DEAR DR. GOTT: I am a 70-year-old male and have been tortured by gout since about my 50th birthday. I have been to several doctors, and most prescribed a limited diet, excluding fish and red meats. The attacks are becoming more frequent and occur in a different spot each time. Please tell me who to see to get to the bottom of this agony.
DEAR READER: Because gout affects joints, it is considered to be a form of arthritis. It frequently affects the big toe but can also appear in wrists, ankles, knees, elbows and other joints.
Gout results when too much uric acid is present in the body. Excessive alcohol consumption, radiation, crash diets and certain medications can trigger an attack.
Because gout can mimic several other conditions, a primary-care physician might have difficulty making an initial diagnosis. When doubt remains, the physician might have a sample of the joint fluid tested to determine whether uric-acid crystals are present.
Dietary changes are vital. Foods high in purines (shellfish, alcohol, organ meats and more) should be avoided. Alcohol should be reduced substantially or eliminated. Cherries — dried, fresh or in juice form and consumed daily — are purported to prevent attacks and should be included in the diet. If an attack occurs, cherries help reduce the pain and its duration. Positive lifestyle changes include weight reduction, control of cholesterol levels and treatment of hypertension. These changes may help keep this extremely painful condition at bay.
When these recommendations don't work, medication might be necessary, and there are several types from which to choose. Some are taken shortly after an attack has begun, while others are taken regularly as a preventive measure.
To give you related information, I am sending you a copy of my Health Report "About Gout." Other readers who would like a copy should send a self-addressed, stamped, No. 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
DEAR DR. GOTT: How much vitamin B can a person take each day? My doctor can't even answer this question. I'm taking Centrum Silver each day and recently bought a vegetarian product at a health store that contains 10 milligrams, or 333 percent of the daily recommended dose of vitamin B.
DEAR READER: B vitamins are essential for releasing energy from carbohydrates, fat and protein. I understand why your physician can't give an explicit answer to your question. The human body stores several years worth of B-12, so a deficiency is quite rare unless a condition such as pernicious anemia or a nonsupplemented vegan diet leads to a deficiency. B-12 is harmless in larger quantities (up to 1000-plus micrograms) and is given as an energy boost to some people, although it may work mostly as a placebo. B-6 is obtained through diet or supplements. The recommended daily allowance is 1.5 milligrams per day. You don't indicate whether you have dietary restrictions, although you purchased a vegetarian supplement. Without knowing this, I cannot determine whether you even need supplements or are obtaining adequate amounts through your diet.
When taking complete B-complex vitamins or any other supplement, be guided by the recommendations on the label, since packaging by different manufacturers can vary. Centrum Silver has 100-percent percent of the daily recommended value of thiamin, riboflavin and niacin; 125 percent of folic acid; 150 percent of B-6; and 417 percent of B-12 in each tablet.
DEAR READER: Because gout affects joints, it is considered to be a form of arthritis. It frequently affects the big toe but can also appear in wrists, ankles, knees, elbows and other joints.
Gout results when too much uric acid is present in the body. Excessive alcohol consumption, radiation, crash diets and certain medications can trigger an attack.
Because gout can mimic several other conditions, a primary-care physician might have difficulty making an initial diagnosis. When doubt remains, the physician might have a sample of the joint fluid tested to determine whether uric-acid crystals are present.
Dietary changes are vital. Foods high in purines (shellfish, alcohol, organ meats and more) should be avoided. Alcohol should be reduced substantially or eliminated. Cherries — dried, fresh or in juice form and consumed daily — are purported to prevent attacks and should be included in the diet. If an attack occurs, cherries help reduce the pain and its duration. Positive lifestyle changes include weight reduction, control of cholesterol levels and treatment of hypertension. These changes may help keep this extremely painful condition at bay.
When these recommendations don't work, medication might be necessary, and there are several types from which to choose. Some are taken shortly after an attack has begun, while others are taken regularly as a preventive measure.
To give you related information, I am sending you a copy of my Health Report "About Gout." Other readers who would like a copy should send a self-addressed, stamped, No. 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
DEAR DR. GOTT: How much vitamin B can a person take each day? My doctor can't even answer this question. I'm taking Centrum Silver each day and recently bought a vegetarian product at a health store that contains 10 milligrams, or 333 percent of the daily recommended dose of vitamin B.
DEAR READER: B vitamins are essential for releasing energy from carbohydrates, fat and protein. I understand why your physician can't give an explicit answer to your question. The human body stores several years worth of B-12, so a deficiency is quite rare unless a condition such as pernicious anemia or a nonsupplemented vegan diet leads to a deficiency. B-12 is harmless in larger quantities (up to 1000-plus micrograms) and is given as an energy boost to some people, although it may work mostly as a placebo. B-6 is obtained through diet or supplements. The recommended daily allowance is 1.5 milligrams per day. You don't indicate whether you have dietary restrictions, although you purchased a vegetarian supplement. Without knowing this, I cannot determine whether you even need supplements or are obtaining adequate amounts through your diet.
When taking complete B-complex vitamins or any other supplement, be guided by the recommendations on the label, since packaging by different manufacturers can vary. Centrum Silver has 100-percent percent of the daily recommended value of thiamin, riboflavin and niacin; 125 percent of folic acid; 150 percent of B-6; and 417 percent of B-12 in each tablet.