Medicine for Gout Series, Entry 2: Colchicine

Hello again! Another week, another post about the dreaded gout.  Hope all reading are getting over your attack rather than getting one, but if you're not today's choice for our medicine treatment is one that has been with us for a long time:  Colchicine.

A Longtime Medical Companion...

In the history of gout, colchicine has been a consistent help to gout sufferers against the bane of their existence since early Egyptian days.  As wikipedia states:

 The plant source of colchicine, the autumn crocus (Colchicum autumnale), was described for treatment of rheumatism and swelling in the Ebers Papyrus (ca. 1500 B.C.), an Egyptian medical papyrus.

So with over 3500 years of history treating gout, I feel it's pretty remarkable that mankind still uses this remedy for gout attacks.  It's no wonder though, if you've never used it you must know: for most people this stuff works.

How it Works:

From a well-respected English medical website:

    Colchicine works by reducing the number of white blood cells which travel into the inflamed areas. This helps break the cycle of inflammation and reduces swelling and pain. It will have been prescribed if you are unable to take anti-inflammatory painkillers, which are the medicines most often used to ease a gout attack.

 

Many people will use Non-Steroid Anti-Inflammatory Drugs (NSAIDS) to stop their gout pain, but as you can see from wikipedia, the side-effects of these medicines can be rough.   Colchicine is an FDA-approved medicine that is known for particularly working to curb gout (among a few other things).

Side-Effects:

 Through as our useful source, wikipedia, we can find a list of colchicine's side-effects:

Adverse effects[edit]Side-effects include gastrointestinal upset and neutropenia. High doses can also damage bone marrow and lead to anemia and also cause hair loss. All of these side-effects can result from hyperinhibition of mitosis.^{[citation needed]}A main side-effect associated with all mitotic inhibitors is peripheral neuropathy, which is a numbness or tingling in the hands and feet due to peripheral nerve damage that can become so severe that reduction in dosage or complete cessation of the drug may be required. Microtubules are involved in vesicular transport. Peripheral nerves are among the longest in the body. Brownian motion is not significant enough in these peripheral nerves to allow vesicles to reach their destination. Thus, they are susceptible to microtubule toxins.^{[citation needed]} 

Toxicity[edit]Colchicine poisoning has been compared to arsenic poisoning. Symptoms start 2 to 5 hours after the toxic dose has been ingested and include burning in the mouth and throat, fever, vomiting,diarrhea, abdominal pain, and kidney failure. These symptoms may set in as many as 24 hours after exposure. Onset of multiple-system organ failure may occur within 24 to 72 hours. This includes hypovolemic shock due to extreme vascular damage and fluid loss through the GI tract, which may cause death. In addition, sufferers may experience kidney damage that causes low urine output and bloody urine, low white blood cell counts (persisting for several days), anemia; muscular weakness, and respiratory failure. Recovery may begin within six to eight days.

I know many people reading this blog probably don't have time to read all of that, so I'll summarize for you. Colchicine is poisonous to the human body!  You don't want to take too much of this stuff, otherwise you'll be giving yourself something akin to arsenic poisoning.  It will kill you if your not careful, so you need to-

Be Careful about Dosing!

If and when prescribed Colchicine you should pay attention to your doctor and your box about the dosing.  You won't want to take too much of Colchicine and cause stomach problems or worse.

There are a few sources out there that will spell it out better than I can, but this Australian website does a good job of showing that low dosing will help you more and cause fewer adverse effects. Just remember what the end of all my posts say: I'm not a medical professional so you need to communicate with a medical professional about these things.

My View on Colchicine:

I have taken Colchicine before, especially in the first few months of taking Allopurinol.  It did a great job of keeping me from too much pain.  I am pretty sure there was one time in the first few months that I went harder on it than I should have and I got a stomach ache and had a bad hour with a couple of messy trips to the toilet.  You're better off pacing yourself and remember that water is also your friend.  

Have you taken Colchicine for your gout?  What were your experiences?  Leave me a comment!

Other Posts in the Medicine for Gout Series:
Allopurinol

**This website is for informative purposes and should not be substituted as advice of a medical professional.  If you believe you have gout, I STRONGLY recommend scheduling an appointment with a medical professional and getting the problem checked out.

Gout: That Picture!

“The Gout” by James Gilray, 1799

Even before I had gout, I was familiar with this picture.  I probably first saw it in a history book.  It didn't make sense to me-probably because most of my pain has been in the lateral side (outside) or on the top of my foot in my arch.  Here we can see some sort of spawn of hell attached to the area near the big toe.

If you've never had gout, you don't don't really understand this picture.  If you do, you can imagine that little imp grabbing onto whichever place your affliction manifests.  The redness, the swelling, the feeling of your own personal hell-that's gout.  This picture captures the feeling perfect.

My experience...

When I was suffering from my regular gout attacks but wasn't diagnosed, It was absolutely awful.   I had gone to a few doctors and none had thought to check my uric acid levels, and to be honest I didn't go to the doctor for every attack.  I was afraid!  My major worry was that my body was weak and I was walking incorrectly.

My answer was to get online and figure out the problem for myself.  This was a major mistake!  My personal diagnosis cheated me out of countless weekends with friends and fun because I went years without getting my problem properly diagnosed.  I let this imp ride along for far too long.

If you're experiencing horrible foot or knee pain that can't really be explained: say you do your daily walking and don't majorly twist your ankle or get your big toe injured by some mishap, get it checked out.  Letting the gout imp into your life and not doing anything about can be hazardous to your health (I'll try writing about a few examples and linking them here in the future).

What to Do if You Have Gout... 

If you do have gout and you haven't been given options by your doctor, you should start by drinking lots of water everyday (at least 2 liters!).  If you're a big guy (read: overweight) like I have been a decent bit of my life, you're probably going to have to clean up your diet a bit especially right now while you figure out what foods are going to trigger the pain.

When you talk to your doctor, try to get on allopurinol and an NSAID.  The allopurinol is not going to solve your pain that same day (in fact it will probably trigger an attack or two) but in the long run you'll thank yourself for doing.

Keep your chin up!  If you take these steps and keep in contact with your doctor you'll be okay.  I walk 5 miles a day these days and enjoy a quality of life that I didn't think possible during the dark days.

If you have a question or comment please leave one!  I'll do my best to answer and assist as best I can.

**This website is for informative purposes and should not be substituted as advice of a medical professional.  If you believe you have gout, I STRONGLY recommend scheduling an appointment with a medical professional and getting the problem checked out.

The Gout Sufferers Cheat Sheet: The New York Times Gout Report

Are you looking for comprehensive gout info?  Look no further than this in-depth report from the New York Times.  All of the scientific research on gout here is 10 years old or less.  No matter your political opinion on the New York Times, the information contained on this page comes from medical professionals whose jobs are assisting people like myself and some of you who are only seeking to improve your quality of life.  In the future on this site, I will be referencing this page quite a bit.

For today, I want to highlight a couple of interesting things I found reading this page my first time.  I'll come back to this page in the future, but for today:

Dietary Considerations

"While meat and certain types of seafood and shellfish do produce high levels of purines in the blood, research has suggested that not all purine-rich foods are associated with gout. Eating a moderate amount of purine-rich vegetables (spinach, cauliflower, mushrooms, legumes) does not appear to increase the risk of gout." [1]

Some people use a chart to determine their diet to avoid gout.  I am going to tackle diet at sometime or another on this blog, but for right now, allow me to turn off my serious gout blogger mode and say this:

(joke over)...As I chat with other gout sufferers I find more and more that the foods that trigger gout for some people don't trigger it for others.  Science seems to strongly suggest that the intake of purine-rich vegetables is okay.  I'd go as far to suggest to you that it's great to consume any vegetable you enjoy because promoting a healthy lifestyle could help you to:

Maintain a Healthy Weight

"A supervised weight-loss program may be a very effective way to reduce uric acid levels in overweight patients. Crash dieting, on the other hand, is counterproductive because it can increase uric acid levels and may cause an acute attack."[1]

Another reference to how gout is a tricky condition.  Do try to lose weight if you are a sufferer, but don't do it by going crazy with the weight loss-cause you could just trigger another attack.  So if the veggies aren't making your toe, ankle, knee, etc etc etc hurt eat 'em up!  Develop a healthier lifestyle to avoid the pain.

Finally...

I hope you'll take time to read through the report for yourself.  Educating yourself about the horribleness that is gout is one of the best ways to take preventative measures against that awful pain, and that report is a VERY good place to start.  

Do you have a helpful resource concerning gout?  Let me know in the comments section! 

**This website is for informative purposes and should not be substituted as advice of a medical professional.  If you believe you have gout, I STRONGLY recommend scheduling an appointment with a medical professional and getting the problem checked out.

[Sources: 1-http://www.nytimes.com/health/guides/disease/gout-chronic/print.html]