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.

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]

Gout Medical Treatment Research

Another post and another topic:  the future of gout prevention and treatment.  We will again look at at the National Institute of Arthritis Musculoskeletal and Skin Diseases website, a very useful resource for learning about gout.  

As I've stated before, gout is a tricky condition, for example, if you are overweight you are more susceptible to developing gout and after you've developed it if you lose that weight you can often get a flare up then. What a horrid place to be in!  Fortunately in my mind the future of gout treatment is looking up!  Let me tell you why:

In my readings, I've learned that gout is rare in animals.  Scientists do believe, however; that poor Sue the Tyrannosaurus  did suffer from gout. Gout is rare in most animals because they have an enzyme that breaks down the purines in their body.  New medicines like Krystexxa help humans to do the same, though this treatment has just hit the market and is very expensive though I am personally hopeful that in the future we will see cheaper versions of this medicine that will be easier to take.  

Let's look at the NIAMS websites discussion on the future of gout treatment:

What Research Is Being Done on Gout?

Scientists are studying:

• Which NSAIDs are the most effective treatments for gout
• Optimal dosages of medications for gout
• New medicines that safely lower uric acid in the blood and reduce symptoms
• New therapies that block a chemical called tumor necrosis factor
• Enzymes that break down purines in the body
• The role of foods and certain vitamins
• The role of genetics and environmental factors
• The interactions of cells involved in acute gout attacks.

Scientists are also studying the role of genetics and environmental factors in hyperuricemia and gout. [1]

 Gout sufferers and friends and family, I believe there is hope. Have you heard any news concerning gout research or treatment?  Leave your comments here!

**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.

[Source: http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp]

How is Gout Treated?

Many people who visit this site are probably hoping for assistance with relieving their gout.  The pain your in probably means that you're looking for a quick fix.  I'll begin with more help again from the National Institute of Arthritis Musculoskeletal  Skin diseases website, then I will give you some of my own experiences. 

If  your experiencing a gout attack the way to treat it according the site is:

How Is Gout Treated?

Doctors use medicines to treat an acute attack of gout, including:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Corticosteroids, such as prednisone
• Colchicine, which works best when taken within the first 12 hours of an acute attack.

Sometimes doctors prescribe NSAIDs or colchicine in small daily doses to prevent future attacks. There are also medicines that lower the level of uric acid in the blood. [1]

 When I had my first experience with gout in China, the doctor didn't know what was wrong with me, but gave me sodium diclofenac, which did the job.  I remember in my first attack it took 2 days for the pain to clear up.  It was over the counter in China, and since I didn't know what my condition was for a long time, I would take this to clear up the pain when I would have a flare up.  I don't recommend doing this because it didn't do anything to clear the condition, rather it slowed and cleared up the symptoms until the next attack.  

This was okay at first, as the following year I still only had 3-4 attacks, the problem was that by 2013 I was having attacks every week or two.  Walking on a gout attack is horrid and something I would only wish upon my worst enemy.  

More recently I began taking colchicine for the pain.  Colchicine works most of the time, but is in general poisonous to the human body.  I will have a future blog about colchicine and will link it here.  You really must be careful with it

Another medicine I have taken for gout is Arcoxia I found this medicine to be very helpful.  The doctor who diagnosed me with gout gave me this medicine and really takes the gout away very quickly.

What medicines do you take to relieve gout?  In my next post I will talk about preventative measures and how they changed my life.

**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.

[Source: http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp]