stake in trying to
understand what is going on. I do have a hurt toe and I am taking
allopurinol and before I started it, I did extensive research on just
what it does and why it works.
"What do you think happens when someone takes allopurinol?Think
about it..it is hard..does the uric acid level change?WELLll golly
gee it does..ain't that a BIG surprise..does it get lowerred?..HOLY
SMOKES..PANACEA..it does..HMMmm I wonder how this happenend?HMMmmm"
Your uric acid level gets lowered because allopurinol stops the
formation of new uric acid. Your body goes on removing the old uric
acid, like it always has, and eventually, after enough time, with no
formation of new uric acid, the normal bodily excretion catches up
and lowers your uric acid level.
Yes, I corrected your statement because you were in error and you
were propagating an incorrect interpretation of what is happening. It
is important that we understand what is correct. It is dangerous, as
you suggest, to fill this or any other forum with incorrect
assertions.
"Lowerring uric acid levels with Allopurinol"..how
many entries come up?..I will tell you..2030..
Read quickly down the page/s..there are literally thousands and
thousands of direct references..quotes..LITERALLY..about doing just
that.."Lowerring uric acid levels with allopurinol"
I went through the first 40 and didn't find even one that suggest
that alloppurinol is responsible for destroying the uric acid that is
already there in the system.
If you can find credible evidence that allopurinol actually acts to
help us destroy uric acid, then I will apolagize. My ego is not in
this, I have studied the mecahnisms of how it works and I believe
that what I have said is backed up with a large amount of scientific
research. It is important to all of us to understand what allopurinol
does, how it does it and what actions are incumbent on us when we are
taking it.
"Don't even bother with the semantics that it is not the
allopurinol that changes(LOWERS) the uric acid LEVELS..but it is the
components of allopurinol..containing an oxidase xanithane
inhibitor..that control/RESTRICT the production of NEW uric acid..and
therefore the LEVEL of uric acid..overall somehow magically gets
lowerred.."
It's not magic, and it is not semantics, it is biochemistry and it's
normal bodily function. When you eliminate the formation mode with
allopurinol, the normal bodily processes take care of lowering your
uric acid level.
Make no new uric acid, excrete some, the level goes down.
The bottom line is that when you are taking allopurinol your uric
acid level will go down, over time, from normal excretion, but it
does not mean that you cannot get gout. If you have had a large
amount of uric acid stored in your tissue you will still have to be
very careful about salt intake, hydration and rapid weight loss for a
very long time.
"With all due respect..you are typical of the bitter gout
sufferer..who knew all..and tried everything..and finally reached the
end of the road..drug dependant..on allopurinol..I have met a LOT of
people like you..my mailbox is full of them."
Well said Arnold, well said.