Torture At 2:00 A.M.

What’s the worst torture of all? Ask Thomas Sydenham and he would quickly say “gout”. Sydenham, often referred to as the English Hippocrates, died in 1698 of gout. To my knowledge, no one since that time has better described the intense pain associated with this disease.

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He wrote, “The victim goes to bed and sleeps in good health. About 2:00 A.M. he is awakened by severe pain in the big toe. The pain becomes intense, violent, tearing and so exquisite the big toe cannot bear the weight of bedclothes or the jar of a person walking into the room. The night is passed in torture.” Gout has often been referred to as the “blue-blooded disease”. It’s easy to see why since it has attacked the likes of King Henry VIII, Leonardo de Vinci, Sir Isaac Newton, Alexander the Great and Benjamin Franklin, to name a few. But in recent times gout has become a much more democratic disease affecting those in all walks of life. Today, over five million North Americans suffer from this problem. And, although males may be the stronger sex, 95 percent of the time it strikes men, usually between 40 to 50 years of age. Women who suffer their first attack are usually in their 60s and 70s. So why are more North Americans developing gout? It was believed that the gluttony of King Henry VIII played a major role in his case. So with today’s fast food outlets selling 1700 calorie lunches, it’s not surprising that more than kings become victims of this disease. But it’s not only the amount of food consumed, it’s also what’s on the plate. Scientists have known for years that patients with gout have high levels of uric acid in their blood. So they looked at foods containing purine that produce large amounts of uric acid. And they soon confirmed that patients with gout often consumed large amounts of these same foods. Dr. Hyon K. Chow, along with Harvard’s Public Health Department, studied 47,150 men for 12 years. They found that men consuming the highest intake of lamb and pork were 41 percent more prone to this disease. In contrast, men who drank two or more glasses of skim milk daily were half as likely to develop gout. Red meat, poultry, liver, kidneys, tongue and mushrooms are also purine-rich foods along with lobster, shrimps and scallops. Since I love seafood and rare steaks this information was not good news. But it’s less likely these purine-rich foods will cause gout unless you behave extravagantly like King henry VIII. Besides, a recent report in the medical journal, The Lancet, shows it’s not just food that triggers gout. Studies in the United States and the Netherlands have identified genes responsible for increasing uric acids levels in the blood. Researchers then conducted studies on 20,000 people in the U.S. and Holland and analyzed over 500,000 genetic variations in these subjects. They found, after a meticulous study, that three genes were associated with increasing levels of uric acid in the blood. A genetic scoring system was developed to identify those patients most likely to develop gout. They discovered that those with the highest genetic risk score had a 40 X greater risk of developing gout than those with the lowest score. So what does this mean to the rest of us? Dr. Ann Kottgen, one of the U.S researchers, reports that “the genetic score is a greater predictor of who gets gout than any of the other known risk factors”. This is just another example of how much genetics plays a role in our lives. And how we would all be in better shape if we’d had the chance to choose our parents. Once this genetic test becomes available to medical consumers it will help to identify those at risk of developing gout. Therapy can then be started at an earlier age to prevent the problems associated with this disease. In the meantime don’t push your luck. Eat a variety of foods moderately. And don’t overindulge like King Henry VIII. Then you’ll have less chance of experiencing torture at 2:A.M.